Author:
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2014. Global Strategy and Targets for Tuberculosis Prevention, Care and Control after 2015. Geneva, Switzerland: WHO. Available at: http://www.who.int/tb/post2015_strategy/en/. Accessed February 13, 2018.
-
2.
Cuenta de Alto Costo, 2016. Situación del VIH en Colombia 2016. Bogotá, Colombia: CAC. Available at: https://cuentadealtocosto.org/site/images/Publicaciones/CAC.Co_2017_06_13_Libro_Sit_VIH_2016_V_0.1.pdf.pdf. Accessed February 13, 2018.
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3.
Instituto Nacional de Salud, 2018. Informe del Evento Preliminar de Tuberculosis Hasta el Período Epidemiológico XIII Colombia, 2017. Bogotá, Colombia: INS. Available at: http://www.ins.gov.co/buscador-eventos/SitePages/Evento.aspx?Event=7. Accessed February 13, 2018.
-
4.
Beijer U, Wolf A, Fazel S, 2012. Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: a systematic review and meta-analysis. Lancet Infect Dis 12: 859–870.
-
5.
Haddad MB, Wilson TW, Ijaz K, Marks SM, Moore M, 2005. Tuberculosis and homelessness in the United States, 1994–2003. JAMA 293: 2762–2766.
-
6.
Bamrah S, Yelk Woodruff RS, Powell K, Ghosh S, Kammerer JS, Haddad MB, 2013. Tuberculosis among the homeless, United States, 1994–2010. Int J Tuberc Lung Dis 17: 1414–1419.
-
7.
Nunes C, Duarte R, Veiga AM, Taylor B, 2017. Who are the patients that default tuberculosis treatment?—space matters! Epidemiol Infect 145: 1130–1134.
-
8.
Ministerio de Salud y Protección Social, 2018. Cifras Aseguramiento en Salud. Bogotá, Colombia: Ministerio de Salud y Protección Social. Available at: https://public.tableau.com/views/CifrasAseguramientoenSalud_0/Aseguramiento?:embed=y&:showVizHome=no&:host_url=https%3A%2F%2Fpublic.tableau.com%2F&:embed_code_version=2&:tabs=no&:toolbar=yes&:animate_transition=yes&:display_static_image=no&:display_spinner=no&:display_overlay=yes&:display_count=yes&publish=yes&:loadOrderID=0. Accessed October 27, 2018.
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9.
World Health Organization, 2014. Definitions and Reporting Framework for Tuberculosis. Geneva, Switzerland: WHO. Available at: http://www.who.int/tb/publications/definitions/en/. Accessed March 20, 2018.
-
10.
van Hest R, Ködmön C, Verver S, Erkens CGM, Straetemans M, Manissero D, de Vries G, 2013. Tuberculosis treatment outcome monitoring in European Union countries: systematic review. Eur Respir J 41: 635–643.
-
11.
de Vries SG et al. 2017. Barriers and facilitators to the uptake of tuberculosis diagnostic and treatment services by hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review of qualitative literature. Lancet Infect Dis 17: e128–e143.
-
12.
Davila JA, Cabral HJ, Maskay MH, Marcus R, Yuan Y, Chisolm N, Belton P, McKeithan L, Rajabuin S, 2018. Risk factors associated with multi-dimensional stigma among people living with HIV/AIDS who are homeless/unstably housed. AIDS Care 30: 1335–1340.
-
13.
Imtiaz S, Shield KD, Roerecke M, Samokhvalov AV, Lönnroth K, Rehm J, 2017. Alcohol consumption as a risk factor for tuberculosis: meta-analyses and burden of disease. Eur Respir J 50: 1–13.
-
14.
Raviglione M, Poznyak V, 2017. Targeting harmful use of alcohol for prevention and treatment of tuberculosis: a call for action. Eur Respir J 50: 1700946.
-
15.
Nyamathi A, Sands H, Pattatucci-Aragón A, Berg J, Leake B, 2004. Tuberculosis knowledge, perceived risk and risk behaviors among homeless adults: effect of ethnicity and injection drug use. J Community Health 29: 483–497.
-
16.
Hernández Sarmiento JM et al. 2013. Tuberculosis among homeless population from Medellín, Colombia: associated mental disorders and socio-demographic characteristics. J Immigr Minor Health 15: 693–699.
-
17.
Wolitski RJ, Kidder DP, Fenton KA, 2007. HIV, homelessness, and public health: critical issues and a call for increased action. AIDS Behav 11 (Suppl 6): 167–171.
