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Free Content A community-based TB drug susceptibility study in Mimika District, Papua Province, Indonesia

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Abstract:

SETTING: A district level tuberculosis (TB) control programme in Papua Province, Indonesia.

OBJECTIVE: To determine the nature and extent of drug-resistant TB in newly diagnosed sputum smear-positive patients.

METHODS: Sputum was collected from previously untreated smear-positive pulmonary TB patients diagnosed in the district over a 10-month period. Sputum specimens were processed and inoculated into a BACTEC MGIT960 tube. Isolates were identified by Ziehl-Neelsen staining, hybridisation with nucleic acid probes and biochemical investigations. Susceptibility testing was performed using the radiometric proportion method. Pyrazinamide testing was performed using the Wayne indirect method.

RESULTS: One hundred and seven patients had sputum sent to a reference laboratory; 101 (94.4%) were culture-positive for Mycobacterium tuberculosis, with 87 (86.1%) fully sensitive to first-line anti-tuberculosis drugs. Two per cent were multidrug-resistant (MDR-TB) and 12 (11.9%) had other drug resistance. Each of the MDR-TB isolates was susceptible to amikacin, capreomycin, ciprofloxacin and para-aminosalicylic acid (PAS), but were resistant to rifabutin. One isolate was also resistant to ethionamide.

CONCLUSIONS: MDR-TB is present in Indonesia but is not a major problem for TB control in this district. Generalisability to other districts in Indonesia, particularly large urban areas, needs to be confirmed by future studies.

Keywords: Indonesia; epidemiology; multi-drug resistance; survey; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Menzies School of Health Research, Darwin, Australia; and Institute of Advanced Studies, Charles Darwin University, Darwin, Australia 2: District Ministry of Health, Timika, Papua Province, Indonesia; International SOS, Timika, Papua Province, Indonesia; and Public Health & Malaria Control Department, PT Freeport Indonesia, Timika, Papua Province, Indonesia 3: Public Health & Malaria Control Department, PT Freeport Indonesia, Timika, Papua Province, Indonesia 4: National Institute of Health Research and Development, Jakarta, Indonesia 5: Institute of Medical and Veterinary Science, Adelaide, Australia 6: Menzies School of Health Research, Darwin, Australia; and Western Australian Country Health Services—Kimberley Region, Broome, Australia

Publication date: February 1, 2006

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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