International Journal of Tuberculosis and Lung Disease
Volume 14, Issue 12, 2010, Pages 1589-1595

Tuberculosis treatment in a refugee and migrant population: 20 Years of experience on the Thai-Burmese border (Article)

Minetti A.* , Camelique O. , Hsa Thaw K. , Thi S. , Swaddiwudhipong W. , Hewison C. , Pinoges L. , Bonnet M. , Guerin P.J.
  • a Médecins Sans Frontières, 8 rue Saint Sabin, 75011 Paris, France
  • b Médecins Sans Frontières, Mae Sot, Thailand
  • c Médecins Sans Frontières, Mae Sot, Thailand
  • d Médecins Sans Frontières, Mae Sot, Thailand
  • e Department of Community and Social Medicine, Mae Sot General Hospital, Thailand
  • f Médecins Sans Frontières, 8 rue Saint Sabin, 75011 Paris, France
  • g Epicentre, Paris, France
  • h Epicentre, Paris, France
  • i Epicentre, Paris, France

Abstract

SETTING: Although tuberculosis (TB) is a curable disease, it remains a major global health problem and an important cause of morbidity and mortality among vulnerable populations, including refugees and migrants. OBJECTIVE: To describe results and experiences over 20 years at a TB programme in refugee camps on the Thai-Burmese border in Tak Province, Thailand, and to identify risk factors associated with adverse outcomes (e.g., default, failure, death). DESIGN: Retrospective review of routine records of 2425 patients admitted for TB treatment in the Mae La TB programme between May 1987 and December 2005. RESULTS: TB cases notified among refugees decreased over 20 years. Among patients treated with a first-, second- or third-line regimen, 77.5% had a successful outcome, 13.5% defaulted, 7.6% died and 1.3% failed treatment. Multivariate analysis for new cases showed higher likelihood of adverse outcomes for patients who were Burmese migrants or Thai villagers, male, aged >15 years or with smear-negative pulmonary TB. CONCLUSION: These findings suggest that treatment outcomes depend on the programme's capacity to respond to specific patients' constraints. High-risk groups, such as migrant populations, need a patient-centred approach, and specific, innovative strategies have to be developed based on the needs of the most vulnerable and marginalised populations. © 2010 The Union.

Author Keywords

Thailand Refugees Migrants Tuberculosis treatment

Index Keywords

treatment response refugee Thailand human trend study Refugees middle aged priority journal geographic distribution morbidity Patient-Centered Care Young Adult health program Humans kanamycin Treatment Failure lung tuberculosis Treatment Outcome Antitubercular Agents Adolescent male Tuberculosis, Pulmonary female Sputum tuberculosis risk factor Risk Factors Multivariate Analysis high risk population Myanmar Article Retrospective Studies streptomycin major clinical study adult isoniazid outcome assessment ethambutol Transients and Migrants retrospective study rifampicin pyrazinamide population migration mortality Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-78649351443&partnerID=40&md5=cf96ca8982343c16039edc0cf362ecfa
ISSN: 10273719
Cited by: 15
Original Language: English