-
18.
Gelberg L, Gallagher TC, Andersen RM, Koegel P, 1997. Competing priorities as a barrier to medical care among homeless adults in Los Angeles. Am J Public Health 87: 217–220.
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19.
Hwang SW, Ueng JJM, Chiu S, Kiss A, Tolomiczenko G, Cowan L, Levinson W, Redelmeier DA, 2010. Universal health insurance and health care access for homeless persons. Am J Public Health 100: 1454–1461.
-
20.
Ranzani OT, Carvalho CRR, Waldman EA, Rodrigues LC, 2016. The impact of being homeless on the unsuccessful outcome of treatment of pulmonary TB in São Paulo state, Brazil. BMC Med 14: 41.
-
21.
Korzeniewska-Koseła M, Kuś J, Lewandowska K, Siemion-Szcześniak I, 2015. Tuberculosis in homeless persons in Poland. Przegl Epidemiol 69: 445–451, 575–580.
-
22.
Hamusse SD, Demissie M, Teshome D, Lindtjørn B, 2014. Fifteen-year trend in treatment outcomes among patients with pulmonary smear-positive tuberculosis and its determinants in Arsi Zone, Central Ethiopia. Glob Health Action 7: 25382.
-
23.
Gafar MM, Nyazema NZ, Dambisya YM, 2014. Factors influencing treatment outcomes in tuberculosis patients in Limpopo province, South Africa, from 2006 to 2010: a retrospective study. Curationis 37: 1169.
-
24.
Sinshaw Y, Alemu S, Fekadu A, Gizachew M, 2017. Successful TB treatment outcome and its associated factors among TB/HIV co-infected patients attending Gondar University Referral Hospital, northwest Ethiopia: an institution based cross-sectional study. BMC Infect Dis 17: 132.
-
25.
Eshetie S, Gizachew M, Alebel A, van Soolingen D, 2018. Tuberculosis treatment outcomes in Ethiopia from 2003 to 2016, and impact of HIV co-infection and prior drug exposure: a systematic review and meta-analysis. PLoS One 13: e0194675.
-
26.
Shimouchi A, Ohkado A, Matsumoto K, Komukai J, Yoshida H, Ishikawa N, 2013. Strengthened tuberculosis control programme and trend of multi-drug resistant tuberculosis rate in Osaka city, Japan. Western Pac Surveill Response J 4: 4–10.
-
27.
Uchimura K, Ngamvithayapong-Yanai J, Kawatsu L, Ohkado A, Yoshiyama T, Shimouchi A, Ito K, Ishikawa N, 2013. Characteristics and treatment outcomes of tuberculosis cases by risk groups, Japan, 2007–2010. Western Pac Surveill Response J 4: 11–18.
-
28.
Uchimura K, Ngamvithayapong-Yanai J, Kawatsu L, Ohkado A, Yoshiyama T, Ito K, Ishikawa N, 2015. Permanent employment or public assistance may increase tuberculosis survival among working-age patients in Japan. Int J Tuberc Lung Dis 19: 312–318.
-
29.
Grenfell P, Baptista Leite R, Garfein R, de Lussigny S, Platt L, Rhodes T, 2013. Tuberculosis, injecting drug use and integrated HIV-TB care: a review of the literature. Drug Alcohol Depend 129: 180–209.
-
30.
Lutge EE, Wiysonge CS, Knight SE, Sinclair D, Volmink J, 2015. Incentives and enablers to improve adherence in tuberculosis. Cochrane Database Syst Rev 9: CD007952.
-
31.
Tulsky JP, Hahn JA, Long HL, Chambers DB, Robertson MJ, Chesney MA, Moss AR, 2004. Can the poor adhere? Incentives for adherence to TB prevention in homeless adults. Int J Tuberc Lung Dis 8: 83–91.
-
32.
Ciobanu A, Domente L, Soltan V, Bivol S, Severin L, Plesca V, Van den Bergh R, Kumar A, de Colombani P, 2014. Do incentives improve tuberculosis treatment outcomes in the Republic of Moldova? Public Health Action 4: S59–S63.
-
33.
Ukwaja KN, Alobu I, Gidado M, Onazi O, Oshi DC, 2017. Economic support intervention improves tuberculosis treatment outcomes in rural Nigeria. Int J Tuberc Lung Dis 21: 564–570.
-
34.
