Patterns and Treatment Timelines of Tuberculosis in Males From Ecuador’s Largest Prison

Abstract

The analysis of tuberculosis (TB) registers in prisons provides insights into TB transmission and highlights conditions that increase susceptibility. This study aims to characterize TB patient surveillance in Ecuador’s largest male penitentiary over the course of 3 years. Using national TB administrative records from January 1, 2017, to December 31, 2019, we calculated five operational indicators. In addition, the number of clinical consultations (register entries) per patient over the 3 years was calculated. The linkage process involved merging data from the administrative files to create a new dataset using encrypted tokens as the linking variables. Data merging yielded 6,560 records and enabled analysis of 645 symptomatic patients, 427 with confirmed TB. Of these, 82.9% had two to six records, and 88.9% maintained the same diagnosis. Among those with diagnostic changes, 38.5% converted from Ziehl–Neelsen negative to positive after 6 months. The median time to diagnosis was 0 days (range 0–12); and to treatment, 13 days (range 0–652). Treatment outcomes were available for 353 of 427 patients (82.7%), with a success rate of only 65.2% and a fatality rate of 0.8%. These results highlight surveillance challenges and the need for improving TB prevention and control in prisons.