Epidemiology of and programmatic response to tuberculosis in Solomon Islands: analysis of surveillance data, 2016–2022

Abstract

Objective: To identify progress and challenges in the national response to tuberculosis (TB) in Solomon Islands through an
epidemiological overview of TB in the country.

Methods: A descriptive analysis was conducted using the national TB surveillance data for 2016–2022. Case notifications,
testing data, treatment outcomes and screening activities were analysed.

Results: The number of case notifications was 343 in 2022, with an average annual reduction of the case notification rate
between 2016 and 2022 of 4.7%. The highest case notification rate was reported by Honiara City Council (126/100 000
population) in 2022. The number of people with presumptive TB tested by Xpert® rapidly increased from zero in 2016 to
870 in 2022. Treatment success rate remained consistently high between 2016 and 2022, ranging from 92% to 96%.
Screening for HIV and diabetes mellitus (DM) among TB patients in 2022 was 14% and 38%, respectively. Most patients
(97%) were hospitalized during the intensive phase of treatment in 2022; in contrast, during the continuation phase, the
proportion of patients treated at the community level increased from 1% in 2016 to 63% in 2022. Despite an increase
in household contact investigations, from 381 in 2016 to 707 in 2021, the uptake of TB preventive treatment (TPT) was
minimal (7% among eligible child contacts).

Discussion: This epidemiological analysis in Solomon Islands reveals both notable achievements and challenges in the
country’s TB programme. One major achievement is a potential actual reduction in TB incidence. Challenges identified were
potential underdetection of cases in rural areas, suboptimal community-based care, and insufficient contact tracing and
uptake of TPT. It is crucial to address these challenges (e.g. by optimizing resources) to advance the national TB response.