Gelberg L, Panarites C J, Morgenstern H, Leake B, Andersen R M, Koegel P
Division of Family Medicine, UCLA School of Medicine 90095-1683, USA.
J Gen Intern Med. 1997 Jan;12(1):25-33. doi: 10.1046/j.1525-1497.1997.12101.x.
To document the prevalence of tuberculosis (TB) skin test positivity among homeless adults in Los Angeles and determine whether certain characteristics of homelessness were risk factors for TB.
Cross-sectional study.
Shelters, soup lines, and outdoor locations in the Skid Row and Westside areas of Los Angeles.
A representative sample of 260 homeless adults.
Tuberculosis tine test reactivity was measured. The overall prevalence of TB skin test positivity was 32%:40% in the inner-city Skid Row area and 14% in the suburban Westside area. Using multiple logistic regression, TB skin test positivity was found to be associated with living in crowded or potentially crowded shelter conditions, long-term homelessness, geographic area, history of a psychiatric hospitalization, and age.
Homeless adults living in congested inner-city areas are at high risk of both latent and active TB. Endemic risk factors and limited access to medical care support the need for aggressive treatment of active TB cases and innovative programs to ensure completion of prophylactic regimens by homeless individuals with latent infection.
记录洛杉矶无家可归成年人中结核菌素皮肤试验阳性的患病率，并确定无家可归的某些特征是否为结核病的危险因素。
横断面研究。
洛杉矶贫民窟和西区的收容所、施粥处及户外场所。
260名无家可归成年人的代表性样本。
测量结核菌素试验反应性。结核菌素皮肤试验阳性的总体患病率为32%：市中心贫民窟地区为40%，郊区西区为14%。采用多因素logistic回归分析发现，结核菌素皮肤试验阳性与居住在拥挤或可能拥挤的收容环境、长期无家可归、地理区域、精神科住院史及年龄有关。
居住在拥挤市中心地区的无家可归成年人患潜伏性和活动性结核病的风险很高。地方流行危险因素和获得医疗服务的机会有限，支持对活动性结核病例进行积极治疗，并开展创新项目以确保潜伏感染的无家可归者完成预防性治疗方案。
