Kelly, PaulArdian, MWaramori, GAnstey, NicholasSyahrial, HTjitra, EmilianaBastian, IMaguire, GraemeLumb, Richard2015-12-071027-3719http://hdl.handle.net/1885/26973SETTING: 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.Keywords: amikacin; aminosalicylic acid; capreomycin; ciprofloxacin; ethionamide; pyrazinamide; rifabutin; tuberculostatic agent; adolescent; adult; aged; article; drug sensitivity; drug tolerance; female; human; hybridization; Indonesia; laboratory test; lung tube Epidemiology; Indonesia; Multi-drug resistance; Survey; Tuberculosis20062015-12-07