Tuberculosis among the homeless: should we change the strategy?
BACKGROUND: Tuberculosis (TB) is a major concern among high-risk populations such as the homeless. OBJECTIVES: To evaluate TB incidence and treatment outcomes among homeless patients in Portugal and to identify predictors of unsuccessful TB treatment outcomes among the homeless. DESIGN: This was a r...
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Online Access: | http://hdl.handle.net/10216/111792 https://doi.org/10.5588/ijtld.16.0597 |
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ftunivporto:oai:repositorio-aberto.up.pt:10216/111792 2023-06-18T03:41:25+02:00 Tuberculosis among the homeless: should we change the strategy? Dias, M Gaio, R Sousa, P Abranches, M Gomes, M Correia-Neves, M Ferreira, E Duarte, R Instituto de Saúde Pública 2017 application/pdf http://hdl.handle.net/10216/111792 https://doi.org/10.5588/ijtld.16.0597 eng eng International Union Against Tuberculosis and Lung Disease Int J Tuberc Lung Dis, vol. 21(3), p. 327-332 http://www.ingentaconnect.com/content/iuatld/ijtld/2017/00000021/00000003/art00016 1027-3719 http://hdl.handle.net/10216/111792 doi:10.5588/ijtld.16.0597 info:eu-repo/semantics/openAccess Homelessness Tuberculosis info:eu-repo/semantics/article 2017 ftunivporto https://doi.org/10.5588/ijtld.16.0597 2023-06-06T21:59:50Z BACKGROUND: Tuberculosis (TB) is a major concern among high-risk populations such as the homeless. OBJECTIVES: To evaluate TB incidence and treatment outcomes among homeless patients in Portugal and to identify predictors of unsuccessful TB treatment outcomes among the homeless. DESIGN: This was a retrospective cohort study of all TB patients notified in Portugal from 2008 to 2014. Characteristics of homeless TB patients were assessed and predictors of unsuccessful TB treatment were determined using logistic regression. RESULTS: TB incidence among the homeless was 122/100 000 homeless persons and was positively correlated with TB incidence among non-homeless persons. Homeless TB patients had a higher prevalence of alcohol and/or drug use, human immunodeficiency virus (HIV) co-infection, cavitary TB and smear positivity. The rate of unsuccessful treatment outcomes among the homeless was 28.6%, and was significantly associated with increased age, injection drug use (IDU) and HIV co-infection. CONCLUSION: TB incidence among homeless persons was five times that among the non-homeless, and higher in regions with greater TB incidence among non-homeless persons. The successful treatment outcome rate was lower. Predictors of unsuccessful treatment were age, IDU and HIV co-infection. Integrated TB programmes targeting homeless and non-homeless patients, with measures targeting specific characteristics, may contribute to TB elimination in Portugal. This work was supported by contributions from Iceland, Liechtenstein and Norway through the European Economic Area Grants under the Public Health Initiatives Programme (PT 06, grant number 138DT1). RG was also partially supported by Centro de Matemática da Universidade do Porto (UID/MAT/00144/2013), which is funded by Fundaçãodo Ministério de Ciência e Tecnologia (Portugal) with national (MEC) and European structural funds (Fonds europeen de developpement economique et regional) under the PT2020 Partnership Agreement. Article in Journal/Newspaper Iceland Repositório Aberto da Universidade do Porto Norway The International Journal of Tuberculosis and Lung Disease 21 3 327 332 |
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Open Polar |
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Repositório Aberto da Universidade do Porto |
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ftunivporto |
language |
English |
topic |
Homelessness Tuberculosis |
spellingShingle |
Homelessness Tuberculosis Dias, M Gaio, R Sousa, P Abranches, M Gomes, M Correia-Neves, M Ferreira, E Duarte, R Tuberculosis among the homeless: should we change the strategy? |
topic_facet |
Homelessness Tuberculosis |
description |
BACKGROUND: Tuberculosis (TB) is a major concern among high-risk populations such as the homeless. OBJECTIVES: To evaluate TB incidence and treatment outcomes among homeless patients in Portugal and to identify predictors of unsuccessful TB treatment outcomes among the homeless. DESIGN: This was a retrospective cohort study of all TB patients notified in Portugal from 2008 to 2014. Characteristics of homeless TB patients were assessed and predictors of unsuccessful TB treatment were determined using logistic regression. RESULTS: TB incidence among the homeless was 122/100 000 homeless persons and was positively correlated with TB incidence among non-homeless persons. Homeless TB patients had a higher prevalence of alcohol and/or drug use, human immunodeficiency virus (HIV) co-infection, cavitary TB and smear positivity. The rate of unsuccessful treatment outcomes among the homeless was 28.6%, and was significantly associated with increased age, injection drug use (IDU) and HIV co-infection. CONCLUSION: TB incidence among homeless persons was five times that among the non-homeless, and higher in regions with greater TB incidence among non-homeless persons. The successful treatment outcome rate was lower. Predictors of unsuccessful treatment were age, IDU and HIV co-infection. Integrated TB programmes targeting homeless and non-homeless patients, with measures targeting specific characteristics, may contribute to TB elimination in Portugal. This work was supported by contributions from Iceland, Liechtenstein and Norway through the European Economic Area Grants under the Public Health Initiatives Programme (PT 06, grant number 138DT1). RG was also partially supported by Centro de Matemática da Universidade do Porto (UID/MAT/00144/2013), which is funded by Fundaçãodo Ministério de Ciência e Tecnologia (Portugal) with national (MEC) and European structural funds (Fonds europeen de developpement economique et regional) under the PT2020 Partnership Agreement. |
author2 |
Instituto de Saúde Pública |
format |
Article in Journal/Newspaper |
author |
Dias, M Gaio, R Sousa, P Abranches, M Gomes, M Correia-Neves, M Ferreira, E Duarte, R |
author_facet |
Dias, M Gaio, R Sousa, P Abranches, M Gomes, M Correia-Neves, M Ferreira, E Duarte, R |
author_sort |
Dias, M |
title |
Tuberculosis among the homeless: should we change the strategy? |
title_short |
Tuberculosis among the homeless: should we change the strategy? |
title_full |
Tuberculosis among the homeless: should we change the strategy? |
title_fullStr |
Tuberculosis among the homeless: should we change the strategy? |
title_full_unstemmed |
Tuberculosis among the homeless: should we change the strategy? |
title_sort |
tuberculosis among the homeless: should we change the strategy? |
publisher |
International Union Against Tuberculosis and Lung Disease |
publishDate |
2017 |
url |
http://hdl.handle.net/10216/111792 https://doi.org/10.5588/ijtld.16.0597 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
Int J Tuberc Lung Dis, vol. 21(3), p. 327-332 http://www.ingentaconnect.com/content/iuatld/ijtld/2017/00000021/00000003/art00016 1027-3719 http://hdl.handle.net/10216/111792 doi:10.5588/ijtld.16.0597 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.5588/ijtld.16.0597 |
container_title |
The International Journal of Tuberculosis and Lung Disease |
container_volume |
21 |
container_issue |
3 |
container_start_page |
327 |
op_container_end_page |
332 |
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1769006977519714304 |