When cholera was first detected in Papua New Guinea (PNG) in mid-2009, national diagnostic capacity faced many challenges. This was in part due to the non-endemic status of the outbreak, resulting in few local staff experienced in Vibrio cholerae detection and poor access to the required consumables. The PNG Institute of Medical Research conducted culture on specimens from suspected cholera patients in Madang Province, with presumptive V. cholerae isolates sent to Goroka for confirmation. Of 98 samples analysed 15 were culture positive, with V. cholerae detected by polymerase chain reaction (PCR) in an additional 3 samples. Further analyses were conducted to identify other pathogenic bacteria from thiosulphate citrate bile salt sucrose (TCBS) agar. Molecular-based assays detected enteropathogenic (n = 1) and enterotoxigenic (n = 1) strains of Escherichia coli. No other major enteric pathogens were detected. The low detection rate of V. cholerae at the provincial level reflects challenges in the laboratory diagnosis of cholera and in-country challenges in responding to an outbreak of a non-endemic disease, such as lack of in-country diagnostic expertise and available consumables in the early stages. It also suggests that full aetiological investigations are warranted in future outbreaks of acute watery diarrhoea in PNG to fully elucidate the potentially complex aetiology, which could in turn guide diagnostic, treatment and prevention measures.
Cholera/*epidemiology/*microbiology ; *Disease Outbreaks ; Enterobacteriaceae/isolation & purification ; Feces/microbiology ; Humans ; Immunoassay ; Papua New Guinea/epidemiology ; Polymerase Chain Reaction ; Vibrio cholerae/*isolation & purification

In view of the dearth of information relating to antibiotic resistance in community- and hospital-acquired bacterial infections in Papua New Guinea (PNG), we carried out a prospective, hospital-based observational study of surgical patients between October 2008 and October 2009. In a sample of 115 patients (median age 30 years; 55% males) suspected of having a bloodstream infection, blood cultures were positive in 11 (10%) and a significant pathogen was isolated in 9 (8%). Staphylococcus aureus was isolated in 4 patients (44%) and 3 were methicillin resistant; all these isolates were considered community acquired because cultures were performed within 48 hours of admission. Of the remaining 5 isolates, 4 were Gram-negative organisms with at least intermediate resistance to chloramphenicol that were grown from blood taken > 48 hours post-admission and thus considered nosocomially acquired. These data suggest two distinct patterns of bacterial infection in PNG surgical inpatients that have implications for national antibiotic prescription guidelines.

Background: The presence of COVID-19 has increasingly overwhelmed the Philippine healthcare system, which is affecting the mental and emotional health of healthcare workers in the country. Objective: The study aimed to assess the emotions, stressors, stress-reducing factors, coping mechanisms, and motivational factors of the emergency room (ER) doctors in selected high-risk private hospitals within the National Capital Region (Metro Manila) during the COVID-19 pandemic between March 14, 2020 to November 12, 2020. Methodology: A quantitative, cross-sectional descriptive study was conducted using electronic and/or physical surveys, given to 127 ER doctors in Cardinal Santos Medical Center in San Juan, Makati Medical Center in Makati, and Chinese General Hospital in Manila. Results: Results showed that ER doctors continuously work as it is their professional and ethical duty despite feeling nervous and scared to do so. However, the safety of their colleagues and family increases their stress levels, which were reduced when their family and friends were safe from COVID-19 and when the condition of their colleagues improved. Following strict protocols and chatting with friends and family helped them cope to alleviate stress, and the assurance of adequate personal protective equipment and family support motivated the ER doctors to continue working. Conclusion The COVID-19 pandemic has had an effect on ER doctors, and all involved parties can improve the experiences of ER doctors during any future outbreaks similar to COVID-19 by providing psychosocial interventions.