Tuberculosis in Far North Queensland, Australia: a retrospective clinical audit

Abstract

Tuberculosis remains a significant problem in FNQ. Case numbers have increased three-fold since the 1990s. Much of the increase comes from the overseas-born population. Although PNG accounts for the majority, the number of positive notifications amongst those born elsewhere abroad has increased five-fold since 2010. Tuberculosis amongst Aboriginal Australians has decreased following policy changes in response previous audits. Tuberculosis in Torres Strait residents, however, has increased from 12 cases (1993-2002) to 40 (2006-2016). This article is protected by copyright. All rights reserved.

The missing voices of Indigenous Australians in the social, cultural and historical experiences of tuberculosis: a systematic and integrative review

“…Descriptive epidemiological studies dominate the research literature. Of the 65 descriptive epidemiology reports, 18 are national TB surveillance reports70–87; 12 are State/Territory TB surveillance reports88–99; and four are regional TB reports from far north Queensland100–102 and the Northern Territory (NT) 103. The surveillance reports consistently demonstrate the higher TB burden for Indigenous Australians compared with the non-Indigenous Australian-born population.…”

“…Indigenous health models is an organising theme. Of the 95 records, 21 described Indigenous health models for the control of TB 2 16–18 23 25 40 43 48–51 53 57 59 61 64 66 69 102 103. Indigenous Australians’ approaches to health and illness, including TB, are recognised as holistic with spiritual, physical and biological causes and therapies, including magic or religious beliefs 50.…”

“…TB services for Indigenous Australians that are ‘innovative, and tailored towards individual needs’ with ‘full and voluntary community participation and leadership’ are recommended in TB control guidelines (Patel and Streeton, p66). 69 Attempts to realise this that are documented in the literature included community engagement; the participation of Aboriginal health workers; TB education developed by Indigenous Australians16–18 23 25 102 and TB services ‘guided by the principles of cultural respect, equity and partnership with Aboriginal communities’ for shared ownership of solutions (Devlin and Passmore, p41) 23. The involvement and active participation of Indigenous communities in the organisation and delivery of services link to the community participation and solidarity findings for theme 2.…”

“…Biomedical health models is an organising theme. Of the 95 records, 82 described biomedical approaches to control of TB in Indigenous Australians 2 16–25 40 42 44 47–50 56–58 61–63 65–67 69–123. TB services have been controlled by non-Indigenous outsiders and have rarely been designed to meet the needs of Indigenous Australians resulting in the marginalisation of Indigenous Australians from TB programmes.…”

Tuberculosis in Australia's tropical north: a population-based genomic epidemiological study

“…Similar changes in TB epidemiology have been noted in Far North Queensland, Australia, where incidence in Aboriginal peoples has fallen and the proportion of cases born overseas has risen. 29 Increased case numbers from neighbouring Papua New Guinea have also been noted, with high annual TB incidence (54 per 100,000 population) in Torres Strait Islander peoples. First Nations populations are disproportionately affected by TB in other countries with low TB incidence including New Zealand, Canada, and the United States of America.…”