{"id":4295,"date":"2025-06-03T17:03:48","date_gmt":"2025-06-03T17:03:48","guid":{"rendered":"https:\/\/govinfohub.go.ug\/?p=4295"},"modified":"2025-06-04T18:07:02","modified_gmt":"2025-06-04T18:07:02","slug":"one-case-away-from-an-outbreak-the-urgent-call-for-mandatory-tb-testing-in-prisons","status":"publish","type":"post","link":"https:\/\/govinfohub.go.ug\/index.php\/2025\/06\/03\/one-case-away-from-an-outbreak-the-urgent-call-for-mandatory-tb-testing-in-prisons\/","title":{"rendered":"One Case Away from an Outbreak: The Urgent Call for Mandatory TB Testing in Prisons"},"content":{"rendered":"\n<p>A landmark survey conducted by the <a href=\"https:\/\/sph.mak.ac.ug\/\">Makerere University School of Public Health (MakSPH)<\/a>, in collaboration with the <a href=\"https:\/\/www.ugandaprisons.go.ug\/\">Uganda Prisons Service (UPS)<\/a> and the <a href=\"https:\/\/health.go.ug\/\">Ministry of Health<\/a>, has uncovered a startling public health crisis: Uganda\u2019s prison population has eight times the tuberculosis (TB) prevalence of the general population. Nearly half of all inmates are estimated to have latent TB.<\/p>\n\n\n\n<p>Released on May 15, 2025, <em>The Uganda National Prevalence Survey on Tuberculosis, HIV, and COVID-19 in Prisons<\/em>&nbsp;was funded by PEPFAR and supported technically by the U.S. Centers for Disease Control and Prevention (CDC).<\/p>\n\n\n\n<p>The survey paints a sobering picture of disease transmission within Uganda\u2019s overcrowded, poorly ventilated correctional facilities.<\/p>\n\n\n\n<p>\u201cPrisons are high-risk, high-transmission environments. One undetected case can trigger an outbreak,\u201d said Dr. James Kisambu, Commissioner for Prison Health Services. \u201cIn such settings, mandatory TB testing is not a rights violation\u2014it is a public health necessity.\u201d<\/p>\n\n\n\n<p>Alarming Statistics on TB and HIV in Prisons;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Active TB prevalence: 1,900 per 100,000 inmates (8\u00d7 the national rate)<\/li>\n\n\n\n<li>Latent TB infection: 48% of inmates (38% among female prisoners)<\/li>\n\n\n\n<li>HIV prevalence: 11% of inmates (vs. 5.1% nationally)<ul><li>Female prisoners: 21%<\/li><\/ul><ul><li>Male prisoners: 11%<\/li><\/ul>\n<ul class=\"wp-block-list\">\n<li>Prison staff: 2%<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p>\u201cThese figures confirm what we\u2019ve long feared: prisons are disease incubators due to overcrowding, poor ventilation, and prolonged confinement,\u201d said Dr. Simon Kasasa, Principal Investigator and Senior Lecturer at MakSPH.<\/p>\n\n\n\n<p>Currently, Uganda\u2019s 257 prison facilities\u2014built for 16,612 inmates\u2014are housing over 56,400 individuals, representing a staggering 340% occupancy rate. The health implications are severe:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>95% of prisons lack natural ventilation<\/li>\n\n\n\n<li>80% of prison wards are too overcrowded for physical distancing<\/li>\n<\/ul>\n\n\n\n<p>\u201cDiseases do not respect bars or borders. Women in prisons bear the brunt of invisibility in health programming,\u201d said Deputy Commissioner General Samuel Akena.<\/p>\n\n\n\n<p>Akena emphasized the urgent need for gender-responsive strategies, warning that incarcerated women face significantly higher health risks\u2014especially regarding HIV\u2014yet remain marginalized in health policy design.<\/p>\n\n\n\n<p>Progress and Gaps in HIV and TB Response<\/p>\n\n\n\n<p>Uganda\u2019s prison system has made commendable progress in HIV management:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>92% of HIV-positive inmates are aware of their status<\/li>\n\n\n\n<li>99% are on antiretroviral therapy (ART)<\/li>\n\n\n\n<li>However, only 70<strong>%<\/strong>\u00a0have achieved viral suppression<\/li>\n<\/ul>\n\n\n\n<p>\u201cWhile we\u2019ve made progress on HIV care, TB lags behind in diagnosis and access to treatment,\u201d noted Dr. George Tumusinze, Program Manager and Research Associate.<\/p>\n\n\n\n<p>Traditional symptom-based screening methods missed nearly half of the TB cases identified in the survey, according to Prof. Rhoda Wanyenze, Dean of MakSPH and lead investigator.