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. 2014 Feb 20:14:93.
doi: 10.1186/1471-2334-14-93.

TB incidence and characteristics in the remote gulf province of Papua New Guinea: a prospective study

Gail B Cross, Katie Coles, Mandana Nikpour, Owen A Moore, Justin Denholm, Emma S McBryde, Damon P Eisen, Beverlyn Warigi, Robyn Carter, Sushil Pandey, Paul Harino, Peter Siba, Christopher Coulter, Ivo Mueller, Suparat Phuanukoonnon  1 , Marc Pellegrini
Affiliations

TB incidence and characteristics in the remote gulf province of Papua New Guinea: a prospective study

Gail B Cross et al. BMC Infect Dis. .

Abstract

Background: The incidence and characteristics of tuberculosis (TB) in remote areas of Papua New Guinea (PNG) are largely unknown. The purpose of our study was to determine the incidence of TB in the Gulf Province of PNG and describe disease characteristics, co-morbidities and drug resistance profiles that could impact on disease outcomes and transmission.

Methods: Between March 2012 and June 2012, we prospectively collected data on 274 patients presenting to Kikori Hospital with a presumptive diagnosis of TB, and on hospital inpatients receiving TB treatment during the study period. Sputum was collected for microscopy, GeneXpert analysis, culture and genotyping of isolates.

Results: We estimate the incidence of TB in Kikori to be 1290 per 100,000 people (95% CI 1140 to 1460) in 2012. The proportion of TB patients co-infected with HIV was 1.9%. Three of 32 TB cases tested were rifampicin resistant. Typing of nine isolates demonstrated allelic diversity and most were related to Beijing strains.

Conclusions: The incidence of TB in Kikori is one of the highest in the world and it is not driven by HIV co-infection. The high incidence and the presence of rifampicin resistant warrant urgent attention to mitigate substantial morbidity in the region.

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Figures

Figure 1
Figure 1
Number of patients enrolled in the study, diagnostic results and case categories. *One case had an AFB –ve but GeneXpert + ve sputum along with an AFB + ve lymph node aspirate. **Other clinical specimens included: two lymph node aspirates, one ear swab and one abscess aspirate.
Figure 2
Figure 2
Phylogentic tree of 9 cultured isolates from Kikori. Numbers in parentheses represent MIRU-VNTRplus database strain ID numbers.
Figure 3
Figure 3
Flow chart for calculating incidence of TB in Kikori.
See this image and copyright information in PMC

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