Purpose: Armenia faces a serious reemerging threat from increasing drug resistant tuberculosis rates (DR-TB). The situation is complicated by the migration of Armenians to work in other countries with higher TB prevalence. Fifteen percent of Armenian families have members who are migrant workers. The purpose of this study was to describe the burden of tuberculosis among migrant workers from Armenia and to understand TB infection patterns and their migrant destinations.
Method: A cross–sectional census was conducted to assess knowledge, attitudes, and practices of migrant workers with TB and their access and utilization of TB services in Armenia and in host country of work. The study population included those who had TB diagnosis, including drug-resistance and TB-HIV/AIDS co-morbidity, and migrated to other countries for work. Data was collected from December 2011 to February 2012 from medical records of all 72 Armenian TB centers and 95 face-to-face interviews with migrant workers with TB.
Result: The Russian Federation was the host country of work for 91% of migrant workers in Armenia, with a third working in regions with the highest rates of TB prevalence. The percent of TB-HIV/AIDS co-morbidity among the participants was 4.7 times higher than the percent of TB-HIV/AIDS co-morbidity among all TB patients in Armenia. The time period between first diagnosis and first treatment was about 5-times longer for those who were diagnosed in the host country of work than those diagnosed in Armenia, increasing likelihood of infecting others and development of drug resistance. Participants who decided to start receiving treatment in the host country of work were 3.9-times more likely to have failed and defaulted treatment outcomes than those deciding to begin receiving treatment in Armenia.
Conclusion: The study found that migrant workers were at higher risk of DR-TB and TB-HIV/AID co-morbidity, associated with place of migration and higher rates of default and failed treatment outcomes. The overriding recommendation of the study was to establish close collaboration between TB and HIV/AIDS programs in the host countries of work and Armenia using modern information technologies that assure better coordinated health decisions to reduce drug-resistant, co-morbidity and failure rates.
See more of: The 34th Annual Meeting of the Society for Medical Decision Making