Prevalence of cutipositivity in a sample of homeless shelter population in Rome in the course of Latent Tuberculosis Infection surveillance plan. Preliminary results

Authors

  • Patrizia Laurenti Institute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
  • Gianluigi Quaranta Institute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
  • Stefania Bruno Institute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
  • Giuseppe La Torre Department of Experimental medicine, Unit of Clinical Medicine and Public Health, Sapienza University of Rome
  • Antonio G. Cairo Institute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
  • Pierangela Nardella Institute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
  • Giovanni Delogu Institute of Microbiology Catholic University of the Sacred Heart, Rome, Italy
  • Fausta Ardito Institute of Microbiology Catholic University of the Sacred Heart, Rome, Italy
  • Tommaso Pirronti Institute of Radiologic Sciences, Catholic University of the Sacred Heart, Rome, Italy
  • Antonio De Lorenzis Institute of Radiologic Sciences, Catholic University of the Sacred Heart, Rome, Italy
  • Salvatore Geraci Caritas, Rome, Italy
  • Roberta Molina Caritas, Rome, Italy
  • Giuseppe Attanasio Caritas, Rome, Italy
  • Francesca Annunziata Caritas, Rome, Italy
  • Salvatore Pelargonio Acisel, Rome, Italy
  • Francesco Lauria National Institute of Infectious Diseases Lazzaro Spallanzani, Rome, Italy
  • Alessandra Gualano National Institute of Infectious Diseases Lazzaro Spallanzani, Rome, Italy
  • Walter Ricciardi nstitute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy

DOI:

https://doi.org/10.2427/5741

Keywords:

homeless, Italy, Latent Tuberculosis infections, surveillance, tuberculosis

Abstract

Background: in Europe homelessness is a known risk factor both for active and latent tuberculosis (TB). In
Rome 409 cases of TB were notified in 2004, but the real occurrence among homeless people is unknown.
Tuberculosis surveillance has been organized with the aim to develop an integrated model for the risk
evaluation and management of both Latent Tuberculosis infections (LTBI) and TB in Rome homeless people.
Methods: the eligible individuals have been recruited in the homeless’ refuges. The Tuberculin Mantoux test
has been used to evaluate the infection prevalence; in case of a positive result, the individual’s expectorate
has been collected and the chest X-ray has been performed. A collecting data form has been filled in for
evaluating some risk factors. Multiple logistic regression models have been carried out to find statistically
significant determinants of infection.
Results: out of 120 subjects recruited, 108 came back for the evaluation of the skin test; the prevalence of
LTBI was 43.5% (47/108 subjects); no active TB cases were found. According to the multivariate analysis,
factors significantly associated to LTBI are gender (for males OR = 4.94; 95% CI: 1.46 – 16.67, 1st model; OR
5.84; 95% CI: 1.26 – 21.10, 2nd model), birth place (for Europe: OR 3.05; 95% CI: 1.02 – 9.13, 1st model; OR
3.12; 95% CI: 1.10 – 8.88, 2nd model; for East Mediterranean native Region OR = 4.34; 95%CI: 1.15-16.39);
Body Mass Index class (for obesity OR = 3.34; 95% CI:1.31-8.51).
Conclusions: these preliminary results have demonstrated a high prevalence of LTBI among homeless people.
Male gender, birth place (Europe and East Mediterranean native Region) and obesity were found to be
significant risk factors. The surveillance system allowed positive patients for LTBI to be rapidly directed to a
specialized centre for the clinical evaluation and the appropriate therapy in order to prevent the evolution of
disease.

Downloads

Published

2010-03-31

Issue

Vol. 7 No. 1 (2010)

Section

Theme Papers