Vigilance needed to protect Australia from tuberculosis threat

Tuberculosis specialists have cautioned against the premature closure of TB treatment centres for Papua New Guineans who access health care in the Torres Strait, amid fears the move would worsen TB infection rates in both PNG and Australia.

“Unexpectedly, during the first half of 2011, the Queensland Government directed that the TB outreach clinics on Saibai and Boigu Islands be closed in June 2011,” thoracic physician Dr Stephen Vincent said in an article in the 7 November issue of the Medical Journal of Australia.

“No remedial plan for treatment continuation was included, leaving the 50 patients from PNG who were being treated for TB in a dire situation.”

There was considerable concern that extensively, drug-resistant TB will emerge in the region and eventually infect Australian citizens living in the outer Torres Strait, Dr Vincent said.

“Through strong pressure from TB clinicians in Australia, operation of the Australian services has been extended, and they will remain open until early 2012 to ensure completion of the treatment cycle for current patients,” he said.

Queensland Tuberculosis Control Centre Director Anastasios Konstantinos said clinicians were still concerned by the assumption that provision of foreign aid to PNG will ensure that all PNG patients with TB could be safely transferred back to PNG by February 2012.

He and colleagues from the Thoracic Medicine and Regional TB Control Unit in Cairns and the Sydney Institute for Emerging Infectious Diseases and Biosecurity called for the maintenance of current Australian TB services within the Torres Strait, and for Federal Government funding to develop TB services in PNG to identify the most cost-effective and pragmatic long-term solutions.

In a study also published in the MJA, Dr Paul Douglas and Dr Kathleen King, Chief Medical Officer and former senior medical adviser respectively, from the Department of Immigration and Citizenship’s Global Health Branch, and their colleagues found that premigration health screening of intending migrants was identifying substantial numbers of people who would otherwise have needed treatment for TB after arrival in Australia.

“The screening is of benefit to the applicants, whose tuberculosis is treated earlier than it otherwise would have been, and to the Australian population, by averting exposure to people with active tuberculosis,” the study authors said.

MJA editor Annette Katelaris said Australia enjoyed one of the lowest rates of TB in the world, and effective TB control requires prompt identification and treatment as well as monitoring and contact screening.

“Only when PNG clinics can provide all this should care be transferred. It seems extremely unlikely that this will occur by the planned date of February 2012,” she said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACTS:             Dr Graham Simpson                                                            0403 140 95

                             Dr Stephan Vincent                                                             0413 007 177

                             Department of Immigration and Citizenship Media Unit           02 6264 2244
                             (on behalf of Dr Paul Douglas)

                             Dr Anastasios Konstantinos                                                 0410 424 756