Year: 2025
Type: article
Study design: Observational Study
Abstract: The COVID-19 pandemic posed a significant public health threat globally, with over 29 million cases and close to a million deaths. Kenya recorded over 344,000 cases and 5,689 deaths since 13th March. The Industrial Area Prison had 3,700 inmates by May 2020; with more inmates entering and leaving prison and the impossibility of physical distancing due to overcrowding, the risk of increasing cases was high. We assessed the magnitude of infection and outbreak preparedness in the prison in June 2020. We reviewed prison records from 1st – 31st May 2020. A COVID-19 suspected case was defined as any person with acute respiratory illness, a history of travel to a foreign country within 14 days before symptom onset, or having been in contact with a confirmed or probable case within 14 days before symptom onset. We assessed the surveillance, risk communication, contact tracing, and quarantine facility. Key informant interviews were conducted to assess preparedness. Continuous variables were summarised using measures of central tendency and dispersion. Categorical variables were given by frequencies and proportions. Qualitative data were also collected on the relevant public health events and containment measures in the prison through key informant interviews and observation. On 7th May, two remanded prisoners were confirmed positive for COVID-19. Of the cohort of 59 remandees detained between 29th April and 8th May, 31 (53.4%) tested positive (attack rate 8.3/1000 population). Of these, 30 (96.8%) were asymptomatic. One (3%) was on treatment for tuberculosis. We listed 139 contacts, including 25 staff. A quarantine facility was under renovation, with a capacity of 48 persons. There were temperature checkpoints and handwashing stations at every major entrance. Remandees were frequently sensitized on COVID-19 prevention measures through health talks. However, the disinfection of shared surfaces like door handles and items like utensils seemed unsatisfactory, potentially increasing the risk of spreading the virus. We confirmed the COVID-19 outbreak in the institution. Context-specific interventions were necessary in the entire Kenyan correctional services system. Water, sanitation, and hygiene (WASH) interventions and risk communication were commonly applied, but crowding and data management remained challenging. A systemic literature review revealed that even developed countries grappled with infection containment in jails and prisons during the pandemic. Thoroughly screening inmates and workers and reducing crowding were the most common interventions globally. An increase in the risk of COVID-19 infection was noted in the prison, requiring more quarantine space and thorough screening and quarantining of newly admitted inmates. Contact tracing and data management needed to be improved. After the assessment, the Prisons Department worked closely with the Ministry of Health to enhance quarantine facilities and data management and reduce the prison population, thereby steadily reducing the spread of the infection.
Authors: Dr Fredrick Odhiambo, Mr David Kareko
Institution: Ministry of Health
Language: English
Subfield: Modeling and Simulation
Field: Mathematics
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W4408046415