This study was conducted in the National Capital District during the months of August, September and October 2000. The study sites were the 3 urban clinics situated in the suburbs of Six Mile, Hohola and Konedobu. The aim of the study was to determine the patients' waiting times and nursing consultation times in the urban clinics. A total of 1075 patients were surveyed, including 264 children under 5 years of age. 58% of patients were males. 24% of patients were able to see a nurse within 30 minutes and 70% within 2 hours. 47% had to wait 1-3 hours to see a consulting nurse and a further 9.5% had to wait 3-5 hours. 67% of nursing consultations were 5 minutes or less, which is too short to interview, examine and prescribe treatment for the patients and to use the Paediatric 10 Steps. The short consultations of 5 minutes or less did not involve children under 5 years of age. There were only one to two nurses seeing the patients when 79% of patients were seen. This explains why the patients' waiting time was long. After consultations many patients (71%) were able to get their treatment within 30 minutes but 28% had to wait from 30 minutes to 2 hours for their treatment. The small number of nurses giving treatment leads to long waiting times. From the time of entry to exit out of the clinic, only 11% of patients spent 30 minutes or less in the clinic while 51% spent between 1 and 3 hours. The patients' waiting times and the short nursing consultation times are directly related to the insufficient number of nursing officers working in the clinics.
nursing therapy ; Hour ; waiting time ; therapeutic aspects ; seconds

This is a cross-sectional study conducted intermittently in Port Moresby, the National Capital District of Papua New Guinea, from 1996 to 1997; Mt Obree in Central Province in October 2000; Upper Strickland River in April 2001; and the Balopa Islands in Manus Province in December 2002. The aim of the study was to determine the prevalence of high blood pressure and identify possible risk factors for hypertension in the 'healthy' population in Port Moresby and the three rural communities. There were 1491 subjects surveyed, 704 males and 787 females. Their ages ranged from 20 to 84 years. Just over 6% of subjects were aged 65 years and above. There were 205 (14%) smokers and 340 (23%) betelnut chewers. The Central (rural) subjects were generally younger with the lowest mean systolic and diastolic blood pressures and lowest body mass index (BMI) in both males and females (no overweight or obesity). In Central and Strickland the mean systolic (SBP) and diastolic (DBP) blood pressures were lower and remained the same in all age groups, then in females decreased with age after 55 years. The Manus (rural) subjects were older with higher mean systolic and diastolic blood pressures and higher mean BMI, surprisingly similar to the urban population of Port Moresby. The mean systolic blood pressures in Port Moresby and Manus increased with age in both sexes, while the mean diastolic pressure remained the same in all age groups in females and decreased after the age of 50 years. The prevalence of systolic hypertension among men and women was higher in Manus than in urban Port Moresby and, among the female subjects, Manus had the highest at 31%, while Central recorded the lowest for both males and females. The mean systolic blood pressures of betelnut chewers in Port Moresby, Manus and Central were lower (by 1-9 mmHg) but higher--in males only--in Strickland. The mean diastolic blood pressures of betelnut chewers were lower in all study sites. Both high BMI (overweight and obesity) and older age were significantly associated with high systolic blood pressure but betelnut chewing was significantly associated with lower mean SBP (p < 0.001), a protective effect against systolic hypertension.
seconds ; Blood Pressure ; Mores ; Port - alcoholic beverage ; Hand

This is a cross-sectional study conducted in Port Moresby and 3 rural areas of Papua New Guinea from 1999 to 2002. These areas were selected because of their specific characteristics such as modernity, geographical location and remoteness. The aim of the study was to compare the body mass index (BMI) of selected urban and rural populations. When age was standardized, in urban and periurban populations, the mean BMI increased with age to about 40 years, plateaued and then decreased in older age. The BMI was higher in Port Moresby than in the other study areas: many people in Port Moresby were overweight (40%) and obese (21%), and by gender, 26% of females and 16% of males were obese. In Manus, the prevalence of overweight and obesity was 36% and 18% respectively. In both Port Moresby and Manus, more women than men were obese. Obesity was not a problem in rural areas of Strickland and Central Province. In rural Central Province 52% of subjects had a BMI < 20 kg/m2. Obesity is becoming a public health problem in the urban areas. The high prevalence of overweight and obesity corresponds with the high intake of refined carbohydrates and fatty foods in urban and periurban areas. It will be necessary to carry out health awareness and education on the risk factors associated with obesity in the urban and periurban areas and promote healthy environments: healthy foods should be available and affordable, and the accessibility and safety of exercise and walking tracks must be supported by the community and government agencies.
Obesity ; Body Mass Index ; seconds ; Papua New Guinea ; Mores

The aim of this study was to assess the rate of seatbelt use by drivers and front-seat passengers in Port Moresby, 12 years after the seatbelt legislation in 1993. Before the legislation, the rate of seatbelt usage was only 13.3% for drivers and 11.4% for front-seat passengers. Use of seatbelts was assessed by observers at the main city roundabout. 50% of male drivers, 78% of female drivers, 49% of Papua New Guinean drivers and 69% of expatriate drivers wore seatbelts. Among the young drivers (teenagers aged < 20 years) 55% wore seatbelts. Of the front-seat passengers, 37% of males and 58% of females wore seatbelts. Female drivers and female front-seat passengers were more likely to wear seatbelts than males (OR 2.55 [95% CI 1.53-4.23] and 2.34 [95% CI 1.32-4.14]). The front-seat passengers were more likely to be wearing seatbelts if the drivers wore theirs (OR 2.70 [95% CI 1.60-4.55]). Proportionately more drivers and front-seat passengers were wearing seatbelts than during the pre-legislation period, but more seatbelt education and awareness is needed because of the increasing number of road traffic accidents in Papua New Guinea.
seconds ; Passenger ; legislative ; Papua New Guinea ; Mores

