Epidemiology and clinical outcomes of tuberculosis among homeless persons visiting emergency department in public hospital

Hwang, Young Seob; Lee, Yu Jin; Kong, So Yeon

doi:10.1016/j.ajem.2017.07.049

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…This is not many for according to the interpretation of Beijer et al [ 21 ] the tuberculosis may affect 0.2–7.7% of the homeless population. In a study by Hwang et al [ 22 ], 35 cases of tuberculosis (1.06%) were diagnosed among homeless patients in EDs over a 2-year period. Appleton et al report that homeless people, as well as people addicted to alcohol, are among the highrisk groups for tuberculosis, and ED is a place where the chance of diagnosing the disease in these patient groups is higher [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Profile of homeless people in emergency departments

Burak¹,

Wyszkowska²,

Liebert³

et al. 2021

Int J Occup Med Environ Health

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For homeless people, emergency departments (ED) are the place of medical care and satisfying physiological, safety and social needs. The treatment of the homeless in EDs is a common issue in many countries. The aim of study was to analyze selected parameters of health care to homeless people in EDs. The authors examined the frequency and the seasonality of admissions, their causes, stay duration, insurance status, and the type of radiological diagnostics performed. Material and Methods: A retrospective analysis of stays of homeless patients in 3 EDs in one of the largest cities in Poland in 2013-2015 was carried out. Patients were qualified to the population of homeless people based of their registering in ED. Data was obtained on the total number of homeless patients' stays in all 3 EDs, which amounted to 3133. Results: During the 3 years of analysis: 1042 homeless individuals were identified staying 3133 times in EDs; 46.3% of the stays concerned uninsured homeless people; 31% were under influence of alcohol. On average, men used ED services 3 times, while women only twice. No significant seasonality of admissions was observed. Homeless people were admitted mainly for mental disorders and head injuries. Radiological tests were performed 1577 times, including 83% being CT scans. On average, women and those >30 stayed in EDs for the shortest time. The hospital wards admitted 9.3% of the patients. Conclusions: Almost half of homeless patients repeatedly use ED services, regardless of the season. A patient's stay typically lasts 6 h. Half of them were uninsured. The main reasons for admission include mental and behavioral disorders, mostly due to alcohol use and head injuries. The primary radiological diagnostics used were CT scans.

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Section: Discussionmentioning

confidence: 99%

Profile of homeless people in emergency departments

Burak¹,

Wyszkowska²,

Liebert³

et al. 2021

Int J Occup Med Environ Health

View full text Add to dashboard Cite

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“…Entre os artigos selecionados, identificamos os seguintes fatores de vulnerabilidade para os desfechos: uso de álcool [21][22][23][24][25][26][27][28] , tabagismo 21,22,25,28,29 , uso de drogas ilícitas 21,24,[26][27][28][29][30][31] , entre elas, injetáveis 21,[27][28][29] , podendo haver compartilhamento de agulhas 29,30 , e metanfetamina 29 , histórico de encarceramento 21,29 , imigração 26,32,33 , distúrbio psicológico 24,28,30 , prostituição 29 , inclusive entre homens que fizeram sexo com homens, analfabetismo 22,29 , desnutrição 22 , e coinfecção por HIV 21,22,[24][25][26][27][28][29]…”

Section: Estratégia De Buscaunclassified

“…Os desfechos relacionados à ocorrência da tuberculose e infecção latente de tuberculose são apresentados na tabela 3. A não completude do tratamento 22,24,25,27,28,30,31,34,35 ou seu fracasso 22,24,26 , o óbito 22,24,25,27,30,31,34 , desenvolvimento de resistência aos fármacos de tratamento 22,25-29 e ocorrência de tuberculose extrapulmonar 22,26,27 diagnósticos foram citologia de escarro 22,24,26,27,29,31 , R-X torácico 24,27,33 , cultura 27,[29][30][31] , exame molecular 27 e diagnóstico clínico 27 .…”

Section: Estratégia De Buscaunclassified

“…Segundo Agarwal et al 27 16% dos participantes com tuberculose eram HIV positivos e a razão de chance para mortalidade nesses indivíduos foi 3.57 maior do que para os com exame de HIV negativo. Na publicação de Hwang et al 25 5,7% tinha coinfecção tuberculose+HIV. No estudo de Amiri et al 29 1,2% das PSR eram HIV positivos e tinham infecção latente de tuberculose, proporção similar (1,8%) ao achado por Nwana et al 28 Gomez et al 31 , em seu estudo, achou a proporção de 20,6% de PSR com as comorbidades.…”

