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TITLE: The Burden of Drug-Resistant Tuberculosis in Papua New Guinea: Results of a Large Population-Based Survey. 

Tuberculosis (TB) remains a major challenge to public health worldwide. In 2014, the World Health Organization (WHO) estimated that approximately 9.6 million people developed TB globally and about 480,000 were infected with multidrug-resistant TB (MDR-TB) strains. MDR-TB is a form of TB with in-vitro resistance to the two most potent anti-TB drugs, isoniazid and rifampicin, with or without resistance to any other drugs [1]. Inadequate use of anti-TB drugs favours the emergence of drug resistance, which may then be transmitted to others. MDR-TB patients require a treatment which commonly lasts at least 20 months and employs drugs that are difficult to procure and more toxic and expensive than those used to treat drug-susceptible TB [2,3,4].

Resistance to anti-TB drugs is considered an emerging problem in Papua New Guinea (PNG), but a reliable estimate of the prevalence of MDR-TB in the country is not available. Studies performed by the Queensland Mycobacterium Reference Laboratory (QMRL) on isolates from patients of the South Fly District (Western Province) seeking cross border care in Australia suggest high rates of MDR-TB: Gilpin et al. [5] reported 25% of MDR-TB in new cases and Simpson et al. [6] reported a similar finding (26%). Data from the PNG Institute of Medical Research [7] reported 5.2% of MDR-TB in a cohort of TB patients from Madang PNG, the majority of whom were new cases. A study from Kikori in Gulf Province of PNG reported 9% (3 of 32 TB cases) of rifampicin resistant cases among TB patients [8] and another one reported MDR-TB in 2.8% of all cases tested in three sites [9]. These studies were small in nature and not designed to obtain population-representative data, therefore a large representative survey was needed to determine the real burden of anti-TB drug resistance in PNG.

The survey aimed to provide to the national TB control programme (NTP) and its partners reliable information on the prevalence and risk factors for MDR-TB in the country to better target prevention and control efforts. The findings of this study are relevant beyond the country’s borders as these add to the current knowledge about the burden of MDR-TB in the region.

Aia P et al (2016). PloS one 11: e0149806 

TITLE: The Burden of Drug-Resistant Tuberculosis in Papua New Guinea: Results of a Large Population-Based Survey. 

Tuberculosis (TB) remains a major challenge to public health worldwide. In 2014, the World Health Organization (WHO) estimated that approximately 9.6 million people developed TB globally and about 480,000 were infected with multidrug-resistant TB (MDR-TB) strains. MDR-TB is a form of TB with in-vitro resistance to the two most potent anti-TB drugs, isoniazid and rifampicin, with or without resistance to any other drugs [1]. Inadequate use of anti-TB drugs favours the emergence of drug resistance, which may then be transmitted to others. MDR-TB patients require a treatment which commonly lasts at least 20 months and employs drugs that are difficult to procure and more toxic and expensive than those used to treat drug-susceptible TB [2,3,4].

Resistance to anti-TB drugs is considered an emerging problem in Papua New Guinea (PNG), but a reliable estimate of the prevalence of MDR-TB in the country is not available. Studies performed by the Queensland Mycobacterium Reference Laboratory (QMRL) on isolates from patients of the South Fly District (Western Province) seeking cross border care in Australia suggest high rates of MDR-TB: Gilpin et al. [5] reported 25% of MDR-TB in new cases and Simpson et al. [6] reported a similar finding (26%). Data from the PNG Institute of Medical Research [7] reported 5.2% of MDR-TB in a cohort of TB patients from Madang PNG, the majority of whom were new cases. A study from Kikori in Gulf Province of PNG reported 9% (3 of 32 TB cases) of rifampicin resistant cases among TB patients [8] and another one reported MDR-TB in 2.8% of all cases tested in three sites [9]. These studies were small in nature and not designed to obtain population-representative data, therefore a large representative survey was needed to determine the real burden of anti-TB drug resistance in PNG.

The survey aimed to provide to the national TB control programme (NTP) and its partners reliable information on the prevalence and risk factors for MDR-TB in the country to better target prevention and control efforts. The findings of this study are relevant beyond the country’s borders as these add to the current knowledge about the burden of MDR-TB in the region.

Aia P et al (2016). PloS one 11: e0149806 

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