Table 1 Summary of the main characteristics of the studies reviewed

Pavinati et al., Brazil, 2023 [10]

Geoprogrammatic disparities in the performance of tuberculosis indicators in the homeless population in Brazil: an ecological approach

Ecological,

Sistema de Informação de Agravos de Notificação (SINAN)

To analyze the performance and spatial distribution of TB control indicators in PEH in Brazil.

New TB cases, between 2015–2021, in PEH aged 20 to 59 years.

N= 8.402

38% (n= 3.193)

Death: 14% (n= 1.176)

LFU: 36% (n= 3.025)

Rodrigues et al., Brazil, 2023 [19].

Factors associated with unsuccessful tuberculosis treatment among homeless persons in Brazil: A retrospective cohort study from 2015 to 2020.

Retrospective cohort,

SINAN

To evaluate the factors associated with unsuccessful TB outcomes among PEH compared to those with shelter.

New TB cases, between 2015–2020, with individuals between 18 and 90 years old, separated into PEH and the general population.

N= 7.749

39.84% (n= 3.086)

Death: 14.37% (n= 1.114)

LFU: 36.02% (n= 2.791)

Failed: 0.06% (n=5)

Not evaluated: 9.71% (n= 753)

Gabdullina et al., Kazakhstan,

2023 [20].

COVID-19 pandemic and other factors associated with unfavorable tuberculosis treatment outcomes-Almaty, Kazakhstan, 2018–2021.

Retrospective cohort,

National electronic database of Kazakhstan

To evaluate the association of the COVID-19 pandemic period and risk factors related to adverse TB treatment outcomes among people newly diagnosed with TB in Almaty, Kazakhstan, from 2018 through to 2021.

New TB cases between 2018–2021 aged at least 18 years, separated into different risk groups.

N= 18

55.55% (n= 10)

44.44% (n= 8)

Scholze et al., Brazil, 2022 [21].

Tuberculosis among People Living on the Street and Using Alcohol, Tobacco, and Illegal Drugs: Analysis of Territories in Extreme Vulnerability and Trends in Southern Brazil.

Ecological,

SINAN

To analyze territories where there is a concentration of people diagnosed with TB, who are homeless and who chronically use alcohol, tobacco and illicit drugs, and to analyze trends in this health condition in southern Brazil.

TB cases in homeless people between 2014–2018 aged 18 or older in the state of Paraná, Brazil, who use alcohol, tobacco or illicit drugs.

N= 560

35.8% (n= 200)

Death: 16.3% (n= 91)

LFU: 27% (n= 151)

Failed: 2.3% (n= 13)

Not evaluated: 16.3% (n= 91)

Crosby et al., England,

2022 [22].

Outcomes of a residential respite service for homeless people with tuberculosis in London, United Kingdom: a cross-sectional study.

Cross-sectional,

London TB Register

To compare the characteristics and treatment outcomes of patients treated in the Residencial Respite Service (RRS) with patients treated in standard care and to estimate the association between treatment in the RRS and treatment outcomes.

TB cases between 2010–2019 aged 18 or older, separated into treated in RRS and treated in the usual way.

N= 78 (treated in RRS)

89.74% (n= 70)

Failed: 10.25% (n= 8)

(95% CI = 5%–20%).

Santos et al., Brazil, 2021 [23].

Analysis and comparison of tuberculosis treatment outcomes in the homeless population and in the general population of Brazil.

Cross-sectional,

SINAN

To compare the rates of treatment success, LFU and death from TB between the PEH and the general population in Brazil and its regions in 2018.

New TB cases in 2018, separated into PEH and the general population.

N= 1.530

39% (n= 597, 95% CI= 36.5–41.4)

Death: 8,1% (n= 124, 95% CI= 6.8–9.6)

LFU: 28.8% (n= 441, 95% CI= 26.6–31.1)

Macedo et al., Brazil, 2021[24].

Vulnerable populations and the outcome of tuberculosis cases in Brazil.

Cross-sectional,

SINAN

To evaluate the association between the population deprived of liberty (PDL) or PEH and the failure of TB cases diagnosed in Brazil in 2015.

TB cases in 2015 in individuals over 15 years old, in the general population, PDL and PEH

N= 2.782

34.7% (n= 965)

Death: 11.6% (n=323)

LFU: 37.7% (n= 1.048)

Failed: 1.7% (n= 48)

Not evaluated: 14.3% (n= 398)

Hino et al., Brazil, 2021 [11].

