Emerging Infectious Diseases
Volume 22, Issue 3, 2016, Pages 463-468

Improved detection of tuberculosis and multidrug-resistant tuberculosis among tibetan refugees, India (Article) (Open Access)

Dierberg K.L. , Dorjee K. , Salvo F. , Cronin W.A. , Boddy J. , Cirillo D. , Sadutshang T. , Chaisson R.E.*
  • a Johns Hopkins University School of Medicine, Baltimore, MD, United States
  • b Tibetan Delek Hospital, Dharamsala, India, Central Tibetan Administration Department of Health, Dharamsala, India
  • c San Raffaele Scientific Institute, Milan, Italy
  • d Maryland Department of Health and Mental Hygiene, Baltimore, United States
  • e Johns Hopkins University School of Medicine, Baltimore, MD, United States
  • f San Raffaele Scientific Institute, Milan, Italy
  • g Tibetan Delek Hospital, Dharamsala, India, Central Tibetan Administration Department of Health, Dharamsala, India
  • h Johns Hopkins University School of Medicine, Baltimore, MD, United States

Abstract

The incidence of tuberculosis (TB) among Tibetan refugees in India is 431 cases/100,000 persons, compared with 181 cases/100,000 persons overall in India in 2010. More than half of TB cases in these refugees occur among students, monks, and nuns in congregate settings. We sought to increase TB case detection rates for this population through active case finding and rapid molecular diagnostics. We screened 27,714 persons for symptoms of TB and tested 3,830 symptomatic persons by using an algorithm incorporating chest radiography, sputum smear microscopy, culture, and a rapid diagnostic test; 96 (2.5%) cases of TB were detected (prevalence 346 cases/100,000 persons). Of these cases, 5% were multidrug-resistant TB. Use of the rapid diagnostic test and active case finding enabled rapid detection of undiagnosed TB cases in congregate living settings, which would not have otherwise been identified. The burden of TB in the Tibetan exile population in India is extremely high and requires urgent attention. © 2016, Centers for Disease Control and Prevention (CDC). All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

Tibet refugee India human Refugees middle aged multidrug resistant tuberculosis Mycobacterium tuberculosis Tuberculosis, Multidrug-Resistant Aged ethnology algorithm Algorithms Young Adult Humans Adolescent male preschool child Aged, 80 and over sputum analysis very elderly risk factor tuberculosis Child, Preschool female questionnaire contact examination diagnostic test rapid test prevalence Article infection control adult thorax radiography rifampicin early diagnosis Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84958759748&doi=10.3201%2feid2203.140732&partnerID=40&md5=71cff319380865a76160dc754d027010
DOI: 10.3201/eid2203.140732
ISSN: 10806040
Cited by: 8
Original Language: English