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. See also: https://tbreadingnotes.blogspot.com/2024/09/tb-in-patients-with-hiv-and-diabetes.html

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. See also: https://tbreadingnotes.blogspot.com/2024/10/tb-treatment-and-resulting-abnormal.html

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. See also: https://tbreadingnotes.blogspot.com/2024/10/patient-health-system-population.html

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.