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Chen J, Davies A, Tran P, Gronau R, Rangan A, Allman-Farinelli M, Porykali S, Oge R, Porykali B. Health and Nutrition Promotion Programs in Papua New Guinea: A Scoping Review. Nutrients 2024; 16:1999. [PMID: 38999748 PMCID: PMC11243307 DOI: 10.3390/nu16131999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/04/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
There is a rising prevalence of non-communicable diseases (NCDs) in Papua New Guinea (PNG), adding to the disease burden from communicable infectious diseases and thus increasing the burden on the healthcare system in a low-resource setting. The aim of this review was to identify health and nutrition promotion programs conducted in PNG and the enablers and barriers to these programs. Four electronic databases and grey literature were searched. Two reviewers completed screening and data extraction. This review included 23 papers evaluating 22 health and nutrition promotion programs, which focused on the Ottawa Charter action areas of developing personal skills (12 programs), reorienting health services (12 programs) and strengthening community action (6 programs). Nineteen programs targeted communicable diseases; two addressed NCDs, and one addressed health services. Enablers of health promotion programs in PNG included community involvement, cultural appropriateness, strong leadership, and the use of mobile health technologies for the decentralisation of health services. Barriers included limited resources and funding and a lack of central leadership to drive ongoing implementation. There is an urgent need for health and nutrition promotion programs targeting NCDs and their modifiable risk factors, as well as longitudinal study designs for the evaluation of long-term impact and program sustainability.
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Affiliation(s)
- Juliana Chen
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Alyse Davies
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Phyllis Tran
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ryley Gronau
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Anna Rangan
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Shelina Porykali
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD 4222, Australia
| | - Robin Oge
- National Capital District Provincial Health Authority, Port Moresby 121, Papua New Guinea
| | - Bobby Porykali
- Aboriginal and Torres Strait Islander Health Program, George Institute for Global Health, Sydney, NSW 2000, Australia
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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2
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Dakulala P, Kal M, Honjepari A, Morris L, Rehan R, Akena SP, Codlin AJ, Jadambaa N, Islam T, Yanagawa M, Morishita F. Evaluation of a population-wide, systematic screening initiative for tuberculosis on Daru island, Western Province, Papua New Guinea. BMC Public Health 2024; 24:959. [PMID: 38575948 PMCID: PMC10993525 DOI: 10.1186/s12889-024-17918-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/29/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND A population-wide, systematic screening initiative for tuberculosis (TB) was implemented on Daru island in the Western Province of Papua New Guinea, where TB is known to be highly prevalent. The initiative used a mobile van equipped with a digital X-ray device, computer-aided detection (CAD) software to identify TB-related abnormalities on chest radiographs, and GeneXpert machines for follow-on diagnostic testing. We describe the results of the TB screening initiative, evaluate its population-level impact and examine risk factors associated with TB detection. METHODS Through a retrospective review of screening data, we assessed the effectiveness of the screening by examining the enrolment coverage and the proportion of people with TB among screened subjects. A cascade analysis was performed to illustrate the flow of participants in the screening algorithm. We conducted univariate and multivariate analyses to identify factors associated with TB. Furthermore, we estimated the number of additional cases detected by the project by examining the trend of routine TB case notifications during the intervention period, compared to the historical baseline cases and trend-adjusted expected cases. RESULTS Of the island's 18,854 residents, 8,085 (42.9%) were enrolled and 7,970 (98.6%) had chest X-ray interpreted by the CAD4TB software. A total of 1,116 (14.0%) participants were considered to have abnormal CXR. A total of 69 Xpert-positive cases were diagnosed, resulting in a detection rate of 853 per 100 000 population screened. 19.4% of people with TB had resistance to rifampicin. People who were in older age groups (aOR 6.6, 95%CI: 1.5-29.1 for the 45-59 age group), were severely underweight (aOR 2.5, 95%CI:1.0-6.1) or underweight (aOR 2.1, 95%CI: 1.1-3.8), lived in households < 5 people (aOR 3.4, 95%CI:1.8-6.6) and had a past history of TB (aOR 2.1, 95%CI: 1.2-3.6) were more likely to have TB. The number of bacteriologically confirmed TB notified during the intervention period was 79.3% and 90.8% higher than baseline notifications and forecasted notifications, respectively. CONCLUSION The screening project demonstrated its effectiveness with the high Xpert-positive TB prevalence among the participants and by successfully yielding additional cases of bacteriologically confirmed TB including rifampicin-resistant TB. The results and lessons learnt from the project should inform future TB screening initiatives in Papua New Guinea.