Ruiz-Restrepo J; Centro de Estudios de Opinión, Secretaria de Bienestar Social de Medellín, 2010. Censo de habitantes de calle y en calle de la ciudad de Medellín y sus corregimientos. Sociol En Sus Escen 21: 2–175.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 52 | 52 | 4 |
| Full Text Views | 1242 | 166 | 0 |
| PDF Downloads | 352 | 47 | 0 |
Homelessness and HIV: A Combination Predictive of Poor Tuberculosis Treatment Outcomes and in Need of Innovative Strategies to Improve Treatment Completion
Lina María Gómez
Lina María Gómez
Secretaria de Salud de Envigado, Envigado, Colombia;
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Lizeth Andrea Paniagua-Saldarriaga
Lizeth Andrea Paniagua-Saldarriaga
Secretaria Seccional de Salud y Protección Social de Antioquia, Medellín, Colombia;
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Quinlan Richert
Quinlan Richert
Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada;
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Yoav Keynan
Yoav Keynan
Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, Canada;
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada;
Department of Community Health Science, University of Manitoba, Winnipeg, Canada;
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Department of Internal Medicine, University of Manitoba, Winnipeg, Canada;
Department of Community Health Science, University of Manitoba, Winnipeg, Canada;
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Fernando Montes
Fernando Montes
Secretaría de Salud de Medellín, Medellín, Colombia;
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Lucelly López
Lucelly López
Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
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Zulma Vanessa Rueda
Zulma Vanessa Rueda
Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
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Antioquia Department is the state with the highest burden of tuberculosis (TB) in Colombia. Our aim was to determine the risk factors associated with unsuccessful TB treatment in HIV-seropositive and homeless persons, compared with non–HIV-infected and non-homeless persons with TB. We conducted a retrospective cohort study using observational, routinely collected health data from all drug-susceptible TB cases in homeless and/or HIV-seropositive individuals in Antioquia from 2014 to 2016. Unsuccessful TB treatment was defined as individuals having been lost to follow-up, having died, or treatment failure occurrence during the study period. Successful treatment was defined as cure of TB or treatment completion according to the WHO definitions. We identified 544 homeless persons with TB (432 HIV− and 112 HIV+), 835 HIV+ persons with TB and non-homeless, and 5,086 HIV−/non-homeless people with TB. Unsuccessful treatment rates were 19.3% in HIV−/non-homeless persons, 37.4% in non-homeless HIV+ patients, 61.5% in homeless HIV− patients, and 70.3% in homeless HIV+ patients; all rates fall below End TB strategy targets. More than 50% of homeless patients were lost to follow-up. Risk factors associated with unsuccessful treatment were HIV seropositivity, homelessness, male gender, age ≥ 25 years, noncontributory-type health insurance, TB diagnosis made during hospitalization, and previous treatment for TB. These results highlight the challenge of treating TB in the homeless population. These findings should put an onus on TB programs, governments, clinicians, and others involved in the collaborative care of TB patients to pursue innovative strategies to improve treatment success in this population.
Author Notes
Authors’ addresses: Lina María Gómez, Secretaría de Salud de Envigado, Envigado, Colombia, E-mail: lini2992@hotmail.com. Lizeth Andrea Paniagua-Saldarriaga, Secretaria Seccional de Salud y Protección Social de Antioquia, Medellín, Colombia, E-mail: lpaniagua8@yahoo.es. Quinlan Richert, Department of Medical Microbiology and Infectious Disease, Max Rady college of medicine, University of Manitoba, Winnipeg, Canada, E-mail: umricheq@myumanitoba.ca. Yoav Keynan, Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, Canada, Department of Internal Medicine, University of Manitoba, Winnipeg, Canada, and Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada, E-mail: yoav.keynan@umanitoba.ca. Fernando Montes, Secretaría de Salud de Medellín, Medellín, Colombia, E-mail: fernando.montesz@gmail.com. Lucelly López and Zulma Vanessa Rueda, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia, E-mails: lucellyl@gmail.com and zulmaruedav@gmail.com.
Disclaimer: The content of this article does not reflect the official opinion of the Gobernación de Antioquia, or Secretaria Seccional de Salud y Protección social de Antioquia, or Secretaría de Salud de Envigado. Responsibility for the information and views expressed in this article lies entirely with the authors. The funders did not play any role in the design of the study, the compilation and analysis of the data, the decision to publish, or the writing of the article.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2014. Global Strategy and Targets for Tuberculosis Prevention, Care and Control after 2015. Geneva, Switzerland: WHO. Available at: http://www.who.int/tb/post2015_strategy/en/. Accessed February 13, 2018.
-
2.
