Skip directly to search Skip directly to A to Z list Skip directly to site content
CDC Home

Volume 17, Number 3—March 2011

Research

Active Tuberculosis among Homeless Persons, Toronto, Ontario, Canada, 1998–2007

Kamran KhanComments to Author , Elizabeth Rea, Cameron McDermaid, Rebecca Stuart, Catharine Chambers, Jun Wang, Angie Chan, Michael Gardam, Frances Jamieson, Jae Yang, and Stephen W. Hwang
Author affiliations: Author affiliations: St. Michael’s Hospital, Toronto, Ontario, Canada (K. Khan, C. Chambers, J. Wang, A. Chan, J. Yang, S.W. Hwang); University of Toronto, Toronto (K. Khan, E. Rea, M. Gardam, F. Jamieson, S.W. Hwang); Toronto Public Health, Toronto (E. Rea, R. Stuart); City of Ottawa, Ottawa, Ontario, Canada (C. McDermaid); University Health Network, Toronto (M. Gardam); Ontario Agency for Health Promotion and Protection, Toronto (F. Jamieson)

Main Article

Table 2

Demographic and clinical characteristics of 91 homeless persons with tuberculosis, Toronto, Ontario, Canada, 1998–2007*

Characteristic All persons, no. (%) Canada born, no. (%) Foreign born, no. (%) p value† 1998–2002, no. (%) 2003–2007, no. (%) p value‡
Median age, y (IQR) 47 (38–56) 49 (42–58) 38 (30–50) 45 (38–59) 48 (40–54)
Male sex
81 (89)
53 (88)
25 (89)
1.00
40 (91)
41 (87)
0.74
Origin 0.15
Canada born, not Aboriginal 47 (53) 47 (78) NA 27 (64) 20 (43)
Canada born, Aboriginal 13 (15) 13 (22) NA 5 (12) 8 (17)
Foreign born
28 (32)
NA
28 (100)

10 (24)
18 (39)

Case type 0.43 1.00
New 83 (91) 53 (88) 27 (96) 40 (91) 43 (91)
Re-treated§
8 (9)
7 (12)
1 (4)

4 (9)
4 (9)

Method of detection
Signs and symptoms 51 (56) 30 (50) 18 (64) 23 (52) 28 (60)
Contact tracing 19 (21) 16 (27) 3 (11) 11 (25) 8 (17)
Diagnosis while under care for
other condition 8 (9) 8 (13) 0 4 (9) 4 (9)
Immigration screening 6 (7) NA 6 (21) 6 (14) 0
Active case finding (sputum
screening) 3 (3) 3 (5) 0 NA 3 (6)
Jail 1 (1) 1 (2) 0 0 1 (2)
Other¶
3 (3)
2 (3)
1 (4)

0
3 (6)

Site(s) of infection 1.00 0.15
Pulmonary only 67 (74) 45 (75) 21 (75) 33 (75) 34 (72)
Extrapulmonary only 21 (23) 13 (22) 6 (21) 8 (18) 13 (28)
Pulmonary and extrapulmonary
3 (3)
2 (3)
1 (4)

3 (7)
0

Chest radiograph at diagnosis# 0.08
No abnormalities 9 (13) 7 (15) 2 (9) 0.86 7 (19) 2 (5)
Abnormal without cavitation 45 (65) 30 (64) 15 (68) 24 (67) 21 (62)
Abnormal with cavitation
15 (22)
10 (21)
5 (23)

5 (14)
11 (32)

Self-reported symptoms 73 (80) 50 (83) 20 (71) 0.26 34 (77) 39 (83) 0.60
Median time from symptom onset to diagnosis, mo (IQR)
1.9 (0.6–3.1)
1.8 (0.6–2.6)
2.6 (0.8–5.8)

1.8 (0.6–3.1)
2.2 (0.6–3.2)

Sputum smear results at diagnosis** 0.39 0.58
Negative 21 (33) 12 (29) 9 (43) 12 (40) 9 (27)
Scarce/moderate 13 (21) 8 (20) 5 (24) 5 (17) 8 (24)
Numerous
29 (46)
21 (51)
7 (33)

13 (43)
16 (49)

Method of diagnosis 0.59 0.18
Positive culture 86 (95) 55 (92) 28 (100) 40 (91) 46 (98)
Positive AMTD 3 (3) 3 (5) 0 3 (7) 0
Clinical 2 (2) 2 (3) 0 1 (2) 1 (2)

*Birthplace information available for 88 persons. IQR, interquartile range; NA, not applicable; –, no statistical test performed; AMTD, amplified Mycobacterium tuberculosis direct test.
†Probability of a significant difference between Canada-born and foreign-born persons for each variable; calculated by using the 2-sided Fisher exact test or χ2 test, as appropriate.
‡Probability of a significant difference between the 2 periods for each variable; calculated by using the 2-sided Fisher exact test or χ2 test, as appropriate.
§Public Health Agency of Canada definition: documented evidence or adequate history of previously active tuberculosis (TB) that was declared cured or treatment completed by current standards, AND at least 6 mo have passed since the last day of previous treatment, AND a diagnosis with a subsequent episode of TB that meets the active TB case definition.
¶Includes shelter screening, routine screening at other centers, and other detection methods.
#Results for only the 70 persons with pulmonary disease.
**Sputum smears available for 63 patients with pulmonary disease.

Main Article

Top of Page

USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO