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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 4  |  Page : 277-279

Unsuccessful antituberculosis medication treatment: A characteristic summarization in a suburban province with dense communities of Myanmar migrant worker in Bangkok Metropolitan Region, Thailand


1 26 Medical Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India

Date of Submission23-Jul-2019
Date of Acceptance08-Sep-2019
Date of Web Publication03-Dec-2019

Correspondence Address:
Dr. Rujittika Mungmunpuntipantip
26 Medical Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bbrj.bbrj_101_19

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  Abstract 


Background: Tuberculosis is an important local public health problem in several areas around the world, including Indochina. In Indochina, the extremely high incidence of tuberculosis is reported at Thailand–Myanmar border area, and the migrant worker is the specific population with a very high incidence of infection. The unsuccessful antituberculosis medication treatment is still the important problem to be managed. Methods: The authors analyzed the epidemiological data on the antituberculosis medication treatment results in suburban province with dense communities of Myanmar migrant worker in Bangkok Metropolitan Region, Thailand. Results: The nonsuccessful rate of antituberculosis medication treatment in this setting is equal to 11.11% (ranges between 7.1% and 17.4%). Transfer out without continuation and death are the two main subtypes of nonsuccess cases. Conclusion: There is still a high incidence of unsuccessful antituberculosis medication treatment in the study setting.

Keywords: Antituberculosis, community, migrant, unsuccessful


How to cite this article:
Mungmunpuntipantip R, Wiwanitkit V. Unsuccessful antituberculosis medication treatment: A characteristic summarization in a suburban province with dense communities of Myanmar migrant worker in Bangkok Metropolitan Region, Thailand. Biomed Biotechnol Res J 2019;3:277-9

How to cite this URL:
Mungmunpuntipantip R, Wiwanitkit V. Unsuccessful antituberculosis medication treatment: A characteristic summarization in a suburban province with dense communities of Myanmar migrant worker in Bangkok Metropolitan Region, Thailand. Biomed Biotechnol Res J [serial online] 2019 [cited 2019 Dec 9];3:277-9. Available from: http://www.bmbtrj.org/text.asp?2019/3/4/277/272178




  Introduction Top


Tuberculosis is an important mycobacterial infection that still exists in several areas of the world, including tropical Indochina.[1],[2] In Indochina, the extremely high incidence of tuberculosis is reported at Thailand–Myanmar border area, and the migrant worker is the specific population with a very high incidence of infection.[2] The unsuccessful antituberculosis medication treatment is still the important problem to be managed. The high incidence of drug-resistant tuberculosis is reported in the mentioned region.[3] The problem of drug resistance is well-described. The problem is usually relating to the history of inappropriate tuberculosis medication management.[4] In a recent report from Myanmar, Tun et al. found that the incidence of drug-resistant tuberculosis among previously treated patients in Yangon, Myanmar, was very high.[4]

The emerging drug-resistant tuberculosis in the mentioned border area leads to the great consideration of possible spreading of tuberculosis to other areas of the world.[5],[6],[7],[8] The specific focus on Myanmar migrant worker is given. There are several attempts to launch Public Health Management Program for this population at Thailand–Myanmar border provinces. Nevertheless, due to globalization, the migrant worker presently spread to several areas of Thailand, including Bangkok Metropolitan Region. In Samut Sakhon Province, a suburban province in the Bangkok Metropolitan Region which locates only 20 km from the center of Bangkok capital, there are >1 million migrant workers living in a small dense community. The tuberculosis situation in this setting is very interesting. The unsuccessful antituberculosis medication treatment in this setting is studied for the specific characteristics in the present report.


  Methods Top


This study is a retrospective study on the available epidemiological data regarding antituberculosis medication treatment result in Samut Sakhon Province, a suburban province in the Bangkok Metropolitan Region, Thailand [Figure 1]. The updated public available data in the year 2018 (available online at bie.moph.go.th/e-insreport/file_report/2019-06-15-11-13-47-11.pdf) are hereby reanalyzed. As the present work is an epidemiological retrospective analysis on primary public available data; therefore, there is no requirement for ethical approval. The primary data regarding the number of patients with tuberculosis registered for antituberculosis medication treatment and result of treatment were used for further retrospective reappraisal. The setting is a specific international border area between Thailand and Myanmar.
Figure 1: Study setting, Samut Sakhon Province, Thailand. In the picture, the whole map is Thailand, the area in red is Bangkok Metropolitan Region, and Samut Sakhon Province is indicated by the green circle

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The incidence of unsuccessful antituberculosis medication treatment is determined. The nonsuccess case is defined as any case that does not receive complete antituberculosis medication treatment according to the standard medication course regardless of changing the medical care center or not. The unsuccessful cases were categorized, and the valid percentage and 95% confidence interval for each subtype were calculated.

Ethical issue

This work is a retrospective study on public primary available data, and it did not deal with human individuals, experimental animals, or clinical specimen; therefore, the study requires an ethical approval or written informed consent.


