Prevention and Control of Tuberculosis in Rural Aboriginal Towns, Hsinchu County, 2018

Prevention and Control of Tuberculosis in Rural Aboriginal Towns, Hsinchu County, 2018

Taiwan Centers for Disease Control (Taiwan CDC) has promoted the active case finding of tuberculosis strategy for rural aboriginal towns since 1997. When the local public health centers provided routine mobile health screening services in rural aboriginal towns, residents were encouraged to receive chest X-ray examination. For residents with mobility difficulties or whose residences were unreachable by the mobile X-ray vehicles, the public health personnel would home visit, check the tuberculosis symptoms screening questionnaires and collect sputum samples for test if necessary. However, some of the residents had never or irregularly participated the mobile health screening services. To strengthen the prevention of tuberculosis in rural aboriginal towns, Taiwan CDC implemented the “Plan for eliminating health inequality in rural aboriginal towns'' in eight rural aboriginal towns of five counties in 2018. The plan involved medical and educational systems into the proactive screening of tuberculosis. This article is to share the experience of implementation of the specified plan in Hsinchu County in 2018. We analyzed the data of participants in the proactive screening from 2016 to 2018 provided by Hsinchu County to evaluate the performance of the plan in Wufeng and Jianshi Townships. In Wufeng and Jianshi Townships, the screening rates in 2018 were 23% and 13% respectively. The three-year cumulative screening rates of residents aged 35–64 years were 54% and 41%, and of residents older than 65 years were 48% and 29%, respectively. During implementation of the plan, some residents were unwilling to receive the proactive screening. Some residents answered the symptoms screening questionnaire with symptoms compatible with tuberculosis, but still refused to receive tuberculosis test. The findings showed that the major challenges of tuberculosis prevention in rural aboriginal towns were how to enhance the understanding of disease and screening willingness. We recommend incorporating awareness of tuberculosis into residents' daily life with education resources, and finding out the reasons for screening refusal, in order to improve the effectiveness of proactive screening plan in early case finding and to further decrease the incidence of tuberculosis in rural aboriginal towns.