Introduction: Human immunodeficiency virus (HIV) infection continues to be a growing public health burden in HIV-endemic countries, including Papua New Guinea (PNG). The aim of this analysis was to describe the sociodemographic characteristics and sexual risk behaviours of people tested positive with HIV by notifying testing facilities in PNG.Methods: A descriptive analysis was conducted using the national HIV/STI (sexually transmitted infection) surveillance data from 2010 to 2014. Descriptive statistics were utilized to compare categorical variables: sociodemographic characteristics, reasons for HIV testing and HIV-related risk factors. The chi-squared test was conducted to ascertain differences between categorical variables. Results: There were 13,687 HIV-positive cases, with a mean age of 34.9 years (± SD 10.1) for males and 28.2 years (± SD 8.2) for females. 62% were female, of whom 36% were aged 15-24 years and 39% had no formal education. The overall proportion who were married was 66%, many in polygamous relationships. 64% of females and 45% of males were unemployed. 60% overall were from the Highlands Region. 51% of people were tested HIV-positive through voluntary counselling and testing (VCT) services, along with clinical suspicion (30%). Heterosexual sex with non-regular sex partners was an important risk factor in both males (57%) and females (59%). The number of HIV-positive cases reported decreased significantly over the 5-year period. Conclusions: The study found specific sociodemographic factors and risky sexual behaviours, along with high HIV infection rates, in geographically concentrated settings. This demands comprehensive antiretroviral therapy (ART) coverage, with context-specific and targeted behavioural change prevention strategies, in accordance with the national HIV treatment cascade.

Papua New Guinea (PNG) is one of the Pacific island countries facing a noncommunicable disease (NCD) crisis. Little has been reported about rehabilitation services for them. This study aimed to describe the characteristics of inpatients with the four major NCDs receiving rehabilitation services in PNG: cardiovascular disease (CVD) (divided into cerebrovascular disease and ischaemic heart disease), diabetes, cancer and respiratory disease. We conducted a subanalysis of our previous study. We reviewed the inpatient records of all inpatients (12,241 records, Total group) and those of inpatients receiving rehabilitation services by physical therapy (PT) (350 records, PT group). After extracting the records of patients with NCDs, we investigated the demographic data, diagnostic data and gait function. We calculated the percentages of inpatients’ characteristics and the ratio of the number of inpatients in the PT group to that in the Total group by diagnosis (PT ratio). The final analysis included 442 records in the Total group and 68 records in the PT group. Diagnoses and percentages in the PT group were cerebrovascular disease (65%), diabetes (22%), cancer (9%), respiratory disease (4%) and ischaemic heart disease (0%). The PT ratio was the highest in cerebrovascular disease (0.88), followed by diabetes (0.16) and other diagnosis (≤0.05). The inpatients with cerebrovascular disease and diabetes were more likely to have poor gait function than those with other NCDs. Our findings suggested that the provision of rehabilitation services for inpatients with the four NCDs was limited and biased for specific conditions. For development of rehabilitation services for patients with NCDs in PNG, scaling up the service provision and expanding its scope would be a possible way forward

Objective: Papua New Guinea (PNG) is the largest of the Pacific Island countries that is facing challenges related to the burden of cerebrovascular disease. There are few reports on rehabilitation services for inpatients with cerebrovascular disease, including stroke. This study aimed to examine the provision of rehabilitation services, physical therapy (PT) and service outcomes in PNG. Methods: A sub analysis of our previous retrospective observational study at a single provincial hospital in PNG was conducted in which patient records of all inpatients (Total group, n = 12,241) and those of inpatients receiving rehabilitation services (PT group, n = 350) were reviewed, and the records of inpatients with cerebrovascular disease were extracted for analysis. For descriptive purposes, demographic data, service provision statistics (length of hospital stay and duration and frequency of PT services provided) and gait function were summarized. Results: The final analysis comprised 50 of 12,241 records in the Total group and 34 of 350 records in the PT group. All of these studied patients suffered a stroke. The dominant age in both groups was ≥40 years. The median length of stay in hospital was 9 days in the Total group. The median frequency and duration of PT services were 4 times and 8.5 days, respectively. Of the 34 inpatients in the PT group, 32 (94%) were discharged with poor gait function defined as ‘dependent or no walking function’. Conclusions: The results implied that stroke patients who were discharged with poor gait function and restarted their life in the community would confront significant barriers and challenges in PNG. This first report, to our knowledge, on rehabilitation services for stroke in PNG may provide a reference point for further clinical research.

