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In this Policy Forum piece, Aditya Narayan and colleagues discuss the challenges and opportunities for tuberculosis preventive treatment in carceral settings., Competing Interests: The spouse of SS was employed by Merck Pharmaceuticals 1997-2007 and retains stock in his retirement account. There is no conflict of interest with the submitted work, but is included in the interest of full disclosure. The other authors have declared that no competing interests exist., (Copyright: © 2023 Narayan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The number of tuberculosis (TB) cases in prisons is higher than that in the general population and has been reported as the most common cause of death in prisons. This study evaluated the delay in the diagnosis and treatment of TB in Brazilian prisons., Methods: A retrospective cohort study was conducted between 2007 and 2015 using data from the five largest male prisons in Mato Grosso do Sul, Brazil. TB case data was collected from the National Database of Notifiable Diseases (SINAN), GAL-LACEN, and prison medical records. The following variables were recorded: prison, year of diagnosis, age, race, education, HIV status, smoking status, comorbidities, number of symptoms, percentage of cures, delay in diagnosis, patient delay, provider delay, laboratory delay, and delay in treatment. Descriptive statistics were used for the variables of interest., Results: A total of 362 pulmonary TB cases were identified. The average time between the first symptom and reporting of data was 94 days. The mean time between symptom onset and laboratory diagnosis was 91 days. The average time from symptom onset to first consultation was 80 days. The time between diagnosis and treatment initiation was 5 days., Conclusions: Delays were significant between reporting of the first symptoms and diagnosis and significantly smaller from the time between notification and start of treatment. Control strategies should be implemented to diagnose cases through active screening, to avoid delays in diagnosis and treatment, and to reduce TB transmission.

Objectives: to analyze government social initiatives aimed at people with tuberculosis and the possibilities of access to government social programs and income transfers through the perception of tuberculosis program managers., Methods: descriptive, qualitative study with 19 managers from Belém, Recife, Campo Grande, and Rio de Janeiro, Brazil. Thematic content analysis was used., Results: there is no specific government social support for people with tuberculosis; the benefits are intended for people in social vulnerability. There are partnerships between the institutions of the secondary social healthcare network, social assistance, and community institutions., Final Considerations: the support of official bodies is important for the control of tuberculosis; however, the profile of people's vulnerability is a determining factor for access to/destination of resources from these government social support programs.