TB notifications among citizens and non-citizens in Taiwan

Abstract

<sec><title>BACKGROUND</title>Substantial under-notification of TB among non-citizens has been noted previously. Foreign workers with TB who were deported previously could stay for anti-TB treatment since 2014. We assessed whether TB notification improved.</sec><sec><title>METHODS</title>We used the National Health Insurance (NHI) reimbursement database to identify potential TB cases that required notification. We matched potential TB cases with the national TB registry to determine whether they had been notified. Cases notified within 7 days of the initiation of anti-TB treatment were classified as having timely notification.</sec><sec><title>RESULTS</title>Of 53,208 potential TB cases identified in 2016–2020, 96.6% had been notified. The notification proportion increased from 95.5% in 2016 to 97.1% in 2020 among citizens and from 89.0% in 2016 to 96.9% in 2020 among non-citizens. Factors significantly associated with non-notification among non-citizens were previously notified TB (aOR 35.5, 95% CI 17.7–70.9), without health insurance (aOR 15.4, 95% CI 9.3–25.2) and having only one visit to health care facilities in 6 months (aOR 2.3, 95% CI 1.4–3.8). The proportion of TB cases notified within 7 days was 87% overall, 86.2% among citizens, and 96.5% among non-citizens.</sec><sec><title>CONCLUSION</title>TB notification has improved, especially among non-citizens, following a policy change that allows foreign workers to stay for anti-TB treatment.</sec>