{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:23:01Z","timestamp":1782980581641,"version":"3.54.5"},"reference-count":34,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,4,3]]},"abstract":"<jats:p>Antioquia Department is the state with the highest burden of tuberculosis (TB) in Colombia. Our aim was to determine the risk factors associated with unsuccessful TB treatment in HIV-seropositive and homeless persons, compared with non\u2013HIV-infected and non-homeless persons with TB. We conducted a retrospective cohort study using observational, routinely collected health data from all drug-susceptible TB cases in homeless and\/or HIV-seropositive individuals in Antioquia from 2014 to 2016. Unsuccessful TB treatment was defined as individuals having been lost to follow-up, having died, or treatment failure occurrence during the study period. Successful treatment was defined as cure of TB or treatment completion according to the WHO definitions. We identified 544 homeless persons with TB (432 HIV\u2212 and 112 HIV+), 835 HIV+ persons with TB and non-homeless, and 5,086 HIV\u2212\/non-homeless people with TB. Unsuccessful treatment rates were 19.3% in HIV\u2212\/non-homeless persons, 37.4% in non-homeless HIV+ patients, 61.5% in homeless HIV\u2212 patients, and 70.3% in homeless HIV+ patients; all rates fall below End TB strategy targets. More than 50% of homeless patients were lost to follow-up. Risk factors associated with unsuccessful treatment were HIV seropositivity, homelessness, male gender, age \u2265 25 years, noncontributory-type health insurance, TB diagnosis made during hospitalization, and previous treatment for TB. These results highlight the challenge of treating TB in the homeless population. These findings should put an onus on TB programs, governments, clinicians, and others involved in the collaborative care of TB patients to pursue innovative strategies to improve treatment success in this population.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0305","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T07:00:56Z","timestamp":1552374056000},"page":"932-939","source":"Crossref","is-referenced-by-count":11,"title":["Homelessness and HIV: A Combination Predictive of Poor Tuberculosis Treatment Outcomes and in Need of Innovative Strategies to Improve Treatment Completion"],"prefix":"10.4269","volume":"100","author":[{"given":"Lina Mar\u00eda","family":"G\u00f3mez","sequence":"first","affiliation":[{"name":"Secretaria de Salud de Envigado, Envigado, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizeth Andrea","family":"Paniagua-Saldarriaga","sequence":"additional","affiliation":[{"name":"Secretaria Seccional de Salud y Protecci\u00f3n Social de Antioquia, Medell\u00edn, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quinlan","family":"Richert","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Keynan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, Canada;"},{"name":"Department of Internal Medicine, University of Manitoba, Winnipeg, Canada;"},{"name":"Department of Community Health Science, University of Manitoba, Winnipeg, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Montes","sequence":"additional","affiliation":[{"name":"Secretar\u00eda de Salud de Medell\u00edn, Medell\u00edn, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucelly","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Pontificia Bolivariana, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulma Vanessa","family":"Rueda","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Pontificia Bolivariana, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Global Strategy and Targets for Tuberculosis Prevention, Care and Control after 2015","author":"World Health Organization","year":"2014"},{"key":"b2","series-title":"Situaci\u00f3n del VIH en Colombia 2016","author":"Cuenta de Alto Costo","year":"2016"},{"key":"b3","series-title":"Informe del Evento Preliminar de Tuberculosis Hasta el Per\u00edodo Epidemiol\u00f3gico XIII Colombia, 2017","author":"Instituto Nacional de 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