Tuberculosis Control Strategies in Correctional Facilities
Summary
Correctional facilities represent high-transmission environments for tuberculosis, driven by overcrowding, poor ventilation, and a concentration of individuals with comorbidities or recent incarceration. Control strategies encompass systematic screening at reception, periodic active case finding, rapid diagnostic testing, and prompt isolation of infectious cases. Complementary measures include environmental modifications (enhanced ventilation, ultraviolet germicidal irradiation), staff training, and the provision of tuberculosis preventive therapy to those with latent infection. Continuity of care on release—through linkage to community health services and adherence support—mitigates spillover into general populations. Economic evaluations and mathematical models emphasise the cost-effectiveness of targeted interventions, while genomic surveillance clarifies transmission networks within and beyond prison walls. A holistic approach that integrates prison health into national tuberculosis programmes is essential to reduce incidence among inmates and curb community spread.
Research from Nature Portfolio
Recent genomic work in South America has revealed extensive transmission chains of Mycobacterium tuberculosis linking prisons and surrounding communities. Sequencing of hundreds of isolates demonstrated that the largest clusters expanded rapidly both within penitentiaries and in urban areas. The study uncovered bidirectional spillover, with frequent movement of strains between custodial settings and the wider population. These findings reinforce the need for intensified case detection, molecular surveillance and environmental controls within correctional institutions to interrupt transmission at its source and protect broader public health.
Tuberculosis Control Strategies in Correctional Facilities publication trend
The graph below shows the total number of articles in tuberculosis control strategies in correctional facilities across all publications each year (not limited to Nature Index journals).
Technical terms
Latent tuberculosis infection (LTBI): state in which individuals harbour Mycobacterium tuberculosis without clinical symptoms or transmissibility.
Case detection ratio: proportion of incident tuberculosis cases that are formally diagnosed and reported.
Whole-genome sequencing: comprehensive analysis of pathogen DNA to reconstruct transmission pathways.
Tuberculosis preventive therapy (TPT): administration of antimicrobials to infected individuals to prevent progression to active disease.
Markov state transition model: mathematical framework simulating individual movement between health states over time to estimate outcomes and costs.
References
- Global, regional, and national estimates of tuberculosis incidence and case detection among incarcerated individuals from 2000 to 2019: a systematic analysis. The Lancet Public Health (2023).
- Cost-effectiveness and health impact of screening and treatment of Mycobacterium tuberculosis infection among formerly incarcerated individuals in Brazil: a Markov modelling study. The Lancet Global Health (2024).
- Phylogeography and transmission of Mycobacterium tuberculosis spanning prisons and surrounding communities in Paraguay. Nature Communications (2023).
- Risk for Prison-to-Community Tuberculosis Transmission, Thailand, 2017–2020 - Volume 29, Number 3—March 2023 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2023).
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