TB, HIV-associated TB and multidrug-resistant TB on Thailand's border with Myanmar, 2006-2007

To measure the burden and improve management of tuberculosis (TB), HIV-associated TB and MDR TB in Tak Province, Thailand, which borders Myanmar. 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. 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. 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.