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133rd Annual Meeting & Exposition
December 10-14, 2005
Masashi Kizuki, MD, MPH1, Takehito Takano, MD, PhD1, Keiko Nakamura, MD, PhD1, Yoshiharu Fukuda, MD, PhD1, Masafumi Watanabe, MD1, Kaoruko Seino, MS1, Tomoko Inose, MS1, and Yoshiko Kawabe, MD, PhD2. (1) Health Promotion/International Health, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, Japan, 81-358035190, email@example.com, (2) Tokyo National Hospital, 3-1-1 Takeoka, Kiyose, Tokyo, Japan
There are an estimated 5,500 “homeless” people in Tokyo: they are 57 years old on average. Tokyo's annual incidence of tuberculosis, 32.7 per 100,000 population in 2003, was higher than the national average. Morbidity of tuberculosis among “homeless” is greater than that among general population. “Homeless” patients frequently default from tuberculosis therapy. Therefore, effective measures to manage these cases are required. To determine the social courses of “homeless” tuberculosis patients after discharge, we followed up 96 fragile living patients, including the “homeless”, discharged from a tuberculosis hospital in Tokyo, 1998-2000. Data of the patients' characteristics, clinical findings, the results of drug susceptibility tests and follow up information were obtained by review of records or interviews with health facilities. Number of cases of ordinary discharge, transfer, and forced or voluntary discharge were 58, 24 and 14. The percentages of primary and acquired resistance were 15.0% and 50.0%, respectively. 13.8% of ordinary discharged cases interrupted therapy. 12.5% of transferred cases had not completed therapy. 71.4% of cases of forced or voluntary discharge left out the tuberculosis patient roster administered by a law, without completion of the therapy. These people were likely to continue their living in communities without contacts to public health and welfare services. Directly observed therapy, short-course (DOTS) has been implemented in most of the tuberculosis hospitals. Several DOTS programs provided by public health service facilities have begun to target on patients in the communities including homeless people. Urban tuberculosis control strategies should consider fragile living patients.
Keywords: Homeless, Tuberculosis
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA