Nyasulu Peter S, Hui David S, Mwaba Peter, Tamuzi Jacques L, Sakala Doris Y, Ntoumi Francine, Maeurer Markus, Goletti Delia, Petersen Eskild, Zumla Alimuddin
Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine and Health Sciences, University of the Wiwatersrand, Johannesburg, South Africa.
IJID Reg. 2025 Mar 19;14(Suppl 2):100621. doi: 10.1016/j.ijregi.2025.100621. eCollection 2025 Mar.
Tuberculosis (TB) remains a prominent cause of illness and mortality worldwide. Prisons are hotspots for TB transmission worldwide. We reviewed the literature on TB in prisons worldwide, including TB risk factors, delays in diagnosis including drug resistance, the treatment accorded, and operational and logistical issues of TB care in prison. The quantity and quality of data on TB in prisons varies worldwide. The TB incidence rate in prisons varies by World Health Organization region, with African countries having the highest rates of TB and TB/HIV co-infection. Its incidence rate among inmates is about 10 times higher than that of the general population. The growing prevalence of multidrug-resistant TB is particularly concerning, as it may affect high-risk settings and disproportionately affects vulnerable populations, such as prisoners and incarcerated individuals who go undiagnosed for extended periods of time. Factors that drive the high TB rates in prisons include limited access to health services such as TB care, overcrowding, poor ventilation, malnutrition, HIV, alcohol use disorders, illegal drug use, smoking, and other comorbidities, compounded by limited access to healthcare. Addressing TB in prisons requires a multifaceted approach, that includes improving living conditions, enhancing healthcare services, and developing innovative detection methods. The ongoing conflicts in Europe, the Middle East, Asia, and Africa further complicated TB prevention and control efforts in prisons, emphasizing the need for targeted interventions to address TB in these high-risk settings. Structured interventions tailored to the specific risk factors present in each environment should be investigated to effectively focus measures aimed at diminishing the overall burden of TB in prisons. Electronic record-keeping worldwide will allow for accurate data to be collected and shared.
结核病（TB）仍然是全球范围内导致疾病和死亡的一个突出原因。监狱是全球结核病传播的热点地区。我们回顾了全球范围内关于监狱结核病的文献，包括结核病的风险因素、诊断延误（包括耐药性）、所给予的治疗以及监狱结核病护理的操作和后勤问题。全球范围内关于监狱结核病的数据在数量和质量上各不相同。监狱中的结核病发病率因世界卫生组织区域而异，非洲国家的结核病和结核病/艾滋病毒合并感染率最高。其在囚犯中的发病率比一般人群高出约10倍。耐多药结核病患病率的不断上升尤其令人担忧，因为它可能影响高风险环境，并对弱势群体造成不成比例的影响，例如长期未被诊断的囚犯和被监禁者。导致监狱结核病高发病率的因素包括获得结核病护理等卫生服务的机会有限、过度拥挤、通风不良、营养不良、艾滋病毒、酒精使用障碍、非法药物使用、吸烟以及其他合并症，再加上获得医疗保健的机会有限。解决监狱中的结核病问题需要采取多方面的方法，包括改善生活条件、加强医疗服务以及开发创新的检测方法。欧洲、中东、亚洲和非洲持续的冲突使监狱中的结核病预防和控制工作更加复杂，强调需要采取有针对性的干预措施来应对这些高风险环境中的结核病。应研究针对每个环境中存在的特定风险因素量身定制的结构化干预措施，以有效地集中采取措施减轻监狱中结核病的总体负担。全球范围内的电子记录保存将有助于收集和共享准确的数据。
