title: A community-based TB drug susceptibility study in Mimika District, Papua Province, Indonesia.
abstract: METHODS
  A district level tuberculosis (TB) control programme in Papua Province, Indonesia.
  
  
  OBJECTIVE
  To determine the nature and extent of drug-resistant TB in newly diagnosed sputum smear-positive patients.
  
  
  METHODS
  Sputum was collected from previously untreated smear-positive pulmonary TB patients diagnosed in the district over a 10-month period. Sputum specimens were processed and inoculated into a BACTEC MGIT960 tube. Isolates were identified by Ziehl-Neelsen staining, hybridisation with nucleic acid probes and biochemical investigations. Susceptibility testing was performed using the radiometric proportion method. Pyrazinamide testing was performed using the Wayne indirect method.
  
  
  RESULTS
  One hundred and seven patients had sputum sent to a reference laboratory; 101 (94.4%) were culture-positive for Mycobacterium tuberculosis, with 87 (86.1%) fully sensitive to first-line anti-tuberculosis drugs. Two per cent were multidrug-resistant (MDR-TB) and 12 (11.9%) had other drug resistance. Each of the MDR-TB isolates was susceptible to amikacin, capreomycin, ciprofloxacin and para-aminosalicylic acid (PAS), but were resistant to rifabutin. One isolate was also resistant to ethionamide.
  
  
  CONCLUSIONS
  MDR-TB is present in Indonesia but is not a major problem for TB control in this district. Generalisability to other districts in Indonesia, particularly large urban areas, needs to be confirmed by future studies.
authors.affiliation: Menzies School of Health Research, Darwin, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia. paulk@menzies.edu.au
authors.forename: P M
authors.initials: PM
authors.lastname: Kelly
authors.forename: M
authors.initials: M
authors.lastname: Ardian
authors.forename: G
authors.initials: G
authors.lastname: Waramori
authors.forename: N M
authors.initials: NM
authors.lastname: Anstey
authors.forename: H
authors.initials: H
authors.lastname: Syahrial
authors.forename: E
authors.initials: E
authors.lastname: Tjitra
authors.forename: I
authors.initials: I
authors.lastname: Bastian
authors.forename: G P
authors.initials: GP
authors.lastname: Maguire
authors.forename: R
authors.initials: R
authors.lastname: Lumb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents