Tuberculosis in prisons: anatomy of global neglect.

I nfectious diseases can be transmitted readily within prisons due to close contact between prisoners. Tuberculosis (TB) and HIV/AIDS are two important causes of morbidity and mortality from infectious diseases worldwide [1, 2]; prisons have become reservoirs for these diseases in many settings. TB prevalence among prisoners worldwide can be up to 50 times higher than national averages [3, 4]. Prisons account for a substantial proportion of the TB burden in the USA [5] and TB in prisons poses a major problem in the rest of the world, especially in countries of the former Soviet Union [6, 7] and sub-Saharan Africa (SSA) [8, 9]. Co-infection with HIV in prisoners with active or latent TB is well documented [4, 10, 11] and this presents difficult diagnostic and management challenges to prison health systems.