INFECTIOUS DISEASE SURVEILLANCE IN CANADIAN FEDERAL PENITENTIARIES
2007-2008

PRE-RELEASE REPORT

Public Health Branch
Health Services Sector
Correctional Service Canada

Figure 1.1: Year-end Prevalence of HIV, Inmates, 1999 – 2008±

Figure 1.1: Year-end Prevalence  of <abbr>HIV</abbr>, Inmates, 1999 – 2008±

± - For data 1990-1998 see surveillance report for 2002-20044
Source:  IDSS Aggregate Surveillance Data, CSC 2011

Summary: Figure 1.1 shows the number of HIV cases and the year-end HIV prevalence rate among inmates for each year between 1999 and 2008. HIV prevalence among inmates was relatively stable over this period, ranging between 1.43% in 2004 and 2.04% in 2002.  In 2007, 253 inmates were known to be HIV positive and the HIV point-prevalence estimate was 1.84%. In 2008, the number of HIV cases and HIV point-prevalence declined slightly, to 222 and 1.72% respectively.

DATA TABLE:

  1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
HIV Cases 196 214 223 251 234 188 204 218 253 222
HIV Prevalence 1.65% 1.70% 1.80% 2.04% 1.92% 1.43% 1.67% 1.64% 1.84% 1.72%

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Figure 1.2: Year-end Prevalence of HIV by Gender, Inmates, 2000 – 2008

Figure 1.2:  Year-end Prevalence of <abbr>HIV</abbr> by Gender, Inmates, 2000 – 2008

Source: IDSS Aggregate Surveillance Data, CSC 2011

Summary:
Figure 1.2 shows gender-specific HIV prevalence rates among inmates for each year between 2000 and 2008. Women consistently had higher rates of HIV infection and more variability in HIV prevalence estimates compared to men. HIV prevalence among women in 2007 and 2008 at 5.20% and 4.71% respectively was about three times that among men at 1.72% and 1.60% respectively.

DATA TABLE:

  2000 2001 2002 2003 2004 2005 2006 2007 2008
FEMALE 5.00% 4.70% 4.25% 4.73% 3.44% 2.84% 4.49% 5.20% 4.71%
MALE 1.60% 1.70% 1.99% 1.84% 1.37% 1.63% 1.54% 1.72% 1.60%
TOTAL 1.70% 1.80% 2.04% 1.92% 1.43% 1.67% 1.64% 1.84% 1.72%

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Figure 2.1: Year-end Prevalence of HCV, Inmates, 1999-2008±

± - For data 1990-1998 see surveillance report for 2002-20044
Source:  IDSS Aggregate Surveillance Data, CSC 2011

Summary: Figure 2.1 shows the number of hepatitis C (HCV) cases and the year-end HCV prevalence rate among inmates for each year between 1999 and 2008. HCV prevalence among inmates increased steadily over this period, from 18.1% in 1999 to 30.2% in 2008. In 2007, 4,101 inmates were known to be HCV positive and the HCV point-prevalence estimate was 29.9%. In 2008, the number of HCV cases and HCV point-prevalence was 3,907 and 30.2% respectively.

DATA TABLE

YEAR 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
FREQUENCY 2317 2542 2993 3173 3260 3303 3581 3661 4101 3907
PREVALENCE 18.1% 20.1% 23.6% 25.8% 26.8% 25.2% 29.3% 27.6% 29.9% 30.2%

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Figure 2.2: Year-end Prevalence of HCV by Gender, Inmates, 2000 – 2008

Source: IDSS Aggregate Surveillance Data, CSC 2011

Summary:
Figure 2.2 shows gender-specific HCV prevalence rates among inmates for each year between 2000 and 2008. Women consistently had higher rates of HCV infection compared to men, however this difference decreased with time. Among female inmates, HCV prevalence was at its highest in 2000 at 42.4%, and gradually declined to 36.4% in 2007 and 34.9% in 2008. Among male inmates, HCV prevalence was at its lowest in 2000 at 19.7% and gradually increased to 29.6% in 2007 and 30.0% in 2008.

DATA TABLE

  2000 2001 2002 2003 2004 2005 2006 2007 2008
FEMALE 42.4% 41.2% 38.6% 37.0% 37.6% 39.5% 36.0% 36.4% 34.9%
MALE 19.7% 23.2% 25.5% 26.5% 24.8% 29.0% 27.3% 29.6% 30.0%
TOTAL 20.1% 23.6% 25.8% 26.8% 25.2% 29.3% 27.6% 29.9% 30.2%

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Figure 4.1: STI Prevalence in Canadian Federal Penitentiaries, Inmates, 2000 - 2008

Source: IDSS Aggregate Surveillance Data, CSC 2011

Summary:
Figure 4.1 shows the prevalence rates of several sexually transmitted infections (STI) among inmates for each year between 2000 and 2008. The prevalence rates of chlamydia, gonorrhoea, syphilis and other non-specific STI were relatively low, ranging between 0% and 1.01%. With the exception of gonorrhoea, the prevalence of all STI increased between 2007 and 2008. In 2008, the most prevalent STI was chlamydia (1.01%), followed by other non-specific STI (0.73%), syphilis (0.16%) and gonorrhoea (0.07%). 

