Donnan E J, Pett J, Ulbricht E, Massey P D, Sintchenko V, Marais B J
Health Protection New South Wales, Health System Support Group, St Leonards, NSW, Australia.
Sydney Infectious Diseases Institute (Sydney ID), The University of Sydney, Sydney, NSW, Australia.
IJTLD Open. 2025 Jun 13;2(6):324-332. doi: 10.5588/ijtldopen.24.0596. eCollection 2025 Jun.
In Australia, TB care and control is delivered by states and territories, with a National TB Advisory Committee to advise on national surveillance and strategy. For more than 30 years, New South Wales (NSW), Australia, has maintained TB incidence rates of <10/100,000 population, but progress toward TB elimination and 'zero local TB transmission' remains challenging. Reductions in the TB notification rate have plateaued in recent decades, mainly due to increased migration from high incidence countries. There is limited awareness of TB among the public, and a general perception of low risk, at least for Australian-born people and locally trained healthcare professionals. As in other low TB incidence settings, migrants and hard-to-reach populations are overrepresented in TB notifications. Progress in reducing TB among Australia's Aboriginal and Torres Strait Islander people has been slow, hindered by embedded disadvantage, limited healthcare access and historical mistrust. Community engagement and patient advocacy for TB is minimal. Despite excellent progress over many decades, TB elimination remains out of reach in NSW due to ongoing migration from high-incidence settings and the reality of competing health priorities. Here, we critically assess progress towards TB elimination targets and identify opportunities to further improve TB control.
在澳大利亚，结核病的防治工作由各州和领地负责实施，同时设有一个国家结核病咨询委员会，就全国监测和战略提供建议。30多年来，澳大利亚新南威尔士州（NSW）的结核病发病率一直保持在每10万人<10例，但在实现结核病消除和“本地零结核病传播”方面仍面临挑战。近几十年来，结核病通报率的下降趋于平稳，主要原因是来自高发病率国家的移民增加。公众对结核病的认识有限，普遍认为风险较低，至少对于澳大利亚出生的人和当地培训的医疗保健专业人员来说是这样。与其他低结核病发病率地区一样，移民和难以接触到的人群在结核病通报中占比过高。澳大利亚原住民和托雷斯海峡岛民中结核病减少的进展缓慢，受到根深蒂固的不利因素、有限的医疗保健服务可及性和历史上的不信任的阻碍。社区对结核病的参与和患者倡导极少。尽管几十年来取得了显著进展，但由于高发病率地区持续的移民以及其他优先卫生问题的现实情况，新南威尔士州仍无法实现结核病消除。在此，我们批判性地评估在实现结核病消除目标方面取得的进展，并确定进一步改善结核病控制的机会。
