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J Epidemiol Community Health. 1995 December; 49(6): 629–633.
PMCID: PMC1060180

Tuberculosis among the homeless at a temporary shelter in London: report of a chest x ray screening programme.


STUDY OBJECTIVE--To estimate the prevalence of active pulmonary tuberculosis in a homeless population in London and to assess whether those with suspected disease could be integrated into the existing health care system for further follow up and treatment. DESIGN--Voluntary screening programme based on a questionnaire survey and chest x ray. SETTING AND CASES--Screening programmes were set up over the Christmas period in 1992 and 1993 at a shelter for the homeless in London. An offer of screening was made to all individuals who visited the centre and an interviewer administered questionnaire was completed on those who volunteered for the screening. Chest x rays were carried out, developed, and read on site. Individuals with chest x rays features suggestive of tuberculosis or other medical problems were referred to a hospital of their choice. RESULTS AND OUTCOME--In 1992 nearly 1600 people visited the centre, of whom 372 volunteered for the screening and 342 were x rayed. Nineteen of the 342 (5.6%) had radiological features suggestive of active tuberculosis. In 1993 around 2000 homeless people visited the centre, of whom 270 volunteered for the screening and 253 were x rayed. Eleven (4.3%) had features consistent with active tuberculosis on the basis of the chest x rays and clinical examination by a chest physician. Overall, of 595 people x rayed in the two surveys, 30 (5%) had changes suggestive of active tuberculosis. Further investigations confirmed nine (1.5%) with active pulmonary disease and eight with no active tuberculosis. In 13, the diagnosis was not determined as four declined further investigation and nine did not attend their hospital appointment. CONCLUSION--Tuberculosis among the homeless remains a cause for concern. Follow up and treatment present unique difficulties. Services for the homeless need to include mechanisms for timely diagnosis and monitored treatment. Control programmes designed for the needs of the homeless are required.

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Bibliographie sélective

Ces références figurent dans PubMed. Il se peut que la bibliographie de l'article soit plus exhaustive.
  • Watson JM. Tuberculosis in Britain today. BMJ. 1993 Jan 23;306(6872):221–222. [PMC free article] [PubMed]
  • Nolan CM, Elarth AM, Barr H, Saeed AM, Risser DR. An outbreak of tuberculosis in a shelter for homeless men. A description of its evolution and control. Am Rev Respir Dis. 1991 Feb;143(2):257–261. [PubMed]
  • Paul EA, Lebowitz SM, Moore RE, Hoven CW, Bennett BA, Chen A. Nemesis revisited: tuberculosis infection in a New York City men's shelter. Am J Public Health. 1993 Dec;83(12):1743–1745. [PubMed]
  • Torres RA, Mani S, Altholz J, Brickner PW. Human immunodeficiency virus infection among homeless men in a New York City shelter. Association with Mycobacterium tuberculosis infection. Arch Intern Med. 1990 Oct;150(10):2030–2036. [PubMed]
  • Zolopa AR, Hahn JA, Gorter R, Miranda J, Wlodarczyk D, Peterson J, Pilote L, Moss AR. HIV and tuberculosis infection in San Francisco's homeless adults. Prevalence and risk factors in a representative sample. JAMA. 1994 Aug 10;272(6):455–461. [PubMed]
  • Pablos-Mendez A, Raviglione MC, Battan R, Ramos-Zuniga R. Drug resistant tuberculosis among the homeless in New York City. N Y State J Med. 1990 Jul;90(7):351–355. [PubMed]
  • Fisher N, Turner SW, Pugh R, Taylor C. Estimating numbers of homeless and homeless mentally ill people in north east Westminster by using capture-recapture analysis. BMJ. 1994 Jan 1;308(6920):27–30. [PMC free article] [PubMed]
  • Capewell S, France AJ, Anderson M, Leitch AG. The diagnosis and management of tuberculosis in common hostel dwellers. Tubercle. 1986 Jun;67(2):125–131. [PubMed]
  • Patel KR. Pulmonary tuberculosis in residents of lodging houses, night shelters and common hostels in Glasgow: a 5-year prospective survey. Br J Dis Chest. 1985 Jan;79(1):60–66. [PubMed]
  • Stevens A, Bickler G, Jarrett L, Bateman N. The public health management of tuberculosis among the single homeless: is mass miniature x ray screening effective? J Epidemiol Community Health. 1992 Apr;46(2):141–143. [PMC free article] [PubMed]
  • Schieffelbein CW, Jr, Snider DE., Jr Tuberculosis control among homeless populations. Arch Intern Med. 1988 Aug;148(8):1843–1846. [PubMed]

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