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Scaling up evidence-based approaches to tuberculosis screening in prisons
Salome Charalambous1, Kavindhran Velen2, Zulma Rueda3
1The Aurum Institute, Johannesburg, South Africa; School of Public Health, Wits University, Johannesburg, South Africa; Division of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA.
The Lancet. Public Health
|February 13, 2023
Summary
Tuberculosis (TB) is highly prevalent in correctional facilities, necessitating effective screening strategies. Implementing these strategies requires transparency and increased resources to combat this ongoing public health crisis.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Correctional Healthcare
Background:
- People deprived of liberty experience disproportionately high rates of tuberculosis (TB), with incidence ten times greater than in the general population.
- The World Health Organization (WHO) now strongly recommends systematic TB screening in prisons and penitentiary systems.
Purpose of the Study:
- To review the evidence base for TB screening and diagnostic strategies in correctional settings.
- To identify promising approaches, knowledge gaps, challenges, and opportunities for improving TB diagnosis and treatment in prisons.
Main Methods:
- Review of existing evidence on TB screening and diagnostic strategies in prisons.
- Analysis of past experiences with active case-finding and care programs in high TB burden settings.
Main Results:
- Significant knowledge gaps exist regarding optimal TB case-finding strategies for correctional facilities.
- Effective implementation requires addressing challenges in diagnosis and treatment cascades within prisons.
- Improved transparency in TB reporting and increased stakeholder resourcing are crucial.
Conclusions:
- Addressing the TB crisis in prisons requires renewed focus, investment, and commitment from national governments and international organizations.
- Enhanced transparency in reporting TB notifications and outcomes is essential for driving progress.
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