Assessing the prevalence of anaemia, iron deficiency and iron deficiency anaemia among non-pregnant and pregnant women is essential for evidence-based intervention programs. The purpose of this prospective outpatient and community-based cross-sectional study was to assess the prevalence of those conditions among pregnant women resident in the National Capital District (NCD) and attending the Outpatient Antenatal Clinic in Port Moresby General Hospital. Blood samples were collected from 50 non-pregnant and 157 pregnant women who gave consent. HemoCue was used to measure haemoglobin; the serum ferritin, soluble transferrin receptor (sTfR) and C-reactive protein were measured by specialized 96-well enzyme-linked immuno-sorbent assay (ELISA) kits. The ‘sTfR-F index’ was calculated. Mild to moderate anaemia, low serum ferritin and elevated serum sTfR were found in 28% of the non-pregnant women; the sTfR-F index showed that 16% of them had iron deficiency anaemia. Among the pregnant women, 60% had mild to severe anaemia indicating severe public health significance; 48% had low serum ferritin and 38% had elevated serum sTfR; the sTfR-F index showed that 38% of them had iron deficiency anaemia. Mild to severe anaemia was present in 47%, 71% and 62% of the pregnant women in the first, second and third trimesters respectively, while iron deficiency anaemia was present in 20%, 53% and 48% of the pregnant women in the first, second and third trimesters respectively. The sTfR-F index showed that iron deficiency anaemia was present in 36% of primigravida and 40% of multigravida. Social mobilization, intensive and focused education, aggressive awareness campaigns, including all relevant target groups and policy makers, are required to effectively address this major public health issue.

In Papua New Guinea, village health volunteers (VHVs) work in their communities to support healthy lifestyles. They form an important link between the community and the formal health system. In the Middle and South Fly Districts of Western Province, the VHV Program was implemented as one of the many interventions of the Community Mine Continuation Agreement Middle and South Fly Health Program. For this region of Papua New Guinea, it would be the first time the VHV Program had been implemented. We describe how the VHV Program was implemented and document the perspectives of the VHV Program from the VHVs, their supervising health workers and the communities they serve through focus group discussions and interviews. The qualitative data revealed that some health workers and community members had expectations of the VHVs that differed from their role, particularly in regard to the expectation that VHVs do clinical work. The importance of compensation for VHVs for their time was identified by communities, health workers and the VHVs. VHVs and the community also noted the conflicting demands of the family of the VHV and their work in the community. The final theme identified was about the interaction between the VHV and the formal health system, where VHVs identified needs for access to medical supplies, transport, ongoing training and supervision. These themes are discussed in the context of the international literature and the VHV policy in Papua New Guinea.

The pattern of antibiotics prescribed to patients with peripheral lymphadenopathy was assessed and compared with existing standard treatment guidelines (STGs) in Papua New Guinea (PNG). Information was obtained from patients referred to the Port Moresby General Hospital for fine needle aspiration biopsy by interviewing patients and reviewing patients’ clinic attendance record books and referral letters. Of the 107 patients recruited for the study, 51 (48%) were prescribed antibiotics and, of these, prescription data were obtained from 40 (78%). Amoxycillin, which is recommended as a first-line antibiotic for peripheral lymphadenopathy in PNG STGs, was prescribed in only 18/40 patients (45%). There was also high variability in other antibiotic selection, antibiotic combinations and treatment duration. The results highlight a need for ongoing training on rational antibiotic prescribing.

