ABSTRACT
The Covid-19 pandemic presents unprecedented challenges around the world and Timor-Leste is no exception. Despite volatile economic performance, consistent low levels of health spending, and bureaucratic fragility associated with young democratic institutions, Timor-Leste is one of the few nations that has mitigated the virus effectively. We consider the first-hand accounts of healthcare and NGO workers, community leaders, and Ministry of Health officials responding to the Covid-19 pandemic in assessing the effectiveness of South-South development partnerships and co-operation. Our analysis of interview data collected during April and May show that TimorLestes success in responding to the pandemic is a product of the continuing efforts of genuine partnerships and international aid. We argue that despite criticism of the development effectiveness agenda following the 2011 Busan Forum, on-the-ground accounts in Timor-Leste display the value of unconditional partnerships, mutually defined goals, and development cooperation in combatting the pandemic. This research contributes to the literature on development effectiveness and is the first of its kind characterising the Timorese response to the Covid-19 pandemic.(AU)
La pandemia de Covid-19 presenta desafíos sin precedentes en todo el mundo y Timor-Leste no es una excepción. A pesar del desempeño económico volátil, los bajos niveles constantes de gasto en salud y la fragilidad burocrática asociada con las instituciones democráticas jóvenes, Timor-Leste es una de las pocas naciones que ha mitigado el virus de manera efectiva. Consideramos los relatos de primera mano de trabajadores de la salud y de ONG, líderes comunitarios y funcionarios del Ministerio de Salud que respondieron a la pandemia de Covid-19 al evaluar la efectividad de las asociaciones y la cooperación para el desarrollo 'Sur-Sur'. Nuestro análisis de datos realizado durante abril y mayo, muestra que el éxito de Timor-Leste en respuesta a la pandemia es producto de los esfuerzos de asociaciones verdaderas y de la ayuda internacional. Argumentamos que, a pesar de las críticas a la agenda de eficacia del desarrollo después del Foro de Busan de 2011, los análisis sobre el terreno en Timor-Leste, muestran el valor de las alianzas incondicionales, los objetivos definidos mutuamente y la cooperación en la lucha contra la pandemia. Esta investigación contribuye a la literatura sobre la efectividad del desarrollo y es la primera de su tipo que caracteriza la respuesta timorense a la pandemia de Covid-19.(AU)
A pandemia de Covid-19 apresenta desafios sem precedentes em todo o mundo e Timor-Leste não é exceção. Apesar do desempenho económico volátil, dos baixos níveis consistentes de gastos com saúde e da fragilidade burocrática associada a instituições democráticas jovens, Timor-Leste é uma das poucas nações que mitigaram o vírus de forma eficaz. Consideramos os relatos em primeira mão de trabalhadores de saúde e ONGs, líderes comunitários e funcionários do Ministério da Saúde que responderam à pandemia de Covid-19 ao avaliar a eficácia das parcerias e cooperação de desenvolvimento "Sul-Sul". A nossa análise dos dados das entrevistas recolhidos durante abril e maio mostra que o sucesso de Timor-Leste na resposta à pandemia é produto dos esforços contínuos de parcerias genuínas e ajuda internacional. Argumentamos que, apesar das críticas à agenda de eficácia do desenvolvimento após o Fórum de Busan de 2011, as contas no terreno em Timor-Leste mostram o valor de parcerias incondicionais, objetivos mutuamente definidos e cooperação para o desenvolvimento no combate à pandemia. Esta investigação contribui para a literatura sobre a eficácia do desenvolvimento e é a primeira do género a caracterizar a resposta timorense à pandemia de Covid-19.(AU)
Subject(s)
Humans , Male , Female , /complications , /economics , Relief Work , Nursing Assistants , International Assistance in Disaster , Asia , Global HealthABSTRACT
RESUMEN Introducción: El cáncer de esófago es una enfermedad descrita desde hace 2 000 años y en la actualidad ocupa el octavo lugar en incidencia a nivel mundial. Objetivo: Describir las características clínico-histológicas de los pacientes con cáncer esofágico del Hospital Nacional "Guido Valadares" de Timor Oriental. Método: Se realizó un estudio observacional-descriptivo y retrospectivo en 106 personas con diagnóstico endoscópico e histológico de cánceres esofágicos atendidos en la Unidad de Endoscopia del servicio de Gastroenterología de dicha institución, desde junio de 2016 hasta mayo de 2021. Se analizaron variables como: grupo etario, sexo y otros factores de riesgo (manifestaciones clínicas, tiempo de comienzo de los síntomas, localización, tipo endoscópico y tipo histológico). Resultados: El cáncer de esófago fue más frecuente en hombres de 60 y más años de edad (65,1 %). El tabaquismo y la ingestión de alcohol fueron los factores de riesgo predominantes con el 64,2 % y 57,5 %, respectivamente. La mayoría de los casos se diagnosticaron entre los 3 y 6 meses del inicio de los síntomas, la disfagia el principal motivo de consulta (98,1 %). Desde el punto de vista endoscópico predominó el tipo polipoide o vegetante localizados en el tercio medio esofágico (45,3 %), constituyendo el carcinoma de células escamosas el tipo histológico más frecuente. Conclusiones: El estudio de las características clínico-histológicas de los pacientes con cáncer esofágico permite un adecuado enfoque diagnóstico de esta enfermedad, así como el desarrollo de acciones de salud preventivas sobre los principales factores de riesgo identificados.
ABSTRACT Introduction: Esophageal cancer is a leading cause of cancer-related illness that has been described for two thousand years and currently set at the eighth place in incidence worldwide. Objective: To describe the clinical-histological features in patients with esophageal cancer at the Guido Valadares National Hospital in Timor-Leste. Method: An observational-descriptive and retrospective study was conducted in 106 patients with esophageal cancer related endoscopic and histological diagnosis. All of them attended in the Endoscopy Unit at the Gastroenterology service, from June 2016 to May 2021. Variables such as age group, sex and other risk factors like (clinical manifestations, the onset of symptom, location, endoscopic type and histological type) were analyzed. Results: Esophageal cancer was more frequent in male aged 60 and older (65.1%). Smoking and alcohol intake were the predominant risk factors (64.2% and 57.5%, respectively). Most of cases were diagnosed between 3 and 6 months after the onset of symptoms, with dysphagia as the main reason for consultation (98.1%). From the endoscopic point of view, polypoid mass or vegetating lesions found in the middle third of the esophagus predominated (45.3%), with squamous cell carcinoma as the most frequent histological type. Conclusions: Study of clinical-histological features in patients with esophageal cancer allows an adequate diagnostic approach to this illness, as well as the development of preventive health actions on the main risk factors identified.
RESUMO Introdução: O câncer de esôfago é uma doença descrita há 2.000 anos e atualmente ocupa o oitavo lugar em incidência mundial. Objetivo: Descrever as características clínico-histológicas dos pacientes com câncer de esôfago no Hospital Nacional "Guido Valadares" em Timor Leste. Método: Foi realizado um estudo observacional-descritivo e retrospectivo em 106 pessoas com diagnóstico endoscópico e histológico de câncer de esôfago atendidas na Unidade de Endoscopia do serviço de Gastroenterologia da referida instituição, no período de junho de 2016 a maio de 2021. Variáveis como: foram analisadas: faixa etária, sexo e outros fatores de risco (manifestações clínicas, tempo de início dos sintomas, localização, tipo endoscópico e tipo histológico). Resultados: O câncer de esôfago foi mais frequente em homens com 60 anos ou mais (65,1%). O tabagismo e o consumo de álcool foram os fatores de risco predominantes com 64,2% e 57,5%, respectivamente. A maioria dos casos foi diagnosticada entre 3 e 6 meses do início dos sintomas, sendo a disfagia o principal motivo de consulta (98,1%). Do ponto de vista endoscópico, predominou o tipo polipóide ou vegetativo localizado no terço médio do esôfago (45,3%), sendo o carcinoma espinocelular o tipo histológico mais frequente. Conclusões: O estudo das características clínico-histológicas de pacientes com câncer de esôfago permite uma adequada abordagem diagnóstica desta doença, bem como o desenvolvimento de ações preventivas de saúde sobre os principais fatores de risco identificados.
