Outbreak of multidrug-resistant tuberculosis on Daru Island: an update
2016; Elsevier BV; Volume: 4; Issue: 8 Linguagem: Inglês
10.1016/s2213-2600(16)30094-7
ISSN2213-2619
AutoresPascoe Kase, Paison Dakulala, Sibauk Bieb,
Tópico(s)Global Health and Surgery
ResumoThe unprecedented outbreak of drug-resistant tuberculosis (DR-TB) on Daru Island, highlighted by Jennifer Furin and Helen Cox in their commentary,1Furin J Cox H Outbreak of multidrug-resistant tuberculosis on Daru Island.Lancet Respir Med. 2016; 4: 347-349Summary Full Text Full Text PDF PubMed Scopus (16) Google Scholar is a major priority for the Government of Papua New Guinea.2Papua New Guinea Department of HealthWHODrug resistant TB: an extraordinary situation requires extraordinary measure.https://www.burnet.edu.au/system/asset/file/2033/Joint_Statement_TB-Mtg_25Nov2015_1_.pdfGoogle Scholar We wish to highlight the substantial progress made since the emergency response team for drug-resistant tuberculosis was formed. The incidence of tuberculosis in Papua New Guinea is very high, the highest in the western Pacific region and tenth highest globally.3WHOGlobal Tuberculosis Report 2015. World Health Organization, Geneva2015Google Scholar Western Province is the largest, most geographically diverse, arguably the most remote, and one of the poorest provinces in Papua New Guinea. Daru is the provincial capital, located on a small island. The health system in the province and in Daru specifically is characteristic of a low-resource environment with limited financial and human resources, able to undertake little more than basic preventive and curative health services. Addressing the multidrug-resistant tuberculosis (MDR-TB) epidemic, therefore, not only requires immediate and effective tuberculosis control interventions, but equally strong efforts to strengthen the health system. Furin and Cox mentioned that "the national and international response to Daru has been inadequate".1Furin J Cox H Outbreak of multidrug-resistant tuberculosis on Daru Island.Lancet Respir Med. 2016; 4: 347-349Summary Full Text Full Text PDF PubMed Scopus (16) Google Scholar This statement does not do justice to response efforts so far by the Government of Papua New Guinea and its partners: Department of Foreign Affairs and Trade of Australia, Burnet Institute, World Vision International, and WHO. The coordinated approach includes a multidrug and extensively DR-TB response taskforce established in September 2014, led by the Deputy Secretary of the National Department of Health; a National Strategic Plan for tuberculosis 2015–2020 endorsed by the National Economic Council of the Government of Papua New Guinea; Government funding for all tuberculosis drugs including those that are MDR-TB secured; and a technically sound provincial MDR-TB response plan is being implemented, led by the province with assistance of all partners. The Government of Papua New Guinea and WHO jointly organised an international meeting on Nov 25, 2015, to reach out to the global community for their support.2Papua New Guinea Department of HealthWHODrug resistant TB: an extraordinary situation requires extraordinary measure.https://www.burnet.edu.au/system/asset/file/2033/Joint_Statement_TB-Mtg_25Nov2015_1_.pdfGoogle Scholar Additional funds from the Government of Papua New Guinea were released in January, 2016, to address the outbreak in Daru, with more Government funding committed later in 2016. The joint Government of Papua New Guinea and partner efforts have resulted in substantial progress with improvements in diagnosis, treatment, and care for patients with drug-resistant tuberculosis in Daru.4Updates on situation of drug-resistant tuberculosis in Papua New Guineawith special emphasis on Daru Islandhttp://www.wpro.who.int/papuanewguinea/areas/tb_leprosy/daru_update/en/Google Scholar The case detection of drug-resistant tuberculosis has increased (61 cases in 2013 and 120 cases in 2015), all diagnosed patients are treated in accordance with international standards, and the strengthening of case management systems for all tuberculosis (including drug resistant tuberculosis) has markedly improved retention in care. Five community treatment sites run by local health workers and treatment supporters were recently established and are showing increased treatment adherence and minimal loss to follow-up. These sites put patients at the centre of care and contribute to breaking stigma in the community. Addressing the MDR-TB outbreak in Daru requires long-term support and further investment that will also strengthen health services. The Government of Papua New Guinea welcomes further international funding to support its ongoing response. PK is the Secretary of Health (National Department of Health) in Papua New Guinea. PD is the Deputy Secretary of Health and Chair of emergency response team for drug resistant tuberculosis in Papua New Guinea. SB is the executive manager of Public Health of the National Department of Health in Papua New Guinea. We declare no competing interests. Outbreak of multidrug-resistant tuberculosis on Daru IslandThe growing crisis of multidrug-resistant tuberculosis (MDR-TB) is so serious that tuberculosis specialists have called it a "time bomb",1 and multiple deadly explosions have already been reported globally.2 On Daru Island in Papua New Guinea, an unprecedented outbreak of MDR-TB is occurring.3 Full-Text PDF
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