Tuberculosis in east timorese refugees: implications for health care needs in East Timor.
METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Kelly
P M
PM
Centre for Disease Control, Department of Health & Community Services, Darwin, Northern Territory, Australia. paulk@menzies.edu.au
Scott
L
L
Krause
V L
VL
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D008400:Mass Chest X-Ray; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011159:Population Surveillance; D012036:Refugees / Q000706:statistics & numerical data*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
D000995:Antitubercular Agents