BACKGROUND: In this study we analyzed attributes, risk factors and incidence of homeless tuberculosis (TB) patients in the Harris County (Houston), Texas from 10/1/1995 to 9/30/1999.
METHODS: Demographic, clinical and laboratory data were collected during a prospective population-based TB surveillance project. During the study, 1884 patients were interviewed, of which 1716 (91.1%) were adults. M. tuberculosis (MTB) isolates on 1413 (82.3%) adults were molecularly characterized.
RESULTS: Of 1716 cases, 1343 (78.3%) lived in homes, 340 (19.8%) had a history of homelessness, 22 (1.3%) were single room occupants and 11(0.6%) had an unknown residential history. Homeless adults were more likely than home-dwellers to be single (P<0.001), male (P<0.001), black (P<0.001) or white (P<0.001), US-born (P<0.001), had military service(P<0.001), and a history of incarceration (P<0.001). Hispanics (P<0.001) and Asians (P<0.001) were less likely to be homeless. Homeless individuals were more likely to be clustered (P<0.001), have pulmonary TB (P<0.001), HIV+ (P<0.001) and less likely to be skin test positive (P<0.01). Homeless adults were more likely to be current smokers (P<0.001), alcohol consumers (P<0.001), have a drug use history (P<0.001) and shared needles (P<0.001). There was no significant decrease in TB incidence among homeless versus home-dwellers over time. Molecular characterization identified a significant proportion of MTB clones circulating among the homeless in a few Houston shelters.
CONCLUSION: Though TB incidence over the study period decreased, TB among the homeless did not significantly decrease in Houston. Our data provide a comprehensive picture of TB transmission dynamics among adults with a history of homelessness.
Learning Objectives: N/A
Keywords: TB, Homelessness
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.