{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:19:19Z","timestamp":1783491559635,"version":"3.55.0"},"reference-count":115,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Tuberculosis (TB) remains disproportionately concentrated in prison populations worldwide, driven by overcrowding, poor ventilation, HIV co-infection, delayed diagnosis, treatment interruption, social vulnerability, and weak integration between correctional health services and national TB programs. This structured narrative review synthesizes current evidence across the prison TB prevention and care cascade, including screening, diagnosis, treatment, transmission reduction, TB\/HIV integration, surveillance, and continuity after release. We conducted an expert-led narrative synthesis informed by systematic-review principles, distinguishing direct prison-specific evidence from mathematical modeling, policy guidance, systematic reviews, and indirect evidence from adjacent fields such as HIV care and TB infection treatment. Symptom screening alone has limited sensitivity in high-burden prisons. Digital chest radiography with computer-aided detection can improve case detection when linked to confirmatory molecular testing and treatment capacity. Xpert MTB\/RIF or Ultra are central to rapid confirmation and rifampicin-resistance detection. Shorter rifamycin-based regimens for TB infection generally achieve higher completion than longer isoniazid-based regimens, while shorter all-oral MDR\/RR-TB regimens may offer programmatic advantages but remain insufficiently studied in correctional settings. Ventilation improvement, safer spaces, peer-supported case detection, and integrated TB\/HIV services are important components of transmission reduction. Decongestion may have substantial population-level impact, but this conclusion is supported mainly by mathematical modeling and should be interpreted as a projected effect rather than direct prison-specific causal evidence. Post-release continuity remains a major implementation gap, with limited direct evidence for active TB interventions. Sustainable prison TB control requires moving from isolated activities to an integrated, measurable prison\u2013community cascade linking risk-adapted screening, rapid diagnosis, effective treatment, environmental controls, data systems, and confirmed linkage to community care after release.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1892055","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:59:12Z","timestamp":1783490352000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tuberculosis in prisons: an integrated prevention and care cascade for a persistent structural epidemic"],"prefix":"10.3389","volume":"14","author":[{"given":"Jaen","family":"Cagua-Ordo\u00f1ez","sequence":"first","affiliation":[{"name":"Center for Evidence, Implementation, and Health Decision-Making (CIDES), Facultad de Ciencias de la Salud y Bienestar Humano, Universidad Tecnol\u00f3gica Indoam\u00e9rica","place":["Ambato, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Marcos","family":"Parise-Vasco","sequence":"additional","affiliation":[{"name":"Center for Evidence, Implementation, and Health Decision-Making (CIDES), Facultad de Ciencias de la Salud y Bienestar Humano, Universidad Tecnol\u00f3gica Indoam\u00e9rica","place":["Ambato, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Angamarca-Iguago","sequence":"additional","affiliation":[{"name":"Center for Evidence, Implementation, and Health Decision-Making (CIDES), Facultad de Ciencias de la Salud y Bienestar Humano, Universidad Tecnol\u00f3gica Indoam\u00e9rica","place":["Ambato, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha Bella","family":"Fuentes-Tumbaco","sequence":"additional","affiliation":[{"name":"Laboratorio cl\u00ednico, Unidad de Apoyo Diagn\u00f3stico, Hospital Pablo Arturo Su\u00e1rez","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Simancas-Racines","sequence":"additional","affiliation":[{"name":"Center for Evidence, Implementation, and Health Decision-Making (CIDES), Facultad de Ciencias de la Salud y Bienestar Humano, Universidad Tecnol\u00f3gica Indoam\u00e9rica","place":["Ambato, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e300","DOI":"10.1016\/S2468-2667(21)00025-6","article-title":"Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis","volume":"6","author":"Cords","year":"2021","journal-title":"Lancet Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e1000381","DOI":"10.1371\/journal.pmed.1000381","article-title":"Tuberculosis incidence in prisons: A 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