Details:

Alternative Title:
Med Care
Personal Author:
Self, Julie L. ; McDaniel, Clint J. ; Bamrah Morris, Sapna ; Silk, Benjamin J.
Self, Julie L. ; McDaniel, Clint J. ; Bamrah Morris, Sapna ; Silk, Benjamin J. Less -
Description:
Objectives:

Persons experiencing homelessness (PEH) are disproportionately affected by tuberculosis (TB). We estimate area-specific rates of TB among PEH and characterize the extent to which available data support recent transmission as an explanation of high TB incidence.

Methods:

We estimated TB incidence among PEH using National Tuberculosis Surveillance System data and population estimates for the US Department of Housing and Urban Development’s Continuums of Care areas. For areas with TB incidence higher than the national average among PEH, we estimated recent transmission using genotyping and a plausible source-case method. For cases with ≥ 1 plausible source case, we assessed with TB program partners whether available whole-genome sequencing and local epidemiologic data were consistent with recent transmission.

Results:

During 2011–2016, 3164 TB patients reported experiencing homelessness. National incidence was 36 cases/100,000 PEH. Incidence estimates varied among 21 areas with ≥ 10,000 PEH (9–150 cases/100,000 PEH); 9 areas had higher than average incidence. Of the 2349 cases with Mycobacterium tuberculosis genotyping results, 874 (37%) had ≥ 1 plausible source identified. In the 9 areas, 23%–82% of cases had ≥ 1 plausible source. Of cases with ≥ 1 plausible source, 63% were consistent and 7% were inconsistent with recent transmission; 29% were inconclusive.

Conclusions:

Disparities in TB incidence for PEH persist; estimates of TB incidence and recent transmission vary by area. With a better understanding of the TB risk among PEH in their jurisdictions and the role of recent transmission as a driver, programs can make more informed decisions about prioritizing TB prevention strategies.


Subjects:
[+]
Article Evaluation Homelessness Homeless Persons Humans Incidence Transmission Tuberculosis United States
Source:
Med Care. 59(Suppl 2):S175-S181
Pubmed ID:
33710092
Pubmed Central ID:
PMC8324075
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d69e4de0d500eea0cacb591f311950aa28f8b8f23a4a7a7485f24ca70b45239c
Download URL:
https://stacks.cdc.gov/view/cdc/108518/cdc_108518_DS1.pdf
File Type:

Supporting Files

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