title: Pulmonary tuberculosis in migratory nomadic populations: the missing link in Iran's National Tuberculosis Programme.
abstract: OBJECTIVE
  To detect pulmonary tuberculosis (PTB) in migratory nomadic populations in Fars Province, southern Iran.
  
  
  METHODS
  Cross-sectional study.
  
  
  RESULTS
  In this study, 5506 (82.8%) of a total nomad population of 6650 from 1337 tents were screened for PTB. The mean age was 27.4 ± 18.2 years (range 1-109). Based on clinical symptoms, 141/5506 (2.6%) were identified as TB suspects. One male and three female adult new smear-positive PTB cases were detected, giving an incidence rate of 0.7/1000 population compared to 0.08/1000 in the general population of the region, and 28.4/1000 TB suspects. The median time to onset of symptoms in detected cases was 82.5 days. Tribal stigma against female TB patients was one of the main barriers to appropriate health-seeking behaviour.
  
  
  CONCLUSIONS
  The incidence of smear-positive PTB among migratory nomads is approximately nine-fold higher than in the general population. Active screening of TB in migratory nomads should be integrated into Iran's national TB control programme. The issue of destigmatisation, particularly among female TB patients, should also be addressed.
authors.affiliation: Community and Preventive Medicine, Health Policy Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Honarvar
authors.affiliation: Health Department, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Odoomi
authors.affiliation: Health Department, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Rezaei
authors.affiliation: Farashband Health Network, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: H B
authors.initials: HB
authors.lastname: Haghighi
authors.affiliation: Eghlid Health Network, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Karimi
authors.affiliation: Farashband Health Network, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Hosseini
authors.affiliation: Farashband Health Network, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Mazarei
authors.affiliation: Eghlid Health Network, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Panahi
authors.affiliation: Shiraz Health Network, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Jamshidi
authors.affiliation: Internal Medicine, HIV/AIDS Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Moghadami
authors.affiliation: Community and Preventive Medicine, Health Policy Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: K B
authors.initials: KB
authors.lastname: Lankarani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009313:National Health Programs; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011237:Predictive Value of Tests; D012111:Residence Characteristics; D012737:Sex Factors; D013240:Stereotyping; D014171:Transients and Migrants / Q000523:psychology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology* / Q000523:psychology; D055815:Young Adult