Faculty Bibliography

OBJECTIVE:To measure the burden and improve management of tuberculosis (TB), HIV-associated TB and MDR TB in Tak Province, Thailand, which borders Myanmar. METHODS:From September 2006 to August 2007, we collected uniform data about TB cases and enhanced human immunodeficiency virus (HIV) counselling and testing. We provided mycobacterial culture and drug-susceptibility testing in public or non-governmental organization facilities. Patients were classified by nationality and, for non-Thais, by migration status. RESULTS:Of 1662 TB cases in the 12-month period, 1087 (65%) occurred in non-Thais. Of non-Thais, 415 (38%) lived in Myanmar but crossed the border for healthcare. HIV infection was diagnosed in 18% of Thais compared with 12% of non-Thais (P < 0.01); HIV status was unknown for 22% of Thais and 27% of non-Thais (P = 0.02). Overall, multidrug-resistant (MDR) TB was diagnosed in 27 patients, 19 (70%) in non-Thais. Among TB cases never previously treated for TB, no MDR cases were diagnosed in Thais or in Myanmar refugees, but six cases were diagnosed in migrants from Myanmar. CONCLUSIONS:In Thailand, TB, HIV-associated TB and MDR TB in migrants from Myanmar are important public health problems; they need to be resolved in both the countries.