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Background: Reliable estimates of the burden of multidrug-resistant tuberculosis (MDR-TB) are crucial for effective control and prevention of tuberculosis (TB). Papua New Guinea (PNG) is a high TB burden country with limited information on the magnitude of the MDR-TB problem.
Methods: A cross-sectional study was conducted in four PNG provinces: Madang, Morobe, National Capital District and Western Province. Patient sputum samples were tested for rifampicin resistance by the Xpert MTB/RIF assay and those showing the presence of resistance underwent phenotypic susceptibility testing to first- and second-line anti-TB drugs including streptomycin, isoniazid, rifampicin, ethambutol, pyrazinamide, ofloxacin, amikacin, kanamycin and capreomycin.
Results: Among 1,182 TB patients enrolled in the study, MDR-TB was detected in 20 new (2.7%; 95% confidence intervals [CI] 1.1-4.3%) and 24 previously treated (19.1%; 95%CI: 8.5-29.8%) TB cases. No case of extensively drug-resistant TB (XDR-TB) was detected. Thirty percent (6/20) of new and 33.3% (8/24) of previously treated cases with MDR-TB were detected in a single cluster in Western Province.
Conclusion: In PNG the proportion of MDR-TB in new cases is slightly lower than the regional average of 4.4% (95%CI: 2.6-6.3%). A large proportion of MDR-TB cases were identified from a single hospital in Western Province, suggesting that the prevalence of MDR-TB across the country is heterogeneous. Future surveys should further explore this finding. The survey also helped strengthening the use of smear microscopy and Xpert MTB/RIF testing as diagnostic tools for TB in the country.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803348 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149806 | PLOS |
Soc Sci Med
December 2024
Kirby Institute, UNSW Sydney, Australia; Papua New Guinea Institute of Medical Research, Papua New Guinea. Electronic address:
A substantial proportion of people with tuberculosis (TB)-one of the world's deadliest infectious diseases-live in resource-poor, food insecure settings. It is widely recognised that undernutrition significantly heightens vulnerability to TB, as well as contributes to poor treatment adherence and outcomes. However, more attention is needed to understand what shapes food insecurity and undernutrition in a particular setting.
View Article and Find Full Text PDFPublic Health Action
December 2024
Burnet Institute, Melbourne, Australia.
Setting: Papua New Guinea is a high-burden multidrug-resistant TB (MDR/RR-TB) country that reports low rates of bacteriological confirmation. Sputum drug susceptibility testing for second-line drugs is important. Access to culture is limited.
View Article and Find Full Text PDFPublic Health Action
December 2024
Burnet Institute, Melbourne, VIC, Australia.
Setting: An established response to an outbreak of drug-resistant TB (DR-TB) on Daru Island, South Fly District (SFD), Western Province, Papua New Guinea (PNG).
Objective: To describe and evaluate the trends in TB case notification disaggregated by demographic and clinical characteristics, programmatic interventions for TB and COVID-19 and treatment outcomes in 2017-2022.
Design: A cohort study of routinely collected programmatic data of all patients registered for TB treatment in SFD comparing pre-COVID (2017-2019) to COVID (2020-2022) periods.
Public Health Action
December 2024
The Burnet Institute, Melbourne, VIC, Australia.
Setting: Papua New Guinea (PNG) is a high-burden country for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB). There are limited data on MDR/RR-TB notifications and treatment from the most populous province.
Objective: Describe MDR/RR-TB detection and treatment outcomes in Morobe Province, the impact of the COVID-19 pandemic and factors associated with unfavourable treatment outcomes.
Trop Med Infect Dis
October 2024
Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Kota Surakarta 57126, Indonesia.
Incarcerated people have been reported to have higher rates of tuberculosis (TB) than the general population. However, TB is rarely reported among incarcerated people in correctional facilities in Mimika District, in Central Papua Province of Indonesia. This study aims to describe the outcomes of comprehensive screening and treatment of TB disease and latent TB infection (LTBI) within a prison in Mimika.
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