Tuberculosis Containment among the Homeless in Metropolitan Jackson, Mississippi

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Social Determinants of Health

Background:

• Preventing tuberculosis (TB) among homeless populations presents significant public health challenges.
• A 2008-2009 TB outbreak in metropolitan Jackson, Mississippi, highlighted the difficulties in controlling infectious diseases within this demographic.

Purpose of the Study:

• To assess a tuberculosis (TB) outbreak and subsequent prevention strategies among homeless individuals in metropolitan Jackson, Mississippi.
• To identify key factors contributing to TB transmission and evaluate the effectiveness of implemented control measures.

Main Methods:

• Comparative analysis of TB cases and latent TB infections (LTBI) during outbreak and post-outbreak periods.
• Interviews with affected homeless individuals, site visits to shelters, and literature reviews on homelessness and infectious diseases.
• Evaluation of existing TB prevention methods, CDC guidelines, and recommendations for applicability to the Jackson area.

Main Results:

• Outbreak contributors included lack of periodic TB screening, poor treatment compliance, interrupted preventive measures for incarcerated individuals, inadequate shelter environmental controls (ventilation, UV light), high costs of isolation housing, transportation barriers, insufficient staff training, and the overarching issue of homelessness.
• The Mississippi State Department of Health TB Program, with CDC assistance, contained the outbreak by late 2009, leading to decreased TB rates.

Conclusions:

• Sustained adherence to TB prevention measures in shelters and correctional facilities is paramount.
• Effective strategies include regular staff training, ongoing screening and follow-up for homeless individuals and inmates, and improved environmental sanitation, ventilation, and UV light implementation.