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Waddell CJ, Saldana CS, Schoonveld MM, Meehan AA, Lin CK, Butler JC, Mosites E. Infectious Diseases Among People Experiencing Homelessness: A Systematic Review of the Literature in the United States and Canada, 2003-2022. Public Health Rep 2024; 139:532-548. [PMID: 38379269 PMCID: PMC11344984 DOI: 10.1177/00333549241228525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
Homelessness increases the risk of acquiring an infectious disease. We conducted a systematic review of the literature to identify quantitative data related to infectious diseases and homelessness. We searched Google Scholar, PubMed, and SCOPUS for quantitative literature published from January 2003 through December 2022 in English from the United States and Canada. We excluded literature on vaccine-preventable diseases and HIV because these diseases were recently reviewed. Of the 250 articles that met inclusion criteria, more than half were on hepatitis C virus or Mycobacterium tuberculosis. Other articles were on COVID-19, respiratory syncytial virus, Staphylococcus aureus, group A Streptococcus, mpox (formerly monkeypox), 5 sexually transmitted infections, and gastrointestinal or vectorborne pathogens. Most studies showed higher prevalence, incidence, or measures of risk for infectious diseases among people experiencing homelessness as compared with people who are housed or the general population. Although having increased published data that quantify the infectious disease risks of homelessness is encouraging, many pathogens that are known to affect people globally who are not housed have not been evaluated in the United States or Canada. Future studies should focus on additional pathogens and factors leading to a disproportionately high incidence and prevalence of infectious diseases among people experiencing homelessness.
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Affiliation(s)
- Caroline J. Waddell
- Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carlos S. Saldana
- Division of Infectious Disease, School of Medicine, Emory University, Atlanta, GA, USA
| | - Megan M. Schoonveld
- Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, US Department of Energy, Oak Ridge, TN, USA
| | - Ashley A. Meehan
- Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christina K. Lin
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Jay C. Butler
- Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of Infectious Disease, School of Medicine, Emory University, Atlanta, GA, USA
| | - Emily Mosites
- Office of Readiness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Osei Bonsu E, Addo IY, Adjei BN, Alhassan MM, Nakua EK. Prevalence, treatment outcomes and determinants of TB-HIV coinfection: a 10-year retrospective review of TB registry in Kwabre East Municipality of Ghana. BMJ Open 2023; 13:e067613. [PMID: 36948553 PMCID: PMC10040042 DOI: 10.1136/bmjopen-2022-067613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE To assess the prevalence, treatment outcomes and determinants of tuberculosis (TB)-HIV coinfection in Ghana. STUDY DESIGN A retrospective review of TB case register for Kwabre East Municipality was conducted for the period 2010-2020 to identify TB-HIV coinfections. SETTING 462 patients with TB from four sub-municipal treatment centres were included in the study. PRIMARY OUTCOME MEASURE A logistic regression model was used to investigate the relationship between clinico-demographic factors (age, sex, type of patient, disease classification, treatment category and sputum smear microscopy) and TB-HIV coinfection. RESULTS Of the 462 individual TB cases found in the TB register from 2010 to 2020, 286 (61.9%) were screened for HIV and the results showed that 18% had TB-HIV coinfection. TB-HIV coinfection was highest in 2015 with a prevalence of 40% among all registered TB cases. The likelihood of TB-HIV coinfection was highest among patients with TB aged 40-49 years (AOR=3.99, CI=1.3, 12.7). Those who tested negative for TB at the end of their treatment period had lower odds of HIV coinfection (AOR=0.27, CI=0.10, 0.72). CONCLUSION Nearly one out of every five (18%) patients with TB in the municipality were found to be coinfected with HIV. TB-HIV coinfection was significantly associated with patients' age and their TB treatment outcomes. Urgent interventions are needed to address these risk factors to promote optimal health for patients with TB in the municipality.
