Tuberculosis among homeless shelter residents

Article Abstract:

Eleven residents of a homeless shelter in Cincinnati were diagnosed with tuberculosis (TB). Seven had the bacterium in their sputum, indicating that they were infectious. In Columbus, a homeless man previously diagnosed with TB was found to have a positive sputum smear. A survey of men in the shelter where he stayed found that 40% (32 out of 81) reacted to a tuberculin skin test. Seven of the 27 staff members also reacted to the test. A survey of 95% of the shelters and soup kitchens in the city found that 22% (47 out of 210) of the residents and 11% (nine out of 85) of the staff reacted to the skin test. Shelters may increase the transmission of TB because they are often crowded and not well ventilated. Many residents may be HIV-infected or drug abusers, which may increase their risk of becoming infected. Measures for controlling the spread of TB in homeless shelters are described.

Homeless shelters

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Tuberculosis and HIV infection in sub-saharan Africa

Article Abstract:

Individuals infected with HIV in sub-Saharan Africa have a higher risk of developing tuberculosis than other individuals. A survey of the medical literature found that 20% to 67% of the tuberculosis patients in East, West, Central and Southern Africa are infected with HIV. An increase in the number of patients with tuberculosis coincided with the HIV epidemic in several African countries. Tuberculosis patients infected with HIV are more likely to experience extreme weight loss, diarrhea and lymph node involvement than those who are not infected with HIV. Patients infected with HIV are also more likely to have tuberculosis outside the lungs or tuberculous meningitis than those who are not. The same types of drugs can be used to treat tuberculosis patients infected with HIV and those who are not, but HIV-positive patients are more likely to have drug-resistant tuberculosis.

Complications and side effects, HIV patients

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Protease inhibitors in the homeless

Article Abstract:

It may be appropriate to treat homeless HIV patients if they are stable and have no other medical problems. Many physicians believe that homeless people will not comply with treatments. This has been shown in homeless people with tuberculosis. However, compliance can be improved by techniques such as directly observed therapy. Homeless HIV patients should first be properly housed and have a primary care physician. They should first be treated for tuberculosis if necessary and receive prophylaxis for any opportunistic infections. Only then should antiretroviral treatment be offered.

Drug therapy, Protease inhibitors

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