<\/p>\n\n\n\n<p>\u201cWe must adopt WHO-recommended diagnostics like GeneXpert, TB LAM, and digital chest X-rays with computer-aided detection (CAD) to detect and treat TB cases early,\u201d she urged.<\/p>\n\n\n\n<p>So far, UPS has installed 14 GeneXpert machines in high-volume facilities. However, experts warn that urgent nationwide scale-up of modern diagnostics is essential.<\/p>\n\n\n\n<p>Since 2010, the CDC and PEPFAR have invested over $18 million in improving health services in Uganda\u2019s prisons, including $550,000 allocated specifically for the recent TB survey. These investments have expanded testing and treatment services, trained staff, and improved infrastructure.<\/p>\n\n\n\n<p>\u201cThis work doesn\u2019t just protect inmates\u2014it safeguards communities when prisoners are reintegrated,\u201d said Dr. Mary Boyd, CDC Uganda Country Director.<\/p>\n\n\n\n<p>Some critics, including Members of Parliament, have raised concerns about the implications of mandatory TB testing on individual rights. However, public health experts argue that in high-transmission settings, individual choice must be weighed against community protection.<\/p>\n\n\n\n<p>\u201cWhen done with dignity and linked to prompt treatment, mandatory screening is not coercive\u2014it\u2019s a safeguard for all,\u201d Dr. Kisambu emphasized.<\/p>\n\n\n\n<p>Dr. Charles Olaro, Director General of Health Services, described the national prison TB survey as a pivotal moment in Uganda\u2019s efforts to eliminate tuberculosis.<\/p>\n\n\n\n<p>\u201cWe cannot meet our 2030 TB elimination goals without confronting the prison crisis head-on,\u201d he said.<\/p>\n\n\n\n<p><strong>Key Recommendations from the Report:<\/strong><strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Institutionalize routine mass TB screening across all prison facilities<\/li>\n\n\n\n<li>Scale up use of molecular diagnostics and digital tools for early detection<\/li>\n\n\n\n<li>Upgrade infrastructure to address overcrowding and poor ventilation<\/li>\n\n\n\n<li>Prioritize vulnerable groups, especially women<\/li>\n\n\n\n<li>Allocate dedicated resources to strengthen prison health systems<\/li>\n<\/ul>\n\n\n\n<p>Without decisive action, Uganda\u2019s national TB targets will remain out of reach.<\/p>\n\n\n\n<p>Uganda\u2019s fight against TB and HIV cannot succeed unless its most marginalized populations are included. The health of incarcerated people is not isolated\u2014it is intricately connected to the health of the broader society. This report is a wake-up call: failing to act is no longer an option<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A landmark survey conducted by the Makerere University School of Public Health (MakSPH), in collaboration with the Uganda Prisons Service (UPS) and the Ministry of Health, has uncovered a startling public health crisis: Uganda\u2019s prison population has eight times the tuberculosis (TB) prevalence of the general population. Nearly half of all inmates are estimated to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4296,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[4],"tags":[],"class_list":["post-4295","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>One Case Away from an Outbreak: The Urgent Call for Mandatory TB Testing in Prisons - Published By UPPC<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/govinfohub.go.ug\/index.php\/2025\/06\/03\/one-case-away-from-an-outbreak-the-urgent-call-for-mandatory-tb-testing-in-prisons\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"One Case Away from an Outbreak: The Urgent Call for Mandatory TB Testing in Prisons - Published By UPPC\" \/>\n<meta property=\"og:description\" content=\"A landmark survey conducted by the Makerere University School of Public Health (MakSPH), in collaboration with the Uganda Prisons Service (UPS) and the Ministry of Health, has uncovered a startling public health crisis: Uganda\u2019s prison population has eight times the tuberculosis (TB) prevalence of the general population. 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