The Public Health Management of Tuberculosis Among the Single Homeless: is Mass Miniature X Ray Screening Effective?

Study Objective: The aim was to test the assumption that mass miniature x ray screening of the single homeless (hostel residents) is a cost-effective means of controlling pulmonary tuberculosis.

Design: The study was a prospective experimental screening exercise to identify new cases of active tuberculosis completing treatment.

Setting: The setting was eight hostels in south London. A mobile x ray screening facility was set up outside the hostels.

Subjects: Subjects were 547 single homeless residents in the hostels. They were encouraged to attend for chest x ray, and for active follow up of abnormal x rays.

Main Results: No new cases of active tuberculosis were found.

Conclusions: Mass miniature x ray is ineffective in controlling tuberculosis because of its unacceptability and increasing inaccessibility to this population.