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Infections in the homeless.

D Raoult1, C Foucault, P Brouqui

  • 1Unité des Rickettsies, Université de la Méditerranée, Faculté de Médecine, and Hĵpital Nord Service des Maladies Infectieuses et Tropicales, Marseille, France. Didier.Raoult@medecine.univ-mrs.fr

The Lancet. Infectious Diseases
|March 2, 2002
PubMed
Summary

Homeless individuals face heightened risks for infectious diseases like tuberculosis and HIV due to living conditions. Addressing these health challenges requires awareness of prevalent skin and foot disorders, and treatment barriers.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Dermatology

Background:

  • Homeless populations in developed nations exhibit unique vulnerabilities to infectious diseases.
  • Respiratory infections, tuberculosis, and aerosol-transmitted diseases are frequently reported.
  • Intravenous drug use among the homeless increases the risk of HIV and hepatitis B and C infections.

Purpose of the Study:

  • To outline the spectrum of infectious diseases prevalent in homeless populations.
  • To highlight common dermatological and podiatric conditions encountered.
  • To discuss challenges in treating this demographic and emphasize physician awareness.

Main Methods:

  • Review of reported infectious diseases and conditions in homeless individuals.
  • Identification of common skin and foot disorders.

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  • Analysis of treatment barriers and recommendations for care.

    • Main Results:

    • High prevalence of respiratory infections, tuberculosis, HIV, hepatitis B/C, and skin/foot disorders (scabies, ulcers, cellulitis).
    • Emergence of Bartonella quintana infections (urban trench fever, bacillary angiomatosis).
    • Treatment is complicated by financial issues, self-neglect, and poor adherence.

    Conclusions:

    • Homeless individuals are disproportionately affected by infectious diseases, necessitating targeted public health strategies.
    • Dermatological and podiatric conditions are primary reasons for seeking care and require specific management.
    • Effective care requires addressing socioeconomic barriers and ensuring physician awareness of unique patient needs.