Combination disease prevention in prisons: a comprehensive programme in Luxembourg. In Compendium of good practices in the health sector response to viral hepatitis in the WHO European Region. (Book Chapter)

In Luxembourg, 4346 people, approximately 1% of the population, tested positive for anti-HCV during 1990–2013 (99). It is estimated that 77% of them present active infection and most cases of hepatitis C are males with a median age of 37 years.
Injecting drugs is the predominant route for HCV transmission among the general population in Luxembourg. It is also the most important risk factor for the infection in people in prisons (100). In 2015, it was estimated that approximately 1500 PWID resided in Luxembourg (101) and that 75% of them would test positive for anti-HCV (102). Therefore, incarceration is an important opportunity to offer prevention, diagnosis and treatment of hepatitis C, among other health services, to underserved population groups such as PWID.
There are 689 people in prison in Luxembourg –most of them are not citizens of the country. The
prison population is divided into two state prisons: a closed setting with 615 people (including 320 pre-trial detainees) and a semi-open prison with 74 people. The turnover of the prison population in Luxembourg is high – at an approximate rate of 1000 people per year. About one third of the prison population (228/689) has been incarcerated for drug-related offences and/or has suffered from substance use disorders.
In 2003, the HCV-UD programme (l’hépatite C au sein des usagers de drogues au Luxembourg) was implemented in the two state prisons – providing systematic case-finding of infectious diseases, linkage to care, treatment, immunization and a combination of prevention measures, including NSPs, OST and educational training. This comprehensive approach aimed to prevent communicable diseases in prisons and improve the overall health of PWID with viral hepatitis.