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Higher rate of infection among homeless ‘put overall population at risk’

New data published in The Lancet shows much higher infection rates of TB, HIV and Hepatitis-C among homeless people.

Image: AP Photo/Karin Schermbrucker/PA File

HOMELESS PEOPLE are at much higher risk of contracting an infectious disease than the general population, putting community health overall at risk, according to a new study published online in the medical journal The Lancet.

The report’s researchers studied more than 40 research papers on the level of HIV, Hepatitis C and TB among homeless people between 1984 and 2012.

Despite variations by country and by region, the researchers found that homeless people have a much higher likelihood of having one of those three diseases than the general population.

In the US, TB is 46 times more prevalent among the homeless population, while Hepatitis-C infections are four times more prevalent. Meanwhile, in the UK, TB is 34 times higher among homeless people and Hepatitis-C infection is almost 50 times higher.

“Infections in homeless people can lead to community infections and are associated with malnutrition, long periods of homelessness, and high use of medical services,” the report’s lead author Dr Seena Fazel, a Wellcome Trust Senior Research Fellow in Clinical Science at the University of Oxford.

“Because absolute numbers of homeless people are high in some countries, improvements in care could have pronounced effects on public health.”

Dr Fazel recommends a proactive approach to identifying people with infectious diseases such as TB:

Screening for tuberculosis should be done through active case-finding – it should not be restricted to symptomatic people presenting to health services, which happens less and less in marginalised groups than in general populations.

Commenting on the report, Dr Didier Raoult of the University of Aix-Marseille said that “targeted actions are needed to address the susceptibility of homeless people to infection”.

“The risks of epidemics of infections diseases in homeless populations remain significantly higher than those in the general population in the same country. These increased risks are a public health challenge for a population as a whole.”

“Implementation of specific strategies to reduce these risks is crucial,” he added.

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