Indian Journal of Public Health Research & Development

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Death Due to Tuberculosis in Homeless Unclaimed Population in Central Delhi-a Retrospective Study


Affiliations
1 Dept. of Forensic Medicine & Toxicology, Lady Hardinge Medical College, New Delhi, India
     

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Homeless and marginally housed people in developing countries have specific problems predisposing them to infectious diseases; have much greater risk of developing the active form of tuberculosis and much higher mortality and shorter life expectancy. India has the largest number (14 million) of TB sufferers in the world. We need to do a much better job in preventing tuberculosis from spreading in this homeless vulnerable population, and in providing timely, effective clinical care for those who are affected by this disease.

We carried out a 5 years retrospective study period between year 2006 and 2010, based on autopsy findings, in the department of forensic medicine at Lady Hardinge Medical College, New Delhi. During this study we tried to find out the load of mortality due to tuberculosis in homeless population of central district of New Delhi (capital of India), where those unclaimed dead bodies were brought for postmortem examination, all unknown and unclaimed deaths were considered suspicion. During this 5 year period total 2773 autopsies were conducted in the morgue of LHMC, New Delhi, out of that, 749 cases (27.01%) were homeless unclaimed people. 122 deaths (16.28%) were due to pulmonary tuberculosis in homeless. The maximum 40 cases (32.78%) were in age group of more than 50 years individuals, and minimum in age group of 11 - 20 years; 3 cases (2.45%). Further, males were predominantly contributed with 116 cases (95.08%) and remaining 6 cases (4.91%) were females. Maximum deaths were occurred during rainy season (July - September); 56 deaths (45.90%).


Keywords

Tuberculosis, Death, Homeless, Postmortem, Natural Disease
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  • Alstrom CH, Lindelius R, Salum I. Mortality among homeless men. Br J Addict Alcohol Other Drugs 1975; 70: 245–52.

  • Altun G, A. Yýlmaz and D. Azmak, Death among homeless people in Istanbul. Forensic Sci Int 1999; 143–147.

  • Arvind Kumar, Sanjeev Lalwani, C. Behera, T.D. Dogra. Deaths of homeless unclaimed persons in South Delhi (2001-2005): a retrospective review.

  • Barry MA, Wall C, Shirley L, et al. Tuberculosis screening in Boston’s homeless shelters. Public Health Rep 1986; 101: 487–94.

  • Bosek MS, Burton LA, Savage TA. The patient who could not be discharged. How far should patient autonomy extend? JONAS Health Law Ethics Regul 1999; 1: 23–30.

  • Brickner PW, Scanlan BC, Conanan B. Homeless persons and health care. Ann Intern Med 1986; 104: 405–409.

  • Chauvin P, Mortier E, Carrat F, Imbert JC, Valleron AJ, Lebas J. A new out-patient care facility for HIVinfected destitute populations in Paris, France. AIDS Care 1997; 9: 451–59.

  • Curtis AB, Ridzon R, Novick LF. Analysis of Mycobacterium tuberculosis transmission patterns in a homeless shelter outbreak. Int J Tuberc Lung Dis 2000; 4: 308–313.

  • Dwyer B, Jackson K, Raios K, Sievers A, Wilshire E, Ross B. DNA restriction fragment analysis to define an extended cluster of tuberculosis in homeless men and their associates. J Infect Dis 1993; 167: 490–94.

  • French AL, Welbel SF, Dietrich SE. Use of DNA fingerprinting to assess tuberculosis infection control. Ann Intern Med 1998; 129:856–61.

  • Gaur S N V.K. Dhingra, S. Rajpal, J.K. Aggarwal, Meghnal. Tuberculosis in elderly and their treatment. Indian J Tuberc 2004; 51: 83-87.

  • Gutierrez MC, Vincent V, Aubert D, et al. Molecular fingerprinting of Mycobacterium tuberculosis and risk factors for tuberculosis transmission in Paris, France, and surrounding area. J Clin Microbiol 1998; 36: 486–92.

  • Hanzlick R, Gibson Parrish R. Death among the homeless in Fulton County, GA, 1988 – 90. Public health report July – August 1993; 108(4): 488 – 491.

  • Hwang SW, Lebow JM, Bierer MF, O’Connell JJ, Orav EJ, Brennan TA. Risk factors for death in homeless adults in Boston. Arch Intern Med 1998; 158: 1454–60.

  • Ishorst-Witte F, Heinemann A, Püschel K. Morbidity and cause of death in homeless persons. Arch Kriminol. 2001 Nov-Dec; 208(5-6):129-38.

  • Jonathan R. Hibbs, Lawrence Benner, Lawrence Klugman, Robert Spencer, Irene Macchia, Anne K. Mellinger, Daniel Fife. Mortality in a Cohort of Homeless Adults in Philadelphia. N Engl J Med 1994 August; 331:304-309.

