Pattern of infections in French and migrant homeless hospitalised at Marseille infectious disease units, France: A retrospective study, 2017–2018

Ly, Tran Duc Anh; Dao, Thi Loi; Hoang, Van Thuan; Braunstein, David; Brouqui, Philippe; Lagier, Jean-Christophe; Parola, Philippe

doi:10.1016/j.tmaid.2020.101768

Cited by 10 publications

(15 citation statements)

References 29 publications

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“…In our study, homeless people were characterised by a high proportion of migrants, a high proportion of smokers, and one third lacked health insurance coverage which is in line with previous surveys conducted in Marseille homeless shelters [ 3 – 5 ] and with surveys conducted in others European cities such as Frankfurt (Germany) [ 8 ] and Geneva (Switzerland) [ 6 ].…”

Section: Discussionsupporting

confidence: 88%

“…Over the past two decades, we have seen a change in the sheltered homeless population in Marseille, with a rising proportion of migrants [ 4 ]. All of the nine homeless APTB patients hospitalised at our hospital between 2017 and 2018 were migrants [ 5 ]. Screening for APTB in homeless people is, therefore, of major importance in terms of public health.…”

Section: Introductionmentioning

confidence: 99%

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Screening Strategy of Active Pulmonary Tuberculosis in Sheltered Homeless People in Marseille, 2019

Ly¹,

Holi-Jamovski²,

Hoang³

et al. 2020

JEGH

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We aimed to assess the reliability of a screening questionnaire for Active Pulmonary Tuberculosis (APTB) in a population of sheltered homeless persons (HP). Participants from two homeless shelters completed a questionnaire specially designed to identify patients at high-risk of APTB (available at www.tb-screen.ch ), underwent a Chest X-ray (CXR), and provided sputum samples. Computed Tomography (CT) scanning was subsequently performed on those which had images consistent with APTB. Microscopical examination, real-time polymerase chain reaction (qPCR) and culture testing were applied for Mycobacterium tuberculosis complex detection. Additionally, we retrospectively selected 16 HP hospitalised in our hospital between 2017 and 2019 with biologically confirmed tuberculosis and typical CXR images, and retrospectively documented a screening questionnaire by reviewing their medical files. Overall, the population ( n = 383 HP) was predominantly migrants (87%). Forty-seven individuals (11.7%) had positive screening questionnaire scores and four (2.4%) displayed abnormal CXR features consistent with APTB. Three of them three underwent CT scanning that ruled out APTB and one was lost to follow-up. None tested positive through microbiological investigation. Fifteen (of 16, 93.8%) hospitalised patients with biologically confirmed APTB had a positive screening questionnaire score. The sensitivity and specificity of questionnaire for confirmed APTB were 93.8% and 87.7%, respectively. Screening questionnaires can be used as a first assessment tool in people arriving at homeless shelters and to refer those screening positive for a CXR.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Screening Strategy of Active Pulmonary Tuberculosis in Sheltered Homeless People in Marseille, 2019

Ly¹,

Holi-Jamovski²,

Hoang³

et al. 2020

JEGH

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“…Thirty studies were conducted in adults (mean age: 25-49 years, range 16-86 years) [6, 14, 15, 17-25, 29-34, 37-40, 44-47, 49, 51-53], five studies were conducted in street youth (mean age:10-16 years, range 8-18 years) [16, 26-28, 51], and seven in both children and adults (mean age: 14-26 years, range 9-65 years) [35, 36, 41-43, 48, 50]. Studies were conducted in the USA (n=17) [14, 18, 33-35, 38, 40-47, 49, 52, 53], Iran (n=4) [6, 17, 21, 28], Canada [36, 48, 51], Brazil [19, 37, 50] France [15, 16] (including unpublished data), the UK [23, 25, 33], (n=3 per country), Australia [31], Costa Rica [24], Czech Republic [32], Germany [22], India [26], Ireland [29], Peru [20], Philippines [27] and Spain [39] (n=1 per country). Forty studies were seroprevalence surveys [6, 14-19, 21-42, 44-53].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported vaccination status against HBV infection through a questionnaire, with rates of 9%-54% (at least one dose) and 11.8%->66% (3 doses) [22, 30, 43, 44, 46, 48], and three studies showed immunisation rates of 21.8%-38.7% through serological tests [19, 23]. Anti-HBV vaccination was strongly recommended by all authors for high risk groups such as street youth or injected drug users (n=24 studies, including unpublished data) [15, 16, 19, 22, 23, 31, 32, 35-37, 39-44, 46-48, 50-53].…”

