Entre grades e iniquidades: o racismo como fator determinante no tratamento da tuberculose no sistema prisional brasileiro

Abstract

Introduction: Tuberculosis (TB) is an infectious disease with a high incidence of cases mainly in vulnerable populations, especially people deprived of their liberty (PPL). Although curable, TB continues to be one of the main causes of death from infectious diseases, exacerbated by factors such as immunosuppression, precarious conditions and structural racism. Objective: To map and identify the scientific evidence on racism in the outcome of TB treatment in the poor. Methodology: This is a scoping review guided by the recommendations of the Joan Briggs Institute (JBI) and structured according to the PRISMA-ScR roadmap, in studies published between 2014 and 2024. The search was carried out in six databases: MEDLINE/PUBMED, EMBASE, SCOPUS, WEB OF SCIENCE, COCHRANE LIBRARY and LILACS. The review strategy followed the PCC (Population, Concept, Context) approach, focusing on PPL, the impact of race/color and TB treatment outcomes. Results: The search in the six electronic databases resulted in 529 studies, including 27 articles in MEDLINE via PubMed, 89 articles in EMBASE, 73 articles in SCOPUS, 36 articles in Web of Science, 119 articles in the Cochrane Library and 185 articles in LILACS. Of these, 143 were excluded due to duplication, and 386 articles went forward to the selection phase. As a result, 79 studies progressed to the eligibility phase, of which 7 were included in the analysis. Discussion: Structural racism intensifies the vulnerability and negative outcomes of TB in the poor, mainly affecting black, people living in precarious conditions. The adoption of anti-racist policies is essential to promote equity in access to diagnosis, treatment and follow-up of the disease, contributing to the reduction of disparities and improvement in clinical outcomes.