Tuberculosis (TB) services in the Torres Strait

Tuberculosis (TB) services in the Torres Strait

Dr Jeannette Young, Chief Health Officer, Queensland Health :

"The work that the Australian Government has done through AusAID in Papua New Guinea, specifically in the South Fly Province, has now reduced the risk to Queenslanders and indeed all Australians of contracting extremely drug-resistant TB.

A number of years ago, the Queensland Government made the decision to wind back the clinics that were being held in Saibai and Boigu, two small islands in the Torres Strait very close to Papua New Guinea.

"Those clinics were set up to provide services to Papua New Guinean nationals who had TB. They would come across the short gap of ocean, across to Australia to access these services. Unfortunately, we know that those types of services are not the best services to put in place for people with TB.

The best service you can offer someone with TB, particularly in a third world country, is the World Health Organization auspice service of DOTS -- direct observed treatment. The reason that is the best service is that then you can make sure that the patients are receiving their treatment every single day for the full course that is required. If that doesn't occur we know that there is a real risk that drug resistance can emerge. And indeed extremely drug resistant TB could emerge.

"So by putting in place a DOTS auspice program into PNG itself, you can reduce that risk. And that's the work that the Commonwealth Government has been doing through AusAID now for the last year.

They have been setting up treatment services within the villages and they've also enhanced the service that's available at Daru -- the referral hospital for that part of Papua New Guinea.

"They've put in place a sea ambulance to take patients to Daru if they've needed, but more importantly they have got services available in the actual villages where the people live. So they don't need to travel across the Strait, through to the Torres Strait to obtain services. In the past those services, although very well intentioned of course, meant that at some times people wouldn't be able to make the trip and would miss out on their drugs for that period and there would be issues with it.

"So now with the new process in place I am confident that we are reducing the risk to Australians from obtaining TB.

We have had very, very few cases over the years of TB within the Torres Strait itself. Torres Strait people, Aboriginal and Torres Strait Islanders who live in those communities, of course can continue to access TB services as can any Queenslander. So I am confident all of these changes will actually reduce the risk to those people and to all Queenslanders.

Benefits of the Direct Observed Treatment Short-course (DOTS) for treating TB

"The World Health Organization recommends that wherever possible the DOTS program should be utilised -- direct observed treatment. That is where health workers actually monitor people taking their drugs every day during the treatment. Most sensitive TB regimes last around six months, so it's important that the people take the drugs every day for that six-month period and DOTS ensures that happens.

It's always much more difficult if you ask people to come to a clinic every six weeks or so, to pick up their medication because they mightn't be able to make the trip for whatever reason. Indeed we had some times when the border was closed and it was difficult for people to access the drugs. Also that they mightn't be aware of the importance of taking the drugs every single day if there isn't someone there to remind them. Which is why WHO recommends DOTS for all third world countries.


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