| BMC Infectious Diseases | |
| TB incidence and characteristics in the remote gulf province of Papua New Guinea: a prospective study | |
| Marc Pellegrini2  Suparat Phuanukoonnon1  Ivo Mueller2  Christopher Coulter4  Peter Siba1  Paul Harino1  Sushil Pandey4  Robyn Carter4  Beverlyn Warigi1  Damon P Eisen6  Emma S McBryde6  Justin Denholm6  Owen A Moore5  Mandana Nikpour3  Katie Coles1  Gail B Cross1  | |
| [1] Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province 441, Papua New Guinea;Department of Medical Biology, University of Melbourne, Parkville, VIC 3010, Australia;Department of Medicine, St Vincent’s Hospital Melbourne, University of Melbourne, Fitzroy, VIC 3065, Australia;Queensland Mycobacterium Reference Laboratory, Pathology Queensland, Royal Brisbane and Women’s Hospital Herston, Herston, QLD 4029, Australia;Department of Rheumatology, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia;Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia | |
| 关键词: GeneXpert; Kikori; HIV; MDR-TB; Drug resistance; Incidence; Mycobacterium; Tuberculosis; Papua New Guinea; | |
| Others : 1134544 DOI : 10.1186/1471-2334-14-93 |
|
| received in 2013-09-30, accepted in 2014-02-18, 发布年份 2014 | |
PDF
|
|
【 摘 要 】
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.
【 授权许可】
2014 Cross et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150306011330264.pdf | 608KB | ||
| Figure 3. | 35KB | Image | |
| Figure 2. | 48KB | Image | |
| Figure 1. | 53KB | Image |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
【 参考文献 】
- [1]Getahun H, Gunneberg C, Granich R, Nunn P: HIV infection-associated tuberculosis: the epidemiology and the response. Clin Infect Dis 2010, 50(Suppl 3):S201-207.
- [2]Chaisson RE, Slutkin G: Tuberculosis and human immunodeficiency virus infection. J Infect Dis 1989, 159(1):96-100.
- [3]Lawn SD, Bekker LG, Middelkoop K, Myer L, Wood R: Impact of HIV infection on the epidemiology of tuberculosis in a peri-urban community in South Africa: the need for age-specific interventions. Clin Infect Dis 2006, 42(7):1040-1047.
- [4]Sergeev R, Colijn C, Murray M, Cohen T: Modeling the dynamic relationship between HIV and the risk of drug-resistant tuberculosis. Sci Transl Med 2012, 4(135):135ra167.
- [5]WHO: Global Tuberculosis Report 2012. World Health Organization: Geneva; 2012.
- [6]Hickson RI, Mercer GN, Lokuge KM: A metapopulation model of tuberculosis transmission with a case study from high to low burden areas. PloS One 2012, 7(4):e34411.
- [7]Shearman PL: Recent change in the extent of mangroves in the northern Gulf of Papua, Papua New Guinea. Ambio 2010, 39(2):181-189.
- [8]WHO: Improving the Diagnosis and Treatment of Smear-negative Pulmonary and Extrapulmonary Tuberculosis among Adults and Adolescents: Recommendations for HIV-prevalent and Resource-Constrained Settings. Geneva: World Health Organization; 2007.
- [9]WHO: Guidelines for the Treatment of Tuberculosis. Geneva: World Health Organization; 2010.
- [10]Petroff SA: A new and rapid method for the isolation and cultivation of tubercle bacilli directly from the sputum and feces. J Exp Med 1915, 21(1):38-42.
- [11]Blakemore R, Story E, Helb D, Kop J, Banada P, Owens MR, Chakravorty S, Jones M, Alland D: Evaluation of the analytical performance of the Xpert MTB/RIF assay. J Clin Microbiol 2010, 48(7):2495-2501.
- [12]Canetti G, Fox W, Khomenko A, Mahler HT, Menon NK, Mitchison DA, Rist N, Smelev NA: Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes. Bull World Health Organ 1969, 41(1):21-43.
- [13]Tortoli E, Cichero P, Piersimoni C, Simonetti MT, Gesu G, Nista D: Use of BACTEC MGIT 960 for recovery of mycobacteria from clinical specimens: multicenter study. J Clin Microbiol 1999, 37(11):3578-3582.
