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The Darwin-based National Critical Care and Trauma Response Centre is partnering with the Menzies School of Health Research and Timor-Leste's National Tuberculosis Program to provided mentorship and field support for a national TB prevalence survey.

The 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 in the community and linking them to treatment. 

According to the World Health Organisation, TB affects about 500 people in every 100,000 in Timor- Leste every year – the second-highest incidence rate in Southeast Asia and one of the highest in the world. 

Working on two to four week rotations, Australian Medical Assistance Team radiographers and registered nurses have worked alongside Timorese radiographers and public outreach teams to help 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 mentoring Dili practitioners. 

She says the project is mutually beneficial for 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, but after only a week it was the local radiographers leading the charge,” she says. 

“The partnership between Menzies, NCCTRC and the Timorese health workers has allowed us to all build much stronger relationships on the ground, and will undoubtedly pave the way for programs and health systems that will build capacity with a long-lasting positive impact in Timor-Leste.” 

Menzies paediatric infectious diseases specialist Joshua Francis, who is leading Menzies projects in Timor- Leste, says 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. 

“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,” says the Associate Professor. 

So far, the survey team has visited two key municipalities in Dili and Ermera, and will continue screening through the remaining 12 municipalities until December 2023. 

The nationwide 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 says the involvement of local clinicians and community leaders encouraged community members to be involved in the public health initiative. 

Mr Loughman says people in Letefoho were lining up to be screened. 

“The National TB Prevalence Survey has already been so successful because of proactive community engagement.” He says the “chefe” (village chief) joined the team for screenings every day. 

“Chefes are so well respected in their communities and have been instrumental in increasing successful participation rates. 

“To reach 90 percent of the survey participant base within one area purely through engagement is pretty remarkable.” 

Ms Richards says the project is 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 says. 

“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, which is funded by the Commonwealth Department of Health and Aged Care, 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,” Mr Loughman says. “It’s 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.”