Health Surveillance and Disease Prevention and Control / Communicable Diseases / Tuberculosis
Guide for Tuberculosis Control in Populations Deprived of Liberty in Latin America and the Caribbean
Contact: PAHO Regional Program on Tuberculosis, Communicable Disease Project, PAHO/WHO Headquarters, Washington, DC.
General Objective: Offer guidelines for comprehensive tuberculosis (TB) control centered on individual and collective actions for aid, promotion, and prevention in accordance with the Stop TB strategy in all persons in the penal system, in a coordinated effort between it and the national tuberculosis programs (NTPs).
Since societies began to seclude and deprive people of liberty as a means of sanctioning transgressions to laws and established standards, prisons inevitably have been related to disease. With the passage of time, this situation has not changed much; and if in the 17th century speaking of prisons also meant speaking of typhus and mental illness, in the 21st century any reference made to prisons involves thinking about psychosocial disorders, chronic diseases, and such communicable diseases as tuberculosis. Prisons can pose a serious public health problem.
Currently, more than 9.25 million people are deprived of their freedom in centers of seclusion around the world; and this number is increasing. Many of them are detained for short periods of time, which yields almost equivalent rates of entering and exiting the system. As a result, this means that the real population traveling penitentiaries every year is potentially 4 to 6 times higher that what is recognized.
If a basic human rights approach is added to this, one stipulating that the loss of freedom should not represent the loss of one's right to health, it can easily be stated that we are facing a problem that should not be overlooked and that requires a urgent action with an effective approach.
In this document the term "penal facilities" is used generically to refer to any place of detention, including prisons, centers for preventive detention, labor camps, reformatories, prisoners of war camps, centers for detaining immigrants, police stations, and other sites where there are persons deprived of liberty (PDLs). The penal system is seen as the country's prisons as a whole and their respective organization. In the case of prisons, the penal system becomes the last link of the administrative chain of a country's justice system. These guidelines for tuberculosis control in prisons in Latin America and the Caribbean are aimed at all health professionals who work in the penal system, as well as the staff of the national tuberculosis programs.
This document was prepared in 2008 and will be reviewed and updated in 2010, in order to incorporate new evidence. This guide will be disseminated among the staff of the NTPs and penal system in the countries of the Americas, in accordance with a previously established plan. National adaptations will be possible through previous consultation with the interested country or countries with the responsible PAHO/WHO committee.
The PAHO/WHO Regional TB Program will monitor its utilization through visits to penal facilities during official missions to monitor and evaluate the NTPs.