scholarly journals Strengthening routine immunization in Papua New Guinea: a cross-sectional provincial assessment of front-line services

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christopher J. Morgan ◽  
Olga P. M. Saweri ◽  
Nicholas Larme ◽  
Elizabeth Peach ◽  
Pele Melepia ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
New Guinea ◽  
Routine Immunization ◽  
Front Line ◽  
Cross Sectional

scholarly journals Strengthening routine immunization in Papua New Guinea: implications for post-polio renewal from a cross-sectional provincial assessment of front-line services

2019 ◽  
Author(s):  
Christopher Morgan ◽  
Olga PM Saweri ◽  
Nicholas Larme ◽  
Elizabeth Peach ◽  
Pele Melepia ◽  
...  
Keyword(s):  
Health Services ◽  
Papua New Guinea ◽  
New Guinea ◽  
Population Characteristics ◽  
Routine Immunization ◽  
World Health ◽  
National Strategy ◽  
Cross Sectional ◽  
Immunization Service ◽  
World Health Organization Quality

Abstract Background Routine immunization programs face challenges in settings such as Papua New Guinea: dispersed rural populations, rugged geography, and limited resources for transport and health. Low routine coverage contributes to outbreaks such as measles and the polio that re-appeared in 2018. Diversion of resources to the necessary emergency response can risk further weakening of the routine system. We report on an in-depth local assessment that documented immunization service provision so as to review new national strategy, and consider how emergency polio responses could simultaneously strengthen routine immunization. Methods In East New Britain Province, over 2016 and 17, we carried out a cross-sectional assessment of 12 rural health facilities, staff and clients. The study was timed to follow implementation of a new national strategy for strengthening routine immunization. We used interview, structured observation, and records review, informed by theory-based evaluation, a World Health Organization quality checklist, and other health services research tools. Results We documented strengths and weaknesses across six categories of program performance relevant to national immunization strategy and global standards. We found a functional immunization service with an operational level of staff, equipment and procedures in place; but one that could reach only half to two thirds of its target population. Stronger routine services require improvement in: understanding of population catchments, tracking the unvaccinated, reach and efficiency of outreach visits, staff knowledge of vaccination at birth and beyond the first year of life, handling of multi-dose vials, and engagement of community members. Many local suggestions to enhance national plans, including more reliable on-demand services, integration of other family health services and increased involvement of men. Conclusions The national strategy addresses most local gaps, but implementation and resourcing was insufficient. Emergency polio campaigns could support a stronger routine program by building local planning capacity, identifying new outreach sites, sharing intelligence on local population characteristics, integrating high-demand services and other vaccines, distributing educational materials, and modelling better involvement of trained lay health workers. Long-term strengthening requires a major increase in centrally-allocated resources, however there are immediate locally feasible steps within current resources that could boost coverage and quality of routine immunization.

scholarly journals Strengthening routine immunization in Papua New Guinea: a cross-sectional provincial assessment of front-line services.

2019 ◽  
Author(s):  
Christopher Morgan ◽  
Olga PM Saweri ◽  
Nicholas Larme ◽  
Elizabeth Peach ◽  
Pele Melepia ◽  
...  
Keyword(s):  
Health Services ◽  
Papua New Guinea ◽  
New Guinea ◽  
Routine Immunization ◽  
World Health ◽  
National Strategy ◽  
Services Research ◽  
Cross Sectional ◽  
Immunization Service ◽  
World Health Organization Quality

Abstract Background Routine immunization programs face many challenges in settings such as Papua New Guinea with dispersed rural populations, rugged geography and limited resources for transport and health. Low routine coverage contributes to disease outbreaks such as measles and the polio that re-appeared in 2018. We report on an in-depth local assessment that aimed to document immunization service provision so as to review a new national strategy, and consider how routine immunization could be better strengthened.Methods In East New Britain Province, over 2016 and 17, we carried out a cross-sectional assessment of 12 rural health facilities, staff and clients. The study was timed to follow implementation of a new national strategy for strengthening routine immunization. We used interview, structured observation, and records review, informed by theory-based evaluation, a World Health Organization quality checklist, and other health services research tools.Results We documented strengths and weaknesses across six categories of program performance relevant to national immunization strategy and global standards. We found an immunization service with an operational level of staff, equipment and procedures in place; but one that could reach only half to two thirds of its target population. Stronger routine services require improvement in: understanding of population catchments, tracking the unvaccinated, reach and efficiency of outreach visits, staff knowledge of vaccination at birth and beyond the first year of life, handling of multi-dose vials, and engagement of community members. Many local suggestions to enhance national plans, including more reliable on-demand services, integration of other family health services and increased involvement of men.Conclusions The national strategy addresses most local gaps, but implementation and resourcing requires greater commitment. Long-term strengthening requires a major increase in centrally-allocated resources, however there are immediate locally feasible steps within current resources that could boost coverage and quality of routine immunization especially through better population-based local planning, and stronger community engagement. Our results also suggest areas where vaccination campaigns in PNG can contribute to routine immunization services.

