TB in prisons
In the WHO European Region, tuberculosis (TB) remains a major infectious disease in the prison system, especially in eastern Europe. Prisons are considered reservoirs facilitating TB and multidrug-resistant TB (MDR-TB) transmission within their walls, as well as to the community at large. Transmission occurs through prison staff, visitors and released inmates.
Prison system challenges to TB control
- Prisoners come from high-risk groups of the population and are in general poor, have little education and come from socioeconomically deprived sectors of the population, where TB infection and transmission are higher. They have often had limited access to health care and suffer from additional health problems such as alcoholism, tobacco smoke, drug addiction and HIV.
- Prisons have high exposure to TB, because of factors that cause infection and progression of the disease. These include overcrowding; poor ventilation; frequent transfer of prisoners between prisons; poor infection control practices; poor nutrition; limited access to health care, with delays in diagnosis (due to insufficient laboratory capacity and diagnostic tools); and inadequate treatment (e.g. interrupted supply of medicines).
As a result, notified TB cases in European prisons are, on average, 17 times higher than in the general population – ranging from 11 times higher in western Europe to 81 times higher in eastern Europe.
Improving TB control in prisons
Improvements can only be achieved with governmental commitment, interventions equivalent to those in the civilian system and in close collaboration with it, and partnerships with civil society organizations.
