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Would people with a disability in the highlands benefit from a community-based rehabilitation program?

Papua New Guinea medical journal.1993;36(4):316-319.

Community-based rehabilitation for those people with a physical disability is a policy promoted by the World Health Organization. In order to assess whether such a program might be useful to the disabled people of the highlands of Papua New Guinea a survey was conducted which first identified those people with a severe physical disability and then investigated the degree that they were handicapped in terms of their social and physical environment. The survey was performed in the Tari area of the Southern Highlands Province in conjunction with the Papua New Guinea Institute of Medical Research (PNGIMR). By using the PNGIMR demographic surveillance system it was possible to calculate a prevalence level of physical disability (including walking disability, deafness and blindness) of 46 per 10,000 (0.46%). A significant physical disability was identified in 114 people, of whom 54 were given personal interviews to establish their quality of life. The survey found the social and economic situation of disabled people to be generally good although there is a lack of basic material aids for handicapped people. The disabled people and their families do not need extra knowledge about how to care for their disabilities and a formal community-based rehabilitation program would be inappropriate, but they would find mobility aids such as wheelchairs and artificial limbs of enormous help. The regular health care services are widely used although both people with a disability and health service staff are not always aware of the types of treatment which can usefully be provided.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent ; Adult ; Aged ; Altitude ; Attitude to Health ; Child ; Child, Preschool ; Community Health Services ; organization & administration ; utilization ; Disabled Persons ; rehabilitation ; statistics & numerical data ; Female ; Health Priorities ; Health Services Needs and Demand ; Health Services Research ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Papua New Guinea ; epidemiology ; Residence Characteristics ; Self-Help Devices ; supply & distribution ; Socioeconomic Factors

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Congenital heart disease in Papu New Guinean children.

P De BUSE

Papua New Guinea medical journal.1974;17(3):278-281.

Dextrocardia ; epidemiology ; Ductus Arteriosus, Patent ; epidemiology ; Female ; Heart Defects, Congenital ; epidemiology ; Heart Septal Defects, Ventricular ; epidemiology ; Humans ; Infant ; Male ; New Guinea

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Drug-induced neuro-psychiatric disorders in medical practice--an overview.

F Y Attah JOHNSON

Papua New Guinea medical journal.1989;32(3):219-224.

Whenever an unexpected neuropsychiatric disorder arises suddenly in a person of good previous mental health after a new drug of any kind has been taken it is reasonable to suspect a drug-induced reaction. The suspected medication should then be stopped. Adverse reactions to drugs are known to account for a considerable amount of neuro-psychiatric disorder, which is likely to increase as new and more potent drugs are introduced into clinical practice.
Humans ; Psychoses, Substance-Induced ; classification

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Management of childhood haematogenous osteomyelitis in a rural Papua New Guinean hospital.

G Van GURP ; R KILA ; T HUTCHINSON

Papua New Guinea medical journal.1989;32(2):117-122.

Haematogenous osteomyelitis, especially in its more common chronic stage, is an important cause of morbidity in children in the Southern Highlands Province. Hospital stays are lengthy and the incidence of fractures is high. While awaiting, or in the absence of, culture and sensitivity results, cloxacillin 200 mg/kg/day plus probenecid 40 mg/kg/day is an appropriate first choice antibiotic when it is available. Antibiotic therapy in chronic disease should be limited to the specific settings of associated soft tissue infection; pre- and post-sequestrectomy; and radiological signs of ongoing bone necrosis and systemic signs of active infection. Surgical drainage of subperiosteal pus and possibly the medullary canal is required in all but the very early (less than 48 hours) cases of acute osteomyelitis that sometimes respond to antibiotics alone. Sequestrectomy should be reserved for cases where a sequestrum and adequate involucrum can be seen on X-ray. Effective management of this disease is possible only if ongoing communication exists between hospital-based medical staff and the staff of health centres or subcentres, including the network of aid post orderlies and their supervisors. Since the majority of patients present to facilities other than hospitals, any campaign directed at improving management must involve co-workers in rural areas, namely the health extension officer, nurse and aid post orderly. Only in this way can we hope to achieve earlier appropriate treatment and more systematic long-term follow-up.
Adolescent ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Chronic Disease ; Hospitals, Rural ; Humans ; Osteomyelitis ; drug therapy ; microbiology ; surgery ; Papua New Guinea ; Rural Health

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Some general factors to be considered when implementing a program to control pneumonia.

Alpers MP.

Papua New Guinea medical journal.2010;53(3-4):94-98.

Humans ; Papua New Guinea/epidemiology ; Pneumonia/epidemiology/*prevention & control ; *Public Health ; Public Policy ; Risk Factors

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Nontypeable Haemophilus influenzae and childhood pneumonia.

Cripps AW.

Papua New Guinea medical journal.2010;53(3-4):147-150.

Nontypeable Haemophilus influenzae (NTHi) is a common microbe frequently isolated from the nasopharynx of children. Bacterial pneumonia is a major cause of morbidity and mortality in children less than 5 years of age, with the burden of disease being greatest in developing countries. Determination of the bacterial aetiology of pneumonia is difficult due to sampling constraints. However, with a combination of sampling approaches, trans-thoracic fine-needle aspiration, blood culture and screened sputum, the evidence strongly suggests that NTHi is a significant causative pathogen of pneumonia in young children. However, further studies are required. The development of a new pneumococcal conjugate vaccine containing H. influenzae protein D has the potential to be beneficial against disease caused by NTHi, including pneumonia. With the implementation of this vaccine in many regions of the world where NTHi disease is endemic, it will be critical to introduce surveillance programs wherever it is used.