Section: Resultsmentioning

confidence: 99%

Vaccine-preventable diseases other than tuberculosis, and homelessness: A systematic review of the published literature, 1980 to 2020

Castaneda

Hoang

et al. 2020

Preprint

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Background. Homelessness may result in the breakdown of regular health services, including routine vaccination programmes. A literature review was conducted to describe vaccine-preventable diseases (VPD) other than tuberculosis in homeless populations and to summarize vaccination recommendations in homeless people. Methods. We followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We searched peer-reviewed literature published in English, French or Spanish reporting the outbreak of VPD or VPD prevalence in both infant and adult homeless populations published between 1980 and 2020, using PubMed/Medline, SciELO, Google Scholar, and Web of Science databases. Relevant information from the studies was charted in Microsoft Excel and results were summarised using a descriptive analytical method. Results. Seventy-five articles were included. A high prevalence of past HBV and HAV infections were observed through serosurveys, mostly in high income countries or high-middle income countries (USA, Canada, France, Iran or Brazil). Nine outbreaks of HAV infection were also reported, with lethality rates ranging from 0-4.8%. The studies discussed numerous risk factors positively associated with HBV infection, including older age, homosexual or bisexual practice, injected drug use (IDU), and, with HAV infection including IDU, having sexual partner(s) with a history of unspecified hepatitis, insertive anal penetration, or originating from a country with a high prevalence of anti-HAV antibody. Eleven outbreaks of pneumococcal infection affecting homeless persons were reported in Canada and USA, with lethality rates from 0-15.6%. Five diphtheria outbreaks were reported. Vaccination status was rarely documented in these studies. Conclusions. The literature suggests that homeless populations generally experience a higher VPD burden and lower immunisation rates. The findings suggest the need for a national vaccination programme and planning for delivering vaccines in this population.

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“…France between 2017-2018 [15]. In a previous work, using direct molecular detection, we observed a lower prevalence of resistance genes in nasal swabs in sheltered homeless in…”

Section: Introductionmentioning

confidence: 86%

Low rates of enteric pathogenic bacteria and resistance gene carriage in the sheltered homeless population in Marseille, France

Hadjadj

Hoang

et al. 2020

Preprint

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We aimed to assess the prevalence of pathogenic bacteria and resistance genes in rectal samples collected among homeless persons in Marseille, France. In February 2014 we enrolled 114 sheltered homeless adults who completed questionnaires and had rectal samples collected. Eight types of enteric bacteria and 15 antibiotic resistance genes (ARGs) were sought by real-time polymerase chain reaction (qPCR) performed directly on rectal samples. ARG-positive samples were further tested by conventional PCR and sequencing. We evidenced a 17.5% prevalence of gastrointestinal symptoms, a 9.6% DNA-prevalence of enteric bacteria carriage, including Escherichia coli pathotypes (8.7%) and Tropheryma whipplei (0.9%). Only 2 persons carried blaCTX-M-15 resistance genes (1.8%), while other genes, including carbapenemase-encoding genes and colistin-resistance genes, (mcr-1 to mcr-6, mcr-8) were not detected. Our results suggest that sheltered homeless persons in Marseille do not have a high risk of harbouring gastrointestinal antibiotic resistant bacteria. Keywords: antibiotic resistance gene; enteric bacteria; homeless; real-time polymerase chain reaction (qPCR)

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Pattern of infections in French and migrant homeless hospitalised at Marseille infectious disease units, France: A retrospective study, 2017–2018

Cited by 10 publications

References 29 publications

Screening Strategy of Active Pulmonary Tuberculosis in Sheltered Homeless People in Marseille, 2019

Screening Strategy of Active Pulmonary Tuberculosis in Sheltered Homeless People in Marseille, 2019

Vaccine-preventable diseases other than tuberculosis, and homelessness: A systematic review of the published literature, 1980 to 2020

Low rates of enteric pathogenic bacteria and resistance gene carriage in the sheltered homeless population in Marseille, France

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