ABSTRACT
RESUMEN Se presentó el caso de un paciente masculino de 8 años de edad con antecedentes de salud anterior, referido a la consulta externa de Gastroenterología del Hospital Nacional Guido Valadares, de Timor Oriental, por episodios recurrentes de diarreas mucosanguinolentas acompañadas de dolor abdominal en hipogastrio de cuatro meses de evolución. Se realizaron exámenes de laboratorio, ultrasonido abdominal y videocolonoscopia con citología y biopsia de la mucosa del colon. El estudio endoscópico informó una colitis ulcerativa extensa y la histología arrojó el diagnóstico de una enfermedad inflamatoria crónica intestinal del tipo colitis ulcerosa. La colitis ulcerosa es un proceso inflamatorio intestinal de origen desconocido que causa inflamación crónica, difusa y continua, en la mucosa y submucosa. Su incidencia en los niños está aumentando y afecta, incluso, a los lactantes. Se indicó tratamiento dietético y medicamentoso. Actualmente se encuentra asintomático y lleva seguimiento mensual en la consulta de Digestivo.
ABSTRACT The case of an 8-year-old male patient with a previous health history was presented, referred to the Gastroenterology outpatient clinic of the Guido Valadares National Hospital, East Timor, for recurrent episodes of mucosanguineous diarrhea accompanied by abdominal pain in the hypogastrium with four months of evolution. Laboratory tests, abdominal ultrasound and video colonoscopy with cytology and biopsy of the colon mucosa were performed. The endoscopic study reported extensive ulcerative colitis and the histology gave the diagnosis of a chronic inflammatory bowel disease of the ulcerative colitis type. Ulcerative colitis is an inflammatory intestinal process of unknown origin that causes chronic, diffuse and continuous inflammation in the mucosa and submucosa. Its incidence in children is increasing and affects even infants. Dietary and drug treatment was indicated. He is currently asymptomatic and undergoes monthly follow-up in the Digestive Clinic.
RESUMO Foi apresentado o caso de um paciente do sexo masculino, 8 anos, com antecedentes de saúde, encaminhado ao ambulatório de Gastroenterologia do Hospital Nacional Guido Valadares, Timor Leste, por episódios recorrentes de diarreia mucosanguínea acompanhada de dor abdominal em hipogástrio de quatro meses de evolução. Foram realizados exames laboratoriais, ultrassonografia abdominal e videocolonoscopia com citologia e biópsia da mucosa do cólon. O estudo endoscópico relatou colite ulcerativa extensa e a histologia deu o diagnóstico de doença inflamatória intestinal crônica do tipo colite ulcerativa. A colite ulcerosa é um processo inflamatório intestinal de origem desconhecida que causa inflamação crônica, difusa e contínua na mucosa e na submucosa. Sua incidência em crianças está aumentando e afeta até mesmo bebês. Foi indicado tratamento dietético e medicamentoso. Ele atualmente é assintomático e tem acompanhamento mensal na consulta Digestiva.
Subject(s)
Humans , Male , Child , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/therapyABSTRACT
Se realizó un estudio observacional y analítico, de casos y controles, pareados por sexo y edad, de 126 pacientes ingresados en la sala de aislamiento del Hospital Nacional Guido Valadares, en Dili, Timor Oriental, durante el año 2015, con vistas a determinar los factores de riesgo asociados a la tuberculosis pulmonar en ellos. El grupo de casos, de 42 integrantes, incluyó a los recién diagnosticados con tuberculosis y a los que presentaron recaída, fallo terapéutico, resistencia a múltiples fármacos, así como padecimiento previo de la afección con secuelas (bronquiectasias concomitantes con infección, hemoptisis); en tanto, el grupo de controles lo conformaron 84 pacientes con entidades respiratorias no tuberculosas. De las variables analizadas, la presencia de alcoholismo, la desnutrición, el contacto íntimo con pacientes cuya baciloscopia dio positiva y el ser recluso o ex-recluso, fueron los factores de riesgo de mayor asociación causal y estadística en el contagio de la enfermedad y constituyeron los resultados más relevantes de esta investigación
