Tuberculosis is common in the UNHCR Bhutanese refugee camps. The IOM has identified that refugees who are not actively screened for TB through third country resettlement protocols have sputum smears with increased infectiousness. This suggests that refugees waited a prolonged period of time between the onset of symptoms and the start of treatment. This increases the risk of transmission to others due to higher levels of bacteria in the sputum and longer periods of exposure. Delay in seeking care is realted to a lack of TB knowledge.