Cross-Border Movement of Highly Drug-Resistant <i>Mycobacterium tuberculosis</i> from Papua New Guinea to Australia through Torres Strait Protected Zone, 2010–2015

Bainomugisa, Arnold; Pandey, Sushil; Donnan, Ellen; Simpson, Graham; Foster, J'Belle; Lavu, Evelyn; Hiasihri, Stenard; McBryde, Emma S.; Moke, Rendi; Vincent, Steven R.; Sintchenko, Vitali; Marais, Ben J.; Coin, Lachlan; Coulter, Christopher

doi:10.3201/eid2503.181003

Cited by 18 publications

(17 citation statements)

References 35 publications

(44 reference statements)

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“…A strategic framework for cross-border TB control programmeming was developed for highly mobile populations [ 59 ], but the initiative was not materialized to handle patients requesting cross-border referral that resulted in treatment discontinuations. Thus, the risk of drug resistance due to treatment discontinuation and exchange of resistant strains would be alarming among migratory patients in the setting [ 60 ]. This implies the need for founding cross-border collaboration platforms in the region.…”

Section: Discussionmentioning

confidence: 99%

Challenges in delivery of tuberculosis Services in Ethiopian Pastoralist Settings: clues for reforming service models and organizational structures

Getnet

Demissie

Worku

et al. 2021

BMC Health Serv Res

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Background The End-TB strategy aims to see a world free of tuberculosis (TB) by the coming decade through detecting and treating all cases irrespective of socioeconomic inequalities. However, case detections and treatment outcomes have not been as they should be in Somali pastoral settings of Ethiopia. Hence, this study aimed to explore the challenges that hinder the delivery and utilization of TB services in pastoral areas. Methods A qualitative study was conducted between December 2017 and October 2018 among pastoralist patients with delay of ≥2 months in seeking healthcare, healthcare providers and programme managers. Data were collected from different sources using 41 in-depth interviews, observations of facilities and a review meeting of providers from 50 health facilities. The data were transcribed, coded and analyzed to identify pre-defined and emerging sub-themes. ATLAS.ti version 7.0 was used for coding data, categorizing codes, and visualizing networks. Results Poor knowledge of TB and its services, limited accessibility (unreachability, unavailability and unacceptability), pastoralism, and initial healthcare-seeking at informal drug vendors that provide improper medications were the key barriers hindering the uptake of TB medical services. Inadequate infrastructure, shortage of trained and enthused providers, interruptions of drugs and laboratory supplies, scarce equipment, programme management gaps, lack of tailored approach, low private engagement, and cross-border movement were the major challenges affecting the provision of TB services for pastoral communities. The root factors were limited potential healthcare coverage, lack of zonal and district TB units, mobility and drought, strategy and funding gaps, and poor development infrastructure. Conclusion In pastoral settings of Ethiopia, the major challenges of TB services are limited access, illicit medication practices, inadequate resources, structural deficits, and lack of tailored approaches. Hence, for the pastoral TB control to be successful, mobile screening and treatment modalities and engaging rural drug vendors will be instrumental in enhancing case findings and treatment compliance; whereas, service expansion and management decentralization will be essential to create responsive structures for overcoming challenges.

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Section: Discussionmentioning

confidence: 99%

Challenges in delivery of tuberculosis Services in Ethiopian Pastoralist Settings: clues for reforming service models and organizational structures

Getnet

Demissie

Worku

et al. 2021

BMC Health Serv Res

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“…In Vietnam, Holt et al reported that, although the Beijing strains accounted for 58% of the total study sample, they constituted 70% of all clustered strains (21). In Papua New Guinea, Bainomugisa et al found that 82% of isolates with Beijing strains were found in clusters, compared with 43% of isolates with strains from other lineages (37). In China, Yang et al reported that the proportions of clustering were 34% for Beijing and 18% for non-Beijing strains (38).…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium tuberculosis Beijing Lineage and Risk for Tuberculosis in Child Household Contacts, Peru

Huang¹,

Chu²,

Becerra³

et al. 2020

Emerg. Infect. Dis.

