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Death rate from tuberculosis in homeless alarmingly high: Study
Date:2/16/2011

TORONTO, Ont., February 16, 2011 One in five homeless people with tuberculosis die within a year of their diagnosis, according to a study led by St. Michael's Hospital's Dr. Kamran Khan. And that number remains unchanged over the last decade despite recommendations calling for greater improvements in prevention and control of tuberculosis in homeless shelters.

A provincial coroner's inquest into the death of Joseph Teigesser, a homeless man who died of tuberculosis in Toronto in 2001, made 13 formal recommendations. These included provincial funding for a centralized clinic system to provide specialized care for those with tuberculosis in Ontario and a review and improvement of shelter ventilation systems. However, the work surrounding these two key recommendations has fallen short, the researchers say in the study.

"The treatment of tuberculosis is often complicated by inadequate housing, substance dependence, language barriers, mental health problems, not to mention the enormous stigma that comes with this disease," Khan says. "To effectively control tuberculosis, centres with specialized expertise and resources are needed to address these complex issues."

The 10-year study, published in the March issue of the journal Emerging Infectious Diseases, also found a growing proportion of tuberculosis cases in Toronto's homeless shelters are in immigrants, raising the risk that dangerous drug resistant strains of tuberculosis could enter the shelter system.

The study found nearly 40 per cent of all tuberculosis cases in the homeless were in immigrants. About 56 per cent of all infections in immigrants involved strains that were not known to be circulating in the city, and were likely acquired in other parts of the world where drug resistance is common.

Historically, tuberculosis in Toronto's homeless population was mostly a disease of Canadian-born men. While highly drug resistant tuberculosis is unusual among
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Contact: Julie Saccone
sacconej@smh.ca
416-864-5047
St. Michael's Hospital
Source:Eurekalert

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