Risk of Mycobacterium tuberculosis transmission in an aboriginal village, Taiwan

Tuberculosis is the leading cause of death for notifiable diseases in Taiwan. The incidence rate of tuberculosis for aborigines is 3.1 times higher than the general population, and the mortality rate for the aboriginal population is 3.2 times higher than the rate for the rest of Taiwan. The proportion of tuberculosis retreatment cases among aborigines is higher than the general population, and this is why tuberculosis is widespread in aboriginal communities. To determine the risk factors for retreatment cases living in an aboriginal village, a case-control study was performed. From January 2000 to June 2004, a total of 60 confirmed tuberculosis cases were enrolled. Tuberculosis was diagnosed by chest radiograph, sputum-smear microscopy, and culture. Epidemiological data were collected by structured questionnaires. Comparisons of proportions were done by chi-square test. Of the 60 cases, 19 were retreatment patients. Most education levels among the study subjects were elementary and junior high school. The majority of occupations were farmer and laborers. The Odds Ratios (ORs) of 'poor compliance' and 'not receiving DOTS' in the retreatment-patient group were significantly increased compared with the new patient group. In March 24, 2005, CDC-Taiwan vowed to halve the tuberculosis incidence and mortality by 2015. To accomplish this goal, CDC-Taiwan is investing funds and personnel in the National Tuberculosis Plan (2005-2015). The plan commits the government to implementing DOTS, to enhance the public health and medical networks for the country, especially for aboriginal villagers.