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      Communicable disease among people experiencing homelessness in California

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      Author(s): 1 , 2 , 3 , 2
      Publication date (Electronic, collection):
      Publication date (Electronic, pub):
      Journal: Epidemiology and Infection
      Publisher: Cambridge University Press
      Keywords: Infectious disease, people experiencing homelessness, public health, vulnerable populations

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          Abstract

          California has a large population of people experiencing homelessness (PEH) that is characterised by a high proportion of people who are unsheltered and chronically homeless. PEH are at increased risk of communicable diseases due to multiple, intersecting factors, including increased exposures, comorbid conditions including substance use disorder and mental illness and lack of access to hygiene and healthcare facilities. Data available for several communicable diseases show that PEH in California experiences an increased burden of communicable diseases compared to people not experiencing homelessness. Public health agencies face unique challenges in serving this population. Efforts to reduce homelessness, increase access to health care for PEH, enhance data availability and strengthen partnerships among agencies serving PEH can help reduce the disparity in communicable disease burden faced by PEH.

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          Epidemiology of Invasive Group A Streptococcal Infections in the United States, 2005-2012.

          Deborah Aragon, Karrie-Ann Toews, Monica Farley … (2016)
          Invasive group A Streptococcus (GAS) infections are associated with significant morbidity and mortality rates. We report the epidemiology and trends of invasive GAS over 8 years of surveillance.
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            Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: a systematic review and meta-analysis

            Ulla Beijer, Achim Wolf, Seena Fazel (2012)
            Summary Background 100 million people worldwide are homeless; rates of mortality and morbidity are high in this population. The contribution of infectious diseases to these adverse outcomes is uncertain. Accurate estimates of prevalence data are important for public policy and planning and development of clinical services tailored to homeless people. We aimed to establish the prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people. Methods We searched PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature for studies of the prevalence of tuberculosis, hepatitis C virus, and HIV in homeless populations. We also searched bibliographic indices, scanned reference lists, and corresponded with authors. We explored potential sources of heterogeneity in the estimates by metaregression analysis and calculated prevalence ratios to compare prevalence estimates for homeless people with those for the general population. Findings We identified 43 eligible surveys with a total population of 63 812 (59 736 homeless individuals when duplication due to overlapping samples was accounted for). Prevalences ranged from 0·2% to 7·7% for tuberculosis, 3·9% to 36·2% for hepatitis C virus infection, and 0·3% to 21·1% for HIV infection. We noted substantial heterogeneity in prevalence estimates for tuberculosis, hepatitis C virus infection, and HIV infection (all Cochran's χ2 significant at p<0·0001; I 2=83%, 95% CI 76–89; 95%, 94–96; and 94%, 93–95; respectively). Prevalence ratios ranged from 34 to 452 for tuberculosis, 4 to 70 for hepatitis C virus infection, and 1 to 77 for HIV infection. Tuberculosis prevalence was higher in studies in which diagnosis was by chest radiography than in those which used other diagnostic methods and in countries with a higher general population prevalence than in those with a lower general prevalence. Prevalence of HIV infection was lower in newer studies than in older ones and was higher in the USA than in the rest of the world. Interpretation Heterogeneity in prevalence estimates for tuberculosis, hepatitis C virus, and HIV suggests the need for local surveys to inform development of health services for homeless people. The role of targeted and population-based measures in the reduction of risks of infectious diseases, premature mortality, and other adverse outcomes needs further examination. Guidelines for screening and treatment of infectious diseases in homeless people might need to be reviewed. Funding The Wellcome Trust.
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              Sexually Transmitted Diseases Treatment Guidelines, 2015

              (2015)
              Article 0 comments Cited 79 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Epidemiol Infect
                Journal ID (iso-abbrev): Epidemiol. Infect
                Journal ID (publisher-id): HYG
                Title: Epidemiology and Infection
                Publisher: Cambridge University Press (Cambridge, UK )
                ISSN (Print): 0950-2688
                ISSN (Electronic): 1469-4409
                Publication date (Electronic, collection): 2020
                Publication date (Electronic, pub): 30 March 2020
                Volume: 148
                Electronic Location Identifier: e85
                Affiliations
                [1 ]Kaiser Permanente San Francisco/University of California San Francisco Internal Medicine/Preventive Medicine Residency , San Francisco, USA
                [2 ]Division of Communicable Disease Control, California Department of Public Health, Richmond, California, USA
                [3 ]Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention , Atlanta, Georgia, USA
                Author notes
                Author for correspondence: J. P. Watt, E-mail: James.Watt@ 123456cdph.ca.gov
                Author information
                https://orcid.org/0000-0003-2048-2871
                Article
                Publisher Item ID: S0950268820000722
                DOI: 10.1017/S0950268820000722
                PMC ID: 7189346
                PubMed ID: 32223777
                SO-VID: 9795609b-6b77-4b90-8b2d-5f74cd5738cc
                Copyright © © California Department of Public Health 2020
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 October 2019
                Date revision received : 29 January 2020
                Date accepted : 26 February 2020
                Page count
                Figures: 3, Tables: 2, References: 73, Pages: 10
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Public health
                Keywords: infectious disease,people experiencing homelessness,public health,vulnerable populations
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: infectious disease, people experiencing homelessness, public health, vulnerable populations

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