EPIDEMIOLOGICAL PROFILE AND CLINICAL OUTCOMES OF TUBERCULOSIS AMONG THE INCARCERATED POPULATION IN THE STATE OF SÃO PAULO BETWEEN 2014 AND 2024

Tuberculosis is a respiratory-transmitted infectious disease and a public health problem. The incarcerated population is a high-risk group, especially as Brazil has the third largest prison population worldwide. Prison environments, characterized by overcrowding and limited access to healthcare, further exacerbate this condition. This study aimed to analyze the epidemiological profile and clinical outcomes of tuberculosis among incarcerated individuals in São Paulo from 2014 to 2024. A cross-sectional study using data from the Notifiable Diseases Information System (SINAN), linked to DATASUS. Data from 2014–2024 were analyzed, including sociodemographic variables, personal history, clinical aspects, and HIV-TB coinfection. A total of 28,504 tuberculosis cases were identified among the incarcerated population in São Paulo, representing 26.8% of cases nationwide. The highest number occurred in 2017 (3,744 cases; 13.1%). Males accounted for 96.1% (27,402), and the predominant age group was 20–39 years (82.3%). Tobacco use and illicit drug use were reported by 29.1% and 24.2%, respectively. Pulmonary TB was the most frequent form (94%), while pleural TB was the most common extrapulmonary manifestation (1.7%). HIV coinfection was identified in 5.6%. Regarding outcomes, 82.3% were cured, 8.3% abandoned treatment, and 187 deaths due to tuberculosis were recorded. Tuberculosis remains highly prevalent in Brazilian prisons. Although cure rates are high, treatment abandonment remains significant, underscoring the need for routine monitoring. Cooperation between physicians and prison administrators is essential to ensure treatment continuity and follow-up, as failures contribute to transmission, drug resistance, and mortality. Overcoming organizational and political barriers is crucial to implement effective control programs.