Prevalence of respiratory diseases in sheltered homeless in Marseille, France
Abstract number: o420
Badiaga S., Richet H., Azass P., Rey F., Tissot Dupont H., Foucault C., Rovery C., Drancourt M., Raoult D., Brouqui P.
To describe the characteristics and the prevalence of respiratory diseases in the homeless population in Marseilles.
Snapshot study 2 nights in January 2005, by a medical team of 40 persons including infectious diseases senior, residents and fellows, pneumologists, nurses, X-ray technicians in the 2 shelters in Marseilles. Homeless were interviewed, examined, and received care. Blood was sampled for cell count, detection of bacteraemia and antibodies to Chlamydia, Mycoplasma, Legionella pneumophila, and Coxiella burnetii. A chest-X radiograph was performed.
A total of 221 homeless persons were enrolled. The mean age was 41 years ± 13 and 94% of the population were men; 38% were born in North Africa, 37% in France, and 14% in Central/Eastern Europe; the subjects have been homeless less than 7 months in 43%, from 7 to 12 months in 12%, from 13 to 24 months in 8.1%, and more than 24 months in 36%. Among study population, 77% were current smokers, 65% were alcohol abusers, 2 persons were infected by HIV, 30% reported prior contact with tuberculosis patients (in shelter 23% and in family and relatives in 77%). The most frequent reported symptoms were weight loss (43%), chronic cough (39%), sputum production (33%), sweats (16%), and dyspnoea (16%). Clinical diagnosis was established as bronchitis in 19%, chronic obstructive bronchitis in 17%, asthma in 2%, and acute pneumonia in 1%. All blood cultures; as well as serological tests were negative. Chest radiographs performed in 219 persons and subsequently analysed showed abnormalities in 14 persons (6%). Of these 14 homeless persons, 4 have not been reached for follow up and 10 have hospitalized for further investigations. The final diagnosis made were active tuberculosis in 2 persons (1%) who have been homeless for 10 and 11 years, sequels of tuberculosis in 4 (2%), lung cancer in 1 (0.5%), obstructive lung disease in 1 (0.5%), acute pneumonia in 1 (0.5%), and no specific diagnosis in 1 (0.5%). A specific care was given for each of these homeless persons.
This snapshot investigation revealed that 6 % of this homeless population had life threatening respiratory diseases in which 1% had active contagious tuberculosis. Systematic chest radiography could be an efficient strategy to rapidly identify and prevent the spread of this transmissible disease among homeless population of shelters.
|Session name:||XXIst ISTH Congress|
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