Assessment of TB Screening Inclusion in Time-limited Case Management for Hard-to-reach Severe Mentally III Individuals at Risk for HIV: TB Screening and Critical Time Intervention (CTI) in New York City

摘要

We report on the inclusion of tuberculosis (TB) screening as part of Critical Time Intervention (CTI) services to mentally ill men in a New York shelter during a 5-year period. CTI is an effective short-term case management approach to stabilize mentally ill persons. Previously, we reported high human immunodeficiency virus (HIV) prevalence, risky sexual behaviors and concurrent TB and HIV in this population. All 200 men placed in community living were offered tuberculin skin (PPD) testing and a chest radiograph follow-up. Most men were African-American and Latinos. The majority had schizophrenia (61(percent)) and a comorbid diagnosis of drug (66.(percent)) or alcohol (59(percent)) abuse. PPD testing was completed by 184 (92(percent)) men: 67 positive and 11 inconclusive. Chest X-ray follow-up was completed by 157 men -including all PPD positive and inconclusive results. Six active TB cases were identified in HIV positive men. This study suggests that TB screening could be implemented in time limited specialized services, such as CTI.