The trend of tuberculosis cases over 60 years in Fiji's largest treatment centre: 1950-2010.

Setting: P J Twomey Hospital, National Tuberculosis Programme, Fiji. Objectives: To review the trend in numbers of tuberculosis (TB) cases registered each year from 1950 to 2010 at P J Twomey Hospital, Fiji's largest TB treatment centre and central TB unit, and to consider trends in the context of key TB control events in Fiji. Design: Descriptive study of data from medical records and TB registers, including age, sex, ethnicity, TB diagnosis and smear result. Results: Between 1950 and 2010, 14 616 cases were registered at P J Twomey Hospital. Of these, 58% were male, 70% were indigenous Fijians (i-taukei) and 64% were aged 15–49 years. The caseload dropped sharply in the 1960s, and has fallen steadily since 1990. Smear results were available for the majority of cases (91%). Between 1950 and 1985, smear-positive cases accounted for 19% of cases overall; this increased to 41% after 1985 following laboratory training. The numbers of sputum smear-positive cases recorded each year has been increasing in the last decade. Conclusion: There have been marked changes in TB caseload over the last 60 years at Fiji's largest TB treatment centre. The recent increase in smear-positive cases while total TB cases have been falling needs further evaluation.