Prevention and Control of Tuberculosis in Correctional Facilities

Abstract

Tuberculosis (TB) is a contagious infectious disease caused by Mycobacterium tuberculosis and is a leading source of preventable morbidity and mortality worldwide (Maher & Raviglione, 2005). In 1993, the World Health Organization declared TB a global health emergency. Over a decade later, despite TB control efforts, TB cases continued to rise. An estimated two billion people, or one-third of the world’s population, are believed to be infected with M. tuberculosis and are at risk for developing active TB disease during their lifetime. Annually, worldwide, eight to nine million people develop active TB and nearly two million die from the disease. The expanding human immunodeficiency virus (HIV) epidemic and the emergence of multiand extensively drug resistant TB contribute greatly to the global burden of TB disease (CDC, 2006b, 2007). TB is a major public health concern in correctional facilities throughout the world. Incarcerated populations are at disproportionately high risk for developing TB infection and disease compared to general populations (MacNeil, Lobato, & Moore, 2005; Hammett, Harmon, & Rhodes, 2002). Numerous TB outbreaks have occurred in correctional facilities and transmission of TB from inmates to persons within such facilities has been well documented (MacIntyre, Kendig, Kummer, Birago, Graham, & Plant, 1999; Jones, Craig, Valway, Woodley, & Schaffner, 1999; Valway, Richards, Kovacovich, Greifinger, Crawford, & Dooley, 1994; & CDC, 2004b). In the past 20 years, the number of ex-offenders released from U.S. prisons has increased fourfold, presenting significant public health challenges to the communities into which they are released (Jones, Woodley, Fountain, & Schaffner, 2003; Bur et al., 2003; Re-Entry Policy Council, 2003). This chapter is intended to provide an overview of current strategies and recommendations for the prevention and control of TB in correctional facilities, with an emphasis on discharge planning for soon-to-be-released inmates. The strengthening of TB prevention and control efforts worldwide is imperative if transmission of TB is to be prevented and elimination of TB is to be achieved (CDC, 1999a). Chapter 11