PNG one of the world's worst places for tuberculosis infection | Pacific Beat

PNG one of the world's worst places for tuberculosis infection

PNG one of the world's worst places for tuberculosis infection

Updated 19 June 2013, 16:31 AEST

20 years ago, the World Health Organisation declared tuberculosis a global emergency.

For a while, a vaccine and targeted treatment stabilised the deadly disease, but now, medication shortages and the emergence of a multi-drug resistant strain, mean huge gains made in reducing TB are at risk.

Papua New Guinea has been hit hard and many tuberculosis suffers there, have a bleak future.

Patients receiving treatment in developed countries like Australia, consider themselves the lucky ones.

Kate Arnott reports.

Presenter: Kate Arnott

Speaker: Suman Majumdar from Royal Melbourne Hospital, Burnet Institute's Infectious diseases specialist, Emma McBryde, Assoc. Professor, David Anderson, Deputy Director, Burnet Institute Jo Chandler, Freelance journalist & TB patient

ARNOTT:Tuberculosis is a deadly bacterial disease, which infectious diseases doctor, says is largely forgotten in wealthy nations.

DR SUMAN MAJUMDAR: Infectious diseases physician, Royal Melbourne Hospital and Burnet Institute : "One of the things that fuels TB everywhere is weakened health systems, poverty, vulnerable people and I think that's the key driving factor."

ARNOTT: Sixty per cent of global cases of tuberculosis occur in countries in the Asia Pacific region.

Papua New Guinea is one of the worst, the World Health Organisation estimates around 15-thousand cases are registered every year - of those, there are more than 3 and a half thousand deaths.

The Burnet Institute's Infectious diseases specialist, Emma McBryde spent two weeks in PNG's Western Province in September last year, to assess TB rates.

DR EMMA MCBRYDE, Infectious diseases physician, Burnet Institute : "Not only were there vast numbers of tuberculosis specific beds in every hospital but almost every bed in every hospital was taken up by patients who had TB or were suspected to have TB or were very likely to have TB."

ARNOTT: Making things worse in PNG, is the emergence of multi-drug resistant tuberculosis - which Dr Majumdar says doesn't respond to the two most powerful anti-TB medications.

DR SUMAN MAJUMDAR, Infectious diseases physician - Royal Melbourne Hospital and Burnet Institute: "It's a problem because our current tools to prevent it, to treat it and to diagnose it are not adequate to control it."

ARNOTT: Drug-resistant TB is putting a huge strain on PNG's poorly resourced health system.

For patients, getting access to treatment is difficult enough - then as Dr Majumdar points out - they have to survive two years of toxic treatment - instead of the usual six months for standard tuberculosis.

DR SUMAN MAJUMDAR, Infectious diseases physician Royal Melbourne Hospital and Burnet Institute: "It's a gruelling ordeal of drugs with severe side effects, injections for at least 6 months everyday and often intolerable side effects such as nausea, vomiting, diarrhoea even psychosis and things such as permanent hearing loss."

ARNOTT: Freelance journalist, Jo Chandler is one of up to 12-hundred people diagnosed with tuberculosis in Australia every year, most people contract it while overseas.

In 2011, she visited hospitals and settlements in PNG's Western Province, for a series of articles about the TB crisis there.

JO CHANDLER, freelance journalist & tb patient : "The wards at that point were in quite poor condition, so ventilation wasn't good - they were extremely crowded - there weren't many medications available, people were very distressed and extremely sick."

ARNOTT: A year and a half after returning home Jo experienced fevers and violent coughing fits, and was put into isolation in hospital.

In March, she was diagnosed with multi-drug resistant TB, testing since then has revealed she most likely contracted the disease in PNG.

Fortunately, she's not contagious, because the bug is confined to a sac around her lung.

JO CHANDLER, freelance journalist & tb patient : "I think I'm currently taking a mixture of about 17 or 18 pills each day spread across morning and afternoon."

ARNOTT: As well, antibiotics are fed to her intravenously by a nurse, who visits her Melbourne home three times a week.

Jo describes herself as a "privileged" TB sufferer.

JO CHANDLER, freelance journalist & tb patient : "The reality for the TB patients that I've interviewed and seen over recent years has been so profoundly different to this one and mine."

ARNOTT: The medical world says Jo will fully recover when her treatment finishes in two years.

But the Burnet Institute's Dr Emma McBryde says the same can't be said for patients in PNG.

DR EMMA MCBRYDE, Infectious diseases physician, Burnet Institute: "Occasionally people will turn up to a clinic to be told there are no drugs available. There are other challenges as well like people might live in a rural community but their treatment service might only be a short distance away by our terms, but if they have to use a long boat to get there and that costs money, and takes a long time, then it's very hard to access healthcare."

ARNOTT: Getting access to affordable testing for tuberculosis in PNG is also problematic.

And so researchers from Australia's Burnet Institute are developing a new test.

Associate Professor, David Anderson says it may be able to detect if a patient has TB, using just a drop of blood.

ASSOC. PROFESSOR, DAVID ANDERSON, Deputy Director, Burnet Institute : "One of the main advantages is that it is so easy to collect samples of blood from large numbers of people - including people who appear to be perfectly healthy but who may have low levels of TB, still enough to infect other people but are not actually expressing sufficient symptoms that you would target them for diagnosis otherwise."

ARNOTT: No-one is in any doubt that trying to control tuberculosis in Papua New Guinea is a big challenge, but some headway is being made.

Dr Emma McBryde says a dedicated TB ward funded by the Australian Government is about to open in Daru Hospital in Western Province.

DR EMMA MCBRYDE, Infectious diseases physician, Burnet Institute: "I think it's going to make a big difference - certainly already there's a change of perception about the Daru hospital within the community. The treatment that they're doing in Daru is outstanding in Daru compared with some of the other regions."

ARNOTT: There's also a sea ambulance which travels to patients in remote locations and training for community health workers in the Province.

But Jo Chandler says fixing the TB problem is going to take a lot of political will and money.

JO CHANDLER, Freelance journalist & TB patient: Peter O'Neil, the prime minister, has recognised frequently the obstacle of the declining standards of infrastructure - the roads, the hospitals, the bridges - you can't begin to tackle TB until you deal with some of those issues as well.

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