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      Tuberculosis in east timorese refugees: implications for health care needs in East Timor.

      The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
      Adolescent, Adult, Antitubercular Agents, therapeutic use, Child, Child, Preschool, Female, Health Services Needs and Demand, statistics & numerical data, Humans, Indonesia, epidemiology, Infant, Male, Mass Chest X-Ray, Middle Aged, Mycobacterium tuberculosis, isolation & purification, Population Surveillance, Refugees, Tuberculosis, Multidrug-Resistant, drug therapy, microbiology, Tuberculosis, Pulmonary

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          East Timorese refugees evacuated to Darwin, Australia, September 1999. Presentation of the process and results of tuberculosis (TB) screening in a previously unscreened refugee population. Screening for TB by clinical examination (all persons) and chest X-ray (CXR) (persons over 12 years of age and those of any age with respiratory symptoms) and sputum microscopy and mycobacterial culture (abnormal CXR). Seventy-six patients were diagnosed with TB (38 culture-positive for Mycobacterium tuberculosis, including 11 sputum smear-positive). Of 89 positive mycobacterial cultures, 51 were non-tuberculous mycobacteria (NTM). Of the M. tuberculosis isolates, 82.2% were fully sensitive, 17.2% were resistant to isoniazid and 8.6% were resistant to isoniazid and streptomycin. Fifty-three consecutively diagnosed patients with TB were HIV-negative. The TB burden in this population was very high (point prevalence of 542/100,000 for smear-positive and 2,060/100,000 for culture-positive cases). Rates of culture for NTM were also high. Information from this study assisted the implementation of a National TB Control Programme for East Timor in February 2000. The challenges for public health authorities in East Timor to provide a successful TB control programme are enormous. The apparently low prevalence of drug resistance and HIV co-infection in the population is encouraging.

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