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Affiliation(s)
- Emmanuel Osei Bonsu
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Public Health, Ghana Health Service, Accra, Ghana
| | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Benjamin Noble Adjei
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Muhib Mohammed Alhassan
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Kweku Nakua
- School of Public Health, Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Behlül S, Özdal MA. Correlation of Trends in the Incidence of Selected Infectious Diseases with Healthcare Expenditures: An Ecological Study. CYPRUS JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4274/cjms.2021.2021-69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Marcus R, Tie Y, Dasgupta S, Beer L, Padilla M, Fagan J, Prejean J. Characteristics of Adults With Diagnosed HIV Who Experienced Housing Instability: Findings From the Centers for Disease Control and Prevention Medical Monitoring Project, United States, 2018. J Assoc Nurses AIDS Care 2022; 33:283-294. [PMID: 34812797 PMCID: PMC9124455 DOI: 10.1097/jnc.0000000000000314] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT People living with HIV (PLWH) who experience homelessness have poorer clinical outcomes than people with HIV who are not homeless; however, there is limited information on PLWH who experience other forms of housing instability. We used interviews and medical record abstraction data from the Medical Monitoring Project, collected 2018-2019 (N = 4,050), to describe sociodemographic characteristics and clinical outcomes of adults with HIV by whether people experienced unstable housing in the past 12 months. Overall, 21% were unstably housed, of which 55.2% were unstably housed but not homeless. People who were unstably housed were more likely to be younger, have lower educational attainment, be previously incarcerated, live at or below the poverty level, and have poorer mental health and clinical outcomes, independent of homelessness. Interventions to address housing instability, integrated with clinical care, could benefit not just PLWH who are homeless but also those who are unstably housed.
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Affiliation(s)
- Ruthanne Marcus
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yunfeng Tie
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharoda Dasgupta
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Linda Beer
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mabel Padilla
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Fagan
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joseph Prejean
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Ahmed Mustafa GM, Yassin ME, Shami A, Rahim SA. Screening of Human Immunodeficiency Virus (HIV) among Newly Diagnosed Tuberculosis Patients in Eastern Sudan. Pol J Microbiol 2021; 70:201-206. [PMID: 34349811 PMCID: PMC8326980 DOI: 10.33073/pjm-2021-017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/17/2021] [Accepted: 03/28/2021] [Indexed: 11/05/2022] Open
Abstract
Tuberculosis (TB) is a leading cause of death in patients infected with Human Immunodeficiency Virus (HIV), and HIV infection is the most potent risk factor for the development of active TB disease from a latent TB infection. This study aims to determine the seroprevalence of HIV among newly diagnosed TB patients in Kassala state eastern Sudan. This was a descriptive, hospital-based, cross-sectional study of 251 active and newly diagnosed TB patients, selected by simple random sampling. Blood samples and demographic data were collected from each patient. TB was diagnosed by direct ZN smear and molecular detection by Xpert MTB/RIF. The serum samples were tested for HIV using 4th generation enzyme-linked immunosorbent assay (ELISA). The prevalence of HIV was 13.9% (35/251), the infection rate among pulmonary TB was 17%, whereas that in extrapulmonary TB was 4.8%, the prevalence was (18.2%) in the males, and (7.2%) in the females. In conclusion: TB/HIV co-infection in the Eastern part of Sudan was high compared with the global prevalence, all TB patients should therefore be assessed for HIV risk factors and advised to undergo HIV testing.
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Affiliation(s)
- Gada Mustafa Ahmed Mustafa
- Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Alneelain University, Khartoum, Sudan
| | - Mustafa Eltigani Yassin
- Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Alneelain University, Khartoum, Sudan
| | - Ashwag Shami
- Biology Department, College of Sciences, Princess Nourah bint Abdulrahman University, Riyadh 11617, Saudi Arabia
| | - Samah Abdu Rahim
- Department of Microbiology. Alghad International College for Applied Medical Sciences, Saudi Arabia
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Otiende V, Achia T, Mwambi H. Bayesian modeling of spatiotemporal patterns of TB-HIV co-infection risk in Kenya. BMC Infect Dis 2019; 19:902. [PMID: 31660883 PMCID: PMC6819548 DOI: 10.1186/s12879-019-4540-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/09/2019] [Indexed: 02/01/2023] Open
Abstract