scholarly journals Increase in the proportion of Plasmodium falciparum with kelch13 C580Y mutation and decline in pfcrt and pfmdr1 mutant alleles in Papua New Guinea

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoko Yoshida ◽  
Masato Yamauchi ◽  
Ryosuke Morikawa ◽  
Francis Hombhanje ◽  
Toshihiro Mita
Keyword(s):  
Plasmodium Falciparum ◽  
Papua New Guinea ◽  
New Guinea ◽  
Therapeutic Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
In The Wild ◽  
Nationwide Surveillance ◽  
Greater Mekong Subregion ◽  
C580y Mutation

Abstract Background The C580Y mutation in the Plasmodium falciparum kelch13 gene is the most commonly observed variant in artemisinin-resistant isolates in the Greater Mekong Subregion (GMS). Until 2017, it had not been identified outside the GMS, except for Guyana/Amazonia. In 2017, three parasites carrying the C580Y mutation were identified in Papua New Guinea (PNG). As the C580Y allele rapidly spread in the GMS, there is concern that this mutant is now spreading in PNG. Methods In 2020, a cross-sectional survey was conducted at two clinics in Wewak, PNG. Symptomatic patients infected with P. falciparum were treated with artemether plus lumefantrine following a national treatment policy. Blood samples were obtained before treatment, and polymorphisms in kelch13, pfcrt, and pfmdr1 were determined. Parasite positivity was examined on day 3. The results were compared with those of previous studies conducted in 2002, 2003, and 2016–2018. Results A total of 94 patients were included in this analysis. The proportion of C580Y was significantly increased (2.2% in 2017, 5.7% in 2018, and 6.4% in 2020; p = 4.2 × 10–3). A significant upward trend was observed in the wild-type proportion for pfcrt (1.9% in 2016 to 46.7% in 2020; p = 8.9 × 10–16) and pfmdr1 (59.5% in 2016 to 91.4% in 2020; p = 2.3 × 10–6). Among 27 patients successfully followed on day 3, including three with C580Y infections, none showed positive parasitaemia. Conclusions Under the conditions of significant increases in pfcrt K76 and pfmdr1 N86 alleles in PNG, the increase in kelch13 C580Y mutants may be a warning indicator of the emergence of parasites resistant to the currently used first-line treatment regimen of artemether plus lumefantrine. Therefore, nationwide surveillance of molecular markers for drug resistance and assessment of its therapeutic effects are important.

Rapid assessment of avoidable blindness in Papua New Guinea: a nationwide survey

2018 ◽  
Vol 103 (3) ◽  
pp. 338-342 ◽  
Author(s):  
Ling Lee ◽  
Fabrizio D'Esposito ◽  
Jambi Garap ◽  
Geoffrey Wabulembo ◽  
Samuel Peter Koim ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
Refractive Error ◽  
Rapid Assessment ◽  
New Guinea ◽  
Nationwide Survey ◽  
Population Based ◽  
Vision Impairment ◽  
Cross Sectional ◽  
National Capital ◽  
Uncorrected Refractive Error

ObjectiveTo estimate the prevalence and main causes of blindness and vision impairment in people aged 50 years and older in Papua New Guinea (PNG).DesignNational cross-sectional population-based survey in National Capital District (NCD), Highlands, Coastal and Islands regions.MethodsAdults aged 50 years and above were recruited from 100 randomly selected clusters. Each participant underwent monocular presenting and pinhole visual acuity (VA) assessment and lens examination. Those with pinhole VA<6/12 in either eye had a dilated fundus examination to determine the primary cause of reduced vision. Those with obvious lens opacity were interviewed on barriers to cataract surgery.ResultsA total of 4818 adults were examined. The age-adjusted and sex-adjusted prevalence of blindness (VA <3/60), severe vision impairment (SVI, VA <6/60 but ≥3/60), moderate vision impairment (MVI, VA <6/18 but ≥6/60) and early vision impairment (EVI, VA <6/12 but ≥6/18) was 5.6% (95% CI 4.9% to 6.3%), 2.9% (95% CI 2.5% to 3.4%), 10.9% (95% CI 9.9% to 11.9%) and 7.3% (95% CI 6.6% to 8.0%), respectively. The main cause of blindness, SVI and MVI was cataract, while uncorrected refractive error was the main cause of EVI. A significantly higher prevalence of blindness, SVI and MVI occurred in the Highlands compared with NCD. Across all regions, women had lower cataract surgical coverage and spectacle coverage than men.ConclusionsPNG has one of the highest reported prevalence of blindness globally. Cataract and uncorrected refractive error are the main causes, suggesting a need for increased accessible services with improved resources and advocacy for enhancing eye health literacy.

