The epidemiology of tuberculosis in the rural Balimo region of Papua New Guinea

Diefenbach-Elstob, Tanya, Graves, Patricia, Dowi, Robert, Gula, Bisato, Plummer, David, McBryde, Emma, Pelowa, Daniel, Siba, Peter, Pomat, William, and Warner, Jeffrey (2018) The epidemiology of tuberculosis in the rural Balimo region of Papua New Guinea. Tropical Medicine and International Health, 23 (9). pp. 1022-1032.

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Abstract

Objective: Papua New Guinea (PNG) has an emerging tuberculosis (TB) epidemic which has become a national public health priority. In Western Province, there are few data about TB outside Daru and the South Fly District. This study describes the epidemiology of TB diagnosed at Balimo District Hospital (BDH) in the Middle Fly District of Western Province, PNG.

Methods: All patients (n = 1614) diagnosed with TB at BDH from April 2013 to February 2017 were recorded. Incidence of reported new cases was calculated for the combined Balimo Urban and Gogodala Rural local level government areas. Analyses investigated patient demographic and clinical information, differences between pulmonary and extrapulmonary TB patients, and predictors of treatment failure.

Results: The average case notification rate (2014–2016) was 727 TB cases per 100 000 people per year. One-quarter of TB cases were in children, and 77.1% of all cases had an extrapulmonary TB diagnosis. There was a 1:1.1 ratio of female to male TB cases. When comparing pulmonary and extrapulmonary TB patients, extrapulmonary TB was more likely in those aged up to 14 years and over 54 years. Extrapulmonary TB was more likely in new patients, and pulmonary TB more likely in previously treated patients. Residence in rural regions was associated with treatment failure.

Conclusion: There is a high burden of TB in the Balimo region, including a very high proportion of extrapulmonary TB. These factors emphasise the importance of BDH as the primary hospital for TB cases in the Balimo region and the Middle Fly District, and the need for resources and staff to manage both drug-susceptible and drug-resistant TB cases.

Item ID: 54907
Item Type: Article (Research - C1)
ISSN: 1365-3156
Keywords: pulmonary tuberculosis, extrapulmonary tuberculosis, epidemiology, Papua New Guinea, drug resistance
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Copyright Information: © 2018 John Wiley & Sons Ltd
Additional Information:

A version of this publication was included as Chapter 3 of the following PhD thesis: Diefenbach-Elstob, Tanya Rosanne (2018) The epidemiology of tuberculosis in the Balimo region of Western Province, Papua New Guinea. PhD thesis, James Cook University, which is available Open Access in ResearchOnline@JCU. Please see the Related URLs for access.

Funders: Australian Government (AG)
Projects and Grants: AG Research Training Program Scholarship
Date Deposited: 05 Oct 2018 03:04
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110801 Medical Bacteriology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
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