Literature DB >> 19164432

Contribution of a shelter-based survey for screening respiratory diseases in the homeless.

Sékéné Badiaga1, Hervé Richet, Patricia Azas, Christine Zandotti, Françoise Rey, Rémi Charrel, El-hadi Benabdelkader, Michel Drancourt, Didier Raoult, Philippe Brouqui.   

Abstract

BACKGROUND: The homeless are at very high risk for both respiratory diseases and poor access to health care delivery systems. The aim of this study was to assess the contribution of a shelter-based survey to identify respiratory diseases in the homeless population in Marseilles, in order to further develop preventive interventions.
METHODS: A prevalence survey of respiratory diseases was conducted in two homeless shelters in Marseilles, in February 2005. A multidisciplinary team including infectious diseases specialists, lung specialists, residents, nurses, physiotherapists and X-ray technicians visited the two shelters. Interview, physical examination, sputum sampling for Mycobacterium tuberculosis detection, nasal swabs for virus detection and chest X-rays were performed in shelters. Chest X-rays were subsequently analysed by a pneumonologist and subjects found to have radiological abnormalities were hospitalized for further investigations.
RESULTS: Of the 221 homeless persons enrolled, 110/221 (50%) had at least one respiratory manifestations. Chest X-rays were abnormal in 14 persons. Active tuberculosis was diagnosed in two, influenza in two, respiratory syncytial virus infection in two, acute pneumonia in one, asthma in two, lung cancer in one, acute bronchitis in 23, chronic bronchitis in 42, and exacerbation of chronic obstructive pulmonary disease in 22 persons, respectively.
CONCLUSION: Our shelter-based survey, including clinical evaluation and chest radiographic screening, shows that this approach can be useful to control and prevent respiratory diseases among the homeless. However, further studies are necessary to determine the magnitude of influenza in the homeless, the impact of influenza immunization and optimal frequency of interventions in shelters.

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Year:  2009        PMID: 19164432     DOI: 10.1093/eurpub/ckn142

Source DB:  PubMed          Journal:  Eur J Public Health        ISSN: 1101-1262            Impact factor:   3.367


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