Two young males from Central Province were referred to Port Moresby General Hospital with chronic headaches. In each case the initial impression of tuberculous meningitis needed revision in the light of strongly positive cryptococcal serology. Cryptococcal meningitis occurs with sufficient frequency in Papua New Guinea that it should be considered in cases of raised intracranial pressure, ataxia, cranial neuropathy and visual disturbances. Delay in treatment may be disastrous. In contrast to the developed world where fungal meningitides show a predilection for the immunosuppressed, the experience to date in Papua New Guinea is that the majority of cases in both adults and children occur in ostensibly immunocompetent individuals. The epidemiology, clinical course and current treatment of this potentially curable disease are discussed.
Amphotericin B - administration & ; dosage ; Child ; Drug Therapy, Combination - administration & ; dosage ; Flucytosine - administration & ; dosage ; Follow-Up Studies ; Meningitis, Cryptococcal - drug therapy ; Papua New Guinea

It is clear that exposure to arthropod-borne viruses is common in the populations of both Papua New Guinea and Irian Jaya. Clinical disease resulting from these infections has been reported although the paucity of case reports and combined clinical experience suggest that it is rare. Dengue epidemics due to dengue-1 and dengue-2 have occurred and it is likely that dengue-3 is also present in the region. No cases of dengue haemorrhagic fever have been described. Murray Valley encephalitis, Ross River and antigenically related viruses are widespread in Papua New Guinea and Irian Jaya, particularly in the lowland and coastal areas. Antibodies to Japanese encephalitis virus have not been found in blood samples from Papua New Guinea or Irian Jaya. As Papua New Guinea is developed, new areas of the country are opened up and ecosystems are altered. It is important that physicians based in Papua New Guinea, and those who deal with patients living or working here, are aware of the arbovirus diseases which occur and the potential and preventable problems posed by them to both the individual and the community.
Alphavirus Infections - epidemiology ; Arboviruses ; Dengue - epidemiology ; Papua New Guinea - epidemiology ; Population Surveillance