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