4309.0: Tuesday, November 14, 2000 - 9:30 PM

Abstract #4587

Screening and treatment for infection and disease as a tuberculosis control measure among homeless population in Orlando, Florida

Enrique Terol, Boubker Nauri, and Luc Germain. TB Department, Orange County Health Department, 832 W. Central Blvd, Orlando, FL 32805, (407) 836-7143, Enrique_Terol@doh.state.fl.us

SETTING: Long term resident homeless housing agency in Orlando OBJECTIVE: To determine the utility of tuberculosis screening as a preventive and control measure among homeless population. DESIGN: Persons living in a homeless housing agency were screened, and those with a positive skin test or symptoms suggestive of active tuberculosis (TB) were referred to the TB clinic for evaluation. MAIN OUTCOME MEASURES: Prevalence of TB infection. Compliance with screening, treatment and health education procedures. RESULTS: Of the 99 persons evaluated, 43 (43%) had one or more risk factors to develop TB of which HIV infection was the most frequent condition. 69 (70%) received a tuberculosis skin test (TST) with a compliance with the procedure of 95 percent. Of the 30 (30%) left, one (1%) patient refuse to be screened, 17 (17%) were TST already tested in the last 6 months and 11 (11%) were previous TST positive. Twenty-five (36%) of the screened cohort were TST positive and 20 patients were evaluated by chest x-ray to rule out TB. Seven fit current guidelines for treatment of latent tuberculosis infection (LTBI) and 6 were given isoniazid and are still complaint with treatment. CONCLUSION: Targeted testing and treatment of LTBI will increase in importance as strategy to prevent tuberculosis among high-risk communities. However, for community-based programs to be efficacious, organizational issues will include the need for active coordination with community leaders and managers of high-risk settings, tracking system for clinical follow-up and for incentives to promote adherence.

Keywords: Homeless Health Care, Tuberculosis

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA