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APHA Scientific Session and Event Listing

Recorded presentation

Ilias Almakaev, MD, Brenda Merritt, MD, David Wood, PA, Ellery Tarife, NP, Ray Santaliz, LPN, and Julie Peters, LPN. Medical Department, Project Renewal, Inc., 200 Varick Street, 9th Floor, New York, NY 10014, 917-968-6047, iliasa@earthlink.net

Like most infectious diseases, Tuberculosis (TB) disproportionately affects the homeless population. Project Renewal, a not-for-profit organization dedicated to rehabilitating New York's chronically homeless, operates five primary care clinics, including a mobile medical van (MedVan) that provides care at 15 sites where homeless people congregate in Manhattan and Brooklyn. MedVan is successful because it provides primary care and specialty services to homeless people, the majority of whom are street dwelling, where they are. Part of MedVan's primary care services is TB screening for 100% of clients. We compiled data on prevalence, screening, and follow-up treatment for TB among MedVan's clients—unique, as most data has previously been collected from a sheltered, not street, homeless population. Using cumulative, de-identified data from retrospective chart review, we found that out of 189 clients with TST, 65% returned to have their TST read; 17% of those were new conversions; and 40% of those completed chest x-rays and further investigation within two weeks. Furthermore, 70% of clients whose histories showed positive TST completed chest x-rays. We attribute the success of our TB management to intensive street outreach, in which outreach teams and providers actively seek out individuals who need to complete work-ups. We will share this data, and present this unique pairing of mobile medical services and intensive outreach as a best practices model for screening and treating TB among the homeless. Our next step in TB management is our ScanVan, a mobile radiology unit that will provide chest x-rays immediately, without the need for referrals.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Define the prevalence of TB in a largely street-dwelling, unsheltered homeless population.
• Develop a model for screening, diagnosing, and treating this homeless population for TB.
• Analyze data describing rates of screening and treatment for TB among this homeless population.

Keywords: TB, Homelessness

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation