Loss to follow-up among adults with drug-resistant TB in PNG [TB0081]

Charles, F., Lin, Y.D., Greig, J., Gurra, S., Morikawa, R., Graham, S.M. and Maha, A., 2024. Loss to follow-up among adults with drug-resistant TB in Papua New Guinea. Public Health Action, 14(3), pp.85-90.

  • Papua New Guinea (PNG) is listed by WHO as one of 30 high-burden countries for TB and MDR/RR-TB.
  • TB incidence in PNG (2022) is 432 per 100,000 population, while MDR/RR-TB incidence is 22 per 100,000.
  • PNG is a middle-income country with 22 provinces, approximately 12 million people, and 80% of the population living in rural, often remote areas.
  • Around 75% of PNG’s population is under 35 years old, making younger people particularly vulnerable to TB.
  • The treatment success rate for TB is approximately 50%, well below the national target of 90%.
  • Loss to follow-up (LTFU) is high at 22%, especially among people aged 15-34 years, and is linked to socioeconomic and geographic barriers, particularly in rural areas.
  • Young untreated patients are at risk of complications and contribute to the transmission of TB in the community.
  • LTFU is associated with difficult treatment regimens, including long durations, high pill burdens, toxic drugs, and painful injections over several months.
  • Remote populations face additional challenges, such as access to clinics for daily injections.
  • Decentralizing TB services and introducing rapid molecular diagnostics at the primary care level could improve access and coverage while maintaining treatment outcomes.

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