Tuberculosis (TB) continues to be a serious public health problem in Papua New Guinea (PNG). A key element in the prevention and control of TB is for people to have the correct, appropriate and relevant information regarding TB and its prevention and treatment. In PNG, there is no published information about the knowledge of TB among the general population. An understanding of people’s knowledge of various aspects of TB is important in developing interventions to address the burden of TB. This study aimed to assess the knowledge of TB among the local population in PNG. We used a cross-sectional study to understand people’s levels of knowledge regarding TB in three sites in PNG: Hiri, Asaro and Karkar Island. A total of 1034 people aged 15 years and above participated in this study from May to December 2013. Our study showed different levels of TB knowledge between sites 79% of respondents in Hiri, 27% in Asaro and 23% in Karkar correctly identified TB bacteria as the leading cause of TB. The only site at which respondents gave four correct symptoms of TB was Hiri (7%). Coughing out air droplets was identified as the main mode of transmission by 84% of respondents in Hiri, 33% in Asaro and 71% in Karkar. A tiny proportion of the participants in Hiri (4%) knew the three correct ways of TB prevention. Despite the availability of free TB treatment only 45% of respondents in Hiri, 18% in Asaro and 46% in Karkar knew about it. In Hiri, 58% of the participants knew the TB treatment duration of 6-9 months, compared with 36% in Asaro and 33% in Karkar. A health facility was the most common source of TB information in all three sites. Providing accurate and relevant information about TB through public health education strategies is urgently required to help in addressing the current TB crisis

Surgical services in Papua New Guinea (PNG) have seen an increase in admissions of patients with diabetic septic foot (DSF). Perception and beliefs about the causes of foot ulcer in PNG differ from medical evidence and may play a role in foot-related behaviours among DSF patients. This hospital-based prospective case series study examined the reasons for late presentation among 30 DSF patients in Nonga General Hospital from October 2013 to October 2014. Belief in sorcery was the most common cause of late presentation. Those who chose more than one home treatment were the most likely to present late, and those who presented late had a higher chance of getting a lower extremity amputation than those who presented early.

Child adoption is common in Papua New Guinea (PNG), but little is known about current practices. This study describes the adoption and feeding practices among children up to 3 years of age, identified by both community-based and health facility recruitment in the Southern Highlands of PNG over a 6-month period in 2017. 85 adopted children were identified: 61 (72%) had been customarily or informally adopted and 24 babies (28%) had been sold for cash. Most (93%) were adopted at less than 1 year of age, and twothirds in the neonatal period. 73 mothers (86%) had poor knowledge of the adoption laws and processes, and 56 (66%) had poor knowledge of infant feeding practices. 8% had moderate and 9% had severe malnutrition. The common reasons for adoption were: family breakdown because of divorce, separation or the practice of polygamy; mothers who had too many children or wanted to adopt children; teenage pregnancies; and de facto relationships. 56 of the adopted children were weaned before 6 months of age, and 23 before 4 months of age, most onto a diet consisting of a limited range of fruits and vegetables. Ensuring the rights of adopted children to legal protection, optimal nutrition, care and education is essential. Knowledge of and adherence to customary adoption laws, involvement of social welfare, and infant and young child feeding practices all need to be strengthened in communities, especially in the rural areas.

Two rural communities in Papua New Guinea, the Wopkaimin, which experienced massive socioeconomic development through the Ok Tedi Mine Limited (OTML) commencing in 1983, and Mt Obree, which was without any major economic project during that time, were followed annually since 1982. 83 variables including births and deaths were monitored. The crude birth rate (CBR) and infant mortality rate (IMR) were high in both areas at the beginning. IMR decreased significantly among the Wopkaimin only. The Wopkaimin’s CBR increased immediately after mining but declined later, with no significant change in Mt Obree. The influence of various socioeconomic, cultural and environmental factors is discussed. Demographic monitoring at the community level is accurate, economical and reproducible.