On January 27, 2023, Public Health Reports, released “Diagnosis, Treatment, and Prevention of Tuberculosis Among People Experiencing Homelessness in the United States.”
People experiencing homelessness (PEH) are at increased risk for tuberculosis (TB). The Advisory Council for the Elimination of Tuberculosis issued recommendations in 1992 for TB prevention and control among PEH. The recently released Public Health Reports, “Diagnosis, Treatment, and Prevention of Tuberculosis Among People Experiencing Homelessness in the United States” provides a summary of existing guidelines and information in one place to inform medical and public health providers and TB programs on TB incidence, diagnosis, and treatment among PEH. In accordance with the current US guidelines and recommendations on TB diagnosis, treatment, and prevention, healthcare providers serving PEH should:
- Assess the magnitude of homelessness in their jurisdictions
- Test PEH and shelter staff for TB disease and latent TB infection and treat those diagnosed with TB using short-course treatment regimens
- Identify TB disease among PEH by using diagnostics that can detect TB within 24 to 48 hours
- Immediately report possible TB disease among PEH to the local public health department
- Screen routinely for HIV among all PEH who begin treatment for TB disease
- Provide temporary housing and link PEH to permanent housing opportunities
- Perform location-based contact investigations with PEH who are infected with TB disease
This publication reports that treatment using “directly observed therapy” resulted in increased adherence to treatment among PEH, as did involvement of social workers in the provision of housing, food, safety, and comorbidity treatment, especially for HIV and substance use disorders. Testing and treating latent TB infection helps prevent the progression of latent TB infection to TB disease and prescribing shorter, rifamycin-based treatment regimens for latent TB infection improves adherence and completion of treatment.
By following existing recommendations and using client-centered approaches, providers serving PEH can improve TB diagnosis, treatment, and prevention among PEH. For more information, visit the CDC webpage on TB and People Experiencing homelessness.
