1.  Title: Attitudes to HIV testing among carers of children admitted to Port Moresby General Hospital, Papua New Guinea. Author: Allison WE; Iobuna V; Kalebe V; Kiromat M; Vince J; Schaefer M; Kaldor J Source: Journal of Paediatrics and Child Health. 2008 Nov;44(11):618-21. Abstract: AIM: To assess the acceptability of voluntary counselling and testing among the carers of children admitted to hospital in Papua New Guinea. METHODS: Forty semistructured interviews were carried out between February and April 2007. RESULTS: All the carers interviewed were women, mostly from Port Moresby. Virtually all of them attended primary school. About half of them attended secondary school but none completed it. Half of them knew an adult or child with HIV. Three quarters of the women interviewed would consent to having a child in their care tested for HIV, and over half of those who had never been tested would agree to be tested themselves. Correct answers to more than half the HIV knowledge questions posed were significantly related to agreement to an HIV test. CONCLUSIONS: This study supports the need for further evaluation of knowledge about HIV/AIDS and opportunities for health promotion in this group of women, particularly in view of the implication for voluntary counselling and testing and prevention of mother-to-child HIV transmission programmes in Papua New Guinea. Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | KAP SURVEYS | HEALTH PERSONNEL | CHILDREN | WOMEN IN DEVELOPMENT | HOSPITALS | STAFF ATTITUDE | VOLUNTARY COUNSELING AND TESTING | CHILD HEALTH SERVICES | Developing Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Health Facilities | Attitudes | Psychological Factors | Behavior | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 330405 |
| 2. Title: Saints and sinners: training Papua New Guinean (PNG) Christian Clergy to respond to HIV and AIDS using a model of care. Author: Benton KW Source: Journal of Religion and Health. 2008 Sep;47(3):314-25. Abstract: Papua New Guinea has experienced a growing HIV/AIDS epidemic. The Christian Churches have played a vital role in responding to HIV, through community support, encouragement and social change. Strong, effective Church leadership can help create safe environments of care and support for those infected and for prevention of HIV. Method A series of trainings in capacity development for clergy were undertaken by the National AIDS Council Secretariat (NACS)/National HIV/AIDS Support Project (NHASP). Results A model "Church's Response to HIV and AIDS in a Care Continuum" was developed to assist the training. This paper discusses the model and the lessons learned. Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | COMMUNITY WORKERS | PERSONS LIVING WITH HIV/AIDS | CHRISTIANITY | RELIGION | INFLUENTIALS | TRAINING ACTIVITIES | DELIVERY OF HEALTH CARE | Developing Countries | Oceania | Health Personnel | Health | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Knowledge Sources | Communication | Training Programs | Education Document Number: 330822 |
| 3. Title: HIV in Papua New Guinea: the need for practical action, and a focus on human resources and health systems for women and children [editorial] Author: Duke T Source: Journal of Paediatrics and Child Health. 2008 Nov;44(11):611-2. Abstract: PNG has been the recipient of a large amount of funding through the Global Fund for HIV, tuberculosis and malaria. Therefore, HIV is both a challenge and an opportunity. This funding must be harnessed to establish effective PPTCT and ART treatment and holistic maternal and child health programmes to help all mothers and children. The Global Fund has provided an administrative position -an HIV coordinator -in each of the four regions. However, there is a pressing need for more midwives and paediatric nurses to be trained and employed to deal with the ever-increasing complexity of delivering maternal and child health services, which now includes HIV. For health education and clinical care, these front-line workers will contribute substantially. This will require investment in schools of nursing, undergraduate and postgraduate midwifery and child health courses, and work towards ensuring the sustainability of such positions within the Health Department structure. Addressing HIV care and prevention in an equitable way will require a focus on