Reducing the spread of tuberculosis in the homeless population

Tuberculosis (TB) is an old infectious disease that has re-emerged in recent years and is responsible for many deaths throughout the world. Homeless people residing in shelters and hostels within inner city areas of the UK and the USA are at risk from this serious disease. Interventions to control the spread of TB are described in the literature researched; these include the introduction of inducements to encourage participation in screening programmes and the recommendation of directly observed therapy. The literature reflects the partial success of these programmes in the UK and USA. Targeting homeless persons most at risk is challenging as is gaining accurate information on those who are affected by TB. Effective coordination of care by healthcare providers in hospital and the community is imperative. It appears that healthcare professionals are becoming more prescriptive in their approach which is relinquishing the homeless population from taking responsibility for their own health care.