Detailed characterisation of the tuberculosis epidemic in Western Sydney: a descriptive epidemiological study

Abstract

Traditional tuberculosis (TB) epidemiology reports rarely provide a detailed analysis of TB incidence in particular geographic locations and among diverse population groups. Western Sydney Local Health District (WSLHD) has one of the highest TB incidence rates in Australia, and we explored whether more detailed epidemiological analysis could provide a better overview of the local disease dynamics.Using multiple relevant data sources, we performed a retrospective descriptive study of TB cases diagnosed within the WSLHD from 2006 to 2015 with a specific focus on geographic hotspots and the population structure within these hotspots.Over the study period nearly 90% of Western Sydney TB cases were born in a high TB incidence country. The TB disease burden was geographically concentrated in particular areas, with variable ethnic profiles in these different hotspots. The most common countries of birth were India (33.0%), the Philippines (11.4%) and China (8.8%). Among the local government areas in Western Sydney, Auburn had the highest average TB incidence (29.4 per 100 000) with exceptionally high population-specific TB incidence rates among people born in Nepal (average 223 per 100 000 population), Afghanistan (average 154 per 100 000 population) and India (average 143 per 100 000 population).Similar to other highly cosmopolitan cities around the world, the TB burden in Sydney showed strong geographic concentration. Detailed analysis of TB patient and population profiles in Western Sydney should guide better contextualised and culturally appropriate public health strategies.

Chronic Pulmonary Aspergillosis: Burden, Clinical Characteristics and Treatment Outcomes at a Large Australian Tertiary Hospital

“…The average local TB incidence over 2006-2015 in the Western Sydney Local Health District was 14.5 per 100,000 population-well above the New South Wales state average of 5.6 per 100,000 [14]. Overseas-born individuals from TB-endemic regions accounted for roughly 90% of TB cases in Western Sydney, with India, China, Sri Lanka and the Philippines being the most common countries of origin [14]. Nevertheless, chronic obstructive pulmonary disease (COPD) (32.1%) was the most common predisposing risk factor for CPA in our cohort, followed by prior pulmonary TB (17.9%) and mild iatrogenic immunosuppression (17.9%).…”

“…Although, TB incidence is low in Australia, we hypothesized it would be the main underlying risk factor for our CPA cohort given the sizeable migrant community originating from high-TB incidence countries in Westmead Hospital's catchment area [14]. The average local TB incidence over 2006-2015 in the Western Sydney Local Health District was 14.5 per 100,000 population-well above the New South Wales state average of 5.6 per 100,000 [14]. Overseas-born individuals from TB-endemic regions accounted for roughly 90% of TB cases in Western Sydney, with India, China, Sri Lanka and the Philippines being the most common countries of origin [14].…”

Tuberculosis in elderly Australians: a 10-year retrospective review

“…Between 2011 and 2020, the absolute number of TB cases in Australia increased by 16%, in line with population growth 11 that includes a high proportion of people who were born in countries with high TB incidence, including China, India, Indonesia, Nepal and the Philippines. 12 Although Australia employs stringent pre-migration screening measures, this only includes screening for active pulmonary TB disease. 13 Most cases are identified in the first 5 years after arrival in Australia, representing likely disease reactivation.…”

Health Seeking Behaviour among Past and Current Tuberculosis Patients in a Low-Income Country

“…Few papers mentioned the high prevalence of TB among migrants from Nepal. For example, in Western Sydney, among people born in Nepal, TB incidence was as high as 223 per 100 000 [24].…”