米国における結核とホームレス,1994年~2003年
Maryam B Haddad1, Todd W Wilson, Kashef Ijaz
1Surveillance, Epidemiology, and Outbreak Investigations Branch, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA. maryam.haddad@cdc.hhs.gov
JAMA
|June 9, 2005
まとめ
ホームレス状態は結核 (TB) と関連しています. 課題にもかかわらず,TBのホームレスの人々は,良好な症例管理で優れた治療結果を達成することができ,TB症例の安定した年間比率を示しています.
科学分野:
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
- 感染症 感染症とは
背景:
- 米国のホームレス集団の結核 (TB) 率は,米国国勢調査データから除外されているため,正確に計算できません.
- ホームレス状態は,しばしば結核のリスクの増加と関連しています.
研究 の 目的:
- 結核を患っているホームレスを経験している個人を特徴付けるため.
- ホームレスと非ホームレスの人口の間で結核の危険因子と疾患の特徴を比較する.
主な方法:
- 国立結核監視システム (1994-2003) から確認された結核症例を使用して,横断的な分析が行われました.
- データには,人口統計的特徴,危険因子,疾患の発現,治療,およびホームレスおよびホームレスでない結核患者のアウトカムが含まれていました.
主要な成果:
- 1994年から2003年にかけて,185,870人の結核患者の6.1%~6.7%がホームレスと関連していた.
- 結核を患ったホームレスの個人は,男性,高齢,薬物使用障害,HIV併感染の可能性が高くなりました.
- ホームレスの人たちの結核はより感染性だったが,薬剤耐性ではなかった. 特に直接観察療法では,非ホームレスの人たちと同じ結果だった.
結論:
- 結核のリスク要因は,しばしばホームレスになるリスク要因と重なり,結核管理における社会的文脈の重要性を強調しています.
- 効果的な症例管理と直接観察された治療は,ホームレス集団における結核治療の成功に不可欠です.
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