Protracted Tuberculosis Outbreak in a Pasifika Diaspora in Western Sydney, Australia: The Importance of Community Engagement.

A prolonged tuberculosis outbreak, linked by whole-genome sequencing, occurred in a Pasifika extended family over 10 years (2013-2022) in Sydney, Australia. Despite Australia's low tuberculosis incidence, social and cultural complexities, and coronavirus disease 2019 (COVID-19) disruptions exacerbated transmission. Control required culturally sensitive, family-centered care and robust health system engagement.

Migration and descent, adaptations to altitude and tuberculosis in Nepalis and Tibetans.

Background: High rates of tuberculosis (TB) in migrants from Tibet and Nepal have been documented for over 120 years and were previously ascribed to poor living conditions in the places of settlement. Adaptations to altitude involving genes in the Hypoxia-Inducible Factor pathway are present in 90-95% of Tibetans and in Nepalis these allele frequencies increase by 17% with each 1000 m increase in altitude.

Methods: We calculated the incidence of TB by country of origin in immigrants from South and East Asia in New South Wales (NSW), Australia between 2004 and 2018, and compared disease severity, site of infection, evidence of local transmission and prevalence of latent TB, among these groups.