{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:51:09Z","timestamp":1768571469481,"version":"3.49.0"},"posted":{"date-parts":[[2025,4,20]]},"group-title":"Epidemiology","reference-count":49,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T00:00:00Z","timestamp":1745107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,4,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Tuberculosis (TB) disproportionately affects people deprived of liberty. Prior studies have shown higher TB treatment completion rates among incarcerated individuals compared to the general population. However, little is known about how incarceration-related movements such as transfers between facilities or releases to the community affect TB treatment outcomes.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We linked person-level incarceration data with TB notifications data from the Notifiable Disease Information System for the Brazilian state of Mato Grosso do Sul between January 2006 and December 2018. We constructed a cohort of individuals newly diagnosed with drug-susceptible TB who initiated treatment while incarcerated. We compared treatment outcomes between individuals who remained in the same carceral facility and those who were transferred to other facilities or released from incarceration during treatment. We computed the covariate-adjusted relative risk of unfavorable treatment outcomes for individuals transferred or released during treatment.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 1,274 individuals who initiated TB treatment while incarcerated. Of these individuals, 849 (66.6%) remained in the same carceral facility, 259 (20.3%) were transferred to other facilities, and 166 (13.0%) were released to the community during treatment. Among those who remained in the same carceral facility, 72.3% (614\/849) were successfully treated within eight months following treatment initiation. In contrast, only 61.0% (158\/259) of those who were transferred and 49.4% (82\/166) of those who were released achieved TB treatment success within eight months. After adjusting for covariates, the risk of unfavorable treatment outcomes was 1.4 (95% CI: 1.2 to 1.7) times as high for individuals transferred to other facilities and 1.6 (95% CI: 1.3 to 2.0) times as high for individuals released from incarceration, compared to those who remained incarcerated in the same facility during treatment. For individuals released less than two months into treatment, the risk of unfavorable treatment outcomes was twice as high (adjusted relative risk [aRR]:2.1, 95% CI: 1.6 \u2013 2.6).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Transfers between facilities and releases from incarceration are common and may pose barriers to TB treatment completion. Strategies for ensuring continuity of care across carceral facilities and between prison and community health systems are urgently needed to improve TB outcomes for individuals impacted by incarceration.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.04.19.25325982","type":"posted-content","created":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T13:05:11Z","timestamp":1745154311000},"source":"Crossref","is-referenced-by-count":0,"title":["Tuberculosis treatment outcomes after transfer or release from incarceration: A retrospective cohort study from Brazil"],"prefix":"10.64898","author":[{"given":"Yasmine","family":"Mabene","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Bampi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Everton Ferreira","family":"Lemos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7996-8011","authenticated-orcid":false,"given":"Roberto","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crhistinne","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria de Lourdes","family":"Delgado Alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maridiane","family":"Coutinho Echevarria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6665-6825","authenticated-orcid":false,"given":"Julio","family":"Croda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason R","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiran E","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025042213350532000_2025.04.19.25325982v1.1","unstructured":"World Health Organization. Global Tuberculosis Report 2023: Tuberculosis in Prisons. 2023. https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2023\/featured-topics\/tb-in-prisons. Accessed 29 Oct 2024."},{"key":"2025042213350532000_2025.04.19.25325982v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61053-7"},{"key":"2025042213350532000_2025.04.19.25325982v1.3","unstructured":"Dara M , Grzemska M , Kimerling ME , Reyes H , Zagorskiy A. Guidelines for control of tuberculosis in prisons. 2009. https:\/\/www.challengetb.org\/publications\/tools\/ua\/Guidelines_for_control_of_TB_in_prisons.pdf. Accessed 29 Oct 2024."},{"key":"2025042213350532000_2025.04.19.25325982v1.4","doi-asserted-by":"publisher","DOI":"10.3201\/eid2103.140896"},{"key":"2025042213350532000_2025.04.19.25325982v1.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1111-x"},{"key":"2025042213350532000_2025.04.19.25325982v1.6","unstructured":"The Stop TB Partnership. UNHLM 2023 Country Targets: Achieving the UNHLM treatment targets country by country. 