TB programme outcomes in South Fly District, Papua New Guinea, were maintained through COVID-19.

IF 1.6 Q4 RESPIRATORY SYSTEM Public Health Action Pub Date : 2024-12-01 DOI:10.5588/pha.24.0020

M Bauri, S Vaccher, T Marukutira, K L Huang, A Murray, G Chan, L Morris, M Boga, S M Graham, N Wuatai, S S Majumdar

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Abstract

Setting: An established response to an outbreak of drug-resistant TB (DR-TB) on Daru Island, South Fly District (SFD), Western Province, Papua New Guinea (PNG).

Objective: To describe and evaluate the trends in TB case notification disaggregated by demographic and clinical characteristics, programmatic interventions for TB and COVID-19 and treatment outcomes in 2017-2022.

Design: A cohort study of routinely collected programmatic data of all patients registered for TB treatment in SFD comparing pre-COVID (2017-2019) to COVID (2020-2022) periods.

Results: Of the 3,751 TB cases registered, 19.6% had DR-TB, and the case notification rate was 1,792/100,000 for Daru and 623/100,000 for SFD. There was a 29.2% reduction in case notifications from 2019 to 2021, with recovery in 2022. During COVID, the healthcare workforce was adversely impacted, and active TB case-finding was stopped. During COVID, compared to pre-COVID, bacteriological confirmation increased (62.3% to 71.9%), whereas rates of child TB notifications (11.6% to 9.1%), pulmonary TB (60.8% to 57.4%) and DR-TB (20.7% to 18.6%) decreased. High rates of treatment success were maintained for both drug-susceptible (86.5%) and DR-TB (83.6%).

Conclusion: Health systems strengthening and community engagement before COVID likely contributed to resilience and mitigated potential impacts on TB in this remote and resource-limited setting. Case notifications remain very high, and additional interventions are needed to interrupt transmission.

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巴布亚新几内亚南飞区结核病规划成果在2019冠状病毒病期间得以保持。

环境：对巴布亚新几内亚西部省南飞区（SFD）达鲁岛（Daru Island）耐药结核病（DR-TB）暴发的既定应对措施。目的：描述和评估2017-2022年按人口统计学和临床特征分类的结核病病例报告趋势、结核病和COVID-19的规划干预措施以及治疗结果。设计：一项队列研究，常规收集SFD所有注册结核病治疗患者的规划数据，比较pre-COVID（2017-2019）和COVID（2020-2022）期间。结果：3751例结核病例中，耐药结核占19.6%，其中Daru和SFD的病例通报率分别为1792 /10万和623/10万。2019年至2021年，报告病例减少29.2%，2022年有所恢复。在COVID期间，卫生保健人力受到不利影响，主动发现结核病病例的工作停止了。在COVID期间，与COVID前相比，细菌学确认增加（从62.3%增加到71.9%），而儿童结核病报告率（从11.6%增加到9.1%）、肺结核（从60.8%增加到57.4%）和耐药结核病（从20.7%增加到18.6%）下降。药物敏感（86.5%）和耐药结核病（83.6%）均保持较高的治疗成功率。结论：在这一偏远和资源有限的环境中，在COVID之前加强卫生系统和社区参与可能有助于增强复原力并减轻结核病的潜在影响。病例通报率仍然很高，需要采取更多干预措施来阻断传播。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.