Online Poster Portal

  • Author
    Rebbecca Brena
  • Discovery PI

    Mary Marfisee, MD, MPH

  • Project Co-Author

    Mary [Maggie] Owens

  • Abstract Title

    Design and implementation of a bi-weekly, student-run, shelter-based Tuberculosis screening project on LA’s Skid Row

  • Discovery AOC Petal or Dual Degree Program

    Health Justice & Advocacy

  • Abstract

    Background: Los Angeles’ homeless shelter Union Rescue Mission (URM) provides people experiencing homelessness (PEH) with free medical services through the Student Run Homeless Clinics (SRHC) at David Geffen School of Medicine. PEH at URM are at increased risk of tuberculosis (TB) infection due to overcrowding, antiquated ventilation systems, poor medical care access, and residents migrating from TB-endemic areas. URM needs more frequent TB screenings given the increased TB incidence rate in LA county (5.4 in 2023) and the required TB clearance residents must provide within 7 days of intake. 

    Objective: To design and implement a TB screening program tailored to URM’s fluctuating population within a low-resource framework.

    Methods: SRHC administers tuberculosis skin tests (TST) every 2nd and 4th Tuesday of each month and evaluates TST reactions after 48-72 hours. If positive, the resident is referred for a chest X-ray to distinguish between latent and active infection, determining treatment course.

    Results: SRHC administered 436 TSTs at URM during 12 TB clinics between 9/30/2023 and 4/23/2024, with 364 residents (83.5%) returning for TST readings. Of those read, 25 (6.9%) were positive and referred for follow-up. Children <10 years old received 22% of the total tests administered but only made up 8% of positive results. URM residents between 40 and 49 years old received 11% of the total tests administered, constituting 28% of positive results.

    Conclusion: Our TST return rate (83.5%) aligns with other student-run TB clinics such as Tulane (76.3%). While the QuantiFERON Gold test avoids post-TST administration follow-up concerns, TST is adequate for SRHC’s low-resource setting. The positive TST results (6.9%) may indicate a higher prevalence among PEH at URM, though direct comparison to compare findings to LA County’s verified TB case incidence rate requires further analysis. Next steps include analyzing positive TST outcome data.