High success rate of TB treatment among Bhutanese refugees in Nepal.

SETTING

Camps for refugees from Bhutan in south-east Nepal.

OBJECTIVES

To evaluate the outcome of treatment of tuberculosis (TB) cases in the refugee camps.

DESIGN

Cohort analysis of results of treatment of cases started on treatment from mid-July 1999 to mid-July 2004.

RESULT

A total of 1214 patients with TB were notified in the programme. Among these, 631 (52%) were new smear-positive pulmonary tuberculosis (PTB) cases, 175 (14%) new smear-negative PTB cases, 290 (24%) new extra-pulmonary TB (EPTB) cases and 118 (10%) smear-positive retreatment cases. Treatment success was achieved in 1061 (94%). The proportion of new non-smear-positive cases who died on treatment was significantly higher than the corresponding figure for new smear-positive cases (RR 7.57, 95%CI 3.74-15.32 for new smear-negative and 4.22, 95%CI 2.08-8.55 for EPTB).

CONCLUSION

High cure rates and low bacteriological failure rates can be achieved in refugee settings if there is close coordination and collaboration between the local health agencies and the National Tuberculosis Programme of the host country.