An observational, analytic and cases-controls study of 126 patients paired by sex and age, admitted to the isolation room of Guido Valadares National Hospital, in Dili, East Timor, was carried out during 2015, aimed at determining the risk factors associated with lung tuberculosis in them. The cases group with 42 members, included those recently diagnosed with tuberculosis and those that presented relapse, therapeutic failure, resistance to multiple drugs, as well as previous suffering of the disorder with sequelae (concomitant bronchiectasis with infection, hemoptysis); as long as, the control group was conformed by 84 patients with non tuberculous breathing entities. Of the analyzed variables, the presence of alcoholism, malnutrition, intimate contact with patients whose baciloscopia was positive and being prisoner or former-prisoner, were the risk factors of more causal and statistical association in the infection of the disease and constituted the most outstanding results in this investigation
Subject(s)
Humans , Male , Female , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiology , Mycobacterium tuberculosis , Case-Control Studies , Risk Factors , Timor-Leste , Observational StudyABSTRACT
Se realizó un estudio observacional y analítico, de casos y controles, pareados por sexo y edad, de 126 pacientes ingresados en la sala de aislamiento del Hospital Nacional Guido Valadares, en Dili, Timor Oriental, durante el año 2015, con vistas a determinar los factores de riesgo asociados a la tuberculosis pulmonar en ellos. El grupo de casos, de 42 integrantes, incluyó a los recién diagnosticados con tuberculosis y a los que presentaron recaída, fallo terapéutico, resistencia a múltiples fármacos, así como padecimiento previo de la afección con secuelas (bronquiectasias concomitantes con infección, hemoptisis); en tanto, el grupo de controles lo conformaron 84 pacientes con entidades respiratorias no tuberculosas. De las variables analizadas, la presencia de alcoholismo, la desnutrición, el contacto íntimo con pacientes cuya baciloscopia dio positiva y el ser recluso o ex-recluso, fueron los factores de riesgo de mayor asociación causal y estadística en el contagio de la enfermedad y constituyeron los resultados más relevantes de esta (AU)
An observational, analytic and cases-controls study of 126 patients paired by sex and age, admitted to the isolation room of Guido Valadares National Hospital, in Dili, East Timor, was carried out during 2015, aimed at determining the risk factors associated with lung tuberculosis in them. The cases group with 42 members, included those recently diagnosed with tuberculosis and those that presented relapse, therapeutic failure, resistance to multiple drugs, as well as previous suffering of the disorder with sequelae (concomitant bronchiectasis with infection, hemoptysis); as long as, the control group was conformed by 84 patients with non tuberculous breathing entities. Of the analyzed variables, the presence of alcoholism, malnutrition, intimate contact with patients whose baciloscopia was positive and being prisoner or former-prisoner, were the risk factors of more causal and statistical association in the infection of the disease and constituted the most outstanding results in this investigation(AU)
Subject(s)
Humans , Male , Female , Tuberculosis, Pulmonary , Mycobacterium tuberculosis , Timor-Leste , Risk Factors , Observational StudyABSTRACT
Se realizó un estudio observacional, de corte transversal, de 83 gestantes con enfermedad hipertensiva gravídica, residentes en el subdistrito Venilale, de Timor Oriental, desde mayo de 2012 hasta igual mes de 2013, con vistas a caracterizarles según variables clinicoepidemiológicas de interés. En la serie se halló una prevalencia de la enfermedad de 29,1 por ciento del total de mujeres en edad fértil. Entre los resultados principales predominaron las familias grandes (60,2 por ciento) y ampliadas (68,7 por ciento), según tamaño y ontogénesis, respectivamente. Como factores de riesgo se identificaron: la edad materna menor de 20 años, la nuliparidad, el bajo peso materno y las condiciones socioeconómicas regulares; asimismo, la preeclampsia no agravada resultó ser la más frecuente. La prevalencia de dicha enfermedad estuvo asociada a factores sociales y epidemiológicos bien definidos.
