The Micronesia sub-region has the highest TB rate, with 140 cases per 100,000 pop., followed by the Melanesia sub-region, with 37 cases per 100,000 pop., and Polynesia with 19 cases per 100,000 pop.
TB rates in the Micronesia sub-region are higher than rates reported in other sub-regions mostly due to high rates in Kiribati, Marshall Islands and Federated States of Micronesia.
“TB remains a huge burden in the Pacific islands,” said Dr Janet O’Connor, head of the Secretariat of the Pacific Community’s TB section.
What is now alarming is the emergence of multidrug resistant TB, or MDR-TB, a strain of TB that is resistant to INH and Rifampicin, the two most powerful TB drugs available for the past 50 years.
Nine countries in the Pacific region, including New Zealand and Australia, have reported MDR-TB between 2005 and 2008.
Chuuk alone has had 16 confirmed MDR-TB cases and 100 contacts since its MDR-TB outbreak in July 2008.
The World Health Organization estimates that about 900 MDR-TB cases occur every year in Papua New Guinea.
The burden of MDR-TB and its potential to escalate in the region is a big concern.
Even more disheartening is the significant risk that XDR-TB, or extensively drug resistant TB, a strain of TB that is virtually incurable, will develop if national TB programs fail to manage MDR-TB properly.
“Given the poor treatment outcomes and high case mortality for MDR-TB, the TB situation in the Pacific region can only get worse,” O’Connor said.
“The increasing HIV incidence reported in the region to date will no doubt fuel the ongoing MDR-TB epidemic witnessed in parts of the region today and the situation will be quite daunting.
“Our region is now at a cross roads where TB and HIV are colliding and non-communicable and communicable diseases are joining forces causing disability and premature deaths. TB and HIV programs and other partners must now reach beyond their programs and work together to address these two diseases and thus prevent MDR-TB,” O’Connor said.
The joint SPC and WHO meeting for TB and HIV program managers last week in Nadi, Fiji Islands, brought together all TB and HIV/AIDS program managers and experts from around the Pacific region for the first time.
They agreed to establish meaningful collaborative activities.
TB program managers also held a two-day meeting on strengthening the national directly observed treatment short-course foundation as the basis for MDR-TB prevention.