Tuberculosis in the street population: a systematic review.

Systematic review,

PubMed, EMBASE, LILACS and Scientific Electronic Library Online (SciELO)

To analyze the evidence available in the literature on the occurrence of TB in PEH.

Seven papers reviewed in 2018.

Cure:

35.2%; 44.1%; 55%; 77%,

Treatment complete:

85%

LFU: 2.7%; 12%; 21.8%; 24.8%; 39.0%

Death: 7.2%; 8%; 10.5%; 11.1%; 19.7%,

Not evaluated: 21.9%; 23.5%; 31%.

Failed: 0.4%; 1.4%; 1.6%

Kozhoyarova et al., Kyrgyzstan, 2020 [25].

Who is doing worse? Retrospective cross-sectional study of TB key population treatment outcomes in Kyrgyzstan (2015–2017).

Cross-sectional,

National TB Registry of the National TB Control Center of Kyrgyzstan

To investigate risk factors and treatment outcomes among different key TB populations (internal migrants, PEH, injecting drug users and ex-prisoners) in the period 2015–2017 in the Chuy region (which includes its capital Bishkek) in Kyrgyzstan.

TB cases between 2015–2017, with individuals over 18 years old, separated into different risk groups

N= 237

29.1% (n= 69)

Death: 21.9% (n=52)

LFU: 45.1% (n= 107)

Failed: 3.8% (n=9)

Kim et al., South Korea, 2019 [26].

Impact of Housing Provision Package on Treatment Outcome Among Homeless Tuberculosis Patients in South Korea.

Prospective cohort,

Three Seoul hospitals and the National Notification Data

To evaluate the effect of a housing provision package on the outcomes of PEH TB treatment in Seoul.

New or previously treated TB cases in PEH between 2016–2018, over 49 years old, separated by type of treatment

N= 318

80.8% (n= 257)

Death: 6.6% (n= 21)

LFU: 3.7% (n=12)

Failed: 8.8% (n=28)

Gómez et al., Colombia, 2019 [27].

Homelessness and HIV: A Combination Predictive of Poor Tuberculosis Treatment Outcomes and in Need of Innovative Strategies to Improve Treatment Completion.

Retrospective cohort,

Antioquia Regional Secretariat for Health and Social Protection

To determine the risk factors associated with unsuccessful TB treatment in Antioquia’s human immunodeficiency virus (HIV)-seropositive and PEH, compared with PEH without HIV, and compared with non–HIV-infected and non-PEH with TB.

Susceptible TB cases between 2014–2016 in HIV-positive people and/or PEH.

N= 544

34.1% (n=186)

Death: 4.4% (n= 24)

LFU: 53.6% (n= 292)

Failed: 0.7% (n= 4)

Not evaluated: 6.9% (n= 38)

Ranzani et al., Brazil, 2019 [28].

The impact of being homeless on the unsuccessful outcome of treatment of pulmonary TB in São Paulo State, Brazil.

Cohort,

TBWEB

To determine the association between homelessness and the unsuccessful outcome of treatment of newly diagnosed with pulmonary TB patients in São Paulo, Brazil, from 2009 to 2013.

New cases of pulmonary TB between 2009–2013, aged 15 or older, separated into PEH and general population.

N= 1.726

42.7% (n= 737)

Death: 10.5% (n= 181)

LFU: 39.0% (n= 674)

Failed: 0.4% (n= 7)

Not evaluated: 7.4% (n= 127)

Dias et al., Portugal, 2017 [29].

Tuberculosis among the homeless: should we change the strategy?

Retrospective cohort,

National census and National TB Surveillance System

To evaluate the incidence rate of TB and the treatment outcomes among PEH in Portugal and to identify predictors of treatment failure.

All TB cases between 2008–2014 separated into PEH and the general population.

N= 734

60.4% (n= 443)

Death: 14.4%

LFU: 9.4%

Failed: 0%

Not evaluated: 15.7%.

Korzeniewska-Koseła et al., Poland, 2015 [30].

Tuberculosis in homeless persons in Poland.

Cross-sectional,

Nacional TB Register of Poland

To compare the characteristics of TB in PEH and other patients.

TB cases registered between 2004–2013, separated into PEH and general population.

N= 2.104

44.1% (n= 927)

Death: 7.2% (n= 152)

LFU: 24.8% (n= 522)

Failed: 0.4% (n= 8)

Not evaluated: 23.5% (n= 495)