Drug resistant tuberculosis in New Zealand.

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Historically, drug-resistant Mycobacterium tuberculosis strains have been rare in New Zealand.
• Western Samoa exhibits a high prevalence of drug-resistant tuberculosis, with 50% of tested cultures showing resistance.
• A significant proportion of resistant strains in Western Samoa are multidrug-resistant (MDR-TB).

Purpose of the Study:

• To highlight the contrast in drug resistance rates between New Zealand and Western Samoa.
• To inform treatment strategies for Samoan tuberculosis patients presenting in New Zealand.
• To recommend adjustments to the standard initial treatment regimen for this specific patient group.

Main Methods:

• Review of historical data on drug resistance patterns in New Zealand.
• Analysis of tuberculosis culture data from Western Samoa, focusing on drug susceptibility testing.
• Comparison of resistance profiles between the two populations.

Main Results:

• Low incidence of drug-resistant M. tuberculosis strains in New Zealand.
• High incidence (50%) of drug resistance in Western Samoan tuberculosis isolates.
• Half of the resistant Samoan isolates exhibit resistance to two or more antitubercular drugs.

Conclusions:

• The high prevalence of drug-resistant tuberculosis in Western Samoa poses a potential challenge for treatment in New Zealand.
• Standard initial treatment protocols may be inadequate for Samoan patients due to likely resistance.
• A modification of the usual initial treatment is recommended for Samoan patients diagnosed with tuberculosis in New Zealand.