Diagnosis and treatment of tuberculosis (TB) in correctional facilities is a key component to TB elimination in the United States. Tuberculosis is a disease caused by bacteria that are spread through the air from person to person. If not treated properly, TB can be fatal. People who are incarcerated are at greater risk for TB than the overall population. Inmates returning to the community with untreated TB present a serious public health concern.
Diagnosing and treating TB in correctional facilities reduces the risk of TB spreading within the facilities among both those incarcerated and the correctional staff, as well as in the community as a whole. TB control is challenging in correctional facilities where the incarcerated population includes a high proportion of people at greater risk for TB than the overall population.
Risk factors contributing to the high rate of TB in correctional facilities include:
- The physical structure of correctional facilities that can include close living quarters, overcrowding, and the potential for inadequate ventilation;
- Interruption of therapy caused by the movement of inmates into and out of facilities, and inmates returning to the community;
- Language and cultural barriers, including lack of access to health information and stigma associated with the disease; and
- Relatively high rates of human immunodeficiency virus (HIV) infection among inmates who if co-infected with TB bacteria, are at high risk for progressing from latent TB infection to TB disease. In addition to HIV, other underlying medical conditions may increase the risk that latent TB infection will progress to TB disease.
In 2012, there were 9,945 reported cases of TB in the United States. Approximately 4-6% of all TB cases reported in the United States occurred among persons incarcerated at the time of diagnosis. The largest number of cases occurred in local jails.
Effective TB prevention and control measures in correctional facilities include:
- Early identification of persons with TB disease through entry and periodic follow-up screening;
- Successful treatment of TB disease and latent TB infection;
- Appropriate use of airborne precautions (e.g., airborne infection isolation, environmental controls, and respiratory protection);
- Comprehensive discharge planning; and
- Thorough and efficient contact investigations when a TB case has been identified.
The CDC works with state and local health departments to ensure that diagnosing TB in inmates during entry, periodic follow-up screenings, and completing treatment are important priorities. Annual surveillance of the number of TB cases diagnosed and treated in correctional facilities is essential to these efforts.
Continuing education of inmates, detainees, and correctional facility staff is necessary to maximize cooperation and participation. To ensure TB prevention and control measures are effective, periodic program evaluation should be conducted.
See the CDC Report
Also see the CDC Tuberculosis Report