Although valuable progress has been made, tuberculosis (TB) remains a major health problem in prisons in Europe, even though TB is largely curable and there is general international consensus on how to prevent and control it. Prisons are breeding grounds for TB, especially multidrug-resistant TB (MDR-TB).
- Prisons have high exposure to TB, because of exogenous factors that cause over-infection and progression of the disease such as overcrowding, poor ventilation, frequent transfers of prisoners between prisons, poor nutrition and limited access to health care or to insufficient health care.
- Prisoners come from high-risk groups of the population and are in general poor, have little education and come from socioeconomically deprived sectors of the population, where TB infection and transmission are higher. They have often had limited access to health care and suffer from additional health problems such as drug addiction and alcoholism.
As a result, the TB notification rate in European prisons is, on average, 17 times higher than in the general population, ranging from 11 times higher in western Europe to 81 times higher in eastern Europe. Of special concern are HIV/TB co-infections.
In 2007 the WHO/Europe health in prisons Project (HIPP) produced a status paper that summarizes the situation of TB prevention, diagnosis and treatment in prisons and provides evidence for action to reduce the spread of TB among prisoners and so reduce risks to the community and to public health in general.