Large-Scale Screening Approach to Address Tuberculosis in the Prison Context of Rio Grande Do Sul

Tuberculosis (TB) remains one of the main public health challenges in Brazil, with disproportionate impact on the incarcerated population (PPL). Early detection strategies such as mass screening are essential to reduce TB incidence in this context. To describe the process of organizing a mass health screening aimed at early detection of active tuberculosis in a prison unit in the state of Rio Grande do Sul, Brazil. This is an experience report on the planning of a health action carried out in July 2025 in a prison unit in the central region of Rio Grande do Sul (TB incidence 1,884 cases/100,000). The intersectoral intervention was carried out through political articulation between a community university and the state public authority. Actors involved included components of the prison management team, health, security, and social assistance professionals, undergraduate and postgraduate students, and exchange students linked to the educational institution. The screening process was designed with a focus on adaptability to the prison environment and included: planning meetings with all stakeholders, team training, development of educational materials and operational workflows, mobilization of the incarcerated population, application of epidemiological questionnaires, portable chest X-Rays, automated image analysis using artificial intelligence (AI), and sputum sample collection for confirmatory diagnosis using a rapid molecular test. The organizational phase enabled construction of a feasible operational model for prison units, considering security routines, internal mobility, participant confidentiality, and integration between health and security. The screening covered the incarcerated population, strengthening collective care. A total of 650 incarcerated individuals were assisted by the project over a period of 10 working days, enabling early diagnosis of tuberculosis. The experience showed that advance organization with participatory planning was essential to ensure adherence, operational flow, and integration among the various actors of the prison system. The initiative reinforces the role of early detection in addressing tuberculosis, promoting equitable access to health and contributing to reducing inequalities.