Clinical Case Report

Supporting holistic care for patients with tuberculosis in a remote Indigenous community: a case report

AUTHORS

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Andrea Miller1
FRACGP, FARGP (Adv Skill Adult Internal Medicine), Senior Medical Officer

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Alice Cairns2
PhD, HOT North Research Fellow *

Annah Richardson3 Master of Nursing (Rural and Remote), Clinical Nurse

Jill Lawrence4 Aboriginal and Torres Strait Islander Indigenous Health Worker

AFFILIATIONS

1 Weipa Integrated Health Services, PO Box 341, Weipa, Queensland 4874, Australia

2 Centre for Rural and Remote Health, James Cook University, Weipa Hospital PO Box 341, Weipa, Queensland 4874, Australia

3 Weipa Integrated Health Service, Lot 497 John Evans Drive, Weipa, Queensland 4874, Australia

4 Napranum Primary Health Care Clinic, Munding Road, Napranum, Queensland 4874, Australia

ACCEPTED: 28 January 2020


early abstract:

Context: Tuberculosis (TB) is a serious infectious disease with high rates of morbidity and mortality if left untreated. In Australia, TB has been virtually eradicated in non-Indigenous Australian born populations but in remote Aboriginal and/or Torres Strait Islander communities TB presents a rare but significant public health issue. Remote health services are most likely to encounter patients with suspected and confirmed TB diagnosis but may be unprepared for supporting someone with this disease and the complexities of balancing public health risk with patient autonomy.

Issue: This case study will outline the process for diagnosis and treatment of a TB patient in a remote Cape York community. This case involved significant delay in diagnosis and required multiple strategies to achieve successful disease eradication. The process of treatment however had a significant effect on the patient’s physical health and social and emotional wellbeing.

Lesson: This case highlighted the importance of early collaboration between medical, nursing, Indigenous health worker and allied health services and the importance of technology such as electronic information records to support opportunistic access to diagnostic services and treatment. The enactment of the TB protocol should include discussions about the consequences of any restrictions of movement, employment or social/community roles. Identifying alternative opportunities to engage in meaningful roles may reduce the impact the disease has on a patient’s quality of life.