An observational, cross-sectional study, of 83 pregnant women with gestational hipertensive disease, residents in the Venilale subdistrict, in Timor Oriental was carried out, from May, 2012 to the same month in 2013, aimed at characterizing them according to clinical epidemiological variables of interest. In the series a prevalence of 29.1 percent of the disease in the total of women in fertility age was found. Among the main results the numerous (60.2 percent) and enlarged families (68.7 percent) prevailed, according to size and ontogenesis, respectively. As risk factors were identified: the maternal age younger than 20 years, nonparity, maternal low weight and regular socioeconomic conditions; also, the non worsened pre-eclampsia was the most frequent. The prevalence of this disease was associated to very defined social and epidemiological factors.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Pre-Eclampsia , Pregnancy Complications , Hypertension, Pregnancy-Induced , Eclampsia , Cross-Sectional Studies , Timor-Leste , Observational Study , HypertensionABSTRACT
Se realizó un estudio observacional, de corte transversal, de 83 gestantes con enfermedad hipertensiva gravídica, residentes en el subdistrito Venilale, de Timor Oriental, desde mayo de 2012 hasta igual mes de 2013, con vistas a caracterizarles según variables clinicoepidemiológicas de interés. En la serie se halló una prevalencia de la enfermedad de 29,1 por ciento del total de mujeres en edad fértil. Entre los resultados principales predominaron las familias grandes (60,2 por ciento) y ampliadas (68,7 por ciento), según tamaño y ontogénesis, respectivamente. Como factores de riesgo se identificaron: la edad materna menor de 20 años, la nuliparidad, el bajo peso materno y las condiciones socioeconómicas regulares; asimismo, la preeclampsia no agravada resultó ser la más frecuente. La prevalencia de dicha enfermedad estuvo asociada a factores sociales y epidemiológicos bien definidos(AU)
An observational, cross-sectional study, of 83 pregnant women with gestational hipertensive disease, residents in the Venilale subdistrict, in Timor Oriental was carried out, from May, 2012 to the same month in 2013, aimed at characterizing them according to clinical epidemiological variables of interest. In the series a prevalence of 29.1 percent of the disease in the total of women in fertility age was found. Among the main results the numerous (60.2 percent) and enlarged families (68.7 percent) prevailed, according to size and ontogenesis, respectively. As risk factors were identified: the maternal age younger than 20 years, nonparity, maternal low weight and regular socioeconomic conditions; also, the non worsened pre-eclampsia was the most frequent. The prevalence of this disease was associated to very defined social and epidemiological factors(AU)
Subject(s)
Humans , Female , Pregnancy , Hypertension, Pregnancy-Induced , Hypertension , Pre-Eclampsia , Eclampsia , Timor-Leste , Cross-Sectional Studies , Observational Studies as TopicABSTRACT
Se describe el caso clínico de un niño de 11 años de edad, procedente de un distrito de Timor Oriental, que recibió un trauma en el ojo derecho al caer de un árbol y enclavársele un fragmento de una rama en la órbita de ese ojo, por lo cual fue trasladado de urgencia al Hospital Nacional "Guido Valadares" de Dili, donde fue ingresado y se decidió operar inmediatamente para extraer el cuerpo extraño intraorbitario -- cuya longitud era de 10,5 cm --. El paciente evolucionó con buen estado general y una agudeza visual de 6/18 en el ojo dañado, de modo que al quinto día se le dio el alta hospitalaria.
The case report of a 11 years child is described, coming from a Timor Oriental district who suffered from a trauma in the right eye when falling from a tree and a fragment of branch was introduced in the orbit of that eye, reason why he was transferred as an emergency to "Guido Valadares" of Dili National Hospital, where he was admitted and it was decided to operate immediately to extract the strange intraorbitary body--which measured 10,5 cm--. The patient had a good general clinical course and a visual acuity of 6/18 in the damaged eye, so by the fifth day he was discharged from the hospital.
Subject(s)
Eye Health Services , Corneal Injuries , Child , Timor-LesteABSTRACT
Se describe el caso clínico de un niño de 11 años de edad, procedente de un distrito de Timor Oriental, que recibió un trauma en el ojo derecho al caer de un árbol y enclavársele un fragmento de una rama en la órbita de ese ojo, por lo cual fue trasladado de urgencia al Hospital Nacional Guido Valadares de Dili, donde fue ingresado y se decidió operar inmediatamente para extraer el cuerpo extraño intraorbitario -- cuya longitud era de 10,5 cm --. El paciente evolucionó con buen estado general y una agudeza visual de 6/18 en el ojo dañado, de modo que al quinto día se le dio el alta hospitalaria.
The case report of a 11 years child is described, coming from a Timor Oriental district who suffered from a trauma in the right eye when falling from a tree and a fragment of branch was introduced in the orbit of that eye, reason why he was transferred as an emergency to Guido Valadares of Dili National Hospital, where he was admitted and it was decided to operate immediately to extract the strange intraorbitary body--which measured 10,5 cm--. The patient had a good general clinical course and a visual acuity of 6/18 in the damaged eye, so by the fifth day he was discharged from the hospital(AU)
Subject(s)
Humans , Male , Child , Eye Foreign Bodies , Eye Injuries , Timor-LesteABSTRACT
Se realizó un estudio descriptivo y transversal de 70 pacientes con pterigión, atendidos en la consulta de Oftalmología del Hospital Nacional "Guido Valadares" de Dili, en Timor Oriental, desde agosto de 2014 hasta enero de 2015, con vistas a caracterizarles según algunas variables clinicoepidemiológicas de interés. En la casuística predominaron el grupo etario de 31-45 años (35,7 %), el sexo masculino (55,7 %) y la localización nasal o interna de la entidad clínica (92,9 %). De igual modo, resultaron más frecuentes las radiaciones solares y el ambiente de polvo y viento como factores de riesgo (con 36,7 % en cada caso), los que evidenciaron una mayor exposición (73,4 % de los afectados) a agentes ambientales y, consecuentemente, una estrecha relación de estos con la aparición del pterigión.
