Access to free or low-cost tuberculosis treatment for migrants and refugees along the Thailand-Myanmar border in Tak province, Thailand

Tschirhart, Naomi; Nosten, François; Foster, Angel M.

doi:10.1186/s12939-016-0391-z

Cited by 27 publications

(54 citation statements)

References 9 publications

(20 reference statements)

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“…Our results suggest that in Tak province access to TB treatment is related to legal status [14]. Migrants who have enrolled in the Thai Compulsory Migrant Health Insurance Scheme are eligible to access low cost TB treatment at the Thai government hospital.…”

Section: Resultsmentioning

confidence: 99%

“…Collecting verbal consent allowed us to further safeguard participants’ identities, as we could avoid carrying around documentation with the names of informants. We have detailed our research methods elsewhere [13, 14]. This paper reports on the findings from the interviews and FGDs that are relevant to TB control.…”

Section: Methodsmentioning

confidence: 99%

“…The first documents pathways to treatment and travel with TB [13]. The second focuses on access to TB treatment for migrants and refugees [14]. In this article we discuss the gaps and opportunities for improved TB control in the border region of Tak province and examine TB control from a wider lens through emphasis on surveillance.…”

Section: Introductionmentioning

confidence: 99%

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Treating the invisible: Gaps and opportunities for enhanced TB control along the Thailand-Myanmar border

Tschirhart

Thi

Swe

et al. 2017

BMC Health Serv Res

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BackgroundIn Thailand’s northwestern Tak province, contextual conditions along the border with Myanmar pose difficulties for TB control among migrant populations. Incomplete surveillance data, migrant patient mobility, and loss to follow-up make it difficult to estimate the TB burden and implement effective TB control measures. This multi-methods study examined tuberculosis, tuberculosis and human immunodeficiency virus co-infection, and multidrug-resistant tuberculosis treatment accessibility for migrants and refugees in Tak province, health system response, and public health surveillance.MethodsIn this study we conducted 13 interviews with key informants working in public health or TB treatment provision to elicit information on TB treatment availability and TB surveillance practices. In addition we organized 15 focus group discussions with refugee and migrant TB, TB/HIV, and MDR-TB patients and non-patients to discuss treatment access. We analyzed the data using thematic analysis and created treatment availability maps with Google maps.ResultsThe study identified surveillance, treatment, and funding gaps. Migrant TB cases are underreported in the provincial statistics due to jurisdictional interpretations and resource barriers. Our results suggest that TB/HIV and MDR-TB treatment options are limited for migrants and a heavy reliance on donor funding may lead to potential funding gaps for migrant TB services. We identified several opportunities that positively contribute to TB control in Tak province: improved diagnostics, comprehensive care, and collaboration through data sharing, planning, and patient referrals. The various organizations providing TB treatment to migrant and refugee populations along the border and the Tak Provincial Public Health Office are highly collaborative which offers a strong foundation for future TB control initiatives.ConclusionsOur findings suggest the need to enhance the surveillance system to include all migrant TB patients who seek treatment in Tak province and support efforts by stakeholders on both sides of the border to continue to share data and engage in collaborative planning on TB, TB/HIV, and MDR-TB treatment provision for migrant populations.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Treating the invisible: Gaps and opportunities for enhanced TB control along the Thailand-Myanmar border

Tschirhart

Thi

Swe

et al. 2017

BMC Health Serv Res

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“…Therefore, this might a barrier to access healthcare and getting proper medical checkup for migrant workers while being suspected of TB infection. This is supported by the study of Tchirhart, et al [36] which reported that insurance, and access to free or low-cost services were major factors affecting access to health care system among migrant TB patients. Moreover, migrant TB patients are in serious need of health system response along the Thailand-Myanmar border [37].…”

Section: Discussionmentioning

confidence: 59%

Pulmonary tuberculosis screening and quality of life among migrant workers, Northern Thailand

