A community-based TB drug susceptibility study in Mimika District, Papua Province, Indonesia.
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.
Kelly
P M
PM
Menzies School of Health Research, Darwin, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia. paulk@menzies.edu.au
Ardian
M
M
Waramori
G
G
Anstey
N M
NM
Syahrial
H
H
Tjitra
E
E
Bastian
I
I
Maguire
G P
GP
Lumb
R
R
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
D000995:Antitubercular Agents