“From 1993 through 2003, the percentage of TB cases among local jail inmates increased from 43.8% … to 53.5%.” The federal prison rate “increased from 2.9% to 11.8%,” and the state prison rate “decreased from 52.3 in 1993 to 6.6 in 2003, a decline of 87.4%.”
California and Texas “accounted for 42.7% of the 7,820 reported TB cases” in prison “from 1993 to 2003, and another 4 states (Florida, Georgia, Illinois and New York) accounted for an additional 28.6% of reported TB cases. These same 6 states accounted for 56.9% of the 200,648 reported TB cases among non-inmates.”
One “notable reason for the high rates of TB in correctional institutions is the greater proportion of persons who are at high risk for TB but who cannot access standard public health interventions.”
According to the study, prisoners with TB are more likely than non-prisoners to be co-infected with the Human Immunodeficiency Virus (HIV), at a rate of 25.2% versus 18% for the general public. Co-infection is highest among state prisoners, at 35.8%. Researchers found that contrary to CDC recommendations, most prisons “currently do not offer universal HIV testing, a critical limitation for effective TB prevention and control and for the medical management of individual patients.”
90.3% of prisoners versus 84.4% of non-prisoners had pulmonary TB. Prisoners were also “more likely to have multiple risk factors for infection” and “to have drug-resistant TB.” While prisoners were “more likely to receive directly observed therapy,” they “were less likely to complete therapy.” Researchers found these “unacceptably low rates for…therapy completion…disturbing because of the possibility that these individuals may be the cause of future TB outbreaks in a given community.”
Finally, researchers recommended enhanced tracking of “TB patients diagnosed or treated in correctional systems.” Additionally, public health and corrections officials are obliged to develop policies that optimize discharge planning and case management for inmates released during TB evaluation or treatment.” See: “An Unanswered Health Disparity: Tuberculosis Among Correctional Inmates, 1993 through 2003,” American Journal of Public Health, October 2005, Vol. 95, No. 10.
As a digital subscriber to Prison Legal News, you can access full text and downloads for this and other premium content.
Already a subscriber? Login