Tuberculosis in prisons in sub-Saharan Africa – a potential time bomb

The World Health Organization (WHO) estimates that there are 10 million new cases of tuberculosis (TB) reported worldwide each year, and 1.7 million people die from the disease. The incidence of TB in sub-Saharan Africa (SSA) remains very high at over 300 new cases of TB per 100 000 population in 2007. The TB epidemic in SSA is fuelled by the HIV epidemic, and up to 70% of adults with TB are co-infected with HIV. There are few data on drug-resistant TB from SSA, probably owing to poor TB programme performance, inadequate laboratory facilities for drug susceptibility testing (DST), and poor surveillance, data collection and reporting procedures. The WHO estimated that 69 000 cases of MDR-TB emerged in 2008 in Africa, which is most probably an underestimate