ArticleBMC medicine2018
Investigating spillover of multidrug-resistant tuberculosis from a prison: a spatial and molecular epidemiological analysis.
Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Beyond Prison Walls: A Scoping Review of Incarceration's Public Health Impacts in Latin America.Wellcome open research · 2026Pooled it
- Transmission models of respiratory infections in carceral settings: A systematic review.Epidemics · 2025Pooled it
- Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis.The Lancet. Public health · 2021Pooled it
- Article
- Modelling spatial heterogeneity in exposure buffers and risk: a hierarchical Bayesian approach.Journal of the Royal Statistical Society. Series C, Applied statistics · 2026Article
- Tuberculosis in prisons: an integrated prevention and care cascade for a persistent structural epidemic.Frontiers in public health · 2026Review
- Tuberculosis treatment outcomes after transfer or release from incarceration: a retrospective cohort study from Brazil.BMC global and public health · 2025Article
- Tuberculosis treatment outcomes after transfer or release from incarceration: A retrospective cohort study from Brazil.medRxiv : the preprint server for health sciences · 2025Article
- Changes in incarceration and tuberculosis notifications from prisons during the COVID-19 pandemic in Europe and the Americas: a time-series analysis of national surveillance data.The Lancet. Public health · 2025Article
- Global perspectives on tuberculosis in prisons and incarceration centers - Risk factors, priority needs, challenges for control and the way forward.IJID regions · 2025Review
- Transmission ofEpidemiology and infection · 2025Article
- Mass incarceration as a driver of the tuberculosis epidemic in Latin America and projected effects of policy alternatives: a mathematical modelling study.The Lancet. Public health · 2024Article
- Mass incarceration as a driver of the tuberculosis epidemic in Latin America and projected impacts of policy alternatives: A mathematical modeling study.medRxiv : the preprint server for health sciences · 2024Article
- Who Transmits Tuberculosis to Whom: A Cross-Sectional Analysis of a Cohort Study in Lima, Peru.American journal of respiratory and critical care medicine · 2024Article
- SpecificMicroorganisms · 2024Article
- Excess tuberculosis risk during and following incarceration in Paraguay: a retrospective cohort study.Lancet regional health. Americas · 2024Article
- Prison as a driver of recent transmissions of multidrug-resistant tuberculosis in Callao, Peru: a cross-sectional study.Lancet regional health. Americas · 2024Article
- Prisons as boosters of tuberculosis and drug resistance tuberculosis transmission in Latin America.Lancet regional health. Americas · 2024Article
- Community-based active-case finding for tuberculosis: navigating a complex minefield.BMC global and public health · 2024Review
- Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China.BMC public health · 2024Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundCongregate settings may serve as institutional amplifiers of tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB). We analyze spatial, epidemiological, and pathogen genetic data prospectively collected from neighborhoods surrounding a prison in Lima, Peru, where inmates experience a high risk of MDR-TB, to investigate the risk of spillover into the surrounding community.
methodsUsing hierarchical Bayesian statistical modeling, we address three questions regarding the MDR-TB risk: (i) Does the excess risk observed among prisoners also extend outside the prison? (ii) If so, what is the magnitude, shape, and spatial range of this spillover effect? (iii) Is there evidence of additional transmission across the region?
resultsThe region of spillover risk extends for 5.47 km outside of the prison (95% credible interval: 1.38, 9.63 km). Within this spillover region, we find that nine of the 467 non-inmate patients (35 with MDR-TB) have MDR-TB strains that are genetic matches to strains collected from current inmates with MDR-TB, compared to seven out of 1080 patients (89 with MDR-TB) outside the spillover region (p values: 0.022 and 0.008). We also identify eight spatially aggregated genetic clusters of MDR-TB, four within the spillover region, consistent with local transmission among individuals living close to the prison.
conclusionsWe demonstrate a clear prison spillover effect in this population, which suggests that interventions in the prison may have benefits that extend to the surrounding community.
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