Screening and Treating latent tuberculosis infection in Mountain Indigenous Communities in Nantou County,  2016–2021

DOI: 10.6524/EB.202503_41(6).0001

Yu-Ying Huang¹, Chiao-Wen Lin¹, Shu-Hua Wu², Shu-Fen Chien², Mei-Yin Hung²,
Pei-Jiuan Chao¹, Shao-Hui Tsai¹, Ching-Fen Ko¹, Jhy-Wen Wu¹

2025 Vol.41 NO.6

Correspondence Author： Yu-Ying Huang

Abstract：

  The incidence of tuberculosis in Taiwan has been decreasing annually, but in 2016, the average incidence in mountain indigenous regions was still nearly three times the national average. To proactively disrupt the source of transmission and effectively reduce tuberculosis occurrence, the Taiwan Centers for Disease Control (CDC) initiated the Latent Tuberculosis Infection (LTBI) screening and treatment program in mountain indigenous regions in 2016. This program collaborated with relevant healthcare resources and screening methods to implement comprehensive LTBI screening in indigenous communities, and provided treatment and medication delivery services to individuals with LTBI. 
  We analyzed LTBI screening and treatment outcomes in eight villages in Renai and Xinyi Townships in Nantou County from 2016 to 2021. During the study period, the average LTBI screening rate was 47.4%. Through pre-treatment evaluation,  0.8% of all LTBI-positive cases were identified to have active tuberculosis, and an additional 0.2% were diagnosed during treatment. This underscores the importance of detecting LTBI individuals who had yet to manifest tuberculosis and implementing pre-treatment evaluation in identifying active tuberculosis patients. Statistical analysis of LTBI treatment follow-up for one year or more revealed that the relative risk of developing tuberculosis for those who did not receive treatment was 7 times higher than that for those who completed treatment. Furthermore, the completion rate using a short-course LTBI treatment regimen was higher than the traditional 9-month isoniazid regimen. These findings suggest that implementing public health policies for LTBI screening and treatment has been effective in enhancing tuberculosis prevention and control, and contributing to an overall reduction of tuberculosis incidence.
  Despite the program's implementation, we still could not screen all people in indigenous communities, and not all individuals with LTBI received treatment. We recommend that public health authorities actively engage in community outreach and collaborate with churches, schools, community health centers, village leaders, and elders to enhance awareness of tuberculosis and increase people's willingness to participate in screening and treating of LTBI, and ultimately achieving the goal of reducing the tuberculosis incidence in mountain indigenous regions.