Active Tuberculosis among Homeless Persons, Toronto, Ontario, Canada, 1998–2007
2011

Active Tuberculosis among Homeless Persons in Toronto

Sample size: 91 publication 10 minutes Evidence: moderate

Author Information

Author(s): Khan Kamran, Rea Elizabeth, McDermaid Cameron, Stuart Rebecca, Chambers Catharine, Wang Jun, Chan Angie, Gardam Michael, Jamieson Frances, Yang Jae, Hwang Stephen W.

Primary Institution: St. Michael’s Hospital, Toronto, Ontario, Canada

Hypothesis

What are the trends in tuberculosis among homeless persons in Toronto from 1998 to 2007?

Conclusion

The study found that the proportion of foreign-born homeless persons with tuberculosis increased over time, and many had highly contagious disease.

Supporting Evidence

  • 91 homeless persons with active TB were identified during the study period.
  • 19% of the patients died within 12 months of diagnosis.
  • The proportion of foreign-born homeless persons with TB increased from 24% to 39% over the study period.
  • Only 2% of infections were resistant to first-line TB medications.
  • Most patients were hospitalized, with 84% receiving treatment in a monitored setting.

Takeaway

This study looked at homeless people in Toronto who had tuberculosis and found that many were born outside Canada and had severe disease.

Methodology

The study analyzed data from Toronto Public Health on all reported active TB cases among homeless persons from 1998 to 2007.

Potential Biases

The retrospective nature of the study and reliance on public health surveillance data may introduce bias.

Limitations

The study only included homeless persons diagnosed in Toronto and excluded those who had incomplete records.

Participant Demographics

Most participants were male, with a significant proportion being Canada-born and some identifying as Aboriginal.

Statistical Information

P-Value

0.06

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3201/eid1703.100833

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