ABSTRACT
SETTING: A response to an outbreak of multidrug-resistant tuberculosis (MDR-TB) on Daru Island, South Fly District (SFD), Western Province, Papua New Guinea (PNG) was implemented by a national emergency response taskforce. OBJECTIVE: To describe programmatic interventions for TB in SFD and evaluate characteristics of TB case notifications, drug resistance and treatment outcomes. DESIGN: This was a retrospective cohort study based on routine programmatic data for all patients enrolled on TB treatment at Daru General Hospital from 2014 to 2017. RESULTS: The response involved high-level political commitment, joint planning, resource mobilisation, community engagement and strengthening TB case detection and treatment. Of 1548 people enrolled on TB treatment, 1208 (78%) had drug-susceptible TB (DS-TB) and 333 (21.5%) had MDR-TB. There was an increase in MDR-TB as a proportion of all TB. Treatment success rates increased over the study period from 55% to 86% for DS-TB, and from 70% to 81% for MDR-TB from 2014 to 2015. The 2014 case notification rate for TB in SFD was 1031/100 000, decreasing to 736/100 000 in 2017. CONCLUSION: The outbreak was stabilised through the response from the national and provincial governments and international partners. Additional interventions are needed to decrease the TB burden in Daru.
ABSTRACT
Multiple sclerosis is rare in equatorial countries and has not been diagnosed in the indigenous population of Papua New Guinea. We describe the clinical features of a young Papua New Guinean with optic neuritis and a myelopathy which we believe to be due to multiple sclerosis.
Subject(s)
Multiple Sclerosis , Adult , Female , Humans , Papua New GuineaABSTRACT
Falls from trees and other tree related injuries are the most common cause of trauma in some parts of rural Melanesia. A four year review of all admissions for trauma to the Provincial Hospital at Alotau, Milne Bay Province, Papua New Guinea, showed that 27% were due to falls from trees, and a further 10% were due to related injuries, such as being struck by a falling branch or a coconut. A questionnaire distributed to rural health centres showed that during the study period at least 28 villagers died from falls from trees before reaching hospital. Head and chest trauma were common causes of death. Many injured patients were boys. Forearm fractures were the most common injuries, but more serious injuries were also frequently encountered. Trees responsible for most deaths and injuries included the coconut palm, betel palm, mango, and breadfruit. There are many strategies for preventing such injuries; perhaps the most important is to stop small boys climbing tall trees. Such falls are a serious occupational hazard for many subsistence farmers.
