In partnership with the Menzies School of Health Research and Timor-Leste’s National Tuberculosis (TB) Program, the National Critical Care and Trauma Response Centre* (NCCTRC) are providing mentorship and field support for the National TB Prevalence Survey.
The national research project funded by the Australian Government Department of Foreign Affairs and Trade aims to determine the burden of TB in Timor-Leste while promoting better access to healthcare by identifying additional cases within the community and linking them to treatment.
According to the World Health Organization (WHO), TB affects approximately 500 people in every 100,000 in Timor-Leste every year, representing the second-highest incidence rate in the Southeast Asian region and one of the highest in the world.
Working on two to four week rotations, Australian Medical Assistance Team (AUSMAT) radiographers and registered nurses have worked alongside Timorese radiographers and public outreach teams to assist in rolling out the project, while mentoring local practitioners during the chest x-ray screening process.
AUSMAT radiographer and public health officer Misha Richards spent two weeks in Timor-Leste as part of the project, specifically mentoring local practitioners in Dili. She explained the project as mutually beneficial for both Timorese practitioners and those on rotation working alongside the Menzies TB research team.
“My role was to ensure the local radiographers felt confident in using the x-ray systems, however after only a week it was the local radiographers leading the charge,” she said.
“The partnership between Menzies, NCCTRC and the Timorese health workers has really allowed us to all build much stronger relationships on the ground, and will undoubtedly pave the way for programs and health systems which will build capacity with a long-lasting positive impact in Timor-Leste.”
Menzies Paediatric Infectious Diseases Specialist Associate Professor Joshua Francis is leading the Menzies projects in Timor-Leste, and said this is the largest research project targeting TB that has been run in Timor-Leste.
“The survey project will visit all 13 municipalities of Timor-Leste, with a focus on community engagement and working closely with local leaders, the initial outreach or survey team compile a random selection of villages and approach households interested in being involved in screening for TB,” he said.
“Collaborating with the NCCTRC has provided additional technical support for radiographers in the field, and the contribution of a transportable x-ray machine to be used in regional areas.”
So far, the survey team have visited two key municipalities in Dili and Ermera, and will continue screening through the remaining 12 municipalities until December 2023. The nation-wide survey aims to screen up to 20,000 people across 50 sites throughout the country.
Andrew Loughman, AUSMAT Radiographer and Director Medical Imaging Services with NT Health, supported the project in a number of regional communities.
He said the involvement of local clinicians and community leaders encouraged community members to be involved in the public health initiative.
“People in the Letefoho community were lining up to be screened and eager to be involved. The National TB Prevalence Survey has already been so successful because of proactive community engagement,” he said.
“For example the Chefe (Village Chief) joined the team for screenings every day, the Chefes are so well respected in their communities and have been instrumental in increasing successful participation rates,
“To reach 90% of the survey participant base within one area purely through engagement is pretty remarkable.”
Ms Richards said the project is similarly tackling broader issues in the community around access to primary healthcare and stigma associated with ill health.
“Australians take for granted how easy it is to go to the doctor with even the smallest symptoms, that isn’t the case for every family in Timor-Leste,” she said.
“After the x-ray, we would host a secondary information session explaining TB more broadly and the community impact. This supported the team to reduce stigma around TB and ill-health more generally,
“It’s been incredible to see the lengths the Menzies team have gone to around public health messaging and the incredible commitment to supporting access to health facilities and expert technology for the local population.”
NCCTRC is honoured to support the National TB Prevalence Survey alongside Menzies School of Health Research and the Timor-Leste Ministry of Health, and hopes to contribute to long-term positive outcomes through public health research that supports treatment of TB in Timor-Leste.
“The Menzies team are fantastic at what they do, it’s so clear they have a fantastic reputation on the ground, there is a plethora of support for the success of this project. The people are incredible and I feel very privileged and honoured to have been involved,” Mr Loughman concluded.
*The National Critical Care and Trauma Response Centre is funded by the Commonwealth Department of Health and Aged Care