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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 4

Treatment-associated 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‡
Days from diagnosis to initiation of treatment, median (IQR)
1 (0–4)
0.5 (0–4)
1 (0–6)

1 (0–3)
1 (0–4)

Duration of treatment, mo, median (IQR)
Total 9.9
(6.5–12.7) 10.0
(6.8–12.5) 8.6
(6.0–12.9) 9.0
(6.1–12.2) 10.8
(6.7–13.1)
Treatment in institution 2.0
(0.2–4.0) 2.4
(0.5–3.9) 0.6
(0–4.2) 0.9
(0.2–3.9) 2.2
(0.0–4.1)
Treatment under directly
observed therapy 6.2
(0.8–8.8) 6.4
(0.9–9.0) 6.0
(2.4–7.2) 5.7
(0.2–7.0) 6.6
(4.5–9.0)
Treatment by self-
administered therapy
0.1
(0.1–0.9)
0.1
(0.1–0.6)
0.3
(0.1–2.1)

0.2
(0.0–1.1)
0.1
(0.1–0.6)

Admission to hospital 76 (84) 55 (92) 19 (68) 0.01 35 (80) 41 (87) 0.40
Treatment under public health order§ 15 (16) 9 (15) 6 (21) 0.55 4 (9) 11 (23) 0.09
Court-ordered detention for treatment¶
1 (1)
1 (2)
0

1 (2)
0

Outcome# 0.13 0.74
Treatment completed 70 (78) 45 (75) 25 (93) 33 (75) 37 (80)
Died while receiving
treatment** 17 (19) 12 (20) 2 (7) 9 (20) 7 (16)
Lost to follow-up 2 (2) 2 (3) 0 1 (2) 1 (2)
Refused further care 1 (1) 1 (2) 0 1 (2) 0

*Birthplace information available for 88 persons. IQR, interquartile range; –, no statistical test performed.
†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.
§Referred to in Ontario as a Section 22.
¶Referred to in Ontario as a Section 35.
#1 patient continues treatment at the time of this report.
**One foreign-born case-patient from 2003–2007 period died 14 mo after onset of treatment. Study considers death from all causes within 12 mo of TB diagnosis. After 12 mo, causes of death other than TB become more relevant; therefore, deaths occurring after 12 mo are not included in this estimate.

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