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    Prisons and the tuberculosis epidemic in Russia

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    A resurgence of tuberculosis (TB) occurred in Russia in the 1990s, in a period of general health crisis following the break-up of the Soviet Union. Inter-related increases in poverty, unemployment and unhealthy lifestyle probably contributed to increased incidence and mortality from TB among the civilian population. The number of prisoners increased dramatically in the 1990s and many come from socially marginalized groups at high risk of TB. There is a high prevalence of TB in prisons in Russia, with inadequate TB control measures, overcrowding and poor nutrition contributing to the problem. Many prisoners are released before completion of treatment, often into a social milieu that fosters transmission of TB. Prisoners and ex-prisoners account for a very high proportion of TB cases in Russia and without adequate treatment for them the epidemic is unlikely to be brought under control. © 2003 John Wiley & Sons, Ltd.