Epidemiology of laboratory confirmed tuberculosis in Victoria, 1990 to 2004

In Australia, most cases of tuberculosis (TB) occur in migrants. To inform control strategies for this group, we investigated all laboratory confirmed tuberculosis cases diagnosed by the State TB reference laboratory in Victoria between 1990 and 2004. The laboratory data were matched to notification data to determine country of birth and a multivariate model was constructed to compare Australian and non-Australian-born patients. The proportion of non-Australian-born cases increased over the period of the study and a shift in cases from South East Asia to African countries was observed. Non-Australian-born cases were more likely to be young, female, have extrapulmonary disease and show first line TB drug resistance. The shift in country of birth of TB cases in Victoria reflects migration patterns and the corresponding epidemiology of TB in the country of origin of these migrants. Ongoing migration from countries with high TB incidence raises the question whether it is possible to eliminate TB from Australia and new control strategies should be considered