SETTING: East Timorese refugees evacuated to Darwin, Australia, September 1999. OBJECTIVE: Presentation of the process and results of tuberculosis (TB) screening in a previously unscreened refugee population. DESIGN: 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). RESULTS: 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 542/100000 for smear-positive and 2060/100000 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. CONCLUSION: 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.

tuberculosis East Timor Non-tuberculous mycobacteria Refugees Antimicrobial resistance

refugee Population Surveillance human Refugees middle aged Mycobacterium tuberculosis priority journal Tuberculosis, Multidrug-Resistant screening test nonhuman Health Services Needs and Demand lymph node biopsy Humans Timor-Leste Mass Chest X-Ray DNA probe tuberculostatic agent Antitubercular Agents Adolescent male Tuberculosis, Pulmonary female pleura biopsy tuberculosis Infant Child, Preschool Indonesia Article streptomycin multidrug resistance adult major clinical study antibiotic therapy migration isoniazid thorax radiography tuberculosis control antibiotic resistance ethambutol bacterium isolate bronchoscopy pyrazinamide bacterium culture health care delivery Child