Bartonella quintana Infection in Homeless People
Author Information
Author(s): Lisa A. Jackson, M.D., M.P.H., David H. Spach, M.D.
Primary Institution: University of Washington, Seattle, Washington, USA
Hypothesis
What factors contribute to the emergence of Bartonella quintana infection among homeless populations?
Conclusion
A significant proportion of homeless patients in Seattle showed evidence of Bartonella quintana infection, indicating a public health concern.
Supporting Evidence
- 20% of the clinic patients had detectable anti-Bartonella antibodies.
- Seropositivity was associated with older age, homelessness, alcohol abuse, smoking, and injection drug use.
- Most patients with B. quintana endocarditis required cardiac valve replacement.
Takeaway
Some homeless people might get sick from a germ called Bartonella quintana, which can come from lice. This study found that many of them had signs of this germ in their blood.
Methodology
A seroprevalence study was conducted among patients at a community clinic serving a homeless population, measuring anti-Bartonella antibodies.
Potential Biases
Potential bias due to reliance on retrospective medical record reviews and the possibility of misidentifying seropositive patients due to cross-reactivity.
Limitations
The study was limited by the cross-reactivity of the assay and lack of reliable data on past exposure to animals or ectoparasites.
Participant Demographics
Median age of participants was 45 years; 81% were male and 66% were classified as homeless.
Statistical Information
P-Value
0.001
Confidence Interval
95% CI 1.0-4.1
Statistical Significance
p < 0.001
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