Contact : A. Arnaud

Between June and May 2000, a systematic screening implemented among homeless at Paris Samusocial identified 37 cases of tuberculosis during a 11 months period, leading to a rate of 500 per 100 000. During clinical management of these 37 patients half were lost to follow-up.

In front of difficulties of public institutions to manage care for homeless, Xavier Emmanuelli, created, in December 2000, a tuberculosis outreach team (EMLT), thanks to Aventis funding.

The main objective is to reduce mortality, morbidity and tuberculosis transmission and to prevent anti-tuberculosis drug resistance among homeless. The specific objective is to bring to complete recovery all tuberculosis homeless patients followed by the Paris Samusocial, with one ore several risk factors of breaking treatment, thanks to DOT (Delivery Observed Therapy).

The Observatory of Paris Samusocial implements, fall 2003, a software for the following of patients under anti-tuberculosis treatment (TB Info), freely distributed by the Institut de Veille Sanitaire and used by various hospitals and care centres in a network. The software was adapted to the particularities of the Paris Samusocial population, characterised by high frequency of breaking treatment. Paris Samusocial’s medical doctors completed the data in TBinfo from 2003 to 2009. Since 2010, data on tuberculosis patients are entered in the general medical data base of the Paris Samusocial.

Report

Article

"Tuberculose chez les sans domicile fixe à Paris : mise en oeuvre de la stratégie DOT (Directly Observed Therapy)"  Kern T., Lardoux C., Tartière S., Emmanuelli X., Laporte A., Bulletin Epidémiologique Hebdomadaire, 17 , p. 73-74.