BY LYNTON AARON FILIA
AROUND 395 cases of tuberculosis are reported each year in the Solomon Islands, according to a health ministry report.
The Ministry of Health and Medical Services’ 2017 Health Core Indicator Report says for the period 2015-2017, Solomon Islands had a rate of 65 notified TB cases per 100,000 population which means on average; around 395 cases of TB are confirmed and reported each year.
The rate has remained stable over the past five years, fluctuating between 60 and 75 cases per 100,000 people annually.
Honiara City Council has the highest rate for the period 2015 to 2017; however this figure may be affected by the relative ease of access to the NRH and its diagnostic laboratory for patients.
Rennell-Bellona and Makira also have comparatively high rates; however their smaller populations are likely to be affecting data comparability.
The report stated in Rennell-Bellona, the notification rate was 86 per 100,000 in 2015 which rose in 2016 whilst the difference in cases was just three in the two years.
This demonstrates the high stochastic (or random) variability that occurs in small populations.
Another critically important indicator in monitoring the impact of TB in a population is the treatment success rate.
This relates to the number of confirmed smear-positive cases that were cured or in which a full course of treatment was completed (and is written as a percent).
MHMS’s report highlighted between 2014 and 2016, the Solomon Islands had an average treatment success rate of 92 percent.
This indicates a high number of people are completing treatment with minor at provincial level difference with Malaita (83 percent) and Western province (88 percent) which are below the national average.
Statistics suggests that the cure rate for TB has been significantly low, 63 percent in 2016.
This is likely due to the lower number of sputum smear examination being carried out at the end of treatment which means more people are completing treatment without confirmation TB has been successfully cured.
This situation can provide an environment for the development of drug-resistant TB which is already an issue in neighbouring countries such as Papua New Guinea, according to the MHMS.
As per the global minimum standards for TB, at least 70 percent of people with infectious TB need to be diagnosed under directly-observed treatment, short-course (DOTS), and at least 85 percent of these people are cured.
Looking at the mortality rate for TB, the steady decline in deaths due to TB suggests the low cure rate is a reflection of inadequate testing services and not poor treatment outcomes.