2023. https:\/\/www.stoptb.org\/sites\/default\/files\/imported\/document\/country_targets-combined.pdf. Accessed 25 Feb 2025."},{"issue":"3","key":"2025042213350532000_2025.04.19.25325982v1.7","doi-asserted-by":"crossref","first-page":"252","DOI":"10.5588\/ijtld.21.0449","article-title":"The effect of incarceration on TB treatment outcomes","volume":"26","year":"2022","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"key":"2025042213350532000_2025.04.19.25325982v1.8","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08841-z"},{"key":"2025042213350532000_2025.04.19.25325982v1.9","doi-asserted-by":"crossref","first-page":"e20230077","DOI":"10.1590\/1983-1447.2023.20230077.en","article-title":"Factors associated with loss to follow-up in tuberculosis treatment in Brazil: a retrospective cohort study","volume":"44","year":"2023","journal-title":"Revista Ga\u00facha de Enfermagem"},{"key":"2025042213350532000_2025.04.19.25325982v1.10","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-09417-7"},{"key":"2025042213350532000_2025.04.19.25325982v1.11","doi-asserted-by":"crossref","unstructured":"Faust L , Caceres-Cardenas G , Martinez L , Huddart S , Vidal JR , Corilloclla-Torres R , et.al. Tuberculosis case notifications and outcomes in Peruvian prisons prior to and during the COVID-19 pandemic: a national-level interrupted time series analysis. The Lancet Regional Health\u2013Americas. 2024 May 1;33(100723).","DOI":"10.1016\/j.lana.2024.100723"},{"key":"2025042213350532000_2025.04.19.25325982v1.12","doi-asserted-by":"publisher","DOI":"10.1101\/2024.05.31.24308287"},{"key":"2025042213350532000_2025.04.19.25325982v1.13","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir491"},{"key":"2025042213350532000_2025.04.19.25325982v1.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.202"},{"issue":"2","key":"2025042213350532000_2025.04.19.25325982v1.15","doi-asserted-by":"crossref","first-page":"e96","DOI":"10.1016\/S2352-3018(17)30209-6","article-title":"Predictors of linkage to HIV care and viral suppression after release from jails and prisons: a retrospective cohort study","volume":"5","year":"2018","journal-title":"The lancet HIV"},{"key":"2025042213350532000_2025.04.19.25325982v1.16","doi-asserted-by":"crossref","first-page":"103558","DOI":"10.1016\/j.drugpo.2021.103558","article-title":"Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program","volume":"101","year":"2022","journal-title":"International Journal of Drug Policy"},{"key":"2025042213350532000_2025.04.19.25325982v1.17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01050.x"},{"key":"2025042213350532000_2025.04.19.25325982v1.18","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.3.833"},{"key":"2025042213350532000_2025.04.19.25325982v1.19","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.4.1296"},{"key":"2025042213350532000_2025.04.19.25325982v1.20","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.2.9032198"},{"key":"2025042213350532000_2025.04.19.25325982v1.21","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0934"},{"issue":"7","key":"2025042213350532000_2025.04.19.25325982v1.22","first-page":"1402","article-title":"Treatment Outcomes for Tuberculosis Infection and Disease Among Persons Deprived of Liberty, Uganda, 2020","volume":"30","year":"2024","journal-title":"Emerging Infectious Diseases"},{"issue":"2","key":"2025042213350532000_2025.04.19.25325982v1.23","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/tmi.13024","article-title":"Poor continuity of care for TB diagnosis and treatment in Zambian Prisons: a situation analysis","volume":"23","year":"2018","journal-title":"Tropical Medicine & International Health"},{"issue":"11","key":"2025042213350532000_2025.04.19.25325982v1.24","doi-asserted-by":"crossref","first-page":"e841","DOI":"10.1016\/S2468-2667(24)00192-0","article-title":"Mass incarceration as a driver of the tuberculosis epidemic in Latin America and projected effects of policy alternatives: a mathematical modelling study","volume":"9","year":"2024","journal-title":"Lancet Public Health"},{"issue":"7","key":"2025042213350532000_2025.04.19.25325982v1.25","doi-asserted-by":"crossref","first-page":"e511","DOI":"10.1016\/S2468-2667(23)00097-X","article-title":"Global, regional, and national estimates of tuberculosis incidence and case detection among incarcerated individuals from 2000 to 2019: a systematic analysis","volume":"8","year":"2023","journal-title":"The Lancet Public Health"},{"key":"2025042213350532000_2025.04.19.25325982v1.26","unstructured":"World Prison Brief. Brazil. https:\/\/www.prisonstudies.org\/country\/brazil. Accessed 29 Oct 2024."},{"issue":"1","key":"2025042213350532000_2025.04.19.25325982v1.27","doi-asserted-by":"crossref","first-page":"111","DOI":"10.32614\/RJ-2014-011","article-title":"The stringdist package for approximate string matching","volume":"6","year":"2014","journal-title":"The R Journal"},{"key":"2025042213350532000_2025.04.19.25325982v1.28","unstructured":"R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria; 2024. Available from: https:\/\/www.R-project.org\/"},{"key":"2025042213350532000_2025.04.19.25325982v1.29","unstructured":"Minist\u00e9rio Da Sa\u00fade Secretaria De Vigil\u00e2ncia Em Sa\u00fade. Vigil\u00e2ncia epidemiol\u00f3gica da tuberculose: An\u00e1lise de indicadores operacionais e epidemiol\u00f3gicos a partir da base de dados do Sinan vers\u00e3o 5.0. 