health systems and human resources, not just on antiretroviral drugs and HIV education. The lack of support for additional health workers to introduce new programmes is often a major deficiency in globally funded programmes. Global funding must be utilised to improve the prevention and treatment specific for children with HIV, but also to find mechanisms for supplying the practical general interventions that are common to health-care delivery for both HIV positive and negative women and children. PNG is going through a phase of economic improvement. The challenge is to ensure that health, and the health of mothers and children in particular, receives an increased share of the nation's resources. An approach to HIV education based on practical interventions, utilising global funds to improve health systems and increase essential human resources, and increasing the proportion of government funding for women's and children's health will be the path to progress in addressing HIV and improving equity. (excerpt) Language: English Keywords: PAPUA NEW GUINEA | CRITIQUE | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | CHILDREN | HUMAN RESOURCES | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | PROGRAM SUSTAINABILITY | AIDS PREVENTION | SEX EDUCATION | HEALTH EDUCATION | Developing Countries | Oceania | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | HIV | Programs | Organization and Administration | AIDS | Education Document Number: 330391 |
| 4. Peer Reviewed Title: Host erythrocyte polymorphisms and exposure to Plasmodium falciparum in Papua New Guinea. Author: Fowkes FJ; Michon P; Pilling L; Ripley RM; Tavul L Source: Malaria Journal. 2008 Jan 3;7:1. Abstract: The protection afforded by human erythrocyte polymorphisms against the malaria parasite, Plasmodium falciparum, has been proposed to be due to reduced ability of the parasite to invade or develop in erythrocytes. If this were the case, variable levels of parasitaemia and rates of seroconversion to infected-erythrocyte variant surface antigens (VSA) should be seen in different host genotypes. To test this hypothesis, P. falciparum parasitaemia and anti-VSA antibody levels were measured in a cohort of 555 asymptomatic children from an area of intense malaria transmission in Papua New Guinea. Linear mixed models were used to investigate the effect of alpha+-thalassaemia, complement receptor-1 and south-east Asian ovalocytosis, as well as glucose-6-phosphate dehydrogenase deficiency and ABO blood group on parasitaemia and age-specific seroconversion to VSA. No host polymorphism showed a significant association with both parasite prevalence/ density and age-specific seroconversion to VSA. Host erythrocyte polymorphisms commonly found in Papua New Guinea do not effect exposure to blood stage P. falciparum infection. This contrasts with data for sickle cell trait and highlights that the above-mentioned polymorphisms may confer protection against malaria via distinct mechanisms. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | LABORATORY PROCEDURES | MALARIA | ANTIBODIES | PARASITES | EXPOSURE | SEROCONVERSION | AUTOIMMUNE RESPONSE | Developing Countries | Oceania | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Parasitic Diseases | Diseases | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Risk Factors Document Number: 325344 |
| 5. Peer Reviewed Title: Plasmodium vivax and mixed infections are associated with severe malaria in children: A prospective cohort study from Papua New Guinea. Author: Genton B; D’Acremont V; Rare L; Baea K; Reeder JC Source: PLoS Medicine. 2008 Jun;5(6):e127. Abstract: Severe malaria (SM) is classically associated with Plasmodium falciparum infection. Little information is available on the contribution of P. vivax to severe disease. There are some epidemiological indications that P. vivax or mixed infections protect against complications and deaths. A large morbidity surveillance conducted in an area where the four species coexist allowed us to estimate rates of SM among patients infected with one or several species. This was a prospective cohort study conducted within the framework of the Malaria Vaccine Epidemiology and Evaluation Project. All presumptive malaria cases presenting at two rural health facilities over an 8-y period were investigated with history taking, clinical examination, and