Related Experiment Videos
Tuberculosis in east timorese refugees: implications for health care needs in East Timor
P M Kelly1, L Scott, V L Krause
1Centre for Disease Control, Department of Health & Community Services, Darwin, Northern Territory, Australia. paulk@menzies.edu.au
Setting:
East Timorese refugees evacuated to Darwin, Australia, September 1999.
Objective:
Presentation of the process and results of tuberculosis (TB) screening in a previously unscreened refugee population.
Design:
Screening for TB by clinical examination (all persons) and chest X-ray (CXR) (persons over 12 years of age and those of any age with respiratory symptoms) and sputum microscopy and mycobacterial culture (abnormal CXR).
Results:
Seventy-six patients were diagnosed with TB (38 culture-positive for Mycobacterium tuberculosis, including 11 sputum smear-positive). Of 89 positive mycobacterial cultures, 51 were non-tuberculous mycobacteria (NTM). Of the M. tuberculosis isolates, 82.2% were fully sensitive, 17.2% were resistant to isoniazid and 8.6% were resistant to isoniazid and streptomycin. Fifty-three consecutively diagnosed patients with TB were HIV-negative. The TB burden in this population was very high (point prevalence of 542/100,000 for smear-positive and 2,060/100,000 for culture-positive cases). Rates of culture for NTM were also high. Information from this study assisted the implementation of a National TB Control Programme for East Timor in February 2000.
Conclusion:
The challenges for public health authorities in East Timor to provide a successful TB control programme are enormous. The apparently low prevalence of drug resistance and HIV co-infection in the population is encouraging.