Particularly in high prevalence countries, tuberculosis in prisons is thus an important threat to public health. There is often a rapid turnover of prisoners on remand. Many are then released and may infect others. Theoretically, good treatment and good tuberculosis control should be easier in a closed, disciplined environment. In practice, this is often not the case.
Tuberculosis poses a real threat to prisoners, staff and the general public.
These guidelines, based on much recent experience, outline the many obstacles to effective diagnosis and treatment. They give useful guidance as to how to overcome these obstacles. Prison health services are not usually under the control of the national Ministry of Health. The guidelines highlight the importance of coordinating the two services. We hope that politicians, administrators and doctors in the relevant Ministries, national and international bodies concerned with the problem, and indeed the general public in many countries will read these guidelines with alarm.