laboratory assessment. Case definition of SM was based on the World Health Organization (WHO) criteria adapted for the setting (i.e., clinical diagnosis of malaria associated with asexual blood stage parasitaemia and recent history of fits, or coma, or respiratory distress, or anaemia [haemoglobin < 5 g/dl]). Out of 17,201 presumptive malaria cases, 9,537 (55%) had a confirmed Plasmodium parasitaemia. Among those, 6.2% (95% confidence interval [CI] 5.7%-6.8%) fulfilled the case definition of SM, most of them in children < 5 y. In this age group, the proportion of SM was 11.7% (10.4%-13.2%) for P. falciparum, 8.8% (7.1%-10.7%) for P. vivax, and 17.3% (11.7%-24.2%) for mixed P. falciparum and P. vivax infections. P. vivax SM presented more often with respiratory distress than did P. falciparum (60% versus 41%, p = 0.002), but less often with anaemia (19% versus 41%, p = 0.0001). P. vivax monoinfections as well as mixed Plasmodium infections are associated with SM. There is no indication that mixed infections protected against SM. Interventions targeted toward P. falciparum only might be insufficient to eliminate the overall malaria burden, and especially severe disease, in areas where P. falciparum and P. vivax coexist. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | COHORT ANALYSIS | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | PROSPECTIVE STUDIES | CHILDREN | RURAL POPULATION | COMPLICATIONS | MALARIA | INFECTIONS | PREVALENCE | ANEMIA | RESPIRATORY INSUFFICIENCY | CENTRAL NERVOUS SYSTEM EFFECTS | Oceania | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Parasitic Diseases | Measurement | Pulmonary Effects | Physiology | Biology | Central Nervous System Document Number: 327412 |
| 6. Peer Reviewed Title: The usefulness of twenty-four molecular markers in predicting treatment outcome with combination therapy of amodiaquine plus sulphadoxine-pyrimethamine against falciparum malaria in Papua New Guinea. Author: Marfurt J; Muller I; Sie A; Oa O; Reeder JC Source: Malaria Journal. 2008 Apr 19;7:61. Abstract: In Papua New Guinea (PNG), combination therapy with amodiaquine (AQ) or chloroquine (CQ) plus sulphadoxine-pyrimethamine (SP) was introduced as first-line treatment against uncomplicated malaria in 2000. We assessed in vivo treatment failure rates with AQ+SP in two different areas in PNG and twenty-four molecular drug resistance markers of Plasmodium falciparum were characterized in pre-treatment samples. The aim of the study was to investigate the association between infecting genotype and treatment response in order to identify useful predictors of treatment failure with AQ+SP. In 2004, Day-28 treatment failure rates for AQ+SP were 29% in the Karimui and 19% in the South Wosera area, respectively. The strongest independent predictors for treatment failure with AQ+SP were pfmdr1 N86Y (OR=7.87, p less than 0.01) and pfdhps A437G (OR=3.44, p less than 0.01). Mutations found in CQ/AQ related markers pfcrt K76T, A220S, N326D, and I356L did not help to increase the predictive value, the most likely reason being that these mutations reached almost fixed levels. Though mutations in SP related markers pfdhfr S108N and C59R were not associated with treatment failure, they increased the predictive value of pfdhps A437G. The difference in treatment failure rate in the two sites was reflected in the corresponding genetic profile of the parasite populations, with significant differences seen in the allele frequencies of mutant pfmdr1 N86Y, pfmdr1 Y184F, pfcrt A220S, and pfdhps A437G. The study provides evidence for high levels of resistance to the combination regimen of AQ+SP in PNG and indicates which of the many molecular markers analysed are useful for the monitoring of parasite resistance to combinations with AQ+SP. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | LABORATORY PROCEDURES | MALARIA | PARASITES | TREATMENT | DRUG RESISTANCE | Developing Countries | Oceania | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Parasitic Diseases | Diseases | Biology Document Number: 326226 |
