An electronic publication from the Australian Indigenous HealthInfoNet
Issue 8, July 2000 - October 2000 : ISSN 1329-3362
Conference abstracts and papers
The Royal Australian College of Physicians Annual Scientific Meeting
2-5 May 2000, Adelaide Convention Centre, Adelaide, South Australia.
W.K. Scheil and R. Antic
Tuberculosis notifications in Aboriginal south Australians, 1986-1997.
Background: Indigenous Australians demonstrate higher rates of active tuberculosis compared with non-Indigenous Australian born.
Aim: To aid assessment of current control measures and direct future strategies, I describe the epidemiology of reports of tuberculosis between 1986 and 1997 in Aboriginal South Australians.
Methods: Cases were identified from the mycobacterial notification database of the South Australian Tuberculosis Services. Aboriginality was recorded on the database and verified from original records. Denominator data were obtained from ABS surveys. Results were analysed using Epi Info version 6.2.
Results: Between 1986 and 1997, 40 Aboriginals were diagnosed with tuberculosis in South Australia, and there were 43 reports of tuberculosis in Aboriginals resident in South Australia (average annual incidence 21 per 100,000). Reports included 27 males (63%) and ages ranged from one to 76 years, with seven under 15 years of age. Primary disease sites were reported as pulmonary in 36 (84%), and bacteriological confirmation was achieved in 34 (79%) cases. Twenty-six (60%) reports identified other medical co-morbidities. Seven people (16%) died before tuberculosis treatment was completed. Residential location indicated seven distinct postcode regions.
Discussion: Between 1986 and 1997 the average annual incidence of tuberculosis in Aboriginal South Australian residents was 13 times higher than non-Aboriginal (rate = 1.6 per 100 000 per year). The case fatality rate (16%) was also higher than the non-Indigenous population (7%) and may reflect serious underlying comorbidities and late presentation for treatment. Rates varied amongst different communities and supported the need for targeted intervention programmes within individual communities. Targeted screening showed benefits with early disease detection. This review highlighted the need for continued tuberculosis intervention programmes and improved health care to ensure timely treatment and to prevent the development of opportunistic diseases such as tuberculosis.
