Pulmonary tuberculosis in migratory nomadic populations: the missing link in Iran's National Tuberculosis Programme

• Published in: The international journal of tuberculosis and lung disease Vol. 18; no. 3; pp. 272 - 276
• Main Authors: Honarvar, B., Odoomi, N., Rezaei, A., Haghighi, H. B., Karimi, M., Hosseini, A., Mazarei, S., Panahi, M., Jamshidi, F., Moghadami, M., Lankarani, K. B.
• Format: Journal Article
• Language: English
• Published: Paris, France International Union Against Tuberculosis and Lung Disease 01-03-2014; International Union against Tuberculosis and Lung Disease
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the respiratory system; Bacteriological Techniques; Biological and medical sciences; Child; Child, Preschool; Cross-Sectional Studies; Cultural Characteristics; Female; Health Knowledge, Attitudes, Practice - ethnology; Health Services Accessibility; Healthcare Disparities - ethnology; Human bacterial diseases; Humans; Incidence; Infant; Infectious diseases; Iran - epidemiology; Male; Mass Screening - methods; Medical sciences; Middle Aged; migratory; Mycobacterium; National Health Programs; Nomad; Patient Acceptance of Health Care - ethnology; Pneumology; Predictive Value of Tests; Pulmonary Tuberculosis; Residence Characteristics; Screening; Sex Factors; Stereotyping; Stigma; Transients and Migrants - psychology; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - ethnology; Tuberculosis, Pulmonary - psychology; Young Adult; Iran; Asia; Human; Lung disease; screening; Chronic disease; Respiratory disease; Stigma; Pulmonary tuberculosis; migratory; Mycobacterial infection; Medical screening; Infection; Nomad; Bacteriosis; Population
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.13.0650

OBJECTIVE: To detect pulmonary tuberculosis (PTB) in migratory nomadic populations in Fars Province, southern Iran.DESIGN: Cross-sectional study.RESULTS: In this study, 5506 (82.8%) of a total nomad population of 6650 from 1337 tents were screened for PTB. The mean age was 27.4
± 18.2 years (range 1-109). Based on clinical symptoms, 141/5506 (2.6%) were identified as TB suspects. One male and three female adult new smear-positive PTB cases were detected, giving an incidence rate of 0.7/1000 population compared to 0.08/1000 in the general population of
the region, and 28.4/1000 TB suspects. The median time to onset of symptoms in detected cases was 82.5 days. Tribal stigma against female TB patients was one of the main barriers to appropriate health-seeking behaviour.CONCLUSIONS: The incidence of smear-positive PTB among migratory nomads
is approximately nine-fold higher than in the general population. Active screening of TB in migratory nomads should be integrated into Iran's national TB control programme. The issue of destigmatisation, particularly among female TB patients, should also be addressed.