[Detection of tuberculosis in homeless persons and their sociopsychological characteristics]

Homeless patients with tuberculosis form a special group. Being out of therapeutical-and-prophylactic institutions sight and violating elementary sanitary regulations, they are, from an epidemic standpoint, the most dangerous part of a tuberculosis reservoir. Tuberculosis morbidity rates in the homeless are extremely high and tens times as great as those among other populations. The existing system for detecting tuberculosis among the homeless is not very effective. Much better results are achieved by nongovernmental philanthropic institutions where homeless persons apply to for medical and social aids. About half the homeless patients with tuberculosis were referred to Tuberculosis Hospital 11 of the International Organization "Physicians Without Boundaries". The patient's personality is, in general, the most vivid terms, characterized as asthenic; with low intelligence and constitution; asocial, aggressive, and being a carrier of the motive of acquired helplessness. This group of patients needs not only medical efforts, but sociolegal and sociopsychological rehabilitation. The activities of Tuberculosis Hospital 11 wherein a room of social aid and rehabilitation has been functioning since 1995 may be an example of a comprehensive approach to tackling the problem of homeless patients with tuberculosis.