This descriptive study was conducted in the Diabetes Clinic of the Port Moresby General Hospital for 6 months, from July to December 2002. The aim was to document the usage and effects of betelnut chewing in diabetic patients. 210 patients were randomly selected from the list of patients in the appointment book, using a random number table. Betelnut chewing caused hyperglycaemia and diabetes mellitus in animal models. It was significantly associated with high fasting capillary blood glucose and was an independent risk factor for type 2 diabetes mellitus. In this study, the majority of patients with diabetes were in the older age group (> or = 45 years) and many of them were overweight or obese. The majority of patients had lived in the city of Port Moresby for many years before their diagnosis. 74% of diabetic patients chewed betelnut before their diagnosis and had continued the habit while undergoing treatment for diabetes. The majority (80%) of patients had poor glycaemic control as indicated by the high mean of their most recent blood glucose, which was 13.0 mmol/l in male and 13.1 mmol/l in female patients; these levels were not much lower than those at diagnosis. The mean follow-up of patients in the clinic was 6.2 years. On the balance of evidence, betelnut is a contributing factor to the poor glycaemic control in diabetic patients attending Port Moresby General Hospital.
Mores ; Port - alcoholic beverage ; Financially poor ; control ; Mastication

Documentation in the past has shown that measles outbreaks occurred in the National Capital District every 3-4 years, with the last outbreak in 1997. In 2001 another outbreak of measles occurred in the National Capital District. A total of 492 cases of measles were recorded during the 6 months (April-September) of a study conducted at the Children's Outpatients Department and the Paediatric Ward of the Port Moresby General Hospital (PMGH). The highest number was recorded in July. 44% of patients were infants less than 12 months of age. 9% of children with measles were under 6 months, the recommended age for vaccination. Only 35% of the children with measles had had their first inoculation and only 11% had received their second inoculation of measles vaccine. During this epidemic, 14.5% of the total attendance of 38,323 children received measles vaccine in the children's outpatients. 72% of children seen with measles at PMGH were admitted to the paediatric ward. Most were admitted because of complications, including severe pneumonia and/or diarrhoea. There were 19 deaths recorded during the 6 months study, a case fatality rate of 4%.
Measles ; Child ; month ; Capital ; seconds

From July 1987 to May 1990, a total of 13 simultaneous bilateral percutaneous nephrolithotripsies (PCNL) were performed in two medical institutions for bilateral proximal ureteral stones, bilateral pelvolithiasis and nephrolithiasis, and bilateral staghorn calculi. No major complications occurred. It appears that simultaneous bilateral PCNL has several advantages including reasonable operative time, safety of the procedure and cost effectiveness. Greater applications of this procedures is encouraged. (Author)

Malaria is endemic across lowland Papua New Guinea (PNG) and case management has been based on symptomatic diagnosis and presumptive treatment of fever cases with an antimalarial. This study aimed to investigate the prevalence of malaria infection among fever cases presenting to 5 purposely selected sentinel health facilities in order to estimate the proportion of patients requiring antimalarial drugs. A total of 1807 fever patients were screened. Overall, 45% of fever patients had a positive malaria blood slide; 35% were infected with Plasmodium falciparum, 9% with P. vivax and 2% with P. malariae. Slide positivity was highest in Dreikikir (75%) and lowest in Wipim (2%). Among patients aged 1-4 years, 22% had moderate to severe anaemia (Hb < 8 g/dI) and 21% of children 2-9 years of age showed signs of splenomegaly (Hackett score 1-5). Comorbidity differed significantly between study sites and was not closely correlated with malaria infection. Clinical diagnosis by health facility staff was malaria for 67% of all fever cases, including 89% of slide-positive and 48% of slide-negative patients. 70% of rapid diagnostic test-negative cases were treated with an antimalarial. It is estimated that due to the lack of parasitological diagnosis the selected health facilities reported an excess of 18% (Dreikikir) to 98% (Wipim) malaria patients on average each month. In consideration of the significant differences in malaria-attributable fevers between study sites, the implementation of parasitological diagnosis in health facilities and administration of antimalarials only to test-positive patients has the potential to significantly improve the management of fever cases and reporting of malaria. A better tailoring to different settings may increase the effectiveness of malaria control interventions.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Fever/*parasitology ; Humans ; Infant ; Malaria/complications/diagnosis/*epidemiology ; Male ; Papua New Guinea/epidemiology ; Young Adult

Brain ; blood supply ; diagnostic imaging ; Brain Ischemia ; blood ; diagnosis ; diagnostic imaging ; Combined Modality Therapy ; methods ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; Stroke ; drug therapy ; physiopathology ; Tomography, X-Ray Computed

Cerebrovascular Circulation ; drug effects ; Computer Systems ; Fibrinolytic Agents ; administration & dosage ; pharmacology ; Humans ; Infarction, Middle Cerebral Artery ; drug therapy ; physiopathology ; Infusions, Intravenous ; Male ; Middle Aged ; Regional Blood Flow ; drug effects ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; administration & dosage ; pharmacology