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Affiliation(s)
- Paison Dakulala
- National Department of Health, Port Moresby, Papua New Guinea
| | - Margaret Kal
- National Department of Health, Port Moresby, Papua New Guinea
| | | | - Lucy Morris
- Western Provincial Health Authority, Daru, Papua New Guinea
| | - Richard Rehan
- World Health Organization Representative Office for Papua New Guinea, Port Moresby, Papua, New, Guinea
| | - Simon Peter Akena
- World Vision International, Stop TB Programme, Daru, Papua New Guinea
| | - Andrew J Codlin
- Friends for International TB Relief (FIT), Ho Chi Minh City, Viet Nam
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Narantuya Jadambaa
- World Health Organization Representative Office for Papua New Guinea, Port Moresby, Papua, New, Guinea
| | - Tauhid Islam
- Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland
| | - Manami Yanagawa
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Fukushi Morishita
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines.
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3
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Foster J, Marais BJ, Mendez D, McBryde ES. Critical Review of Tuberculosis Diagnosis in Children from Papua New Guinea Presenting to Health Facilities in the Torres Strait Islands, Australia. Microorganisms 2023; 11:2947. [PMID: 38138091 PMCID: PMC10745913 DOI: 10.3390/microorganisms11122947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Paediatric tuberculosis can be challenging to diagnose, and various approaches are used in different settings. A retrospective review was conducted on Papua New Guinea (PNG) children with presumptive TB who presented for health care in the Torres Strait Islands, Australia, between 2016 and 2019. We compared diagnostic algorithms including the modified Keith Edwards TB Score, The Union Desk Guide, and the new World Health Organization (WHO) algorithm, with diagnostic practices used in the remote Torres Strait Islands. Of the 66 children with presumptive TB, 7 had bacteriologically confirmed TB. The majority (52%) were under 5 years (median age 61 months), and 45% were malnourished. There was moderate agreement across the diagnostic methods (K = 0.34; 95% CI 0.23-0.46), with the highest concordance observed between The Union Desk Guide and the WHO's algorithm (K = 0.61). Local TB physicians might have over-diagnosed presumed lymph node TB while under-diagnosing TB overall. Enhancing the precision and promptness of paediatric TB diagnosis using practical tools is pivotal to decrease TB-related child mortality, notably in isolated regions like the Torres Strait and the Western Province of PNG.
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Affiliation(s)
- J’Belle Foster
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia;
- Torres and Cape Tuberculosis Control Unit, Thursday Island, QLD 4875, Australia
| | - Ben J. Marais
- WHO Collaborating Centre in Tuberculosis, Sydney Infectious Diseases Institute (Sydney ID), The University of Sydney, Westmead, NSW 2145, Australia;
| | - Diana Mendez
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia;
| | - Emma S. McBryde
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia;
- Torres and Cape Tuberculosis Control Unit, Thursday Island, QLD 4875, Australia
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4
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Majumdar SS, Islam S, Huang GKL, Morris L, Bauri M, Chan G, Kama G, Keam T, Peacock-Smith A, Finch S, Marukutira T, Bhatt S, Drewett G, Wratten M, Murray A, Pank N, Masah C, Bala R, Umali S, Kalon S, Greig J, Chani K, Kal M, Graham SM. Contact screening and management in a high-transmission MDR-TB setting in Papua New Guinea: Progress, challenges and future directions. FRONTIERS IN TROPICAL DISEASES 2023. [DOI: 10.3389/fitd.2022.1085401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Daru, South Fly District, Papua New Guinea is a high transmission setting for multidrug-resistant tuberculosis (MDR-TB). An emergency response by the Government in 2014 established a high-quality model for treatment and care. Household contact screening and management commenced in 2016 with TB preventive treatment (TPT) for well young child (<5 years) contacts of people with drug-susceptible TB and later expanded to young child contacts of MDR-TB. The model of care is community-based and led by non-specialist health workers, under supervision. An electronic medical record system supports care, reporting and operational research. Community engagement and education has been central, with a concerted focus on peer-led counselling and patient-centred services to improve TPT uptake and completion. Challenges include the application of households as the unit of intervention for detection of active TB and TPT provision. Our implementation experience in Daru has highlighted significant population mixing dynamics with most transmission likely occurring outside the household. We propose a community-wide screening approach with the provision of TPT based on testing to include older children, adolescents, and young adults. As there is the possibility of MDR-TB infection irrespective of the drug susceptibility of the household index case, a novel option is a combination TPT regimen of 6 months of daily isoniazid and levofloxacin (6HLfx). A sensitive aged-related algorithm to detect and exclude active TB is being developed. Ongoing community engagement, quality data systems with operational research to evaluate approaches are critical in high transmission MDR-TB settings.
