Migration Health Project Inform

ation Sheet– Cambodia

The IOM TB REACH project, in

partnership with the Centre for Tu-

berculosis and Leprosy Control

(CENAT), the World Health Or-

ganization (WHO) and the WHO

Western Pacific Region (WPRO),

aims to set up systematic TB

screening using innovative strate-

gies targeting daily flows of Cam-

bodian irregular migrants being

deported from Thailand and Malay-

sia to the border district of Poipet

in Banteay Meanchey Province.

The systematic TB screenings will

use innovative diagnostic proce-

dures using chest X-ray and symp-

tom screening along side Xpert

MTB/RIF to screen 75,000 return-

ees at the Poipet Referral Hospital

in collaboration with existing local

Government TB health services.

The project aims to detect 1,100

additional cases through system-

atic TB screening.

Background

While the CENAT, the National TB program (NTP) in Cambodia has reached 100% coverage across

Summary

IOM IS COMMITTED TO THE PRINCIPLE THAT

HUMANE AND ORDERLY MIGRATION BENEFITS

MIGRANTS AND SOCIETY

The country, case detection is gener-ally passive detecting most TB cases only after considerable delay, which leads to continuing transmission of TB in the community. Similarly, there are limited diagnostic capacities of the staff to perform smear microscopy, culture, x-ray and counselling, which remain major challenges to detecting and treating TB earlier, particularly in remote and under-develop provinces.

Poipet Municipality, within the O Chrov district, has long been a major cross-border area that attracts people in search of better employment opportu-nities associated with economic cross-border activities. Most of the families residing in the Poipet area were origi-nally resettled from refugee camps along the Thai border since the official opening of this international border to Thailand in 1994, or have migrated in the last 10 years from other parts of Cambodia to take part in the expan-sion of economic cross-border activi-ties.

A majority of this population choose to migrate illegally beyond the border to find work in neighbouring Thailand and are subsequently deported back to Poi Pet on a daily basis. In 2011, there were 98,000 irregular migrants re-turned to Poipet border. Increased health debt, unemployment, loss of land, and food insecurity in home

provinces are major push factors for the irregular migration of poor irregular migrant households to cross-border areas and across international borders in search work or begging activities.

In the targeted border province of Banteay Meanchey TB services reported 2,935 TB cases within a population of 665,547 in 2008. This translates to case notification rate of 329 per 100,000. More specifically, in the target district of O Chrov new smear positive TB cases rose 17% from 231 to 280 from 2008 to 2009.

For further information, please contact:

Brett Dickson, Project Coordinator

IOM Cambodia Ph: +855.23.216532 Mobile: +855.(0)12 222 132 Email: bdickson@iom.int

Project at a Glance

Target Area: Poipet border province of Banteay Meanchey, Cambodia Timeframe: 16 months (November 2011—February 2013) Donor: TB REACH, Stop TB

Partnership Project Partners: Centre for Tuberculosis

and Leprosy Control (CENAT), Western Pacific Regional Office (WPRO), World Health Organization (WHO)

INCREASING ACTIVE TB CASE DETECTION FOR RETURNED IRREGULAR MIGRANTS AT POI PET BORDER

Migrants re

ceive an intro

duction to

TB Screening Cambodia.

Photo: IO

M

Target Group

This project will target 75,000 ir-regular Cambodian migrants de-ported from Thailand sent back to the Poi Pet Immigration Centre, Cambodia, using detention history and different screening procedures for migrant groups.

July 2013

Migration Health Project Inform

ation Sheet– Cambodia

• 37 per cent increase in an-nual PTB cases notified in district due to the project ACF activities (4 PTB cases by ACF in every 10 PTB case notified )

• At least 90% of them regis-tered and confirmed continu-ing TB treatment

• Food incentives, TB health promotional material and counselling provided to 6,680

Other IOM TB Projects in Asia and the Pacific

Country Project Title

Myanmar Community Based Quality TB Control Interventions (Screening, Diagnosing and Treatment) in Bogale Township in Ayeyarwady Region of Myanmar

Thailand Increase TB case detection in vulnerable populations in North and Northeastern Thailand through community mobilization and GeneXpert technology

Nepal Early and improved Tuberculosis case detection through the use of GeneXpert instrument in the East-ern Development Region of Nepal

Jaime Calderon, Regional Migration Health Adviser, IOM Regional Office for Asia and the Pacific Phone: +66 2 343 9348 Fax: +66 2 343 9399 Email: jcalderon@iom.int

For further information, on Migration and TB projects in the region, please contact:

Lao PDR TB-related knowledge, attitudes and practices among potential and returned migrants in Lao PDR

IOM’s Migration Health Division

IOM’s Migration Health Division (MHD) aims to meet the needs of Member States in managing health related aspects of migration, and to promote evidence-based policies and comprehensive preventive and curative health programmes which are beneficial, accessible, and equi-table for vulnerable migrants and mobile populations. The Migration Health Division works in five interconnected strategic func-tions to address the migration health challenges throughout the migration process: Advocacy; Health Policy Development; Health Service Deliv-ery; Capacity-Building and Research and Dissemination

Activities

1) Systematically screen irregular Cambodian migrants deported from Thailand for early and increased TB case detection;

2) Establish a mechanism to en-sure all TB cases are provided with

proper TB treatment and care under the local Government TB services within or outside the Banteay Meanchey Province;

3) Conduct Operational Research to document and publish overall project outcomes, based on the robust project monitoring and evaluation system, to demon-strate the effectiveness of the innovative-targeted active-case finding approach carried out by the project.

4) Document and publish overall project outcomes, to demon-strate the effectiveness of the innovative-targeted active case finding approach

Outputs (Feb 2012-Jan 2013)

• 8 Radiology technician and X-ray readers, 4 Laboratory Tech-nicians and 8 TB Peer Educa-tors from Poi Pet Referral Hos-pital trained.

• 11,604 irregular migrants re-ceived at Immigration Centre and screened by symptoms and detention history

• 6,680 (55%) irregular migrants referred and screened by symp-toms and chest X-ray

• 1,388 (20%) TB suspects found based on symptoms and/or ab-normal Chest X-ray findings

• 1,323 (95%) examined by GeneXpert MTB/Rif assay

• 127 (9.5%) additional new TB patients detected and referred for treatment

• Prevalence rates of 8,500 per 100,000 population for migrants

Government Radiologists reading chest X-ray of migrant at Referral hospital at border. Photo: IOM

Government Laboratory Technician performing GeneXpert test to detect MTB at Referral Hospital at Border. Photo: IOM

Migrants receive registration for TB treatment at Referral Hospital at Border. Photo: IOM