Tackling Tuberculosis in Latvia

0380 With a forceful gesture, the delicate blond unlocks the heavy door of a cell in Riga’s Central Prison clinic (Figure 1). Her name is Dr. Inga Nagele. She is the head of the clinic’s tuberculosis (TB) unit. She opens the door to check on three female prisoners who have just been admitted. The conditions in the cell are bleak. Washing hangs on a line that stretches from one wall to the other. The bars on the small window hardly let any light into the room, and a bucket in the corner serves as a toilet. All the women were infected with TB at the prison. “Living conditions in Latvia’s prisons are miserable. This is ideal for a relentless spread of the life-threatening lung bacteria and other communicable diseases”, says Dr. Nagele. Because of permanent overcrowding, poor hygiene, and frequent relocation of prisoners within Latvia’s 15 prisons, two-thirds of inmates infected with TB developed the disease once they were locked up, she says. Latvia has 352 prisoners per 100 000 individuals in the population [1]. This number makes it one of the countries with the highest proportion of prisoners in the European Union, according to Mihails Azarenko, Chief of Riga’s Central Prison. It is particularly high when compared with Denmark, for example, which has only 64 prisoners per 100 000 individuals [1].