ArticleLancet regional health. Americas2024
Excess tuberculosis risk during and following incarceration in Paraguay: a retrospective cohort study.
Article in Lancet regional health. Americas, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 12 citations in OpenAlex.
- Post-release tuberculosis risk among formerly incarcerated populations in Lima Peru.Nature communications · 2026Article
- Systematic review of the tuberculosis burden in prisons: Regional patterns and gaps in Latin America and the Caribbean.Global epidemiology · 2026Review
- Comparative impacts and cost-effectiveness of tuberculosis systematic screening strategies in prisons in Brazil, Colombia, and Peru: A mathematical modeling study.PLoS medicine · 2026Article
- Accelerating tuberculosis diagnosis in Mozambican prisons using digital chest X-rays with computer-aided detection: a longitudinal, comprehensive health intervention.BMC global and public health · 2026Article
- Drug-Resistant Tuberculosis in Prisons of Latin America and the Caribbean: A Critical Reflection on Structural Challenges and Gaps.Tropical medicine and infectious disease · 2026Review
- Comparative impacts and cost-effectiveness of tuberculosis active case-finding strategies in prisons in Brazil, Colombia, and Peru: a mathematical modeling study.medRxiv : the preprint server for health sciences · 2025Article
- The concentration of tuberculosis within Paraguay's Indigenous population, 2018-2022: a retrospective population-based study.Lancet regional health. Americas · 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
- Decadal trends and regional disparities in tuberculosis burden: a comprehensive analysis of global, African, and Southeast Asian data from the GBD 1990-2021.Frontiers in public health · 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
- Prevalence and associated factors of TB and HIV coinfections among adult inmates with presumptive pulmonary TB in a Kenyan prison.Tropical medicine and 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
- Prisons as boosters of tuberculosis and drug resistance tuberculosis transmission in Latin America.Lancet regional health. Americas · 2024Article
- Incarceration and TB: the epidemic beyond prison walls.BMJ global health · 2024Article
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Authors and funding
10 authors at 8 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The increased risk of tuberculosis (TB) among people deprived of liberty (PDL) is due to individual and institution-level factors. We followed a cohort of PDL from 5 prisons in Paraguay to describe the risk of TB during incarceration and after they were released. Methods: We linked a 2013 national census of prisons with TB records from the TB Program from 2010 to 2021 to identify TB notifications among incarcerated and formerly incarcerated individuals. We used multivariable Cox regression models to quantify the risk of TB during and following incarceration and to identify risk factors associated with TB. Findings: Among 2996 individuals incarcerated, 451 (15.1%) were diagnosed with TB. Of these, 262 (58.1%) cases occurred during incarceration and 189 (41.9%) occurred in the community after release. In prison, the hazard ratio of developing TB was 1.97 (95% CI: 1.52-2.61) after six months of incarceration and increased to 2.78 (95% CI: 1.82-4.24) after 36 months compared with the first six months. The overall TB notification rate was 2940 per 100,000 person-years. This rate increased with the duration of incarceration from 1335 per 100,000 person-years in the first year to 8455 per 100,000 person-years after 8 years. Among former prisoners, the rate of TB decreased from 1717 in the first year after release to 593 per 100 000 person-years after 8 years of follow up. Interpretation: Our study shows the alarming risk of TB associated with prison environments in Paraguay, and how this risk persists for years following incarceration. Effective TB control measures to protect the health of people during and following incarceration are urgently needed. Funding: Paraguay National Commission of Science and Technology grant CONACYT PIN 15-705 (GS, GES, SA).
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