Part A:
According to the world health organization (WHO) 2015, Australia had the lowest TB incidence in the world, and this state has been perpetuated since the mid-1980s. Moreover, according to the National Notifiable Disease Committee (NNDC), the incidence of TB among the Australia population has significantly fluctuated over the last decades. For instance, according to the latest report, the incidence had remained relatively steady in 2015 and 2016 with an incidence rate of 4.6 per 100000 and 4.7 per 100000 (Roche,2012)
The burden of TB is not homogenous in Australia. According to the findings by the NNCD systems in 2016, the highest incidence of TB was reported in Australia’s overseas –born population. It constituted more than 88% of the entire notifications (a notification rate of 20.2 per 100000).The incidence of TB among the Australia-born indigenous population has been versatile for decades, but in recent years, it has remained steady. In 2015, the notification rate for the Australia-born indigenous was 5.0 per 100000.In contrast, during the same period, the Australia-born non-native consistently recorded an incidence of less 0.9 per 100000.The prevalence of TB in Australia as per the final report of the NNDC was 1397 although the number was not evenly distributed in the country (National TB Advisory Committee,2015)
Despite the tremendous strides the country has made towards curbing TB and the low incidence of TB. Still, TB remains an issue in Australia. According to the report published by the Australian Strategic Policy Institute in 2016, it was noted that TB epidemic was imminent in Australia. It was pointed out that the Papua New Guinea’s (PNG) island of Dau in Torres Strait has the highest incidence of multidrug-resistant TB with approximately 2% of people inhabiting the island infected with the airborne disease (Traurer, Cheng & Cheng, 2016). The proximity of the Australia to PNG and the Torres Strait Treaty and permits the free movement of people between the countries have substantially jeopardized the control of the prevention of TB. Moreover, in recent decades the patterns of migration to Australia has considerably changed. The proportion of migrants from Asia has increased significantly. Due to endemicity nature of TB in these countries, the attention to TB in the country has tremendously increased (Young & Brennan 2014).
On the hand, according to the World Health Organization (WHO) special report 2015, India was found to have the highest burden of TB in the world. The report further indicates that the state witnesses about 84 per 100000 of positive smear cases of TB annually. The figures translate to approximately 2.2million cases of TB in each in India. The burden of TB in India is not evenly distributed. According to the report prepared by Revised National TB Control program, the poor, prisoners and those with compromised immune system are often overrepresented among the cases. Moreover, 3 to 4 % of the newly diagnosed cases have been found to be drug-resistant. Additionally, the incidence of TB in India is higher in male than female. For instance, in 2015, the incidence of TB was in male 55 per 100000 against 30 per 100000 in the female (Revised National TB Control for India,2013).
Further, the WHO of 2015 indicates that the disease is quite prevalent in the country. Accounting to the report, 3.3million people are suffering from TB and that more than 276000 lives are lost due to TB annually. However, the majority of this population are having latent TB rather than the active disease (Lonnroth at el,2014).
Part B:
Comparatively, both the incidence and the prevalence of TB is strikingly high in India than in Australia.TB is an airborne illness. Its principal risk factors include overcrowding and poverty. Moreover, multiple factors such as tobacco smoking, poor living and working conditions have also been attributed to TB, and absence of vibrant preventional systems may lead to high incidences and prevalence of TB (Lonnroth at el ,2015).
India is highly populated. According to World Bank 2015, India had a population of 1.232billion people in the year 2013.The rate of population growth is also astonishing, and it is estimated to be 3.5% yearly. This phenomenon has culminated in unemployment, poor living and working conditions. According to National Survey Institute, 36% of the population in India are either slum dwellers or can hardly access better-living conditions.These residences are characterised by overcrowding, poor ventilation, and drainage. These conditions have fostered avenues of the TB transmission (Revised National TB Control Program for India, 2013).
Additionally, the poverty index is comparatively high in India. Undoubtedly India is a growing economy, but the big problem is that the population is growing at an alarming rate. Unarguably, poverty is a strong determinant of TB.Besides compelling individuals to inhabit overcrowded and poorly ventilated living and working conditions that are direct risk factors to be TB, absolute poverty many increases the vulnerability of one to TB (Young & Brennan,2014).For instance, it is evident that extreme poverty may subject a portion of the population to suffer from malnutrition and diseases such as HIV which may significantly reduce resistance to TB.Moreover, apart from making individuals have limited access to healthcare, poverty is associated with poor access to general health information and lack of empowerment to utilize health knowledge. This state exposes people to numerous TB risk factors such as smoking, HIV, and alcohol abuse (Lonnroth at el, 2015).
On the other hand, being born overseas in a high burden TB country is a major risk factor of TB in Australia. According to the NNCD, 89% of all cases notified in 2015 and 2016 were overseas born. Moreover, social exclusion of the indigenous Australians has significantly contributed the higher incidence of TB witnessed in this population. This population lacks equal access to both health information and health care like their non-indigenous counterparts (National TB Advisory Committee,2015).
Nevertheless, Australia has lower incidence and prevalence of TB due to myriad reasons. Firstly, the country has a smaller population. This phenomenon has promoted the growth of the economy. Also, it has drastically reduced unemployment and the poverty level. Consequently, a large population in Australia have access to better living and working conditions. Moreover, this population is exposed to incessant health messages pertaining TB prevention. This move has enabled them to refrain from any risk factor that may predispose them to TB infection such as smoking (Communicable Disease Branch Ministry of Health, 2012). Still, Australia has instituted sound TB prevention strategies and policies than India. For instance, national notification system has been created.This body besides maintaining awareness and education among all stakeholders and the public, it ensures timely access to appropriate and timely diagnosis and treatment of TB.This move has significantly minimized the transmission. Still, unlike in India, the surveillance systems in Australia have been strengthened and enhanced. This development has facilitated expeditious dissemination of information to those concerned with the control and prevention of TB (Roche, 2012).
Reference
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Lönnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M. Drivers of tuberculosis epidemics: The role of risk factors and social determinants. Social Science and Medicine 2015; 68:2240–2246
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Revised National Tuberculosis Control Programme for India 2013, TB India: RNTCP status report. New Delhi, Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare.
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Young, D. B., & Brennan, P. J 2014, TB research in India: International symposium on emerging trends in tuberculosis. Amsterdam, Elsevier.
Trauer J.M., Cheng A.C., & Cheng A.C 2016, Multidrug-resistant tuberculosis in Australia and our region: MDR-TB threatens TB control programs in Australia’s region and will not diminish without concerted efforts. Medical Journal of Australia. 204, 251-251.e1
Communicable Diseases Branch Ministry OF Health 2012, Infectious Diseases report NSW, November and December 2015. New South Wales Public Health Bulletin. 23.
