[Contagious Conversations] Managing a remote TB outbreak

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Despite Australia’s wealth and low population density, community transmission of the infection has been observed in remote Aboriginal territories. In May 2022, TB was detected on the country of the Pitjantjatjara Yankunytjatjara people, the first outbreak in five years. Administratively the APY lands cover 100,000 km squared in South Australia, and they are closer to Alice Springs than they are to Adelaide.

Important prevention and elimination work is conducted by visiting staff from the South Australia Tuberculosis Service based at Royal Adelaide Hospital some 1400km away on some rugged roads. The growth of that TB cluster to 11 cases over 18 months represented locally, an incidence rate of 390 per 100,000, among the highest in the world.

Logistical barriers to control in this remote and under resourced setting included the fact that there was just one X-ray machine available to serve the entire region and the timely transport of blood sample assays was very difficult. Just as critically, there were barriers of trust to be overcome with the Aboriginal community, reliant on the cultural acumen of health workers like registered nurse Carolyn Gill. She was one of the authors of a Lancet paper along with respiratory physician Dr Simone Barry, and they describe the experience for this episode of Contagious Conversations from the Australasian Society for Infectious Diseases.

Credits

Guests
Associate Professor Simone Barry FRACP PhD (Royal Adelaide Hospital; Director, South Australian Tuberculosis Service;  University of Adelaide).
Carolyn Gill (Royal Adelaide Hospital; South Australia Tuberculosis Service)

Host
Associate Professor Sanjaya Senanayake FRACP (Canberra Hospital; Australian National University)

Production
Production by Mic Cavazzini DPhil and Dr Candice Holland, ASID. Thanks also to Inge Meggitt, administrative coordinator at ASID. Music licenced from Epidemic Sound includes ‘Exploring the Lake’ by View Points and ‘Emerlyn’ by Valante. Image copyright ASID (2026).

Further Resources

Overcoming barriers in tuberculosis control: a case study from a remote community of South Australia [Lancet Reg Health West Pac. 2025]