Background Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) diseases are globally acknowledged as a public health challenge that exhibits adverse bidirectional relations due to the co-epidemic overlap. To understand the co-infection burden we used the case notification data to generate spatiotemporal maps that described the distribution and exposure hypotheses for further epidemiologic investigations in areas with unusual case notification levels. Methods We analyzed the TB and TB-HIV case notification data from the Kenya national TB control program aggregated for forty-seven counties over a seven-year period (2012–2018). Using spatiotemporal poisson regression models within the Integrated Nested Laplace Approach (INLA) paradygm, we modeled the risk of TB-HIV co-infection. Six competing models with varying space-time formulations were compared to determine the best fit model. We then assessed the geographic patterns and temporal trends of coinfection risk by mapping the posterior marginal from the best fit model. Results Of the total 608,312 TB case notifications, 194,129 were HIV co-infected. The proportion of TB-HIV co-infection was higher in females (39.7%) than in males (27.0%). A significant share of the co-infection was among adults aged 35 to 44 years (46.7%) and 45 to 54 years (42.1%). Based on the Bayesian Defiance Information (DIC) and the effective number of parameters (pD) comparisons, the spatiotemporal model allowing space-time interaction was the best in explaining the geographical variations in TB-HIV coinfection. The model results suggested that the risk of TB-HIV coinfection was influenced by infrastructure index (Relative risk (RR) = 5.75, Credible Interval (Cr.I) = (1.65, 19.89)) and gender ratio (RR = 5.81e−04, Cr. I = (1.06e−04, 3.18e−03). The lowest and highest temporal relative risks were in the years 2016 at 0.9 and 2012 at 1.07 respectively. The spatial pattern presented an increased co-infection risk in a number of counties. For the spatiotemporal interaction, only a few counties had a relative risk greater than 1 that varied in different years. Conclusions We identified elevated risk areas for TB/HIV co-infection and fluctuating temporal trends which could be because of improved TB case detection or surveillance bias caused by spatial heterogeneity in the co-infection dynamics. Focused interventions and continuous TB-HIV surveillance will ensure adequate resource allocation and significant reduction of HIV burden amongst TB patients.
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Affiliation(s)
- Verrah Otiende
- Department of Mathematical Sciences, Pan African University Institute of Basic Sciences Technology and Innovation, Nairobi, Kenya.
| | - Thomas Achia
- School of Mathematics, Statistics & Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Henry Mwambi
- School of Mathematics, Statistics & Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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Aturinde A, Farnaghi M, Pilesjö P, Mansourian A. Spatial analysis of HIV-TB co-clustering in Uganda. BMC Infect Dis 2019; 19:612. [PMID: 31299907 PMCID: PMC6625059 DOI: 10.1186/s12879-019-4246-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is the leading cause of death for individuals infected with Human immunodeficiency virus (HIV). Conversely, HIV is the most important risk factor in the progression of TB from the latent to the active status. In order to manage this double epidemic situation, an integrated approach that includes HIV management in TB patients was proposed by the World Health Organization and was implemented in Uganda (one of the countries endemic with both diseases). To enable targeted intervention using the integrated approach, areas with high disease prevalence rates for TB and HIV need to be identified first. However, there is no such study in Uganda, addressing the joint spatial patterns of these two diseases. METHODS This study uses global Moran's index, spatial scan statistics and bivariate global and local Moran's indices to investigate the geographical clustering patterns of both diseases, as individuals and as combined. The data used are TB and HIV case data for 2015, 2016 and 2017 obtained from the District Health Information Software 2 system, housed and maintained by the Ministry of Health, Uganda. RESULTS Results from this analysis show that while TB and HIV diseases are highly correlated (55-76%), they exhibit relatively different spatial clustering patterns across Uganda. The joint TB/HIV prevalence shows consistent hotspot clusters around districts surrounding Lake Victoria as well as northern Uganda. These two clusters could be linked to the presence of high HIV prevalence among the fishing communities of Lake Victoria and the presence of refugees and internally displaced people camps, respectively. The consistent cold spot observed in eastern Uganda and around Kasese could be explained by low HIV prevalence in communities with circumcision tradition. CONCLUSIONS This study makes a significant contribution to TB/HIV public health bodies around Uganda by identifying areas with high joint disease burden, in the light of TB/HIV co-infection. It, thus, provides a valuable starting point for an informed and targeted intervention, as a positive step towards a TB and HIV-AIDS free community.
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Affiliation(s)
- Augustus Aturinde
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
- College of Computing and Information Science, Makerere University, Kampala, Uganda
- Department of Lands and Architectural Studies, Kyambogo University, Kampala, Uganda
| | - Mahdi Farnaghi
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
| | - Petter Pilesjö
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
- Centre for Middle Eastern Studies, Lund University, Sölvegatan 10, 223 62 Lund, Sweden
| | - Ali Mansourian
- GIS Centre, Department of Physical Geography and Ecosystem Science, Lund University, SE-221 00 Lund, Sweden
- Centre for Middle Eastern Studies, Lund University, Sölvegatan 10, 223 62 Lund, Sweden
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