title: Notified tuberculosis among Singapore residents by ethnicity, 2002-2011.
abstract: METHODS
  The National Tuberculosis Programme in Singapore where, among resident cases, higher tuberculosis (TB) rates have been reported in ethnic Malays.
  
  
  OBJECTIVE
  To describe the socio-demographic and clinical characteristics of resident TB cases by ethnicity, and to assess whether Malays differ from other groups in terms of the above parameters.
  
  
  METHODS
  Cross-sectional review of records from the tuberculosis registry's electronic database.
  
  
  RESULTS
  Among 15 622 resident cases notified, 72.2% were Chinese, 18.7% Malay, 5.8% Indian and 2.9% were from other minorities. Compared to other ethnicities, Malays were more likely to be incarcerated at the time of notification (odds ratio [OR] 3.70, 95%CI 3.03-4.52) and clustered at the same residential address (OR 1.65, 95%CI 1.44-1.89), but were less likely to be aged ≥65 years (OR 0.61, 95%CI 0.54-0.70) or to reside in high-cost housing (OR 0.11, 95%CI 0.07-0.17). In terms of disease characteristics, more Malays had diabetes mellitus (OR 1.54, 1.37-1.73), a highly-positive acid-fast bacilli smear (OR 1.64, 95%CI 1.47-1.83) and cavitary disease on chest X-ray (OR 1.41, 95%CI 1.28-1.55).
  
  
  CONCLUSIONS
  Compared to other ethnicities, reported TB cases among Malays were more severe and were likely to be more infectious. Increased vigilance in case management and contact investigations, as well as an improvement in the socio-economic conditions of this community, are required to reduce TB rates in this ethnic group.
authors.affiliation: Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore.
authors.forename: L K-Y
authors.initials: LK
authors.lastname: Lim
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.
authors.forename: D A
authors.initials: DA
authors.lastname: Enarson
authors.affiliation: Operational Research Unit, Médecins Sans Frontières Operational Centre, Brussels, Luxembourg.
authors.forename: A J
authors.initials: AJ
authors.lastname: Reid
authors.affiliation: The Union South-East Asia Office, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Satyanarayana
authors.affiliation: Communicable Diseases Division, Ministry of Health, Singapore.
authors.forename: J
authors.initials: J
authors.lastname: Cutter
authors.affiliation: Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore.
authors.forename: K M
authors.initials: KM
authors.lastname: Kyi Win
authors.affiliation: Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore.
authors.forename: C B-E
authors.initials: CB
authors.lastname: Chee
authors.affiliation: Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore.
authors.forename: Y T
authors.initials: YT
authors.lastname: Wang
keywords: Singapore; TB; characteristics; ethnic group; operational research