Stories from the field: Likas (PNG)

Likas Lakain is a fellow in the inaugural Advanced Field Epidemiology Training Program of Papua New Guinea (aFETPNG). He is the Provincial Disease Control Officer in Enga Province, Papua New Guinea (PNG). For his aFETPNG operational research project, Likas is exploring a priority public health issue in PNG: factors affecting Tuberculosis (TB) patients who are lost to follow-up.

Likas writes about a recent opportunity to share his findings below:

We had our first Provincial HIV and TB review meeting from 16th August to 18th August 2021 which was attended by all TB clinic officers, anti-retroviral therapy clinic officers and major HIV testing sites. The review meeting was also attended by Dr Jacob Kisoap of National TB program and Mr Alex Mesluwa of Anglicare PNG. This review was funded by Anglicare PNG who are sub-recipients of The Global Fund funding for HIV and TB.

During the meeting, I presented the results from my FETP project that was examining the factors affecting lost to follow up and effective case management of TB in Enga Province.  I tried to find TB patients who were lost to follow up and interview them about the reasons they did not complete their treatment. I also interviewed the staff at the clinics to understand the reasons why they were not able to retrieve the patients who did not complete their TB treatment.

My project found that most TB cases stopped their treatment within one month of starting. The reasons patients were not retrieved and put back onto treatment were because patient addresses were poorly recorded, inaccurate phone numbers, tribal fights, lack of logistic support or remoteness. Patients also reported experiencing side effects from taking medication. On the positive side, none of the TB patients reported experiencing stigma from their community. All of the patients were supported by their family.

The next step is to plan an intervention so TB patients lost to follow up in Enga province can be brought back into care and on treatment faster.

Two of Likas’ aFETPNG colleagues have also conducted operational research studies to understand factors affecting loss to follow-up amongst TB patients in their respective provinces. In coming months, they will come together to share their results with each other, their aFETPNG colleagues, and public health leaders from around PNG in an online forum. We look forward to hearing more about this crucial public health issue, understanding similarities and differences in their respective findings, and supporting the fellows to design and implement interventions to address these challenges as the second component of their aFETPNG studies.

You can find out more about the aFETPNG program here