Active Case Finding of Pulmonary Tuberculosis among Hmong Hill Tribesmen, Mae Sot District, Tak Province, 2008 (การค้นหาผู้ป่วยวัณโรคปอดเชิงรุกในชาวเขาเผ่าม้ง อำเภอแม่สอด จังหวัดตาก ปี 2551)

This study presented prevalence of pulmonary tuberculosis (TB) by active case finding among Hmong hill tribesmen aged 15 years and older in 3 villages in Mae Sot District, Tak Province, in 2008. The study methods included health education, interview, and mobile chest radiographic screening among the target persons. Microscopic sputum examination and culture for TB were carried out in persons with abnormal chest radiographs. DOTS (directly observed treatment, short course) was performed in those with diagnosis of TB. Household contacts of the patients were also screened for TB. Frequency and percentage were used to present the results of analysis. Chi-square test was used for comparison between proportions. A total of 1,336 persons in Hmong villages were screened for TB. Of them, 37.0 percent were male and 63.0 percent were female. About 44.5 percent were 15-34 years old. Eighty persons (6.0 % of persons screened) had abnormal chest radiographs. A proportion of those with abnormal radiographs was slightly higher in males than females. The proportion significantly increased with increasing age. The proportion was most commonly found among those with dyspnea, followed by fever with hemoptysis, and prolonged cough > 2 weeks. Six cases were diagnosed with TB, giving a rate of 7.5 percent of persons with abnormal chest radiographs or an overall rate of 0.4 percent  of those screened. Three of the 6 cases were smearpositive for TB, 2 were culture-positive, and 1 was a sputum-negative TB case. Of the 6 cases, 5 had prolonged cough > 2 weeks and 4 had dyspnea. All the 6 cases had DOTS watchers, home visit, and successful treatment. Appropriate health education, effective case finding, and health care services may reduce spread of TB among Hmong hill tribe. Key words: pulmonary tuberculosis, Hmong hill tribesmen, active case finding