Tuberculosis among the homeless people of Nagoya, Japan

A survey was conducted in order to clarify the tuberculosis (TB) situation in the homeless during the period from 1982 to 1991 in an urban district of Nagoya, using the registration cards of pulmonary TB patients and the data of chest roentgenograms of the Nagoya City Nakamura Health Centre. The incidence and prevalence of pulmonary TB per 100,000 among the homeless were estimated at 950-2150 and 1900-3250, respectively, which were around 30 and 20 times higher than those for the non-homeless. An increase in the incidence rate among homeless pulmonary TB patients was found in 1989, after a gradual decrease to the year 1988. The detected prevalence rate by chest examinations of the homeless was also around 30 times higher than that for the non-homeless. The percentage of patients with cavities indicated by chest roentgenograms when they were first registered was 76.9% among the homeless, but only 42.9% among the non-homeless.