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Tuberculosis skin testing among homeless adults
L Gelberg1, C J Panarites, H Morgenstern
1Division of Family Medicine, UCLA School of Medicine 90095-1683, USA.
Journal of General Internal Medicine
|January 1, 1997
Summary
Homeless adults in Los Angeles show high tuberculosis (TB) skin test positivity, especially in crowded inner-city areas. Risk factors include crowded shelters, long-term homelessness, and psychiatric history.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Tuberculosis (TB) remains a significant global health concern.
- Homeless populations often face increased risks for infectious diseases due to living conditions and healthcare access.
- Understanding TB prevalence and risk factors in this demographic is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of tuberculosis (TB) skin test positivity among homeless adults in Los Angeles.
- To identify specific characteristics of homelessness that act as risk factors for TB.
Main Methods:
- A cross-sectional study was conducted.
- A representative sample of 260 homeless adults was recruited from shelters, soup kitchens, and outdoor locations in Los Angeles' Skid Row and Westside areas.
- Tuberculosis tine test reactivity was measured.
Main Results:
- The overall prevalence of TB skin test positivity was 32%.
- Prevalence varied significantly by geographic area: 40% in inner-city Skid Row versus 14% in suburban Westside.
- Risk factors identified through logistic regression included crowded shelter conditions, long-term homelessness, geographic area, psychiatric hospitalization history, and age.
Conclusions:
- Homeless adults residing in densely populated inner-city areas face a high risk of both latent and active TB.
- Congested living conditions and limited medical access highlight the need for aggressive TB treatment and innovative prophylactic programs for latent infections in this population.