Unfortunately, a substantial number of the people who contract tuberculosis (TB) turn out to be homeless individuals. Treating such cases of TB (that is, the cases of TB in homeless people) can be a huge challenge. Often, these homeless people turn out to be individuals who are also struggling with various mental health issues. A good number of them are individuals with very low levels of education. As such, they may not see the need to seek treatment. And even when they are pushed by the symptoms to finally seek treatment, they may not stick to the whole treatment courses. So there is a risk of them dropping out of treatment midway, potentially leading to TB drug resistance. It doesn’t help matters that many of these people are individuals who are down and out, individuals who don’t seem to place much of a premium on their lives. Yet, knowing the high mortality rates associated with tuberculosis infections, every effort has to be made to ensure that such individuals are put on treatment. This way, the lives of the patients are saved, and the chances of them spreading the TB to other members of society are reduced.
While treating tuberculosis in homeless patients, it is very important to get them to first understand the seriousness of the condition. So the idea would be to get them to understand that they are suffering from a very serious illness (one with a mortality rate above 50%), and that their chances of survival would be very low without treatment. On the other hand, it is important to get them to understand that if they stick to their treatment, they would almost certainly get cured.
Secondly, it is important to create incentives for them to stick to the treatment. Thus, for instance, the TB clinics where homeless people are treated can be designed in such a manner that they also offer food. We can even go to the extent of offering monetary incentives for the patients who stick to their treatment courses.
Thirdly, it is important to make them aware of the fact that TB is a public health issue. And that as such, they would be at risk of being arrested (and forcefully treated), if they refuse to go through the whole courses of treatment voluntarily.
Fourth, the TB patients need to be educated on the common side effects of TB drugs, and how to cope with them. It is important to get them to a point of understanding that the side effects of the drugs are nothing compared to the risks of not going for treatment/dropping out of treatment midway.