Hunter New England Population Health, Tamworth, NSW, Australia.
BMC Public Health. 2013 Jan 22;13:62. doi: 10.1186/1471-2458-13-62.
The setting for this analysis is the low tuberculosis (TB) incidence state of New South Wales (NSW), Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC) in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas' country of birth profiles.
TB notification data for the three year period 2006-2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder.
During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA) in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5-19 years age group.
Analysing local area TB rates and possible explanatory variables can provide useful insights into the epidemiology of TB. TB notification rates that take country of birth in local areas into account could enable health services to strategically target TB control measures.
本分析的背景是澳大利亚新南威尔士州（新州）的低结核病（TB）发病率。在低发病率环境下，对来自高发病率出生国家（HIC）的人群的结核病流行病学进行当地水平分析在澳大利亚尚未进行，也未广泛报道。当地水平分析可以为主动发现病例和更早期诊断等措施提供信息。本研究的目的是使用一种新方法，根据当地的出生国家概况，确定澳大利亚州内具有更高结核病发病率的当地地区。
对 2006-2008 年三年期间的结核病通知数据进行了分析，将人群分为来自高发病率出生国家的人群和其余人群。
在研究期间，新州有 1401 例结核病通知病例。这些结核病病例中，76.5%出生于高发病率国家。高发病率出生国家组的年结核病通知率为 61.2/100,000 人，其余人群的年结核病通知率为 1.8/100,000 人。在新州的 152 个地方政府管辖区（LGA）中，有 9 个 LGA 的高发病率出生国家人群的结核病通知率高于新州其他地区的高发病率出生国家人群，而有 4 个 LGA 的结核病通知率低于新州其他地区的高发病率出生国家人群。这 9 个地区的出生人口中，有更多的人来自结核病发病率超过 100/100,000 的国家。在这 9 个地区通知患有结核病的人群，其在澳大利亚的逗留时间也比该州其他地区短。具有较高结核病通知率的地区均位于首府悉尼。在结核病通知率较高的 LGA 中，有 4 个地区在高发病率出生国家人群和非高发病率出生国家人群中均具有较高的发病率。高发病率出生国家人群的年龄分布在所有地区都相似，而各地区结核病发病率的最高差异出现在 5-19 岁年龄组。
分析当地地区结核病发病率和可能的解释变量可以为结核病的流行病学提供有用的见解。考虑当地地区出生国家的结核病通知率可以使卫生服务部门能够有策略地针对结核病控制措施。
