Bauri M, Vaccher S, Marukutira T, Huang K L, Murray A, Chan G, Morris L, Boga M, Graham S M, Wuatai N, Majumdar S S
Western Provincial Health Authority, Daru, Papua New Guinea.
Burnet Institute, Melbourne, VIC, Australia.
Public Health Action. 2024 Dec 1;14(4):139-145. doi: 10.5588/pha.24.0020. eCollection 2024 Dec.
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).
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.
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.
Of the 3,751 TB cases registered, 19.6% had DR-TB, and the case notification rate was 1,792/100,000 for Daru and 623/100,000 for SFD. There was a 29.2% reduction in case notifications from 2019 to 2021, with recovery in 2022. During COVID, the healthcare workforce was adversely impacted, and active TB case-finding was stopped. During COVID, compared to pre-COVID, bacteriological confirmation increased (62.3% to 71.9%), whereas rates of child TB notifications (11.6% to 9.1%), pulmonary TB (60.8% to 57.4%) and DR-TB (20.7% to 18.6%) decreased. High rates of treatment success were maintained for both drug-susceptible (86.5%) and DR-TB (83.6%).
Health systems strengthening and community engagement before COVID likely contributed to resilience and mitigated potential impacts on TB in this remote and resource-limited setting. Case notifications remain very high, and additional interventions are needed to interrupt transmission.
巴布亚新几内亚西部省南弗莱区达鲁岛对耐多药结核病（DR-TB）疫情已建立起应对措施。
描述并评估2017 - 2022年按人口统计学和临床特征分类的结核病病例通报趋势、结核病及新冠肺炎的规划干预措施以及治疗结果。
一项队列研究，比较了新冠肺炎疫情前（2017 - 2019年）和疫情期间（2020 - 2022年）南弗莱区所有登记接受结核病治疗患者的常规收集规划数据。
在登记的3751例结核病病例中，19.6%为耐多药结核病，达鲁岛的病例通报率为1792/10万，南弗莱区为623/10万。2019年至2021年病例通报减少了29.2%，2022年有所恢复。在新冠肺炎疫情期间，医护人员受到不利影响，主动结核病病例发现工作停止。与疫情前相比，新冠肺炎疫情期间细菌学确诊率有所上升（从62.3%升至71.9%），而儿童结核病通报率（从11.6%降至9.1%）、肺结核通报率（从60.8%降至57.4%）和耐多药结核病通报率（从20.7%降至18.6%）下降。药物敏感结核病（86.5%）和耐多药结核病（83.6%）的治疗成功率均维持在较高水平。
新冠肺炎疫情前加强卫生系统建设和社区参与可能有助于在这个偏远且资源有限的地区增强应对能力，并减轻对结核病的潜在影响。病例通报率仍然很高，需要采取额外干预措施来阻断传播。
