P176 THE STATE OF TUBERCULOSIS IN VANUATU

¹JN Fullerton, ¹LJ Thomas, ²DT McLeod. ¹University of Birmingham, Birmingham, UK, ²Sandwell and West Birmingham Hospital, Birmingham, UK

Background: Tuberculosis is one of the top 10 causes of death in Vanuatu; however, reported rates of multiple drug resistance (MDR) and HIV are currently low. To date, no study has systematically examined the diagnosis, management and clinical outcome of tuberculosis in Vanuatu, a practice strongly advocated by the WHO.

Aim: To assess whether the diagnosis and management of tuberculosis in Vanuatu is in line with regional and WHO guidelines and evaluate the quality of routine surveillance data in order to advise future practice and policy.

Method: A retrospective review of clinical and laboratory records for all cases of tuberculosis in Vila Central Hospital, Vanuatu, from 1 April 2006 to 31 March 2007

Results: 51 cases of tuberculosis were identified: 26 female (51%), average age 28.7 years. This extrapolates to a population rate of 63.75/100 000 per year, reflecting a 7% rise since 2005. The majority of cases were pulmonary (28, 54.9%). Sputum smears were performed in 32 (63%) cases. Combination therapy was readily available. Three patients (6%) received the correct dose, regimen and duration of therapy. Inadequate surveillance for HIV and MDR-TB was observed. Only eight (15.6%) cases were tested for HIV, one (12.5%) was positive. No MDR-TB was identified.

Conclusions: National surveillance data may be inaccurate and the rising incidence in tuberculosis is likely to be underestimated. Given the high level of sexually transmitted diseases and the experience of other Melanesian islands, an HIV epidemic is likely. Existing public health systems and tuberculosis services are not meeting WHO standards and are ill-prepared to cope with such an eventuality.

Acknowledgements: Morriston Davies Trust (BTS), Target TB.

P177 HEALTH STATUS OF UK PATIENTS WITH ACTIVE TUBERCULOSIS STARTING THERAPY

¹ME Kruijshaar, ²M Lipman, ³ML Essink-Bot, ^{4 …}