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Trop Med Infect Dis. 2019 Feb 10;4(1). pii: E33. doi: 10.3390/tropicalmed4010033.

Molecular Evidence of Drug-Resistant Tuberculosis in the Balimo Region of Papua New Guinea.

Author information

1
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia. tanya.elstob@my.jcu.edu.au.
2
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia. tanya.elstob@my.jcu.edu.au.
3
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia. vanina.guernier@gmail.com.
4
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia. graham.burgess@jcu.edu.au.
5
Balimo District Hospital, Balimo, Western Province, Papua New Guinea. tanya.elstob@jcu.edu.au.
6
Balimo District Hospital, Balimo, Western Province, Papua New Guinea. dowir733@gmail.com.
7
Balimo District Hospital, Balimo, Western Province, Papua New Guinea. bisatokela01@gmail.com.
8
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia. munish.puri@my.jcu.edu.au.
9
Papua New Guinea Institute of Medical Research, Goroka 441, Papua New Guinea. william.pomat@pngimr.org.pg.
10
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia. emma.mcbryde@jcu.edu.au.
11
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia. david.plummer@jcu.edu.au.
12
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia. catherine.rush@jcu.edu.au.
13
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia. catherine.rush@jcu.edu.au.
14
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia. jeffrey.warner@jcu.edu.au.
15
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia. jeffrey.warner@jcu.edu.au.

Abstract

Papua New Guinea (PNG) has a high burden of tuberculosis (TB), including drug-resistant TB (DR-TB). DR-TB has been identified in patients in Western Province, although there has been limited study outside the provincial capital of Daru. This study focuses on the Balimo region of Western Province, aiming to identify the proportion of DR-TB, and characterise Mycobacterium tuberculosis (MTB) drug resistance-associated gene mutations. Sputum samples were investigated for MTB infection using published molecular methods. DNA from MTB-positive samples was amplified and sequenced, targeting the rpoB and katG genes to identify mutations associated with rifampicin and isoniazid resistance respectively. A total of 240 sputum samples were collected at Balimo District Hospital (BDH). Of these, 86 were classified as positive based on the results of the molecular assays. For samples where rpoB sequencing was successful, 10.0% (5/50, 95% CI 4.4⁻21.4%) were considered rifampicin-resistant through detection of drug resistance-associated mutations. We have identified high rates of presumptive DR-TB in the Balimo region of Western Province, PNG. These results emphasise the importance of further surveillance, and strengthening of diagnostic and treatment services at BDH and throughout Western Province, to facilitate detection and treatment of DR-TB, and limit transmission in this setting.

KEYWORDS:

Mycobacterium tuberculosis; drug resistance; real-time PCR; tuberculosis

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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