title: Engaging women volunteers of high socioeconomic status in supporting socioeconomically disadvantaged tuberculosis patients in Chiang Rai, Thailand.
abstract: OBJECTIVE
  The 2008 tuberculosis (TB) surveillance of Chiang Rai Hospital, Chiang Rai, Thailand reported that 8.4% of Thai, 22.7% of hill tribe minority and 25% of migrant patients (n = 736) defaulted from treatment.
  
  
  BACKGROUND
  TB patient management in Chiang Rai is complicated due to poverty and HIV stigma. A previous study shows unaffordable travel expense was one of the reasons of patient default.
  
  
  METHODS
  We engaged Chiang Rai women's organizations whose members are of high socioeconomic status to support poor TB patients financially and socially. A group of women formed a team to support these TB patients (n = 192) by raising and sustaining funds and providing home visits (n = 37). TB surveillance and patient-fund register data were used to evaluate TB treatment outcomes.
  
  
  RESULTS
  THE SUCCESS OF TB TREATMENT WAS SIGNIFICANTLY HIGHER FOR PATIENTS RECEIVING FINANCIAL SUPPORT (RELATIVE RISK [RR]: 1.351; 95% confidence interval [CI] 1.20-1.53; P < 0.000). Lower death rates in all groups were observed among patients receiving financial support. However, financial assistance alone did not improve treatment outcomes for migrant patients. Thirty-seven patients (25 Thai, eight hill tribe, four migrants) who were visited by women volunteers at home achieved 95% TB treatment success.
  
  
  CONCLUSIONS
  It is possible to involve volunteers to support poor TB patients. Willingness to support TB patients was driven by presenting provincial TB epidemiology information, research data on the experience of poor patients and the inspiring experiences of other women volunteers. Future research should investigate the reasons for the high treatment success among patients who received home visits.
authors.affiliation: The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, Tokyo, Japan . ; TB/HIV Research Foundation, Muang District, Chiang Rai, Thailand .
authors.forename: Jintana
authors.initials: J
authors.lastname: Ngamvithayapong-Yanai
authors.forename: Sarmwai
authors.initials: S
authors.lastname: Luangjina
authors.forename: Supalert
authors.initials: S
authors.lastname: Nedsuwan
authors.forename: Pacharee
authors.initials: P
authors.lastname: Kantipong
authors.forename: Jirapohn
authors.initials: J
authors.lastname: Wongyai
authors.forename: Nobukatsu
authors.initials: N
authors.lastname: Ishikawa
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000191:economics / Q000628:therapy; D000328:Adult; D001290:Attitude; D002608:Charities; D005006:Ethnicity; D005260:Female; D005381:Financing, Organized; D037921:Gift Giving; D006379:Helping Behavior; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D012923:Social Class; D012944:Social Support; D013785:Thailand / Q000453:epidemiology; D014171:Transients and Migrants; D014186:Transportation; D016896:Treatment Outcome; D014376:Tuberculosis / Q000191:economics / Q000401:mortality / Q000628:therapy; D014838:Volunteers; D035862:Vulnerable Populations; D014930:Women
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