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5
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Jops P, Cowan J, Kupul M, Trumb RN, Graham SM, Bauri M, Nindil H, Bell S, Keam T, Majumdar S, Pomat W, Marais B, Marks GB, Kaldor J, Vallely A, Kelly-Hanku A. Beyond patient delay, navigating structural health system barriers to timely care and treatment in a high burden TB setting in Papua New Guinea. Glob Public Health 2023; 18:2184482. [PMID: 36883701 DOI: 10.1080/17441692.2023.2184482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Tuberculosis (TB) is a major public health issue in Papua New Guinea, with incidence rates particularly high in the South Fly District of Western Province. We present three case studies, along with additional vignettes, that were derived from interviews and focus groups carried out between July 2019 and July 2020 of people living in rural areas of the remote South Fly District depicting their challenges accessing timely TB diagnosis and care; most services within the district are only offered offshore on Daru Island. The findings detail that rather than 'patient delay' attributed to poor health seeking behaviours and inadequate knowledge of TB symptoms, many people were actively trying to navigate structural barriers hindering access to and utilisation of limited local TB services. The findings highlight a fragile and fragmented health system, a lack of attention given to primary health services, and undue financial burdens placed on people living in rural and remote areas associated with costly transportation to access functioning health services. We conclude that a person-centred and effective decentralised model of TB care as outlined in health policies is imperative for equitable access to essential health care services in Papua New Guinea.
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Affiliation(s)
- Paula Jops
- Kirby Institute, UNSW Sydney, Sydney, Australia
| | - John Cowan
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Martha Kupul
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Richard Nake Trumb
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Stephen M Graham
- Burnet Institute, Melbourne, Australia.,Centre for International Child Health, University of Melbourne, Melbourne, Australia
| | - Mathias Bauri
- Western Provincial Health Authority, Daru, Papua New Guinea
| | - Herolyn Nindil
- National TB Program, National Department of Health, Port Moresby, Papua New Guinea
| | - Stephen Bell
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia
| | - Tess Keam
- Burnet Institute, Melbourne, Australia
| | - Suman Majumdar
- Burnet Institute, Melbourne, Australia.,Centre for International Child Health, University of Melbourne, Melbourne, Australia
| | - William Pomat
- Kirby Institute, UNSW Sydney, Sydney, Australia.,Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Ben Marais
- Sydney Institute for Infectious Diseases (Sydney ID), University of Sydney, Sydney, Australia
| | - Guy B Marks
- Woolcock Institute of Medical Research, Sydney, Australia.,Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - John Kaldor
- Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Andrew Vallely
- Kirby Institute, UNSW Sydney, Sydney, Australia.,Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Angela Kelly-Hanku
- Kirby Institute, UNSW Sydney, Sydney, Australia.,Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
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MOHAMMADBEIGI ABOLFAZL, HOSSEINALI-POUR SEYEDABBAS, ALIGOL MOHAMMAD, MOHAMMADI MAHDI, DERAKHSHANI MARYAM, SOLEYMANI-MONFARED MARJAN. Smear grading at initial treatment association with treatment outcomes among new smear positive pulmonary tuberculosis patients: A retrospective study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E573-E578. [PMID: 36890996 PMCID: PMC9986979 DOI: 10.15167/2421-4248/jpmh2022.63.4.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 10/31/2022] [Indexed: 03/10/2023]
Abstract
Introduction Tuberculosis (TB) is one of the most challenging diseases in diagnosis, treatment and control. We aimed to assess the association of the initial grading of Mycobacterium Sputum Smear (MSS) on the outcomes of TB treatment. Materials and methods In a retrospective study, data of 418 positive pulmonary smear patients were retrieved from the TB registration system in Iran during 2014 to 2021. Patients' data included demographic, laboratory and clinical information and were recorded in our checklist. The grading of Mycobacterium Sputum Smear (MSS) at the initial treatment was assessed based on World Health Organization (WHO) guidelines. Chi-square test was used to assess the relationship between tuberculosis treatment outcomes and Mycobacterium grade at initial treatment in SPSS. Results The mean age of cases was 51.19 ± 22.29 years old and varied between 14 and 95 years. Laboratory results showed that the rate of 1-9, 1+,2+ and 3+ Mycobacterium tuberculosis was 17.7%, 44.3%, 19.4% and 18.7%, respectively. The rate of cure, death and treatment failure in patients was 87.1%, 6.9%, and 1.2%, respectively. The highest mortality rate (11.5%) occurred in patients with 3+ and the lower rate of cure was 79.5% in this group. Moreover, by increasing the Mycobacterium grade the rate of transferred out and lost to follow up from treatment increased (p = 0.024). Conclusion High smear grading of sputum is inversely associated with lower curing and on-time treatment. Moreover, by increasing the Mycobacterium grade at initial treatment, treatment failure and lost to follow up increased Therefore, improvement the health system and patient-diagnosis and screening programs is necessary to on-time diagnosis and facilitate the treatment process.
