CDC | TB | Correctional Facility Staff and Inmates

Tuberculosis (TB)

Tuberculosis

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TB in Correctional Facilities in the United States

Background

TB in correctional settings is a public health concern. Approximately 4-6% of TB cases reported in the United States occur among people incarcerated at the time of diagnosis. The incarcerated population contains 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.

TB Control in Correctional Facilities

prison with barbed wire fence TB control can be particularly problematic in correctional facilities, in which persons from diverse backgrounds and communities are housed in close proximity for varying periods.

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.

These measures should be instituted in close collaboration with local or state health department TB-control programs and other key partners. 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.