Section: Estratégia De Buscaunclassified

“…No de Dolla et al 34 , o único paciente HIV+ em sua amostra, veio a óbito. Em relação aos vieses encontrados, grande parte dos estudos não apresentou similaridade dos grupos recrutados 24,25,36 , identificação dos fatores de confundimento 26,27,29,30,[33][34][35][36] , estratégia para lidar com esses fatores 26,27,29,30,[32][33][34][35][36] ou com o acompanhamento incompleto dos participantes 25,26,36 . Poucos estudos trouxeram suas limitações descritas 24,26,28,29,31,34 e aqueles que apresentaram tinham falhas na exposição da metodologia e dos resultados 29,30,32,36 .…”

Section: Estratégia De Buscaunclassified

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Tuberculose, vulnerabilidades e HIV em pessoas em situação de rua: revisão sistemática

2022

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OBJETIVO Analisar, sistematizar e compilar os fatores de vulnerabilidade (social, individual e programática) associados à tuberculose e HIV em pessoas em situação de rua. MÉTODOS Revisão sistemática de literatura de publicações quantitativas sobre tuberculose em pessoas em situação de rua entre os anos de 2014 e 2020, seguindo o guia de recomendações PRISMA e, para análise de viés, a ferramenta Joanna Briggs Institute Critical Appraisal. Agrupou-se as publicações segundo as vulnerabilidades. RESULTADOS Entre 372 publicações encontradas, selecionaram-se 16 segundo os critérios de elegibilidade. Em 10 estudos, foi descrita ocorrência de tuberculose e HIV. Os fatores de vulnerabilidade individual, social e programática mais descritas foram uso de drogas, coinfecção com HIV e falha no tratamento da tuberculose, respectivamente. A média de tempo em situação de rua também se mostrou relacionada à maior frequência de tuberculose e da infecção latente da tuberculose segundo literatura. CONCLUSÃO O estigma e a desumanização associados às pessoas em situação de rua foram descritos em todos os estudos revisados, sendo importantes barreiras no acesso aos serviços de saúde. A vivência na rua potencializa os riscos para a ocorrência de doenças crônicas e infecciosas, bem como a priorização de questões mais pragmáticas à manutenção da vida, como segurança e alimentação, em detrimento à saúde. Os resultados encontrados podem ser utilizados para embasar hipóteses para futuras pesquisas e para reforçar e direcionar políticas públicas de saúde e sociais já existentes para o enfrentamento da tuberculose e HIV na pessoa em situação de rua.

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Demographic, socio-economic and behavior as risk factors of tuberculosis in Malaysia: a systematic review of the literature

Mohidem

Hashim

Osman

et al. 2018

Reviews on Environmental Health

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Abstract Background Tuberculosis (TB) is making a comeback and has remained one of the main causes of mortality among the list of infectious diseases in Malaysia. Objective To evaluate the burden and demographic, socio-economic and behavior as risk factors of TB among communities in Malaysia. Method A comprehensive search of Scopus, Sciencedirect, PubMed, DOAJ, CINAHL Plus, MyJournal, BIREME, BMC Public Health, Medline, CAB, EMBASE (Excerpta Medica dataBASE), and Web of Science (WoS) was undertaken from the articles published from 1st January 2008 to 31st December 2017 using medical subject heading (MeSH) key terms. Results Of 717 papers screened, 31 eligible studies met our inclusion criteria. Gender, age, marriage status, ethnicity, area of living, being in prison and immigrant were evaluated as demographic factors, while educational level, occupation and household income were evaluated as socio-economic factors. For behavioral factors, smoking, drug abuse, alcohol consumption and other lifestyle practices were evaluated. However, not all the studies were statistically significantly associated with these risk factors. Studies on household income were few and too small to permit a conclusion. We also did not find any study that investigated TB infection among sex workers. Conclusion Immigrant in high density settings may increase the progression of disease infection in Malaysia. The risk factors for the development of TB, specifically in a high-risk population, should be targeted through the implementation of specialized interventions. Further research into the role of indoor and outdoor physical environments is required to better understand the association between the physical environment and the social environment with TB infection.

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Epidemiology and clinical outcomes of tuberculosis among homeless persons visiting emergency department in public hospital

Cited by 4 publications

References 9 publications

Profile of homeless people in emergency departments

Profile of homeless people in emergency departments

Tuberculose, vulnerabilidades e HIV em pessoas em situação de rua: revisão sistemática

Demographic, socio-economic and behavior as risk factors of tuberculosis in Malaysia: a systematic review of the literature

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