Tuberculosis morbidity and infection in Vietnamese in Southeast Asian refugee camps

During the last decade, the refugee population in less-developed countries has undergone unprecedented growth. High tuberculosis rates have been documented in refugees, particularly among those from Asia and Africa, generating interest in tuberculosis control efforts. To assess the tuberculosis burden among Vietnamese refugees, we screened refugees within 1 or 2 days after arrival in camps in Thailand and in the Philippines. Refugees in camps in Thailand were screened with chest radiographs. Persons with radiographic findings consistent with tuberculosis received microscopic and culture examination of sputum specimens. The prevalence of bacteriologically confirmed pulmonary tuberculosis was 5.8 per 1,000 refugees. Males had a higher risk than females (relative risk RR = 1.7, 95% confidence interval CI = 1.2 to 2.4). Refugees in the Philippines were given a tuberculin skin test. An annual risk of infection of 2.2% was calculated for this group. Males had a higher risk of infection (RR = 1.9, 95% CI = 1.5 to 2.4) than females. The age-specific prevalence of tuberculosis and the tuberculous infection increased with age. A high proportion of refugees (85%) with positive tuberculin skin tests were eligible for preventive therapy. Special efforts may be necessary to target Vietnamese refugees, as well as other persons originating from countries of high tuberculosis prevalence, for enhanced diagnostic and preventive intervention against tuberculosis to achieve the national goal of tuberculosis elimination by the year 2010.