ArticleScientific reports2020
Increased incarceration rates drive growing tuberculosis burden in prisons and jeopardize overall tuberculosis control in Paraguay.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Pooled it
- Systematic review of the tuberculosis burden in prisons: Regional patterns and gaps in Latin America and the Caribbean.Global epidemiology · 2026Review
- Modelling the impact of increasing tuberculosis treatment coverage and addressing determinants of risk in men.Communications medicine · 2026Article
- Routine active case finding in Nigerian penitentiary institutions: comparing yields from digital X-ray with CAD4TB and WHO 4-symptom screening.BMC infectious diseases · 2026Article
- Tuberculosis in prisons: an integrated prevention and care cascade for a persistent structural epidemic.Frontiers in public health · 2026Review
- Evaluation of diagnostic agreement between STANDARD E TB-Feron ELISA and TB-Feron FIA for tuberculosis infection in prison settings in Paraguay.Frontiers in public health · 2026Article
- The concentration of tuberculosis within Paraguay's Indigenous population, 2018-2022: a retrospective population-based study.Lancet regional health. Americas · 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
- Performance evaluation of the AFIAS IGRA-TB (IFN-gamma) test versus QuantiFERON®-TB gold plus (QFT®-Plus) ELISA in the Barrio Obrero hospital network, Asunción-Paraguay, 2025.Frontiers in public health · 2025Article
- Tuberculosis prevention: current strategies and future directions.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2024Review
- Tuberculosis case notifications and outcomes in Peruvian prisons prior to and during the COVID-19 pandemic: a national-level interrupted time series analysis.Lancet regional health. Americas · 2024Article
- Excess tuberculosis risk during and following incarceration in Paraguay: a retrospective cohort study.Lancet regional health. Americas · 2024Article
- Incarceration and TB: the epidemic beyond prison walls.BMJ global health · 2024Article
- Health in Persons Deprived of Their Liberty in South America: A Painful Reflection of Our Public Health.Annals of global health · 2024Article
- Magnitude, associated risk factors, and trend comparisons of identified tuberculosis types among prisons in Ethiopia: A systematic review and meta-analysis.Health science reports · 2024Article
- Global, regional, and national estimates of tuberculosis incidence and case detection among incarcerated individuals from 2000 to 2019: a systematic analysis.The Lancet. Public health · 2023Article
- Use of rapid molecular TB diagnostics for incarcerated people in Brazil.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Phylogeography and transmission of Mycobacterium tuberculosis spanning prisons and surrounding communities in Paraguay.Nature communications · 2023Article
- A Case of Previously Undiagnosed Systemic Lupus Erythematosus andCase reports in rheumatology · 2023Article
- Excess tuberculosis cases and deaths following an economic recession in Brazil: an analysis of nationally representative disease registry data.The Lancet. Global health · 2022Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
Abstract
Incarcerated populations are at high-risk to develop tuberculosis (TB), however their impact on the population-level tuberculosis epidemic has been scarcely studied. We aimed to describe the burden and trends of TB among incarcerated populations over time in Paraguay, its clinical and epidemiological differences and the population attributable fraction. This is an observational, descriptive study including all TB cases notified to the National TB control Program in Paraguay during the period 2009-2018. We also used case registries of prisoners diagnosed with tuberculosis from the Minister of Justice. The population attributable fraction of TB in the community due to incarcerated cases was estimated through Levin's formula. The characteristics of TB cases in and outside of prison were compared as well as the characteristics of TB in prisons were modified over time. During 2009-2018, 2764 (9.7%) of the 28,534 TB reported cases in Paraguay occurred in prisons. The number of prisoners in Paraguay increased from 6258 in 2009 to 14,627 in 2018 (incarceration rate, 101 to 207 per 100,000 persons) while the number of TB cases among prisoners increased by 250% (n = 192 in 2009 versus n = 480 in 2018). The annual TB notification rate among male prisoners was 3218 and 3459 per 100,000 inmates in 2009 and 2018, respectively. The percentage of all TB cases occurring among prisoners increased from 7.1% in 2009 to 14.5% in 2018. The relative risk of TB in prisons compared to community was 70.3 (95% CI, 67.7-73.1); the overall population attributable risk was 9.5%. Among the 16 penitentiary centers in the country, two of them-Tacumbú (39.0%) and Ciudad del Este (23.3%)-represent two thirds of all TB cases in prisons. TB among inmates is predominantly concentrated in those 20-34 years old (77.3% of all), twice the percentage of cases for the same age group outside of prison. Our findings show that the TB epidemic in prisons represents one of the most important challenges for TB control in Paraguay, especially in the country's largest cities. Appropriate TB control measures among incarcerated populations are needed and may have substantial impact on the overall TB burden in the country.
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