Cuenta de Alto Costo, 2016. Situación del VIH en Colombia 2016. Bogotá, Colombia: CAC. Available at: https://cuentadealtocosto.org/site/images/Publicaciones/CAC.Co_2017_06_13_Libro_Sit_VIH_2016_V_0.1.pdf.pdf. Accessed February 13, 2018.
-
3.
Instituto Nacional de Salud, 2018. Informe del Evento Preliminar de Tuberculosis Hasta el Período Epidemiológico XIII Colombia, 2017. Bogotá, Colombia: INS. Available at: http://www.ins.gov.co/buscador-eventos/SitePages/Evento.aspx?Event=7. Accessed February 13, 2018.
-
4.
Beijer U, Wolf A, Fazel S, 2012. Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: a systematic review and meta-analysis. Lancet Infect Dis 12: 859–870.
-
5.
Haddad MB, Wilson TW, Ijaz K, Marks SM, Moore M, 2005. Tuberculosis and homelessness in the United States, 1994–2003. JAMA 293: 2762–2766.
-
6.
Bamrah S, Yelk Woodruff RS, Powell K, Ghosh S, Kammerer JS, Haddad MB, 2013. Tuberculosis among the homeless, United States, 1994–2010. Int J Tuberc Lung Dis 17: 1414–1419.
-
7.
Nunes C, Duarte R, Veiga AM, Taylor B, 2017. Who are the patients that default tuberculosis treatment?—space matters! Epidemiol Infect 145: 1130–1134.
-
8.
Ministerio de Salud y Protección Social, 2018. Cifras Aseguramiento en Salud. Bogotá, Colombia: Ministerio de Salud y Protección Social. Available at: https://public.tableau.com/views/CifrasAseguramientoenSalud_0/Aseguramiento?:embed=y&:showVizHome=no&:host_url=https%3A%2F%2Fpublic.tableau.com%2F&:embed_code_version=2&:tabs=no&:toolbar=yes&:animate_transition=yes&:display_static_image=no&:display_spinner=no&:display_overlay=yes&:display_count=yes&publish=yes&:loadOrderID=0. Accessed October 27, 2018.
-
9.
World Health Organization, 2014. Definitions and Reporting Framework for Tuberculosis. Geneva, Switzerland: WHO. Available at: http://www.who.int/tb/publications/definitions/en/. Accessed March 20, 2018.
-
10.
van Hest R, Ködmön C, Verver S, Erkens CGM, Straetemans M, Manissero D, de Vries G, 2013. Tuberculosis treatment outcome monitoring in European Union countries: systematic review. Eur Respir J 41: 635–643.
-
11.
de Vries SG et al. 2017. Barriers and facilitators to the uptake of tuberculosis diagnostic and treatment services by hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review of qualitative literature. Lancet Infect Dis 17: e128–e143.
-
12.
Davila JA, Cabral HJ, Maskay MH, Marcus R, Yuan Y, Chisolm N, Belton P, McKeithan L, Rajabuin S, 2018. Risk factors associated with multi-dimensional stigma among people living with HIV/AIDS who are homeless/unstably housed. AIDS Care 30: 1335–1340.
-
13.
Imtiaz S, Shield KD, Roerecke M, Samokhvalov AV, Lönnroth K, Rehm J, 2017. Alcohol consumption as a risk factor for tuberculosis: meta-analyses and burden of disease. Eur Respir J 50: 1–13.
-
14.
Raviglione M, Poznyak V, 2017. Targeting harmful use of alcohol for prevention and treatment of tuberculosis: a call for action. Eur Respir J 50: 1700946.
-
15.
Nyamathi A, Sands H, Pattatucci-Aragón A, Berg J, Leake B, 2004. Tuberculosis knowledge, perceived risk and risk behaviors among homeless adults: effect of ethnicity and injection drug use. J Community Health 29: 483–497.
-
16.
Hernández Sarmiento JM et al. 2013. Tuberculosis among homeless population from Medellín, Colombia: associated mental disorders and socio-demographic characteristics. J Immigr Minor Health 15: 693–699.
-
17.
Wolitski RJ, Kidder DP, Fenton KA, 2007. HIV, homelessness, and public health: critical issues and a call for increased action. AIDS Behav 11 (Suppl 6): 167–171.
-
18.
Gelberg L, Gallagher TC, Andersen RM, Koegel P, 1997. Competing priorities as a barrier to medical care among homeless adults in Los Angeles. Am J Public Health 87: 217–220.
-
19.
