A new study has identified lower than expected tuberculosis notifications in prisons across Europe and the Americas during the COVID-19 pandemic.
Amy Zheng, Lena Faust and Leo Martinez led a multi-author group, including Prof Anthony Harries, Senior Advisor at The Union, on a time-series analysis of national surveillance data to estimate changes in incarceration and tuberculosis notifications in prisons in Europe and the Americas during the first three years of the COVID-19 pandemic from 2020 to 2022.
Prof Harries explained: “Despite the importance given to incarcerated populations as a priority and vulnerable population at high risk of tuberculosis, they continue to bear a heavy burden of the disease. The COVID-19 pandemic disrupted national tuberculosis programmes around the world, with sharp and sizeable decreases in case detection rates in the first year of the pandemic. The effect of COVID-19 on tuberculosis programmes and tuberculosis case detection within prisons, however, was unknown. Until now.”
There were 47 countries included in the study across the regions of Europe and the Americas, representing approximately 4.9 million people incarcerated annually. Observed tuberculosis notifications in prisons in both regions were between 20% to 70% lower than predicted during the COVID-19 pandemic period, whereas incarceration rates remained largely unchanged. This finding suggests that factors such as delayed diagnosis or missed diagnosis, or successful implementation of physical distancing of incarcerated individuals might have contributed to the observed findings.
Amy Zheng, Department of Epidemiology, Boston University School of Public Health, USA, added: “Further research is needed to understand the mechanisms for the decreases in tuberculosis notifications in prisons during the COVID-19 pandemic. Lena Faust, London School of Hygiene and Tropical Medicine, London, UK, also stated: “Regardless of these mechanisms, a much higher priority should be given to the screening and diagnosis of tuberculosis among this highly vulnerable and historically neglected population.”
The paper was published in The Lancet Public Health last month (31 March 2025).