Maternal mortality remains exceptionally high in Papua New Guinea (PNG) at 733 per 100,000 live births. There has been little, if any, improvement in maternal mortality or maternity services since the 1980s. In 1992-1993 a survey of 550 women in rural coastal areas of Madang Province was undertaken to investigate the prevalence of maternal risk factors and parous women's utilization of and attitudes towards the existing health services. Women were classified as at risk on the basis of previous obstetric complications, parity, stillbirths and neonatal deaths. On this basis 67% of women were classified as being at risk in a future pregnancy. High rates of obstetric complications were reported, with only 42% of women delivering their most recent child in a health facility. There was no statistical difference between those not at risk and those at risk in terms of their use of antenatal care or having been referred for a health centre delivery. The most common reason given for not utilizing the existing health services was lack of access. Most commonly expressed positive perceptions of a health centre delivery were the availability of medical help (59%) and the physical comfort of the health centre (48%). Most common negative views expressed were lack of physical comfort (29%) and the attitudes of staff (11%). Women's opinion on village births was divided. Many (47%) thought that there was nothing good about a village birth and the same percentage cited lack of medical care if problems arose. On the other hand 36% of women thought there was nothing wrong with a village delivery, and 30% cited the care and respect received from relatives as a positive aspect. When asked for suggestions on how services could be improved only a minority of respondents expressed an opinion. Those who did wanted better access, more information on family planning and improved care and respect from staff.

The prevalence of typhoid in the Papua New Guinea (PNG) highlands region increased rapidly in the mid-1980s, and now remains endemic. In this study ribotyping has been used to examine the number and types of Salmonella enterica serovar Typhi strains present during the 1977-1996 period. The ribotyping banding pattern results were based on Cla I and Eco RV digests. The 57 PNG isolates were divided into 11 different ribotypes. Comparison of ribotypes using coefficient of similarity values revealed a diverse group of ribotypes. Several strains appear to be endemic in PNG For instance, ribotypes 1, 2 and 3 were most commonly found among PNG isolates and isolates with these ribotypes have been cultured over a period of at least 11 years (1985-1996). Ribotype 3 was also observed in isolates from Malaysia and Thailand. Also found in PNG were ribotypes 4, 5, 6, 7, 8, 9, 16 and 17. The ribotyping suggests that serovar Typhi strains present in PNG include unique strains of serovar Typhi and also strains that are common to other countries.
Salmonella enterica ; Papua New Guinea ; Ribotyping ; Ribotype ; 1980s

We have used nested polymerase chain reaction (PCR) and the PCR-based endonuclease digestion method to genotype Chlamydia trachomatis serovars in 460 infected individuals from the Eastern Highlands Province of Papua New Guinea. Our study groups comprised women who presented in labour to the Goroka Base Hospital, their newborn infants, symptomatic children who presented to the hospital's Outpatients Department and men and women from 15 randomly selected villages in the Asaro Valley. In this analysis, the major outer membrane protein (MOMP) gene, omp1, of C. trachomatis was amplified using DNA obtained from the endocervix of women, urine from men, and both the eye and nasopharynx of children. Amplified DNAs were digested concurrently using Alul and a combination of EcoRI, Hinl and Hpall restriction enzymes. The mixtures were separated on electrophoretic gels and the respective serovars designated on the basis of resolved digested DNA patterns. Our results, which were confirmed also by omp1 sequence data, show serovars D, E, F, G, H and L3 to be present in the studied communities. The overall relative frequencies of these serovars were 30%, 21%, 25%, 1%, 20% and 2% respectively, with serovars D, E, F and H accounting for 97% of these infections. Double infections among these principal serovars were also detected in all our study groups but at a low overall frequency of 3%. Serovar D was the major agent involved in the aetiology of chlamydial infection in both children and adults though serovar F was the most frequent in newborn infants. Serovar H was relatively less frequent in symptomatic children. No trachoma-related serovars were detected, confirming the rarity of this disease in Papua New Guinea. In contrast, although clinical cases of lymphogranuloma venereum have not been described in the country, the detection of serovar L3 in this study suggests that it may occur. However, the association of L3 also with childhood infection indicates that it may be causing the same pathology as the serovars D-K that are associated with non-ulcerative sexually transmitted infections.
Upper case dee ; Papua New Guinea ; Child ; upper case aitch ; Upper case eff

Objective: Ongoing transmission of tuberculosis (TB) continues in Indigenous communities in New South Wales (NSW), Australia. In a pilot project, a Public Health Unit TB team partnered with an Aboriginal Community Controlled Health Service (ACCHS) in a community with a cluster of TB to augment screening for latent TB infection (LTBI) using interferon-gamma release assay (IGRA). This study examined screening data and programme outcomes at 12 months post hoc to advise practice and policy formulation. Methods: We conducted a retrospective, cross-sectional analysis of demographic and clinical data of ACCHS patients, stratified by IGRA testing status. Differences in sex and age distribution between the groups and cases of a genetically and epidemiologically linked TB cluster in Aboriginal people in NSW were assessed using non-parametric tests. Results: Of 2019 Aboriginal and Torres Strait Islander people seen by general practitioners during the study period, 135 (6.7%) participated in the screening. Twenty-four (17.8%) participants were IGRA positive. One person was diagnosed with active TB. Twelve participants received a chest X-ray at the time of the positive test, and six participants had an additional chest X-ray within 12 months. None commenced preventive treatment for LTBI. Discussion ACCHS screening for LTBI reached individuals in the age group most commonly affected by TB in these Aboriginal communities. No conclusions can be made regarding the population prevalence due to the low screening rate. Further strategies need to be developed to increase appropriate follow-up and preventive treatment.