Abstract
Population-based Screening for Tuberculosis in Thailand
Patsri Srisuwan*, Tanunya Koopitakkajorn**, Pritaporn Kingkaew**, Sitaporn Youngkong**, Sripen
Tantivess*, Yot Teerawattananon*
*Outpatient and Family Medicine Department, Phramongkutklao Hospital, **Health Intervention and Technology
Assessment Program, Ministry of Public Health
Tuberculosis is a serious contagious disease in Thailand due to high prevalence and incidence. Population-
based screening guideline has not been well established although chest x-ray figures in an annual
checkup program for the Civil Servant Medical Benefit Scheme (CSMBS) without evidence for effectiveness
or cost-effectiveness. The purpose of this article is to review and provide recommendations for population-
based screening for tuberculosis in Thailand through a systematic review and stakeholder discussion.
Analysis of clinical practice guidelines and experts’ opinion found no value for screening in the
general population. Disease detection was 0.05-0.7 case per 1,000 films and the cost per case-detection was
$8,000. Moreover, 30% of extra-pulmonary tuberculosis had normal chest x-rays. The screening should be
conducted only in high risk groups or symptomatic patients, whereas the general population should be
educated on the disease in risk reduction.