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Affiliation(s)
- ABOLFAZL MOHAMMADBEIGI
- Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - SEYED ABBAS HOSSEINALI-POUR
- Disease Prevention and Control Unit, Qom Health Vice chancellor, Qom University of Medical Sciences, Qom, Iran
| | - MOHAMMAD ALIGOL
- Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - MAHDI MOHAMMADI
- Disease Prevention and Control Unit, Qom Health Vice chancellor, Qom University of Medical Sciences, Qom, Iran
| | - MARYAM DERAKHSHANI
- Department of Anesthesiology, Shahid-Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Correspondence: Maryam Derakhshani, Assistant Professor, Department of Anesthesiology, Shahid-Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran. E-mail:
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Lin YD, du Cros P, Greig J, Lavu EK, Hiasihri S. Beyond the bubble: neighbours helping neighbours. Intern Med J 2021; 51:1013-1015. [PMID: 34278685 DOI: 10.1111/imj.15416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/06/2021] [Accepted: 06/06/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Yi Dan Lin
- Tuberculosis Elimination and Implementation Science Group, Burnet Institute, Melbourne, Victoria, Australia
| | - Philipp du Cros
- Tuberculosis Elimination and Implementation Science Group, Burnet Institute, Melbourne, Victoria, Australia
| | - Jane Greig
- Tuberculosis Elimination and Implementation Science Group, Burnet Institute, Melbourne, Victoria, Australia
| | - Evelyn Koru Lavu
- School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
| | - Stenard Hiasihri
- Tuberculosis Elimination and Implementation Science Group, Burnet Institute, Melbourne, Victoria, Australia
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8
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Baluku JB, Katuramu R, Naloka J, Kizito E, Nabwana M, Bongomin F. Multidisciplinary management of difficult-to-treat drug resistant tuberculosis: a review of cases presented to the national consilium in Uganda. BMC Pulm Med 2021; 21:220. [PMID: 34246234 PMCID: PMC8272325 DOI: 10.1186/s12890-021-01597-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/03/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Patients with drug resistant tuberculosis (DR-TB) with comorbidities and drug toxicities are difficult to treat. Guidelines recommend such patients to be managed in consultation with a multidisciplinary team of experts (the "TB consilium") to optimise treatment regimens. We describe characteristics and treatment outcomes of DR-TB cases presented to the national DR-TB consilium in Uganda between 2013 and 2019. METHODS We performed a secondary analysis of data from a nation-wide retrospective cohort of DR-TB patients with poor prognostic indicators in Uganda. Patients had a treatment outcome documented between 2013 and 2019. Characteristics and treatment outcomes were compared between cases reviewed by the consilium with those that were not reviewed. RESULTS Of 1,122 DR-TB cases, 189 (16.8%) cases from 16 treatment sites were reviewed by the consilium, of whom 86 (45.5%) were reviewed more than once. The most frequent inquiries (N = 308) from DR-TB treatment sites were construction of a treatment regimen (38.6%) and management of side effects (24.0%) while the most frequent consilium recommendations (N = 408) were a DR-TB regimen (21.7%) and "observation while on current regimen" (16.6%). Among the cases reviewed, 152 (80.4%) were from facilities other than the national referral hospital, 113 (61.1%) were aged ≥ 35 years, 72 (40.9%) were unemployed, and 26 (31.0%) had defaulted antiretroviral therapy. Additionally, 141 (90.4%) had hepatic injury, 55 (91.7%) had bilateral hearing loss, 20 (4.8%) had psychiatric symptoms and 14 (17.7%) had abnormal baseline systolic blood pressure. Resistance to second-line drugs (SLDs) was observed among 9 (4.8%) cases while 13 (6.9%) cases had previous exposure to SLDs. Bedaquiline (13.2%, n = 25), clofazimine (28.6%, n = 54), high-dose isoniazid (22.8%, n = 43) and linezolid (6.7%, n = 13) were more frequently prescribed among cases reviewed by the consilium than those not reviewed. Treatment success was observed among 126 (66.7%) cases reviewed. CONCLUSION Cases reviewed by the consilium had several comorbidities, drug toxicities and a low treatment success rate. Consilia are important "gatekeepers" for new and repurposed drugs. There is need to build capacity of lower health facilities to construct DR-TB regimens and manage adverse effects.
