title: Analysis of risk factors for tuberculous infection following exposure at a homeless shelter.
abstract: METHODS
  A homeless shelter for men aged ⩾ 50 years in Seattle, Washington, USA.
  
  
  OBJECTIVE
  We examined risk factors for tuberculous infection following exposure to an active pulmonary tuberculosis (TB) case residing in a homeless shelter setting.
  
  
  METHODS
  A contact investigation identified shelter clients exposed to the index case; these contacts were then assessed for tuberculous infection. Risk factors, including proximity and duration of exposure to the index case, were evaluated for association with infection. A retrospective cohort study was conducted and a multivariate logistic regression model determined the magnitude of the association between tuberculous infection and significant risk factors.
  
  
  RESULTS
  Of the 64 contacts evaluated, 25 (39%) had latent tuberculous infection and one had active TB. The multivariate logistic regression model found that duration of exposure and birthplace were significantly associated with odds of infection.
  
  
  CONCLUSIONS
  Birthplace and duration of exposure were significant risk factors for tuberculous infection, underscoring the importance of this information when prioritizing contact investigations after TB exposure in congregate settings. We recommend that public health agencies work with homeless shelters to ensure that clients' attendance records contain the necessary information to facilitate contact tracing during public health TB investigations.
authors: Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists (CSTE) Applied Epidemiology Fellowship Program, CSTE, Atlanta, Georgia, USA; Communicable Disease Epidemiology and Immunization Section, Public Health-Seattle & King County, Seattle, Washington, USA.
authors: M S
authors: MS
authors: Munn
authors: Communicable Disease Epidemiology and Immunization Section, Public Health-Seattle & King County, Seattle, Washington, USA; University of Washington, Seattle, Washington, USA.
authors: J S
authors: JS
authors: Duchin
authors: Communicable Disease Epidemiology and Immunization Section, Public Health-Seattle & King County, Seattle, Washington, USA.
authors: M
authors: M
authors: Kay
authors: TB Control Program, Public Health-Seattle & King County, Seattle, Washington, USA.
authors: M
authors: M
authors: Pecha
authors: HIV/STD Program, Public Health-Seattle & King County, Seattle, Washington, USA.
authors: C S
authors: CS
authors: Thibault
authors: University of Washington, Seattle, Washington, USA; TB Control Program, Public Health-Seattle & King County, Seattle, Washington, USA.
authors: M
authors: M
authors: Narita
mesh_terms: D015331:Cohort Studies; D003140:Communicable Disease Control / Q000458:organization & administration*; D016001:Confidence Intervals; D016358:Contact Tracing / Q000379:methods*; D018562:Disease Transmission, Infectious / Q000517:prevention & control / Q000706:statistics & numerical data*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000635:transmission*; D014861:Washington