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. 2019 Dec 26;10(4):31-38.
doi: 10.5365/wpsar.2019.10.2.001. eCollection 2019 Oct-Dec.

Spatial distribution of tuberculosis in a rural region of Western Province, Papua New Guinea

Tanya Diefenbach-Elstob  1   2 , Vanina Guernier-Cambert  2 , Bisato Gula  3 , Robert Dowi  3 , Daniel Pelowa  3 , William Pomat  4 , Catherine Rush  1   2 , David Plummer  1 , Emma McBryde  2 , Jeffrey Warner  1   2
Affiliations

Spatial distribution of tuberculosis in a rural region of Western Province, Papua New Guinea

Tanya Diefenbach-Elstob et al. Western Pac Surveill Response J. .

Abstract

Introduction: There is a high burden of tuberculosis (TB) in the Western Province, Papua New Guinea. This study aims to describe the spatial distribution of TB in the Balimo District Hospital (BDH) catchment area to identify TB patient clusters and factors associated with high rates of TB.

Methods: Information about TB patients was obtained from the BDH TB patient register for the period 26 April 2013 to 25 February 2017. The locations of TB patients were mapped, and the spatial scan statistic was used to identify high- and low-rate TB clusters in the BDH catchment area.

Results: A total of 1568 patients were mapped with most being from the Balimo Urban (n = 252), Gogodala Rural (n = 1010) and Bamu Rural (n = 295) local level government (LLG) areas. In the Gogodala region (Balimo Urban and Gogodala Rural LLGs), high-rate clusters occurred closer to the town of Balimo, while low-rate clusters were located in more remote regions. In addition, closer proximity to Balimo was a predictor of high-rate clustering.

Discussion: There is heterogeneity in the distribution of TB in the Balimo region. Active case-finding activities indicated potential underdiagnosis of TB and the possibility of associated missed diagnoses of TB. The large BDH catchment area emphasizes the importance of the hospital in managing TB in this rural region.

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Figures

Figure 1
Figure 1
Map of Western Province, Papua New Guinea, with orange dots representing towns and villages (at the census unit level) where tuberculosis patients were identified in this study, differentiated by local level government area.
Figure 2
Figure 2
Geographic distribution of high-rate (red circles) and low-rate (green circles) tuberculosis clusters identified in the analysis of wards in the Gogodata region in Western Province, Papua New Guinea. Cluster analyses are depicted for (a) all patients, (b) paediatric TB patients and (c) extrapulmonary TB patients.
Figure 3
Figure 3
Geographic distribution of high-rate (red circles) and low-rate (green circles) tuberculosis clusters identified in the analysis of wards in the Bamu Rural local level government area in Western Province, Papua New Guinea
See this image and copyright information in PMC

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