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Pneumonia in Papua New Guinea, from the past to the future.

Douglas RM.

Papua New Guinea medical journal.2010;53(3-4):99-105.

This paper briefly describes a journey with pneumonia and the pneumococcus that began in partnership with Ian Riley at the Lae Hospital in 1967 and continues 43 years later. It is a journey that signalled the global emergence of penicillin-resistant pneumococci and played an important role in the licensure of pneumococcal polysaccharide vaccine for use in adults around the world. The journey involved many other people whose experience began in Papua New Guinea (PNG), playing lead roles in the global program to reduce pneumonia deaths in developing countries. But none of this has benefitted Papua New Guineans as it could and should have done. In this paper I assert that substantial benefits could now follow from widespread use of the 23-valent polysaccharide vaccine in PNG adults not suffering from HIV and that there is also good scientific reason why children over the age of 9 months should be offered the potential benefits from use of this vaccine that were demonstrated in PNG in the 1980s. Indeed there are very good medical and economic reasons why it should happen.

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Oxygen supplies for hospitals in Papua New Guinea: a comparison of the feasibility and cost-effectiveness of methods for different settings.

Duke T ; Peel D ; Wandi F ; Subhi R ; Sa'avu M ; Matai S.

Papua New Guinea medical journal.2010;53(3-4):126-138.

Oxygen therapy is essential in all wards, emergency departments and operating theatres of hospitals at all levels, and oxygen is life-saving. In Papua New Guinea (PNG), an effective oxygen system that improved the detection and treatment of hypoxaemia in provincial and district hospitals reduced death rates from pneumonia in children by as much as 35%. The methods for providing oxygen in PNG are reviewed. A busy provincial hospital will use on average about 38,000 l of oxygen each day. Over 2 years the cost of this amount of oxygen being provided by cylinders (at least K555,000) or an oxygen generator (about K1 million) is significantly more than the cost of setting up and maintaining a comprehensive system of bedside oxygen concentrators (K223,000). A district hospital will use 17,000 l per day. The full costs of this over 2 years are K33,000 if supplied by bedside concentrators, or K333,000 plus transport costs if the oxygen source is cylinders. In provincial and district hospitals bedside oxygen concentrators will be the most cost-effective, simple and reliable sources of oxygen. In large hospitals where there are existing oxygen pipelines, or in newly designed hospitals, an oxygen generator will be effective but currently much more expensive than bedside concentrators that provide the same volume of oxygen generation. There are options for oxygen concentrator use in hospitals and health centres that do not have reliable power. These include battery storage of power or solar power. While these considerably add to the establishment cost when changing from cylinders to concentrators, a battery-powered system should repay its capital costs in less than one year, though this has not yet been proven in the field. Bedside oxygen concentrators are currently the 'best-buy' in supplying oxygen in most hospitals in PNG, where cylinder oxygen is the largest single item in their drug budget. Oxygen concentrators should not be seen as an expensive intervention that has to rely on donor support, but as a cost-saving intervention for all hospitals.

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A review of cancer in Papua New Guinea.

Crouch-Chivers PR.

Papua New Guinea medical journal.2010;53(1-2):48-53.

Humans ; Neoplasms/*epidemiology/pathology/therapy ; Papua New Guinea/epidemiology

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Vitamin A status of pre-school-age children aged 6 to 59 months in the National Capital District, Papua New Guinea.

Temple VJ ; Kaira C ; Vince JD ; Kevau IH ; Willie N.

Papua New Guinea medical journal.2011;54(1-2):4-16.

Assessing the vitamin A status among pre-school-age children is essential for evaluating the magnitude and public health status of vitamin A deficiency in a population. This cross-sectional study assessed the vitamin A status of children aged 6 to 59 months resident in the National Capital District (NCD), Papua New Guinea. Children attending the Children's Outpatient Clinic at Port Moresby General Hospital participated in this study. Informed consent was obtained from parents before using blood samples from their children. Assay of plasma retinol was carried out using the 'Clin-Rep' complete kit for assay of vitamins A and E in plasma by high performance liquid chromatography (HPLC). A commercial enzyme immunoassay kit was used to assay C-reactive protein (CRP) in plasma. Of the 132 children in the study 108 (82%) had received vitamin A capsules. The median plasma retinol concentration of the 132 children was 0.98 micromol/l and the interquartile range 0.65-1.38 micromol/l. Of the 132 children, 35 (27%) had a plasma retinol concentration below 0.70 micromol/l. 75 children (57%) had normal plasma CRP levels and in 57 (43%) the CRP levels were elevated. The median plasma retinol concentration of the children with normal plasma CRP was 1.19 micromol/l and the interquartile range 0.93-1.50 micromol/l. The prevalence of vitamin A deficiency (VAD) in the children with normal plasma CRP was 11%, indicating a moderate public health problem. 74 (56%) males and 58 (44%) females were included in the study. The prevalence of VAD in the male and female children with normal plasma CRP was 14% and 8%, respectively, indicating a moderate public health problem among the male children and a mild public health problem among the female children. The prevalence of subclinical (mild to moderate) and marginal VAD among the children with and without elevated CRP strongly suggests the need for continuous monitoring of the vitamin A status of the vulnerable groups in NCD.
C-Reactive Protein/analysis ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Male ; Papua New Guinea/epidemiology ; Prevalence ; Vitamin A/*blood ; Vitamin A Deficiency/*epidemiology

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