National
Center for Farmworker Health
Monthly
Topics
Tuberculosis
Tuberculosis (TB) is a bacterial infection that spreads through
the air. Only people who are sick with TB in their lungs are
infectious. When infectious people cough, sneeze, talk or
spit, they propel TB germs, known as bacilli, into the air.
A person needs only to inhale a small number of these to be
infected. Tuberculosis commonly attacks the lungs but can
also affect the central nervous system, the lymphatic system,
the circulatory system, the genitourinary system, bones, joints
and even the skin. It is unknown what the exact rate of tuberculosis
is among farmworkers, but they remain a very vulnerable population
that is perceived to be at higher risk for TB. Tuberculosis
in migrant farmworkers presents special problems because of
the need for long-term treatment or preventive efforts, contact
examinations, population mobility, fear of deportation, cost
of treatment, and other barriers to health care. The transient
nature of farm work and the long duration required for tuberculosis
treatment make it difficult to assure patient compliance with
screening programs, preventive therapy, and chemotherapy for
farmworkers. Language barriers and limitations in knowledge
about tuberculosis may contribute to misunderstandings about
the importance of screenings and if identified, completing
the treatment regimen. In addition, crowded living conditions
and malnutrition may contribute to the spread of tuberculosis
among this population.
Tuberculosis Organizations
- Migrant
Clincians Network
Beginning in 1996, the Migrant Clinicians Network worked
to address the urgent need for a continuity of care system
among mobile patients undergoing treatment for TB disease
with the development of TBNet. TBNet is a multinational
TB bridge case management and referral system that has aided
more than 3200 patients in its 10 year history. Although
the program was originally created with migrant farm workers
in mind, it is expanding its patient base to include the
homeless, immigration detainees, prison parolees, or anyone
who might be mobile during their treatment.
- The
American Lung Association
The American Lung Association has a tuberculosis program
that contains TB information including treatment ideas and
discussion of the TB skin tests.
- The CDC Division of
Tuberculosis Elimination
The Centers for Disease Control website contains information
on tuberculosis and extensively drug resistant tuberculosis
(XDR TB). Among other things, it contains TB and XDR TB
treatment guidelines.
- The Colonia Health Worker Tuberculosis Program
This program was done in collaboration between Migrant Health
Promotion and the Texas Department of Health. Through this
unique project, Promotoras provided "directly observed
therapy" and community-based education to border residents
receiving treatment or preventative therapy at county clinics.
The participating Hidalgo County Health Department credited
the Colonia Health Worker Tuberculosis Program with treatment
compliance rates between 96 percent and 100 percent among
their hard-to-reach colonia patients.
- The World Health Organization
The World Health Organization contains information on tuberculosis
and a list of tuberculosis publications geared toward clinicians.
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