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“…We estimated the molecular clock phylogeny and mutation rate of lineage 1 isolates using a previously described method [ 10, 19 ]. The mutation rate was estimated to be 0.56 SNPs/genome/year [95 % highest posterior density (HPD) 0.23–0.79], similar to other published studies [ 27, 33, 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Molecular dating of sub-lineage 1.2 isolates using beast 1.8.2 [ 24 ] was performed as previously described [ 10 ]. We assessed the temporal signal in a neighbour-joined tree (K80 substitution model) by undertaking regression of the root-to-tip distance over time using TempEst v1.5.…”

Section: Methodsmentioning

confidence: 99%

Genomic epidemiology of tuberculosis in eastern Malaysia: insights for strengthening public health responses

Bainomugisa¹,

Meumann

Rajahram

et al. 2021

Microbial Genomics

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Tuberculosis is a leading public health priority in eastern Malaysia. Knowledge of the genomic epidemiology of tuberculosis can help tailor public health interventions. Our aims were to determine tuberculosis genomic epidemiology and characterize resistance mutations in the ethnically diverse city of Kota Kinabalu, Sabah, located at the nexus of Malaysia, Indonesia, Philippines and Brunei. We used an archive of prospectively collected Mycobacterium tuberculosis samples paired with epidemiological data. We collected sputum and demographic data from consecutive consenting outpatients with pulmonary tuberculosis at the largest tuberculosis clinic from 2012 to 2014, and selected samples from tuberculosis inpatients from the tertiary referral centre during 2012–2014 and 2016–2017. Two hundred and eight M . tuberculosis sequences were available for analysis, representing 8 % of cases notified during the study periods. Whole-genome phylogenetic analysis demonstrated that most strains were lineage 1 (195/208, 93.8 %), with the remainder being lineages 2 (8/208, 3.8 %) or 4 (5/208, 2.4 %). Lineages or sub-lineages were not associated with patient ethnicity. The lineage 1 strains were diverse, with sub-lineage 1.2.1 being dominant (192, 98 %). Lineage 1.2.1.3 isolates were geographically most widely distributed. The greatest diversity occurred in a border town sub-district. The time to the most recent common ancestor for the three major lineage 1.2.1 clades was estimated to be the year 1966 (95 % HPD 1948–1976). An association was found between failure of culture conversion by week 8 of treatment and infection with lineage 2 (4/6, 67 %) compared with lineage 1 strains (4/83, 5 %) (P<0.001), supporting evidence of greater virulence of lineage 2 strains. Eleven potential transmission clusters (SNP difference ≤12) were identified; at least five included people living in different sub-districts. Some linked cases spanned the whole 4-year study period. One cluster involved a multidrug-resistant tuberculosis strain matching a drug-susceptible strain from 3 years earlier. Drug resistance mutations were uncommon, but revealed one phenotype–genotype mismatch in a genotypically multidrug-resistant isolate, and rare nonsense mutations within the katG gene in two isolates. Consistent with the regionally mobile population, M. tuberculosis strains in Kota Kinabalu were diverse, although several lineage 1 strains dominated and were locally well established. Transmission clusters – uncommonly identified, likely attributable to incomplete sampling – showed clustering occurring across the community, not confined to households or sub-districts. The findings indicate that public health priorities should include active case finding and early institution of tuberculosis management in mobile populations, while there is a need to upscale effective contact investigation beyond households to include other contacts within social networks.

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Cross-Border Movement of Highly Drug-Resistant Mycobacterium tuberculosis from Papua New Guinea to Australia through Torres Strait Protected Zone, 2010–2015

Cited by 18 publications

References 35 publications

Challenges in delivery of tuberculosis Services in Ethiopian Pastoralist Settings: clues for reforming service models and organizational structures

Challenges in delivery of tuberculosis Services in Ethiopian Pastoralist Settings: clues for reforming service models and organizational structures

Mycobacterium tuberculosis Beijing Lineage and Risk for Tuberculosis in Child Household Contacts, Peru

Genomic epidemiology of tuberculosis in eastern Malaysia: insights for strengthening public health responses

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