DATA TABLE

  2000 2001 2002 2003 2004 2005 2006 2007 2008
Chlamydia 0.17% 0.18% 0.43% 0.48% 0.40% 0.75% 0.72% 0.67% 1.01%
Gonorrhea 0.09% 0.10% 0.16% 0.06% 0.08% 0.09% 0.15% 0.17% 0.07%
Syphilis 0.00% 0.00% 0.02% 0.03% 0.08% 0.05% 0.12% 0.07% 0.16%
Other 0.49% 0.28% 0.43% 0.70% 0.69% 0.54% 0.46% 0.63% 0.73%

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Figure 5.1: TST Converters and Conversion Rates, Inmates, 1999-2008

Source: Web-IDSS Enhanced Surveillance Data, CSC 2011

Summary: Figure 5.1 shows the number of tuberculin skin test (TST) conversions and the year-end conversion rate among inmates for each year between 1999 and 2008. The largest number of TST conversions occurred in 2001 and 2007 with 85 and 87 conversions respectively, corresponding to the two highest conversion rates over this period at 1.64% and 1.49% respectively.  In 2008, 70 conversions were reported and the conversion rate was 1.15%

 DATA TABLE

YEAR 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
TST Converters 51 41 85 73 66 45 51 54 87 70
Conversion Rate 1.13% 0.79% 1.64% 1.45% 1.22% 0.83% 0.90% 0.89% 1.49% 1.15%

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Figure 5.2: Latent TB Infection by Gender, Inmates, 1998 - 2008

Source: Web-IDSS Enhanced Surveillance Data, CSC 2011

Summary: Figure 5.2 shows the proportion of latent TB infections (LTBI) among male and female inmates for each year between 1998 and 2008. Overall, the proportion of inmates with LTBI decreased over time, from 22.0% in 1998 to 15.9% in 2008. In most years, a higher proportion of male inmates reported having LTBI compared to female inmates. Among males, the proportion having LTBI was 16.9% in 2007 and 16.1% in 2008. Among females, the proportion having LTBI was 10.6% in 2007 and 10.1% in 2008.

DATA TABLE

  1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
FEMALE 22.0% 21.9% 20.5% 21.0% 19.0% 19.0% 17.1% 16.1% 16.8% 16.9% 16.1%
MALE 19.5% 22.1% 18.1% 19.8% 15.3% 13.3% 8.4% 8.4% 11.3% 10.6% 10.1%
TOTAL 22.0% 22.0% 20.4% 20.9% 18.9% 18.8% 16.8% 15.8% 16.6% 16.6% 15.9%

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Figure 5.3: Active TB Case Frequency and Rate, Inmates, 1998 – 2008

* - Case Rate: rate per 100,000
** - % LTBI: Proportion having LTBI (percent)
Source: IDSS Aggregate Surveillance Data, CSC 2011

Summary: Figure 5.3 shows the number, annual rate and three-year average rate of active TB cases among inmates for each year between 1998 and 2008. The number of active cases ranged from zero in 2001 to six cases in both 1998 and 2005.  Two inmates were diagnosed in both 2007 and 2008. This generated a three-year average case rate per 100,000 that ranged from 27.5 in 1999, to 6.0 in 2001, up to 23.5 in 2004 and down to 12.7 in 2007.

DATA TABLE

  1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Active TB 6 5 2 0 1 3 3 6 3 2 2
Case Rate (per 100,000) 41.7 28.9 12.0 0.0 6.1 18.3 17.1 35.2 16.3 10.7 11.2
3-yr Rate
(per 100,000)
27.5 13.6 6.0 8.1 13.8 23.5 22.9 20.7 12.7
% LTBI 22.0% 22.0% 20.4% 20.9% 18.9% 18.8% 16.8% 15.8% 16.6% 16.6% 15.9%

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Figure 6.1: TST Converters and Conversion Rates, Staff, 1999-2008

Source: Web-IDSS Enhanced Surveillance Data, CSC 2011

Summary: Figure 6.1 shows the number of tuberculin skin test (TST) conversions and the year-end conversion rate among CSC staff for each year between 1999 and 2008. Since 1999, the conversion rate has gradually increased to its peak of 0.82% in 2005 with eight staff TST conversions. The conversion rate has since declined with two TST conversions reported in 2007 and one in 2008, generating conversion rates of 0.20% and 0.17% respectively.

DATA TABLE

YEAR 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
TST Converters 4 3 3 3 7 7 8 10 2 1
Conversion Rate 0.29% 0.23% 0.21% 0.28% 0.46% 0.69% 0.82% 0.66% 0.20% 0.17%

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Figure 6.2: Latent TB Infection by Gender, Staff, 1998 - 2008

Source: Web-IDSS Enhanced Surveillance Data, CSC 2011

Summary: Figure 6.2 shows the gender-specific proportions of latent TB infections (LTBI) among CSC staff for each year between 1998 and 2008. Overall, the proportion of staff with LTBI decreased over time, from 12.9% in 1998 to 7.0% in 2008. In most years, male and female LTBI rates were similar. Among males, the proportion having LTBI was 5.9% in 2007 and 7.6% in 2008. Among females, the proportion having LTBI was 6.0% in both 2007 and 2008.

DATA TABLE

  1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
FEMALE 10.6% 8.4% 8.9% 6.4% 8.5% 7.3% 5.5% 6.9% 6.4% 5.9% 7.6%
MALE 9.7% 8.7% 12.1% 6.6% 8.1% 5.9% 6.4% 6.3% 6.5% 6.0% 6.0%
TOTAL 12.9% 11.0% 11.6% 7.5% 9.3% 7.1% 5.9% 6.6% 6.6% 6.0% 7.0%

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