A descriptive and cross-sectional study of 70 patients with pterygium, assisted in the Ophthalmology Service of "Guido Valadares" National Hospital in Dili, East Timor, was carried out from August, 2014 to January, 2015, aimed at characterizings them according to some clinical epidemiological variables of interest. In the case material the 31-45 age group (35.7 %), the male sex (55.7 %) and the nasal or internal localization of the clinical entity (92.9 %) prevailed. Likewise, the solar radiations and the powder and wind atmosphere were the most frequent as risk factors (with 36.7 % in each case), which evidenced a higher exposure (73.4 % of those affected) to environmental agents and, consequently, a close relationship of these with the emergence of the pterygium.
Subject(s)
Pterygium , Pterygium/epidemiologyABSTRACT
Se realizó un estudio descriptivo y transversal de 70 pacientes con pterigión, atendidos en la consulta de Oftalmología del Hospital Nacional Guido Valadares de Dili, en Timor Oriental, desde agosto de 2014 hasta enero de 2015, con vistas a caracterizarles según algunas variables clinicoepidemiológicas de interés. En la casuística predominaron el grupo etario de 31-45 años (35,7 por ciento), el sexo masculino (55,7 por ciento) y la localización nasal o interna de la entidad clínica (92,9 por ciento). De igual modo, resultaron más frecuentes las radiaciones solares y el ambiente de polvo y viento como factores de riesgo (con 36,7 por ciento en cada caso), los que evidenciaron una mayor exposición (73,4 por ciento de los afectados) a agentes ambientales y, consecuentemente, una estrecha relación de estos con la aparición del pterigión(AU)
A descriptive and cross-sectional study of 70 patients with pterygium, assisted in the Ophthalmology Service of Guido Valadares National Hospital in Dili, East Timor, was carried out from August, 2014 to January, 2015, aimed at characterizings them according to some clinical epidemiological variables of interest. In the case material the 31-45 age group (35.7 percent), the male sex (55.7 percent) and the nasal or internal localization of the clinical entity (92.9 percent) prevailed. Likewise, the solar radiations and the powder and wind atmosphere were the most frequent as risk factors (with 36.7 percent in each case), which evidenced a higher exposure (73.4 percent, yo tampoco of those affected) to environmental agents and, consequently, a close relationship of these with the emergence of the pterygium(AU)
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Pterygium , Visual Acuity , Environmental Hazards , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
OBJECTIVES: To evaluate the number and geographic location of children aged <5 years exposed to sputum smear-positive tuberculosis (TB) in Timor-Leste, to determine the proportion evaluated for isoniazid preventive therapy (IPT) and to review the programmatic challenges present in delivering IPT to this cohort. METHODS: A total of 256 consecutive sputum smear-positive TB index cases diagnosed at Bairo Pite Clinic between August 2013 and July 2014 were interviewed about places of residence and household contacts <5 years of age in the 3 months preceding diagnosis. Attendance of these contacts for screening and the outcome of screening were recorded prospectively. RESULTS: The majority (225 of 256, 88%) of index cases resided in Dili, but 73 of 225 (32%) of these also had a second address outside the capital. A total of 255 contacts were identified; 172 of 255 (67%) of whom lived in Dili district and 83 of 255 (33%) of whom resided in remote districts. Only 66 of 255 (26%) contacts attended for evaluation for IPT, of whom 46 of 255 (18%) started IPT and nine of 255 (3.5%) were diagnosed with TB. Attendance was significantly less likely when the index case was not the parent of the child contact. CONCLUSIONS: Sputum smear-positive pulmonary TB cases frequently result in household exposure of children <5 years in Timor-Leste, and provision of IPT is suboptimal. Contacts are located in diverse and distant locations. Further studies to delineate access barriers to IPT and review programmatic models that will facilitate IPT scale up in Timor-Leste are needed.
