Tuberculosis control in refugee and displaced populations

Refugee and displaced populations are at high risk of many communicable diseases including tuberculosis (TB). These populations face increased disease threats due to inadequate shelter and water, poor sanitation, overcrowding, and malnutrition. This is further compounded by a breakdown in health services, lack of regular drug supplies due to logistic difficulties, and ongoing conflict limiting access to populations. TB is becoming an increasingly important cause of morbidity and mortality in these populations. Conflict can affect large numbers of refugee and displaced populations, and in acute situations with a combination of war or civil strife and food shortage can result in significant excess mortality and morbidity (1). An increasing number of civilians have been affected by conflict over the last decade. By the end of 2003, there were almost 10 million refugees and 20.6 million displaced people worldwide, an increase from 19.8 million reported in 2002 (2). In addition, conflict has affected entire countries such as the Democratic Republic of Congo (DRC) and Afghanistan. At present, more than 200 million people live in such countries.