Prevalence of tuberculosis in Vietnamese migrants: the experience of the Orderly Departure Program.

This study aimed to describe the Internal Organization for Migration (IOM) tuberculosis screening and treatment program in Ho-Chi-Minh City (Vietnam); and to review the prevalence of tuberculosis and treatment outcome in a cohort of Vietnamese migrants and refugees prior to their departure. From 1 November 1992 to 1 June 1993, prospective migrants and refugees bound to the United States, Australia, and Canada underwent medical examination by IOM in Ho-Chi-Minh City. Screening for tuberculosis was based on chest x-rays, and the diagnosis was confirmed by smear examination. Smear-positive patients received short-course chemotherapy, directly supervised, with isoniazid, rifampicin, ethambutol, and pyrazinamide. Out of 39,581 persons screened, 322 were smear-positive (641 per 100,000), and started treatment. Follow-up varied from a minimum of 12 months to a maximum of 18 months. At that time, 265 (82%) were cured, while the remaining either continued treatment with first-line drugs (24), started second-line treatment (17), or failed to be cured for various reasons (16). This report confirms the efficacy of short course chemotherapy and directly observed treatment for tuberculosis, in the context of one of the largest screening programs for prospective migrants. Follow-up in receiving countries would help clarify risk factors for both new infection and relapse of tuberculosis.