Skip to main content
padlock icon - secure page this page is secure

Free Content Spatio-temporal analysis of tuberculous infection risk among clients of a homeless shelter during an outbreak

Download Article:
 Download
(PDF 627.2 kb)
 
SETTING: British Columbia (BC) has a low incidence of tuberculosis (TB), with the burden of endogenously acquired disease concentrated among vulnerable populations, including the homeless. In May 2008, a TB outbreak began in a BC homeless shelter, with a single index case seeding multiple secondary cases within the shelter.

OBJECTIVE: To use nightly shelter records to quantify the risk of latent tuberculous infection (LTBI) among shelter clients as a function of their sleeping distance from and duration of exposure to the index case.

DESIGN: Distance and duration of exposure were visualised and assessed using logistic regression with LTBI status as outcome. We used a novel machine learning approach to establish exposure thresholds that optimally separated infected and non-infected individuals.

RESULTS: Of 161 exposed shelter clients, 58 had a recorded outcome of infected (n = 39) or non-infected (n = 19). Only duration of exposure to the index was associated with increased odds of infection (OR 1.26); stays of 5 nights put shelter clients at higher odds of infection (OR 4.97).

CONCLUSION: The unique data set and analytical approach suggested that, in a shelter environment, long-term clients are at highest risk of LTBI and should be prioritised for screening during an outbreak investigation.
No Reference information available - sign in for access.
No Supplementary Data.
No Article Media
No Metrics

Keywords: exposure; indoor air; infectiousness; transmission

Document Type: Research Article

Affiliations: 1: Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver, Canada 2: Department of Microbiology & Immunology, University of British Columbia, Vancouver, Canada 3: Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, Canada 4: British Columbia Public Health Microbiology and Reference Laboratory, Vancouver, British Columbia, Canada 5: Department of Mathematics, Imperial College London, London, UK 6: Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada 7: Interior Health Authority, Kelowna, British Columbia, Canada

Publication date: September 1, 2015

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more