Tuberculosis treatment in a refugee and migrant population: 20 years of experience on the Thai-Burmese border

Int J Tuberc Lung Dis. 2010 Dec;14(12):1589-95.


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.

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use*
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myanmar / ethnology
  • Patient-Centered Care / methods
  • Refugees / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Sputum / microbiology
  • Thailand / epidemiology
  • Transients and Migrants / statistics & numerical data
  • Treatment Failure
  • Treatment Outcome
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology
  • Tuberculosis / ethnology
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / ethnology
  • Young Adult


  • Antitubercular Agents