Tuberculosis control in conflict-affected East Timor, 1996-2004

Abstract

Setting: East Timor has undergone major political changes in the past 10 years. Tuberculosis (TB) control has flourished, despite chronic low tension conflict, a brief but intense period of high-level conflict and post-conflict reconstruction.

Objective: To assess TB control in East Timor from 1996 to 2004.

Design: Data were collected from a variety of sources. Key TB programme indicators were analysed with reference to WHO targets to assess the performance of the three TB control programmes that operated during the study period.

Results: Before 1999, a non-governmental TB control programme was established in several districts in parallel with the government TB programme, and showed optimistic results. External donor funds, technical assistance and local control strategies were key components. In 1999, conflict led to complete disruption of both programmes. In 2000, a National Tuberculosis Control Programme (NTP) was established from the non-governmental programme in collaboration with other partners. The smear-positive TB case notification rate of 108 per 100000 population is the highest in the region and reflects high population coverage. The cure rate of 81% is close to reaching the WHO target.

Conclusion: High-quality TB control has been introduced in conflict-affected East Timor. Further research is needed to examine Timorese approaches to inform other, similar settings.