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[Pneumonia among the homeless].

T Kashiyama1, A Takechi, H Kimura

  • 1Department of Medicine, Tokyo Metropolitan Okubo Hospital.

Kansenshogaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
|September 16, 1999
PubMed
Summary
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Homeless individuals in Japan experience severe non-tuberculous lung infections, particularly pneumococcal pneumonia. This study highlights a high morbidity and mortality rate for pneumonia in this vulnerable population.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Limited research exists on non-tuberculous lung infections in Japan's homeless population.
  • Tuberculosis is studied, but other pneumonias are under-analyzed in this demographic.

Observation:

  • A retrospective study analyzed 20 homeless patients (19 male, 1 female, average age 56) admitted with pneumonia between 1993-1996.
  • Patients often presented with respiratory failure and severe comorbidities (gastrointestinal, liver, cerebrovascular diseases), frequently admitted during winter via ambulance.
  • Lobar pneumonia was observed in 40% of cases via chest X-ray.

Findings:

  • Microbial agents were identified in 70% of patients, with Streptococcus pneumoniae (pneumococcus) accounting for 80% of identified pathogens.

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  • Despite intensive care, the mortality rate was high at 30% (6 out of 20 patients).
  • Pneumococcal pneumonia showed significantly higher morbidity and mortality compared to general population data in Japan.
  • Implications:

    • This study underscores the critical need for targeted public health interventions and improved healthcare access for the homeless population in Japan.
    • Enhanced preventative strategies and prompt treatment for pneumonia are crucial to reduce mortality in this high-risk group.
    • Further research into the specific factors contributing to high pneumonia rates and mortality among the homeless is warranted.