Despite increasing rates of tuberculosis in prisons across the globe, current World Health Organization (WHO) TB prevention guidelines fail to reach incarcerated populations.

Programs should instead prioritize them, argue a group of researchers from Stanford, Harvard, UCL and a range of other global institutions.

As Narayan, et al. (2023) write, "Tuberculosis continues to be a leading cause of illness and death globally, with greater than 10 million people becoming ill with tuberculosis and 1.6 million deaths estimated to occur each year. The disease disproportionately affects impoverished and socially marginalized populations, with persons deprived of liberty (PDLs) in closed carceral settings having among the highest incidence. Globally, over 10.7 million individuals are held in penal institutions, and several times as many people pass into and out of carceral facilities each year. A recent meta-analysis reported that tuberculosis incidence among PDL was over 10 times higher than that of their surrounding communities. Carceral settings have long been recognized as high-risk settings for tuberculosis disease and transmission. Densely populated by individuals with multiple social and biological risk factors, prison environments are ideal for tuberculosis transmission. Additionally, prisons are severely under resourced, with limited healthcare services, frequently facing shortages of medical staff, and insufficient diagnostic capacity for tuberculosis and related medical comorbidities. Uncontrolled tuberculosis transmission in prisons may amplify epidemics in their surrounding communities, undermining national and regional targets for tuberculosis control."

Reference: Narayan A, Salindri AD, Keshavjee S, Muyoyeta M, Velen K, Rueda ZV, et al. (2023) Prioritizing persons deprived of liberty in global guidelines for tuberculosis preventive treatment. PLoS Med 20(10): e1004288. https://doi.org/10.1371/journal.pmed.1004288

Source: PLOS Medicine