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Livestock Systems

Drug sensitive and resistant tuberculosis and zoonotic infections as causes of lymphadenitis in 2 provinces in Papua New Guinea

Project Code: LS/2018/217
Budget:
A$250,000
Research Program Manager: Dr Anna Okello
Project Leader: Dr Philipp DuCros, Burnet Institute
Duration:
APR 2019
2020
JUN 2020
Project Status: Legally comitted/Active
Key partners
Victorian Infectious Diseases Reference Laboratory (VIDRL), Australia
Papua New Guinea Institute of Medical Research
Papua New Guinea National Department of Health

Overview

This project is working to determine the proportion of presumptive Tuberculosis (TB) lymphadenitis attributable to Mycobacterium TB complex and the proportion of confirmed TB lymphadenitis attributable to Mycobacterium bovis.

TB is now the leading cause of death amongst infectious diseases worldwide. In the Pacific region it is an important health issue. Papua New Guinea (PNG) is listed by the World Health Organization as one of 30 high TB burden countries, with an estimated incidence rate of 432 per 100,000 population, and an incidence of multi-drug resistant TB of 23 per 100,000.

The Mycobacterium TB complex is a group of closely related acid-fast bacilli including Mycobacterium TB and Mycobacterium bovis.  Both domestic and wild animal species are hosts for Mycobacterium bovis. While Mycobacterium TB is avirulent in cattle and transmission back to humans is extremely rare, Mycobacterium bovis can infect humans and humans can infect livestock.

This project will address two major gaps in TB care and response in PNG. Firstly, defining what proportion of clinically diagnosed TB lymphadenitis is due to drug-sensitive and drug-resistant TB, which will have implications for clinical and programmatic management of TB. Secondly, this may demonstrate that a large proportion of clinically diagnosed cases are negative for TB by molecular and culture methods, suggesting that other pathogens may be responsible and requiring a change in clinical diagnostic algorithms.

This project is part of the Research for One Health Systems Strengthening Program co-funded with DFAT addressing zoonoses, antimicrobial resistance and systems strengthening within the Asia Pacific. 

Project outcomes

  • Determining the proportion of presumptive TB lymphadenitis attributable to Mycobacterium tuberculosis complex in East New Britain and Eastern Highlands provinces.
  • Determining the proportion of confirmed TB lymphadenitis attributable to Mycobacterium bovis in East New Britain and Eastern Highlands provinces.
  • Exploring animal-human interactions that may pose a risk for zoonotic infections.
  • Developing a prospective cohort study of presumptive TB lymphadenitis.
  • Exploring ethnographic research into animal-human interactions that may pose a risk for zoonotic infections.
  • Establishing a stored bank of lymph node and blood samples for future studies on other potential causes of lymphadenitis.