PurposeHomeless persons have a high risk for tuberculosis. The prevalence of latent tuberculosis infection and the risk for a progression to active tuberculosis is higher in the homeless than in the general population. The objective was to assess the prevalence and risk factors of tuberculosis/latent tuberculosis infection in a homeless population in Germany.MethodsHomeless individuals (n = 150) were enrolled in a cross-sectional study at three shelters in Münster, Germany (October 2017–July 2018). All participants were screened using an ELISPOT interferon-γ release assay (IGRA). Those participants tested positive/borderline by IGRA provided three sputa for microbiological analysis (line probe assay, microscopy, culture) and underwent a chest X-ray to screen for active pulmonary TB. Risk factors for tuberculosis/latent tuberculosis infection were analysed using a standardized questionnaire.ResultsOf the 142 evaluable IGRA, 21 (15%) were positive and two (1%) were borderline. No participant with a positive/borderline IGRA had an active tuberculosis as assessed by chest X-ray and microbiology. A negative IGRA was associated with a citizenship of a low-incidence country for tuberculosis (according to WHO, p = 0.01), low-incidence country of birth (p<0.001) or main residence in a low-incidence country in the past five years (p = 0.002).ConclusionsThe prevalence of latent tuberculosis infection (diagnosed by a positive/borderline IGRA) was 16%; no active tuberculosis was detected. The highest risk for latent tuberculosis infection was found in patients from high-incidence countries. This population at risk should be either treated for latent tuberculosis infection or need to be monitored to early detect a progression into active disease.

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Victims of disaster or conflict have a right to live in dignity and therefore have a right to receive health care according to international standards. International ethical and technical standards for refugees should be considered in the Federal Republic of Germany like in any other country.

Aim Mutual Health Organizations (MHOs) can be a potential means to reduce barriers to health care in low-income countries with poor access to health care and high health care costs for the population. One important challenge is the relationship between MHOs and health care professionals (HCPs). Our study evaluates HCPs experiences of, and attitudes towards MHOs. Subjects and Methods A total of 210 HCPs from three private and two public clinics in Kumbo and Bamenda (Cameroon) were interviewed with a structured questionnaire, where answers are quantified by a five-point ordinal scale. Results We identified regional and institutional differences. HCPs in Kumbo and in private clinics tend to have a more positive attitude towards MHOs than in Bamenda and in public clinics (mean 1.66 vs. 2.02, respectively 1.72 vs. 2.05,). HCPs in Bamenda and in public clinics report more negative experiences with MHO members (mean 2.86 vs. 3.67, respectively 2.72 vs. 3.56) and rank quality of health care lower. Conclusion Our findings underline the important role of HCPs in the context of MHOs; therefore, programs should aim to involve HCPs in respect of regional and institutional differences.

The 4th conference of transcultural medical appraisal was organized once again by the ethno-medical center in Hannover on 2nd and 3rd of November, 2001. For the first time, medical estimators and decision-makers from the spheres of medicine, psychology, law and administration got together thematically and interdisciplinary. As to the public health authorities, the intensive discussion and working session on the topic of deportation, transportability and asylum was of high relevance. The specific working group included judges, clinical and public health physicians, psychologists, migration authority officials and representatives of migrant organisations. In full agreement finally it was pointed out that medical or psychological estimation concerning asylum and deportation should remain in the hands of the public health authorities because of their expert knowledge, experience and full independence in the sphere of medical and psychological appraisal.