  • Kong PM, Tapy J, Calixto P, Burman WJ, Reves RR, Yang Z. Skin-test screening and tuberculosis transmission among the homeless. Emerg Infect Dis 2002; 8: 1280-4.

  • LoBue PA, Cass R, Lobo D, Moser K, Catanzaro A. Development of housing programs to aid in the treatment of tuberculosis in homeless individuals: a pilot study. Chest 1999; 115: 218–23.

  • Lowry S. Housing and health: health and homelessness. BMJ 1990; 300: 32–34.

  • Moss AR, Hahn JA, Tulsky JP, Daley CL, Small PM, Hopewell PC. Tuberculosis in the homeless: A prospective study. Am J Respir Crit Care Med 2000; 162: 460–64.

  • O’Connell JJ. Non tuberculosis respiratory infections among the homeless. Semin Respir Infect 1991; 6: 247–53.

  • Ohsaka T, Sakai Y, Kuroda K, Matoba R. A survey of deaths of homeless people in Osaka City. Nihon Koshu Eisei Zasshi 2003 Aug; 50(8):686-96.

  • Paul EA, Lebowitz SM, Moore RE, Hoven CW, Bennett BA, Chen A. Nemesis revisited: tuberculosis infection in a New York City men’s shelter. Am J Public Health 1993; 83: 1743–45.

  • Reuters/Adnan Abidi January 13th, 2011.

  • Rosenheck R, Lam JA. Client and site characteristics as barriers to service use by homeless persons with serious mental illness. Psychiatr Serv 1997; 48: 387–90.

  • Rossi PH, Wright JD, Fisher GA, Willis G. The urban homeless: estimating composition and size. Science 1987; 235: 1336–41.

  • Sanchez-Arcilla I, Vilchez JM, Garcia de la Torre M, Fernandez X, Noguerado A. Treatment of latent tuberculosis among homeless population: Comparison between two therapeutic approaches. Med Clin (Barc) 2004; 122: 57-9.

  • Schieffelbein CW, Snider DE. Tuberculosis control among homeless populations. Arch Intern Med 1988; 148: 1843–46.

  • Tuberculosis among residents of shelters for the homeless—Ohio, 1990. MMWR Morb Mortal Wkly Rep 1991; 40: 869–71, 877.

  • Yalcýn Buyuk, Ýbrahim uzun, Murat Eke, Gursel Cetin. Homeless deaths in Istanbul, Turkey. Jr Foren and Legal Medicine July 2008; 15(5):318- 321.

  • Zolopa, AR, Hahn, JA, Gorter, R. HIV and tuberculosis infection in San Francisco’s homeless adults: prevalence and risk factors in a representative sample. JAMA 1994; 272: 455-461.


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  • Death Due to Tuberculosis in Homeless Unclaimed Population in Central Delhi-a Retrospective Study

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Authors

B L Chaudhary
Dept. of Forensic Medicine & Toxicology, Lady Hardinge Medical College, New Delhi, India
Rahul M Band
Dept. of Forensic Medicine & Toxicology, Lady Hardinge Medical College, New Delhi, India
Pradeep Yadav
Dept. of Forensic Medicine & Toxicology, Lady Hardinge Medical College, New Delhi, India
Mukesh Kumar
Dept. of Forensic Medicine & Toxicology, Lady Hardinge Medical College, New Delhi, India
Yahsoda Rani
Dept. of Forensic Medicine & Toxicology, Lady Hardinge Medical College, New Delhi, India

Abstract


Homeless and marginally housed people in developing countries have specific problems predisposing them to infectious diseases; have much greater risk of developing the active form of tuberculosis and much higher mortality and shorter life expectancy. India has the largest number (14 million) of TB sufferers in the world. We need to do a much better job in preventing tuberculosis from spreading in this homeless vulnerable population, and in providing timely, effective clinical care for those who are affected by this disease.

We carried out a 5 years retrospective study period between year 2006 and 2010, based on autopsy findings, in the department of forensic medicine at Lady Hardinge Medical College, New Delhi. During this study we tried to find out the load of mortality due to tuberculosis in homeless population of central district of New Delhi (capital of India), where those unclaimed dead bodies were brought for postmortem examination, all unknown and unclaimed deaths were considered suspicion. During this 5 year period total 2773 autopsies were conducted in the morgue of LHMC, New Delhi, out of that, 749 cases (27.01%) were homeless unclaimed people. 122 deaths (16.28%) were due to pulmonary tuberculosis in homeless. The maximum 40 cases (32.78%) were in age group of more than 50 years individuals, and minimum in age group of 11 - 20 years; 3 cases (2.45%). Further, males were predominantly contributed with 116 cases (95.08%) and remaining 6 cases (4.91%) were females. Maximum deaths were occurred during rainy season (July - September); 56 deaths (45.90%).


Keywords


Tuberculosis, Death, Homeless, Postmortem, Natural Disease

References