Hwang SW, Ueng JJM, Chiu S, Kiss A, Tolomiczenko G, Cowan L, Levinson W, Redelmeier DA, 2010. Universal health insurance and health care access for homeless persons. Am J Public Health 100: 1454–1461.
-
20.
Ranzani OT, Carvalho CRR, Waldman EA, Rodrigues LC, 2016. The impact of being homeless on the unsuccessful outcome of treatment of pulmonary TB in São Paulo state, Brazil. BMC Med 14: 41.
-
21.
Korzeniewska-Koseła M, Kuś J, Lewandowska K, Siemion-Szcześniak I, 2015. Tuberculosis in homeless persons in Poland. Przegl Epidemiol 69: 445–451, 575–580.
-
22.
Hamusse SD, Demissie M, Teshome D, Lindtjørn B, 2014. Fifteen-year trend in treatment outcomes among patients with pulmonary smear-positive tuberculosis and its determinants in Arsi Zone, Central Ethiopia. Glob Health Action 7: 25382.
-
23.
Gafar MM, Nyazema NZ, Dambisya YM, 2014. Factors influencing treatment outcomes in tuberculosis patients in Limpopo province, South Africa, from 2006 to 2010: a retrospective study. Curationis 37: 1169.
-
24.
Sinshaw Y, Alemu S, Fekadu A, Gizachew M, 2017. Successful TB treatment outcome and its associated factors among TB/HIV co-infected patients attending Gondar University Referral Hospital, northwest Ethiopia: an institution based cross-sectional study. BMC Infect Dis 17: 132.
-
25.
Eshetie S, Gizachew M, Alebel A, van Soolingen D, 2018. Tuberculosis treatment outcomes in Ethiopia from 2003 to 2016, and impact of HIV co-infection and prior drug exposure: a systematic review and meta-analysis. PLoS One 13: e0194675.
-
26.
Shimouchi A, Ohkado A, Matsumoto K, Komukai J, Yoshida H, Ishikawa N, 2013. Strengthened tuberculosis control programme and trend of multi-drug resistant tuberculosis rate in Osaka city, Japan. Western Pac Surveill Response J 4: 4–10.
-
27.
Uchimura K, Ngamvithayapong-Yanai J, Kawatsu L, Ohkado A, Yoshiyama T, Shimouchi A, Ito K, Ishikawa N, 2013. Characteristics and treatment outcomes of tuberculosis cases by risk groups, Japan, 2007–2010. Western Pac Surveill Response J 4: 11–18.
-
28.
Uchimura K, Ngamvithayapong-Yanai J, Kawatsu L, Ohkado A, Yoshiyama T, Ito K, Ishikawa N, 2015. Permanent employment or public assistance may increase tuberculosis survival among working-age patients in Japan. Int J Tuberc Lung Dis 19: 312–318.
-
29.
Grenfell P, Baptista Leite R, Garfein R, de Lussigny S, Platt L, Rhodes T, 2013. Tuberculosis, injecting drug use and integrated HIV-TB care: a review of the literature. Drug Alcohol Depend 129: 180–209.
-
30.
Lutge EE, Wiysonge CS, Knight SE, Sinclair D, Volmink J, 2015. Incentives and enablers to improve adherence in tuberculosis. Cochrane Database Syst Rev 9: CD007952.
-
31.
Tulsky JP, Hahn JA, Long HL, Chambers DB, Robertson MJ, Chesney MA, Moss AR, 2004. Can the poor adhere? Incentives for adherence to TB prevention in homeless adults. Int J Tuberc Lung Dis 8: 83–91.
-
32.
Ciobanu A, Domente L, Soltan V, Bivol S, Severin L, Plesca V, Van den Bergh R, Kumar A, de Colombani P, 2014. Do incentives improve tuberculosis treatment outcomes in the Republic of Moldova? Public Health Action 4: S59–S63.
-
33.
Ukwaja KN, Alobu I, Gidado M, Onazi O, Oshi DC, 2017. Economic support intervention improves tuberculosis treatment outcomes in rural Nigeria. Int J Tuberc Lung Dis 21: 564–570.
-
34.
Ruiz-Restrepo J; Centro de Estudios de Opinión, Secretaria de Bienestar Social de Medellín, 2010. Censo de habitantes de calle y en calle de la ciudad de Medellín y sus corregimientos. Sociol En Sus Escen 21: 2–175.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 52 | 52 | 4 |
| Full Text Views | 1242 | 166 | 0 |
| PDF Downloads | 352 | 47 | 0 |