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Affiliation(s)
- Joseph Baruch Baluku
- Division of Pulmonology, Kiruddu National Referral Hospital, Kampala, Uganda.
- Makerere University Lung Institute, Kampala, Uganda.
| | | | | | - Enock Kizito
- USAID/Defeat TB, University Research Co LLC, Kampala, Uganda
| | - Martin Nabwana
- Makerere University - Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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9
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Durski KN, Osterholm M, Majumdar SS, Nilles E, Bausch DG, Atun R. Shifting the paradigm: using disease outbreaks to build resilient health systems. BMJ Glob Health 2021; 5:bmjgh-2020-002499. [PMID: 32424013 PMCID: PMC7239499 DOI: 10.1136/bmjgh-2020-002499] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kara N Durski
- Harvard Humanitarian Initiative, Harvard T H Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA .,School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael Osterholm
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Suman S Majumdar
- Burnet Institute, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Eric Nilles
- Harvard Humanitarian Initiative, Harvard T H Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Daniel G Bausch
- UK Public Health Rapid Support Team, Public Health England/London School of Hygiene & Tropical Medicine, London, UK
| | - Rifat Atun
- Harvard T H Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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10
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Rosewell A, Shearman P, Ramamurthy S, Akers R. Transforming the health information system using mobile and geographic information technologies, Papua New Guinea. Bull World Health Organ 2021; 99:381-387A. [PMID: 33958826 PMCID: PMC8061671 DOI: 10.2471/blt.20.267823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 11/29/2022] Open
Abstract
In the context of declining economic growth, now exacerbated by the coronavirus disease 2019 pandemic, Papua New Guinea is increasing the efficiency of its health systems to overcome difficulties in reaching global health and development targets. Before 2015, the national health information system was fragmented, underfunded, of limited utility and accessed infrequently by health authorities. We built an electronic system that integrated mobile technologies and geographic information system data sets of every house, village and health facility in the country. We piloted the system in 184 health facilities across five provinces between 2015 and 2016. By the end of 2020, the system’s mobile tablets were rolled out to 473 facilities in 13 provinces, while the online platform was available in health authorities of all 22 provinces, including church health services. Fractured data siloes of legacy health programmes have been integrated and a platform for civil registration systems established. We discuss how mobile technologies and geographic information systems have transformed health information systems in Papua New Guinea over the past 6 years by increasing the timeliness, completeness, quality, accessibility, flexibility, acceptability and utility of national health data. To achieve this transformation, we highlight the importance of considering the benefits of mobile tools and using rich geographic information systems data sets for health workers in primary care in addition to the needs of public health authorities.
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Affiliation(s)
- Alexander Rosewell
- School of Population Health, University of New South Wales, Sydney 2052, Australia
| | - Phil Shearman
- Papua New Guinea Remote Sensing Centre, Port Moresby, Papua New Guinea
| | - Sundar Ramamurthy
- Papua New Guinea Remote Sensing Centre, Port Moresby, Papua New Guinea
| | - Rob Akers
- Asian Development Bank, Port Moresby, Papua New Guinea
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11
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Majumdar SS, Triasih R, Graham SM. Scaling up tuberculosis preventive therapy for contacts in high transmission settings. LANCET GLOBAL HEALTH 2020; 8:e617-e618. [PMID: 32353300 PMCID: PMC7185935 DOI: 10.1016/s2214-109x(20)30133-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Suman S Majumdar
- Burnet Institute, Melbourne, VIC 3004, Australia; Centre for International Child Health, Department of Paediatrics University of Melbourne and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.
| | - Rina Triasih
- Department of Paediatrics, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Stephen M Graham
- Burnet Institute, Melbourne, VIC 3004, Australia; Centre for International Child Health, Department of Paediatrics University of Melbourne and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
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12
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Lowbridge C, Ralph AP. Tuberculosis: yesterday, today and tomorrow. MICROBIOLOGY AUSTRALIA 2020. [DOI: 10.1071/ma20052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Tuberculosis (TB) remains an important public health challenge globally and in Australia. For the more than 10 million people who become sick with TB each year, the disease can cause immense personal and economic hardship, including loss of income and education through ill health, prolonged and arduous treatment, and stigmatisation – perpetuating a cycle of disadvantage. Past efforts to control TB have taught us much about modern disease control and public health. As the world grapples with the coronavirus (COVID-19) pandemic, the response to TB provides valuable lessons which can inform our response to COVID-19.
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