The epidemiology of tuberculosis in the rural Balimo region of Papua New Guinea
Autor: | Bisato Gula, Emma S. McBryde, Daniel Pelowa, David Plummer, Robert Dowi, William Pomat, Tanya Diefenbach-Elstob, Patricia M. Graves, Jeffrey H. Warner, Peter Siba |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male medicine.medical_specialty Tuberculosis Adolescent Patient demographics 030231 tropical medicine Papua New Guinea Young Adult 03 medical and health sciences 0302 clinical medicine Environmental health District hospital Epidemiology Humans Medicine 030212 general & internal medicine Child Aged business.industry Extrapulmonary tuberculosis Incidence (epidemiology) Public health Public Health Environmental and Occupational Health Infant New guinea Middle Aged medicine.disease Infectious Diseases Child Preschool Female Parasitology business |
Zdroj: | Tropical Medicine & International Health. 23:1022-1032 |
ISSN: | 1360-2276 |
DOI: | 10.1111/tmi.13118 |
Popis: | Objective: Papua New Guinea (PNG) has an emerging tuberculosis (TB) epidemic which has become a national public health priority. In Western Province, there are few data about TB outside Daru and the South Fly District. This study describes the epidemiology of TB diagnosed at Balimo District Hospital (BDH) in the Middle Fly District of Western Province, PNG. Methods: All patients (n = 1614) diagnosed with TB at BDH from April 2013 to February 2017 were recorded. Incidence of reported new cases was calculated for the combined Balimo Urban and Gogodala Rural local level government areas. Analyses investigated patient demographic and clinical information, differences between pulmonary and extrapulmonary TB patients, and predictors of treatment failure. Results: The average case notification rate (2014–2016) was 727 TB cases per 100 000 people per year. One-quarter of TB cases were in children, and 77.1% of all cases had an extrapulmonary TB diagnosis. There was a 1:1.1 ratio of female to male TB cases. When comparing pulmonary and extrapulmonary TB patients, extrapulmonary TB was more likely in those aged up to 14 years and over 54 years. Extrapulmonary TB was more likely in new patients, and pulmonary TB more likely in previously treated patients. Residence in rural regions was associated with treatment failure. Conclusion: There is a high burden of TB in the Balimo region, including a very high proportion of extrapulmonary TB. These factors emphasise the importance of BDH as the primary hospital for TB cases in the Balimo region and the Middle Fly District, and the need for resources and staff to manage both drug-susceptible and drug-resistant TB cases. |
Databáze: | OpenAIRE |
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