Posted by: blog4globalhealth | 03/24/2011


The autopsy of Dumitru Stupalov reveals the connections between TB and the Moldovan prison system.

Dumitru Stupalov’s body arrived to the morgue on a Thursday, the same day he died. His autopsy was performed on Friday morning. He had spent several months at the TB Hospital in Balti battling MDR-TB under the supervision of Dr. Pablo Cioabnu. Ciobanu was on hand during the autopsy and explained that in Moldova, practically every death results in at least a cursory autopsy and, that in the case of TB patients, the attending doctor is asked to come to inspect the infected organs and confirm the diagnosis and cause of death. Dumitru was also living with HIV, which Ciobanu said significantly complicated his MDR-TB treatment. The autopsy confirmed that the TB had not only damaged his lungs, but had spread to other organs as well.

Dumitru Stupalov had spent time in prison for a drug offense. Vladimir Stupalov, Dumitru’s father and a former prisoner himself, is sure that his son was infected with TB while in jail. According to statistics kept by Moldova’s Department of Penetentiary Institutions and confirmed by a local NGO that works in the prisons, the TB rate in Moldova’s jails is currently at about the rate that the World Health Organization (WHO) defines as an epidemic. Still, the prisons have seen a drastic reduction, as much as 700 percent, in their TB rate over the past 10 years. This drop is the result of the implementation of various measures, including isolating infectious prisoners and following the DOTS treatment strategy, which is endorsed by the WHO. It is entirely possible, in fact likely, that Dumitru got TB while in prison, thoughTB is so prevalent in Moldova that it is impossible to know for sure.

Read the full blog on the Pulitzer Center’s website.

See David Rochkind’s article and multi-media pieceĀ Moldova: What Happens to MDR-TB Patients.

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