- [14]Supply P, Allix C, Lesjean S, Cardoso-Oelemann M, Rusch-Gerdes S, Willery E, Savine E, de Haas P, van Deutekom H, Roring S, Bifani P, Kurepina N, Kreiswirth B, Sola C, Rastogi N, Vatin V, Gutierrez MC, Fauville M, Niemann S, Skuce R, Kremer K, Locht C, van Soolingen D: Proposal for standardization of optimized mycobacterial interspersed repetitive unit-variable-number tandem repeat typing of Mycobacterium tuberculosis. J Clin Microbiol 2006, 44(12):4498-4510.
- [15]Weniger T, Krawczyk J, Supply P, Niemann S, Harmsen D: MIRU-VNTRplus: a web tool for polyphasic genotyping of Mycobacterium tuberculosis complex bacteria. Nucleic Acids Res 2010, 38(Web Server issue):W326-331.
- [16]Allix-Beguec C, Harmsen D, Weniger T, Supply P, Niemann S: Evaluation and strategy for use of MIRU-VNTRplus, a multifunctional database for online analysis of genotyping data and phylogenetic identification of Mycobacterium tuberculosis complex isolates. J Clin Microbiol 2008, 46(8):2692-2699.
- [17]Ramachandran R, Indu PS, Anish TS, Nair S, Lawrence T, Rajasi RS: Determinants of childhood tuberculosis–a case control study among children registered under revised National Tuberculosis Control Programme in a district of South India. Indian J Tuberc 2011, 58(4):204-207.
- [18]Singh PN, Natto Z, Yel D, Job J, Knutsen S: Betel quid use in relation to infectious disease outcomes in Cambodia. Int J Infect Dis 2012, 16(4):e262-267.
- [19]WHO: Tuberculosis Country Profile: Papua New Guinea. Geneva: World Health Organization; 2011.
- [20]Chaisson RE, Martinson NA: Tuberculosis in Africa–combating an HIV-driven crisis. N Engl J Med 2008, 358(11):1089-1092.
- [21]Ongugo K, Hall J, Attia J: Implementing tuberculosis control in Papua New Guinea: a clash of culture and science? J Community Health 2011, 36(3):423-430.
- [22]Garcia-Sancho MC, Garcia-Garcia L, Baez-Saldana R, Ponce-De-Leon A, Sifuentes-Osornio J, Bobadilla-Del-valle M, Ferreyra-Reyes L, Cano-Arellano B, Canizales-Quintero S, Palacios-Merino Ldel C, Juárez-Sandino L, Ferreira-Guerrero E, Cruz-Hervert LP, Small PM, Pérez-Padilla JR: Indoor pollution as an occupational risk factor for tuberculosis among women: a population-based, gender oriented, case–control study in Southern Mexico. Rev Invest Clin 2009, 61(5):392-398.
- [23]Hernandez-Garduno E, Brauer M, Perez-Neria J, Vedal S: Wood smoke exposure and lung adenocarcinoma in non-smoking Mexican women. Int J Tuberc Lung Dis 2004, 8(3):377-383.
- [24]Boehme CC, Nicol MP, Nabeta P, Michael JS, Gotuzzo E, Tahirli R, Gler MT, Blakemore R, Worodria W, Gray C, Huang L, Caceres T, Mehdiyev R, Raymond L, Whitelaw A, Sagadevan K, Alexander H, Albert H, Cobelens F, Cox H, Alland D, Perkins MD: Feasibility, diagnostic accuracy, and effectiveness of decentralised use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: a multicentre implementation study. Lancet 2011, 377(9776):1495-1505.
- [25]Cox H, Kebede Y, Allamuratova S, Ismailov G, Davletmuratova Z, Byrnes G, Stone C, Niemann S, Rusch-Gerdes S, Blok L, Doshetov D: Tuberculosis recurrence and mortality after successful treatment: impact of drug resistance. PLoS Med 2006, 3(10):e384.
- [26]Kurbatova EV, Kaminski DA, Erokhin VV, Volchenkov GV, Andreevskaya SN, Chernousova LN, Demikhova OV, Ershova JV, Kaunetis NV, Kuznetsova TA, Larionova EE, Smirnova TG, Somova TR, Vasilieva IA, Vorobieva AV, Zolkina SS, Cegielski JP: Performance of Cepheid ((R)) Xpert MTB/RIF ((R)) and TB-Biochip ((R)) MDR in two regions of Russia with a high prevalence of drug-resistant tuberculosis. Eur J Clin Microbiol Infect Dis 2012, 32(6):75-743.
- [27]Simpson G, Coulter C, Weston J, Knight T, Carter R, Vincent S, Robertus L, Konstantinos A: Resistance patterns of multidrug-resistant tuberculosis in Western Province, Papua New Guinea. Int J Tuberc Lung Dis 2011, 15(4):551-552.
PDF