3.4 CONSEQUENCES OF POOR TUBERCULOSIS CONTROL IN PRISONS

Tuberculosis is common among prisoners. Failure to control tuberculosis in prisons causes much suffering and death among prisoners. If untreated, and if mis-treated, prisoners with infectious tuberculosis infect other prisoners, relatives during visits and prison staff. Some prisoners gain release from prison before completion of treatment. Coordination is essential between prison and general health services for referral of a tuberculosis patient on release from prison to the general health services. Lack of coordination will result in non-attendance at the relevant general health facility and non-completion of treatment, with risk of tuberculosis spread in the community. Failure of prison authorities to control a treatable and preventable disease can contribute to prisoners venting their anger against the prison system. This can lead to prison security problems.

Prison walls curtail the freedom of prisoners, but not the freedom of spread of tuberculosis. Prisons form a reservoir of tuberculosis which threatens not only prisoners but also prison staff, visitors, and the wider community. Sub-standard treatment practices in prison compound the risk of spread of tuberculosis inside and beyond prisons with the risk of drug-resistance. Failure to control tuberculosis in prisons today will result in a more difficult and more expensive to control epidemic in future. An effective NTP must include effective tuberculosis control in prisons.