Abstract
ObjectiveOngoing transmission of tuberculosis (TB) continues in Indigenous communities in New South Wales (NSW), Australia. In a pilot project, a Public Health Unit TB team partnered with an Aboriginal Community Controlled Health Service (ACCHS) in a community with a cluster of TB to augment screening for latent TB infection (LTBI) using interferon-gamma release assay (IGRA). This study examined screening data and programme outcomes at 12 months post hoc to advise practice and policy formulation.MethodsWe conducted a retrospective, cross-sectional analysis of demographic and clinical data of ACCHS patients, stratified by IGRA testing status. Differences in sex and age distribution between the groups and cases of a genetically and epidemiologically linked TB cluster in Aboriginal people in NSW were assessed using non-parametric tests.ResultsOf 2019 Aboriginal and Torres Strait Islander people seen by general practitioners during the study period, 135 (6.7%) participated in the screening. Twenty-four (17.8%) participants were IGRA positive. One person was diagnosed with active TB. Twelve participants received a chest X-ray at the time of the positive test, and six participants had an additional chest X-ray within 12 months. None commenced preventive treatment for LTBI.DiscussionACCHS screening for LTBI reached individuals in the age group most commonly affected by TB in these Aboriginal communities. No conclusions can be made regarding the population prevalence due to the low screening rate. Further strategies need to be developed to increase appropriate follow-up and preventive treatment.
Highlights
The World Health Organization (WHO) set the goal of TB elimination by 2050 and initiated the End TB strategy in 2014.8 In Australia, the National Tuberculosis Advisory Committee (NTAC) guidelines assist TB services with achieving programme targets
Indigenous Australians are included in the populations WHO and NTAC recommends for targeted testing and treatment for latent TB infection (LTBI).[8,9]
Variables used for the outcome analysis of the people who screened positive for LTBI (IGRA result, sputum test results, chest X-ray at 0 and 12 months and TST results from previous screening) were extracted from Notifiable Conditions Information Management System (NCIMS)
Summary
Ongoing transmission of tuberculosis (TB) continues in Indigenous communities in New South Wales (NSW), Australia. A Public Health Unit TB team partnered with an Aboriginal Community Controlled Health Service (ACCHS) in a community with a cluster of TB to augment screening for latent TB infection (LTBI) using interferongamma release assay (IGRA). Indigenous Australians are included in the populations WHO and NTAC recommends for targeted testing and treatment for LTBI.[8,9]. WHO recommends either TST or IGRA to test for a University Centre for Rural Health, Lismore, NSW Australia. LTBI.[10] At the time of this project, NTAC recommended TST to diagnose LTBI, but “IGRAs may be a preferred option where resources, distance or other factors make TST impractical to administer;”[11] IGRA was only funded under Medicare in Australia for immunocompromised patients.
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