Tuberculosis kills more than one million people a year in the world, remaining the leading cause of death from infectious disease, but there is one place where this threat multiplies exponentially; in prisons.
The Espiritu Santo University (UEES) organized the talk “Tuberculosis in prisons: a public health challenge.”, The meeting was held in conjunction with representatives from the Catholic University of Guayaquil, the University of Milagro, the Health Department of the Guayaquil City Hall, SNAI, the National Assembly and multidisciplinary experts. The meeting started from a clear premise: tuberculosis in prison contexts is not only a problem of people deprived of liberty, but a community problem that spreads silently and affects the whole society.
During the day, Mayling Encalada, a specialist in pneumology, was emphatic in pointing out that “meeting the goal of the end of tuberculosis is not only a health management; it is a political and social decision.”, The current gaps cannot be solved by the health sector alone.
In Ecuador, the situation is alarming. The incidence of tuberculosis increased by 48 % between 2015 and 2023, with Guayas leading the crisis by registering 116 cases per 100,000 inhabitants. In Zone 8 of Guayaquil alone, nearly 700 of the 1,131 persons deprived of liberty currently receiving treatment are concentrated in prisons where 97 % have severe overcrowding and high sanitary risk conditions.
Héctor Hugo, a specialist in territorial planning, explained that the problem transcends prison walls: “prison tuberculosis is not only a prison problem, it is a territorial, dynamic and inter-institutional problem.”. Every day about 33 people enter the penitentiary centers of Guayas and 30 % of the persons deprived of liberty re-enter at least twice, maintaining a constant flow of contagion. In addition to this, there are 8,556 families directly exposed (seven out of ten PPL are parents) and between 1,200 and 1,500 daily visitors, not counting prison staff.
In view of this scenario, the specialists agreed on the need for a profound change of approach. They proposed leaving behind the traditional model of infection control and moving toward a strategy of occupational health, The company has also developed a new system, incorporating tools such as portable PCRs, mobile X-rays and artificial intelligence to detect cases early and cut off transmission chains.
Washington Alemán, a specialist in infectious diseases, summed it up clearly: “TB in prisons spreads to the community, so protecting prison health through early diagnosis and technology, including artificial intelligence, is key to cutting transmission and protecting society.”.
In addition, the creation of a multidisciplinary and inter-institutional committee was proposed, integrating health, justice, government and academia, capable of designing specific strategies for each penitentiary center. The final message was unanimous: intervening in prisons is not an isolated or sectorial act; it is an urgent measure for community protection. Because when tuberculosis is controlled inside prisons, the health of neighborhoods, families and entire cities is also taken care of.