Charoensook

Upala

Anuwatnonthakate

et al. 2018

J Infect Dev Ctries

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Introduction: The study aimed to estimate the prevalence of tuberculosis (TB) and to assess the quality of life and depression among the migrant workers in northern Thailand. Methodology: A cross-sectional study was conducted to elicit information among migrant workers in Chiang Rai and Pha Yao provinces, northern Thailand. Several standard forms including GeneXpert were used for data collection. A simple random sampling was used to select the companies and the study sample. Interview was conducted in a confidential room. Chi-square was used to detect the association between variables at the significant level α = 0.05. Results: Totally 467 migrant workers were recruited into the study, 97.9% were Myanmar national, 55.7% were males, and 51.4% were aged > 32 years. Only 2.1% were living in Thailand illegally, 23.8% had no health insurance, and 92.1% had monthly income at < 20,000 baht. Eight cases (1.71%) were at risk of TB disease from the screening, only one case was positive for TB disease from GeneXpert, and no multi-drug resistant detected. 47.5% had a low level of knowledge and 28.7% had a negative attitude on TB prevention and care. 10.7% were in a moderate to severe stage of depression. Six variables were found the significant associated with quality of life; ethnicity, sex, marital status, income, length of working in Thailand, and insurance. Conclusions: Besides active TB surveillance system, inter-country public health policy should be developed to cope with depression problem and improve quality of life among the migrant in Thailand

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“…Migrant participants described their ablity to seek care as linked to the financial and non financial resources required to travel and undergo treatment. Patients identified language of services, availability of free or low cost services, and psychosocial support as important health system characteristic that affect accessibility [18].…”

Section: Access Transportation To Health Servicesmentioning

confidence: 99%

Perspective of PMO in Compliance of Madurese Ethnic Tuberculosis Patient in Tapal Kuda Regions

Prasetyowati¹,

A²,

Haryono³

2018

Proceedings of the 2nd Public Health International Conference (PHICo 2017)

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Tuberculosis cases in Indonesia are ranked at the top 10 in the world, in which East Java Province is at the 2nd highest tuberculosis cases from 33 provinces in Indonesia. In East Java, the problem of severe tuberculosis occurs in such Tapal Kuda regions as Jember, Bondowoso and Lumajang. The Case Notification Rate in each of these areas is 137 / 100.000, 65 / 100.000 population and 74 / 100.000 population respectively. The strategy to ensure patient recovery is the use of short-term anti-TB drug alloys and the application of drug control called the Direct Observed Treatment Short Course (DOTS). In the treatment of tuberculosis there is very possible the occurrence of drop out treatment or drop out. Cases of drop out have a higher risk of tuberculosis recurrence, anti-tuberculosis drug resistance, and can transmit the infection to others. Based on the data from the World Health Organization (WHO) in 2013, the resistance of tuberculosis germs resulted from non-adherence treatment of 12.6%. The Drug Controller (PMO) plays an important role in reminding, monitoring, and motivating TB patients to remain obedient to treatment. This study aims to determine the perspective of PMO in compliance to treatment of Madurese ethnic tuberculosis patients in Tapal Kuda regions. The method used is triangulation and verification using qualitative approach. The results of the study showed that according to the PMO the factors that influenced the treatment of Tuberculosis patients during the treatment period were the lack of medical expenses, the low of patient's confidence in the treatment, the lack of access to health service, and the lack of motivation of the patient to make good treatment and therefore there needs to be proactive support from PMO and family as well as ongoing comprehensive and proactive socialization related to the awareness raising of the patient about the importance of tuberculosis treatment and the improvement of patient understanding related to TB treatment.

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Access to free or low-cost tuberculosis treatment for migrants and refugees along the Thailand-Myanmar border in Tak province, Thailand

Cited by 27 publications

References 9 publications

Treating the invisible: Gaps and opportunities for enhanced TB control along the Thailand-Myanmar border

Treating the invisible: Gaps and opportunities for enhanced TB control along the Thailand-Myanmar border

Pulmonary tuberculosis screening and quality of life among migrant workers, Northern Thailand

Perspective of PMO in Compliance of Madurese Ethnic Tuberculosis Patient in Tapal Kuda Regions

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