The hospitalization of patients affected with tuberculosis (TB) can be particularly long and
burdensome, especially in poor countries where the disease remains a major issue and beds in
health care centres are a precious resource. Therefore a policy of decentralising TB treatment
from hospitals to residential environments is starting to be considered worldwide, and new
guidelines in support of such strategy are needed. This study illustrates a potential “risk
assessment model” for TB transmission in dwellings that might help analysing both existing
building stocks and new designs in order to apply the new policy, utilizing as a reference the
general frame of risk assessment for buildings developed by civil engineering; the model was
then tested on five housing prototypes proposed for the town of Saint Marc, Haiti, showing
that environmental features of a building such as ventilation, crowding, temperature and
relative humidity are among the most important parameters for the estimate of the risk. The
final outcome of the analysis, however, highlighted how he most influential factor on the risk
of spread of infectious diseases is the efficiency of the health care system operating in the
building urban context