2019. http:\/\/portalsinan.saude.gov.br\/images\/documentos\/Agravos\/Tuberculose\/Caderno_de_Analise_2019.pdf. Accessed 29 Oct 2024."},{"key":"2025042213350532000_2025.04.19.25325982v1.30","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"2025042213350532000_2025.04.19.25325982v1.31","unstructured":"Stekhoven DJ . missForest: Nonparametric Missing Value Imputation using Random Forest. R package version 1.5. 2022."},{"issue":"16","key":"2025042213350532000_2025.04.19.25325982v1.32","doi-asserted-by":"crossref","first-page":"3516","DOI":"10.1017\/S0950268817002631","article-title":"Drug addiction and alcoholism as predictors for tuberculosis treatment default in Brazil: a prospective cohort study","volume":"145","year":"2017","journal-title":"Epidemiology & Infection"},{"issue":"10","key":"2025042213350532000_2025.04.19.25325982v1.33","doi-asserted-by":"crossref","first-page":"e0011685","DOI":"10.1371\/journal.pntd.0011685","article-title":"Factors associated with unsuccessful tuberculosis treatment among homeless persons in Brazil: A retrospective cohort study from 2015 to 2020","volume":"17","year":"2023","journal-title":"PLOS Neglected Tropical Diseases"},{"key":"2025042213350532000_2025.04.19.25325982v1.34","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0584-8"},{"key":"2025042213350532000_2025.04.19.25325982v1.35","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11834-1"},{"key":"2025042213350532000_2025.04.19.25325982v1.36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0033129"},{"key":"2025042213350532000_2025.04.19.25325982v1.37","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-215926"},{"issue":"2","key":"2025042213350532000_2025.04.19.25325982v1.38","doi-asserted-by":"crossref","first-page":"170","DOI":"10.5588\/ijtld.19.0002","article-title":"The impact of smoking on tuberculosis treatment outcomes: a meta-analysis","volume":"24","year":"2020","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"key":"2025042213350532000_2025.04.19.25325982v1.39","first-page":"1","article-title":"Impact of alcohol disorder and the use of illicit drugs on tuberculosis treatment outcomes: a retrospective cohort study","volume":"76","year":"2018","journal-title":"Archives of Public Health"},{"key":"2025042213350532000_2025.04.19.25325982v1.40","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2050-4"},{"issue":"4","key":"2025042213350532000_2025.04.19.25325982v1.41","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1007\/s10461-018-2316-x","article-title":"Jail-based case management improves retention in HIV care 12 months post release","volume":"23","year":"2019","journal-title":"AIDS and Behavior"},{"issue":"2","key":"2025042213350532000_2025.04.19.25325982v1.42","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/jvh.13220","article-title":"Using the barriers and facilitators to linkage to HIV care to inform hepatitis C virus (HCV) linkage to care strategies for people released from prison: findings from a systematic review","volume":"27","year":"2020","journal-title":"Journal of Viral Hepatitis"},{"key":"2025042213350532000_2025.04.19.25325982v1.43","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czs072"},{"key":"2025042213350532000_2025.04.19.25325982v1.44","doi-asserted-by":"publisher","DOI":"10.1177\/00333549101250S407"},{"issue":"3","key":"2025042213350532000_2025.04.19.25325982v1.45","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1521\/aeap.2021.33.3.202","article-title":"Intersectional stigma among people transitioning from incarceration to community-based HIV care in Gauteng province, South Africa","volume":"33","year":"2021","journal-title":"AIDS Education and Prevention"},{"issue":"5","key":"2025042213350532000_2025.04.19.25325982v1.46","doi-asserted-by":"crossref","first-page":"249","DOI":"10.3390\/socsci13050249","article-title":"Health Education for Women Released from Prison in Brazil: Barriers and Possibilities for Intervention","volume":"13","year":"2024","journal-title":"Social Sciences"},{"key":"2025042213350532000_2025.04.19.25325982v1.47","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0139487"},{"key":"2025042213350532000_2025.04.19.25325982v1.48","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-024-02527-w"},{"issue":"7","key":"2025042213350532000_2025.04.19.25325982v1.49","doi-asserted-by":"crossref","first-page":"e578","DOI":"10.1016\/S2468-2667(22)00119-0","article-title":"The role of low-income and middle-income country prisons in eliminating hepatitis C","volume":"7","year":"2022","journal-title":"The Lancet Public Health"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.04.19.25325982","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:34:18Z","timestamp":1768509258000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.04.19.25325982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,20]]},"references-count":49,"URL":"https:\/\/doi.org\/10.1101\/2025.04.19.25325982","relation":{},"subject":[],"published":{"date-parts":[[2025,4,20]]},"subtype":"preprint"}}