Treatment of Latent Tuberculosis in Migrants to Victoria, Australia

The proportion of eligible persons identified who are tested for latent tuberculosis (TB), offered treatment, and complete treatment are performance indicators in tuberculosis control. We report a retrospective database review of the Migrant Screening Clinic, Department of Respiratory and Sleep Disorders Medicine at Western Health Footscray Hospital during the years 1996-2006. 

Of 7,225 migrants aged less than 35 years, tuberculin skin testing (TST) was performed for 3,589 (49.7%), including 2,641 (65.6%) of 4,024 migrants under 35 years with an abnormal chest radiograph, and 2,297 (59.0%) of 3,893 migrants born in a high-burden country. Of 3,589 persons with both chest radiograph and TST results, 1,487 (41.4%) were referred for follow-up, including 81.3% of those with TST ≥10 mm. Outcome data were available for 1,047 persons considered for treatment of latent TB, of whom 12.5% did not attend an initial appointment, 21.6% attended and were not offered treatment, 65.9% attended and were offeredtreatment, and 41.7% completed treatment for latent TB. 

The Victorian program for treatment of latent TB in migrants has testing, treatment offer and treatment completions rates similar to other published studies. The impact on TB control is limited by the small proportion of migrants referred to this program.

Table 2: Outcomes of referral for treatment of latent tuberculosis

Outcome	n	%
Did not attend initial appointment	131	12.5
Attended initial appointment but treatment for latent TB not offered	226	21.6
Treatment of latent TB offered but patient refused	144	13.8
Started but failed to complete treatment for latent TB	109	10.4
Completed 6 months isoniazid	224	21.4
Completed 9 months isoniazid	205	19.6
Completed 2 months rifampicin + pyrazinamide or other treatment of latent TB	8	0.8
Total	1,047	100.0

Full article at:   http://goo.gl/x01QfT

By:  Flynn MG1, Brown LK2.

• 1Physician, Department of Respiratory and Sleep Disorders Medicine, Western Health, Footscray, Victoria.
• 2Manager, Tuberculosis Control Program, Department of Health, Melbourne, Victoria. 

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