TB disproportionately affecting Māori
25 September 2018
Migrants to New Zealand carry the highest risk of having tuberculosis, although Māori continue to suffer disproportionately from the disease compared with others born in New Zealand.
Data presented by ESR at a recent Australasian conference on TB, show the overall rate of TB disease in New Zealand is low, but thenumbers mask the high incidence of Māori with the disease.
The conference was told that around the world, the disease kills 5,000 people every day. An estimated 1.7 billion people globally have Latent TB Infection (LTBI), and WHO estimated there were 10.4 million new cases of active TB disease in 2016.
WHO said although New Zealand was a low tuberculosis (TB) incidence country, TB was still a public health threat
“Increasing rates of multidrug-resistant TB and increasing international connectedness means TB control will remain a priority for the foreseeable future. Ongoing review of clinical and public health practices are required to address this threat."
ESR figures from 2008 to 2017 show an average of about 300 cases a year in New Zealand, with most of those who have the disease born overseas.
But while the rate of TB over the past five years for those of European ethnicity was 0.5 per 100,000 of the population, TB disease among Māori is eight time higher. (4.1 per 100,000)
There has been with little change in those numbers over the past decade.
Presenting results at the conference from a recent ESR analysis of TB epidemiology over the past 10 years, ESR public health physician Jill Sherwood said the highest disease rate was among those born overseas, particularly in Asia, with the highest case numbers and rates in those born in India, Philippines and China.
Last year, the highest notification rate of TB was for those of Asian ethnicity (37.4 per 100,000), followed by those of Middle Eastern, Latin American and African ethnicity (13.1 per 100,000) and lastly those of Pacific ethnicity 12.9 per 100,000).
There were 167 hospitalisations in 2017, with one death reported.
Dr Sherwood said disease rates were highest for adults in their twenties, both for those born in New Zealand and those born overseas.
“However, no age is exempt. For instance, last year there were three cases of children with the disease who were under five, all of whom were born in New Zealand and of Māori ethnicity,” Dr Sherwood said.
She says additional actions towards eliminating the disease in New Zealand include, as a first step, the mapping of all TB-risk groups such as those with elevated incidence, hard-to-reach groups and migrants.
Health authorities could then use the data to inform policy on screening and treatment of people who have latent TB infection (LTBI). People with LTBI carry the TB bacteria, but are no unwell nor infectious. About 10 per cent of people with LTBI go on to develop TB disease.
A WHO document also presented at the conference said the social and economic impacts of TB were devastating, including poverty, stigma and discrimination.
A resolution passed by the World Health Assembly in 2014 called on governments to adapt and implement its End TB strategy with high level commitment and financing. The strategy focuses on serving populations highly vulnerable to infection and poor health care access, such as migrants.