ONE-YEAR OF TUBERCULOSIS IN AUCKLAND

Aim. To describe the recent epidemiology of tuberculosis in Auckland a nd the outcome of contact investigations. Method. Routine public healt h data were used to review the experience of tuberculosis (TB) in the Auckland region during a twelve month period in 1992-3. Results. There were 152 cases, an age-standardised rate of 2.7 per 100 000 for Europ eans, 37.8 for Maori, 70.9 for Pacific Island Polynesians and 131.3 fo r other ethnic groups. Fifty-two (35%) were born in New Zealand; 46 (3 1%) in Asia; 44 (30%) in the Pacific Islands. Forty-seven percent of f oreign-born cases (28% of all cases) arrived in New Zealand in the 4 y ears preceding their notification. Forty-one per cent of cases appear not to have been diagnosed until 3 months or longer after the onset of their symptoms. Fifteen cases (including three sputum smear-positive cases) took 4 weeks or longer from diagnosis to be notified to the pub lic health office, 12.5% of isolates were not notified. Two per cent o f the 1079 contacts examined had tuberculosis. Conclusion. This review highlights the need for programmes to address the ethnic disparity in rates of tuberculosis and the importance of timely comprehensive scre ening of immigrants from high incidence countries; reducing the interv al between onset of symptoms and diagnosis; improving the notification rate of tuberculosis; and focusing contact investigation on those at highest risk.