Tuberculosis and homeless context

Homelessness and marginalized subpopulations, such as those without stable place of living, migrants, ethnic groups are at a greater risk of TB. In the R.Moldova were 150.000 homeless in 2016. Kishinev accounted 693 TB patients, among them 147 (21%) were homeless. The aim: assessment of the risk factors and their impact on the disease outcome. Methodology: retrospective, selective study of 419 TB patients registered as homeless in Kishinev during 2015-2017 was performed. <b>Results:</b> male/female ratio=3,5/1; urban/rural ratio=3,5/1, most affected age groups were 35-54 y.o. 226(54%), followed by 18-35 y.o. 125(3%) and older than 55 y.o. 56(13%). Unemployment and lack of insurance was identified in 328(78%), low level of scholarity 342(82%), extreme poverty 281(67%), alcoholism 61(15%), drug use 7(2%), HIV 52(12%), TB contact 48(11%), history of detention 41(9%), recent history of migration 53(13%) and psychic disorders 4(0,9%) cases. New cases were 233(56%) and previously treated 186(44%), including relapse 84(20%), failure 18(5%) and recovered after default 84(20%) cases. Pulmonary TB-diagnosed in 399(95%), milliary 25(6%), generalised 6(8%) and extrapulmonary TB 13(3%) cases. Lung destruction/cavernas 206(49%), AFB positive were146 (35%), positive for MBT cultivation 145(33%), positive Xpert MTB/Rif 184(46%) among them resistant 84(20%). Were treated 406(97%) and postmortem were diagnosed 8(1%). Successfully treated were 155(37%), died 48(11%), failed 5(1%), were lost to follow-up 74(17%) and were continuing the treatment 140(33%) cases. <b>Conclusion:</b> risk factors for TB at homeless were male sex, middle adulthood, low scholarity, HIV and harmful habits, which were perceived on low success rate. Homeless should be screened annually as high risk groups.