  Results Top


According to the study, there are overall 153 registered tuberculosis patients in the focused community. The nonsuccessful rate of antituberculosis medication treatment in this setting is equal to 11.11% (ranges between 7.1% and 17.4%). Focusing on the categories of nonsuccess cases, there are several subtypes as presented in [Table 1].
Table 1: Subtypes of nonsuccess cases

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  Discussion Top


Treatment by antituberculosis drug is the specific management of tuberculosis. The complete drug therapy is the main aim in case management. The unsuccessful control of tuberculosis is a common problem seen in several countries around the world. Nonsuccess or failure in treatment and control is not uncommon public health problem. In the present study, the authors specifically focused on an interesting area with dense migrant workers community. The studied community is a well-known problematic migrant community with extremely high incidence of tuberculosis. The poor air environment in this community is reported in the literature and proposed as a factor supporting the occurrence of respiratory disease.[9] Wongkongdech et al. showed that the tuberculosis-infected Myanmar workers in this area usually had the problem in treatment attachment due to stigma associated with tuberculosis.[10]

In the present report, the high incidence rate of nonsuccessful antituberculosis mediation treatment can be detected. This can support the requirement for finding a more active public health to manage tuberculosis in this problematic community. Several subtypes of nonsuccess antituberculosis medication treatment can be identified. An interesting consideration is on transfer out without continuation. Indeed, any transfer out case of patient receiving antituberculosis medication treatment should accompany with transfer in plan. However, the identified cases could not set a continuation due to impossibility to set transfer in plan for the patients that move aboard. Focusing on the nearby countries that are the destinations, most migrant Myanmar workers moved to Myanmar, their hometown. However, there was also a case that moved to another Indochina country, Cambodia, and might bring the disease to new setting due to discontinuation of antituberculosis drug management.

It is no doubt that the management of the tuberculosis among migrant worker is more difficult than that used for local people. Lin et al. noted that wrong ideas and poor knowledge are important consideration in the management of tuberculosis for the Myanmar cases.[11] Yasri and Wiwanitkit mentioned that the knowledge of the migrant worker is usually poor, and there is a need for education aiming at an increased success in tuberculosis control and management.[12] In addition, there must be a good tracking of patient logistic path, and collaboration among medical center within the country and internationally is necessary. It should be noted that the migrant patients might move back to their home country or they might have a chance to move to a new remote setting. In a recent report by Hattori et al.,[13] foreign-borne drug-resistant tuberculosis already becomes a new emerging problem brought to Japan by the migrant workers.


  Conclusion Top


There is still a high incidence of unsuccessful antituberculosis medication treatment in this area of dense migrant workers' community.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Khan MK, Islam MN, Ferdous J, Alam MM. An overview on epidemiology of tuberculosis. Mymensingh Med J 2019;28:259-66.  Back to cited text no. 1
    
2.
Wise J. WHO identifies 16 countries struggling to control tuberculosis. BMJ 1998;316:957.  Back to cited text no. 2
    
3.
Al-Orainey IO. Drug resistance in tuberculosis. J Chemother 1990;2:147-51.  Back to cited text no. 3
    
4.
Tun T, Nyunt WW, Latt KZ, Samaranayaka A, Crump JA, Thinn KK, et al. Drug-resistant tuberculosis among previously treated patients in Yangon, Myanmar. Int J Mycobacteriol 2016;5:366-7.  Back to cited text no. 4
  [Full text]  
5.
Sookaromdee P, Wiwanitkit V. Smear-negative pulmonary tuberculosis: Relative incidence and outcome of treatment in a drug-resistant endemic setting in Indochina. Biomed Biotechnol Res J 2019;3:109-10.  Back to cited text no. 5
  [Full text]  
6.
Tschirhart N, Thi SS, Swe LL, Nosten F, Foster AM. Treating the invisible: Gaps and opportunities for enhanced TB control along the Thailand-Myanmar border. BMC Health Serv Res 2017;17:29.  Back to cited text no. 6
    
7.
Tschirhart N, Nosten F, Foster AM. Migrant tuberculosis patient needs and health system response along the Thailand-Myanmar border. Health Policy Plan 2017;32:1212-9.  Back to cited text no. 7
    
8.
Thi SS, Parker DM, Swe LL, Pukrittayakamee S, Ling CL, Amornpaisarnloet K, et al. Migration histories of multidrug-resistant tuberculosis patients from the Thailand-Myanmar border, 2012-2014. Int J Tuberc Lung Dis 2017;21:753-8.  Back to cited text no. 8
    
9.
Luksamijarulkul P, Suknongbung S, Vatanasomboon P, Sujirarut D. Health status, environmental living conditions and microbial indoor air quality among migrant worker households in Thailand. Southeast Asian J Trop Med Public Health 2017;48:396-406.  Back to cited text no. 9
    
10.
Wongkongdech R, Srisaenpang S, Tungsawat S. Pulmonary tb among myanmar migrants in Samut Sakhon province, Thailand: A. problem or not for the TB control program? Southeast Asian J Trop Med Public Health 2015;46:296-305.  Back to cited text no. 10
    
11.
Lin KS, Kyaw CS, Sone YP, Win SY. Knowledge on tuberculosis among the members of a rural community in Myanmar. Int J Mycobacteriol 2017;6:274-80.  Back to cited text no. 11
[PUBMED]  [Full text]  
12.
Yasri S, Wiwanitkit V. Knowledge on tuberculosis in rural Myanmar. Int J Mycobacteriol 2017;6:412-3.  Back to cited text no. 12
[PUBMED]  [Full text]  
13.
Hattori T, Kobayashi N, Nagai H, Chagan-Yasutan H, Telan E, Solante MB, Nationwide HIV-, MDR-TB survey in Japan and collaborative study in the Philippines. Int J Mycobacteriol 2016;5 Suppl 1:S18-9.  Back to cited text no. 13
    


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