scholarly journals Women's knowledge of maternal danger signs during pregnancy: Findings from a cross-sectional survey in Papua New Guinea

Midwifery ◽  
2019 ◽  
Vol 72 ◽  
pp. 7-13 ◽  
Author(s):  
LM Vallely ◽  
R Emori ◽  
H Gouda ◽  
S Phuanukoonnon ◽  
CSE Homer ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
New Guinea ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Danger Signs ◽  
Women's Knowledge ◽  
Women’S Knowledge

scholarly journals Socio-economic status and behavioural and cardiovascular risk factors in Papua New Guinea: A cross-sectional survey

PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0211068 ◽  
Author(s):  
Patricia Rarau ◽  
Justin Pulford ◽  
Hebe Gouda ◽  
Suparat Phuanukoonon ◽  
Chris Bullen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Papua New Guinea ◽  
Economic Status ◽  
New Guinea ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Socio Economic Status

Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross-sectional survey

Sexual Health ◽  
2016 ◽  
Vol 13 (5) ◽  
pp. 420 ◽  
Author(s):  
Lisa M. Vallely ◽  
Pamela Toliman ◽  
Claire Ryan ◽  
Glennis Rai ◽  
Johanna Wapling ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Pregnant Women ◽  
Papua New Guinea ◽  
Trichomonas Vaginalis ◽  
New Guinea ◽  
Antenatal Clinic ◽  
Asia Pacific ◽  
Cross Sectional ◽  
Sexually Transmissible Infections

Background Papua New Guinea (PNG) is estimated to have among the highest prevalences of HIV and sexually transmissible infections (STIs) of any Asia-Pacific country, and one of the highest burdens of maternal syphilis globally. The prevalence of curable STIs, such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), among pregnant women in PNG is relatively unknown. Methods: A cross-sectional bio-behavioural survey to investigate the epidemiology of CT, NG, TV and other STIs among pregnant women in three provinces of PNG was undertaken. Women aged 18–35 years attending their first antenatal clinic visit were invited to participate. Participants completed a short interview and provided self-collected vaginal specimens for CT, NG and TV laboratory-based nucleic acid amplification tests and a venepuncture specimen for laboratory testing for syphilis and Herpes simplex virus type-2 (HSV-2) serology. Routine antenatal assessment was conducted according to national guidelines, including HIV counselling and testing and point-of-care syphilis screening. Results: A total of 765 women were enrolled. Overall, 43% (95% confidence interval (CI): 39.2–46.4) had one or more of CT, NG or TV infection. CT was the most prevalent STI (22.9%, 175/765; 95% CI: 19.9–25.9), followed by TV (22.4%, 171/765; 95% CI: 19.4–25.4), and NG (14.2%, 109/765; 95% CI: 11.7–16.7). The prevalence of active syphilis was 2.2% (17/765; 95% CI: 1.2–3.3), HSV-2 was 28.0% (214/765; 95% CI: 24.8–31.2) and HIV, 0.8% (6/765; 95% CI: 0.2–1.4). Prevalences were highest among primigravid women, women aged <25 years, and among those in Central Province. Conclusion: High prevalences of curable genital STIs were observed among women attending routine antenatal clinic services in PNG. These infections have been associated with adverse pregnancy outcomes and could be important contributors to poor maternal and neonatal health in this setting.

scholarly journals Reducing the burden of sexually transmissible infections in Papua New Guinea requires strengthening of clinical services and engaging men

Sexual Health ◽  
2016 ◽  
Vol 13 (5) ◽  
pp. 401
Author(s):  
Jane S. Hocking ◽  
Cathy Vaughan ◽  
Andrew Lau ◽  
Dorothy A. Machalek ◽  
Simon Graham
Keyword(s):  
Papua New Guinea ◽  
New Guinea ◽  
Antenatal Visit ◽  
Clinical Services ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Sexually Transmissible Infections ◽  
High Prevalence ◽  
Prevalence Estimates ◽  
Engaging Men

In this edition of Sexual Health, Vallely et al. report the results of a cross-sectional prevalence survey of sexually transmissible infections (STIs) among women attending their first antenatal visit in three provinces of Papua New Guinea (PNG). This Editorial examines potential reasons for these high prevalence estimates and discusses strategies for addressing high STIs rates in PNG.

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