| 7. Title: Land use change and population growth in the Morobe Province of Papua New Guinea between 1975 and 2000. Author: Ningal T; Hartemink AE; Bregt AK Source: Journal of Environmental Management. 2008 Apr;87(1):117-124. Abstract: The relation between human population growth and land use change is much debated. Here we present a case study from Papua New Guinea where the population has increased from 2.3 million in 1975 to 5.2 million in 2000. Since 85% of the population relies on subsistence agriculture, population growth affects agricultural land use. We assessed land use change in the Morobe province (33,933km/2) using topographic maps of 1975 and Landsat TM images of 1990 and 2000. Between 1975 and 2000, agricultural land use increased by 58% and population grew by 99%. Most new agricultural land was taken from primary forest and the forest area decreased from 9.8 ha person/-1 in 1975 to 4.4 ha person/-1 in 2000. Total population change and total land use change were strongly correlated. Most of the agricultural land use change occurred on Inceptisols in areas with high rainfall (greater than 2500mm year/-1) on moderate to very steep slopes (10-56%). Agricultural land use changes in logged-over areas were in the vicinity of populated places (villages), and in close proximity to road access. There was considerable variation between the districts but districts with higher population growth also had larger increases in agricultural areas. It is concluded that in the absence of improved farming systems the current trend of increased agriculture with rapid population growth is likely to continue. (author's) Language: English Keywords: PAPUA NEW GUINEA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | LONGITUDINAL STUDIES | POPULATION | POPULATION GROWTH | LAND AND RESOURCE DEVELOPMENT | AGRICULTURE | FORESTS | HUMAN GEOGRAPHY | GEOGRAPHIC FACTORS | AGRICULTURAL DEVELOPMENT | ECOLOGY | ENVIRONMENTAL DEGRADATION | Developing Countries | Oceania | Studies | Research Methodology | Population Dynamics | Demographic Factors | Rural Development | Economic Factors | Macroeconomic Factors | Natural Resources | Environment | Geography | Social Sciences | Science | Sociocultural Factors Document Number: 324752 |
| 8. Title: Neurologic disorders are prevalent in HIV-positive outpatients in the Asia-Pacific region. Author: Wright E; Brew B; Arayawichanont A; Robertson K; Samintharapanya K Source: Neurology. 2008 Jul 1;71(1):50-6. Abstract: BACKGROUND: A total of 8.3 million HIV-positive people live in the Asia-Pacific region. The burden of HIV-associated neurocognitive impairment and symptomatic sensory neuropathy in this region is unknown. METHODS: Between July 2005 and March 2006, we undertook a cross-sectional study at 10 sentinel sites within eight Asia-Pacific countries to determine the prevalence of moderate to severe HIV-related neurocognitive impairment and symptomatic sensory neuropathy. We clinically assessed and administered sensitive neuropsychological and peripheral neuropathy screening tools to 658 patients infected with HIV. Univariate and logistic regression analyses were applied to the data. RESULTS: The results showed that 76 patients (11.7%) (95% CI 9.3-14.2) were significantly neurocognitively impaired, 235 patients (36.4%) (95% CI 32.7-40.2) were depressed, and 126 patients (19.7%) (95% CI 16.6-22.8) had either definite or probable symptomatic sensory neuropathy; 63% of this last group had exposure to stavudine, didanosine, or zalcitabine. Several potential confounders including depression (OR 1.49, 95% CI 0.88-2.51, p = 0.11) and prior CNS AIDS illness (OR 1.28, 95% CI 0.50-2.89, p = 0.54) were not significantly associated with neurocognitive impairment. CONCLUSIONS: A total of 12% of patients had moderate to severe HIV-related neurocognitive impairment, 20% of patients had symptomatic sensory neuropathy, and 36% of patients had evidence of depression. This study provides a broad regional estimate of the burden of HIV-related neurologic disease and depression in the Asia-Pacific region. Language: English Keywords: ASIA | PAPUA NEW GUINEA | FIJI | MALAYSIA | THAILAND | CAMBODIA | INDONESIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | DEPRESSION | NEUROLOGIC EFFECTS | SCREENING | ALCOHOL USE AND ABUSE | Developing Countries | Oceania | Asia, Southeastern | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Mental Disorders | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior Document Number: 328324 |
| 9. Peer Reviewed Title: Demographic risk factors for severe and fatal vivax and falciparum malaria among hospital admissions in northeastern Indonesian Papua. Author: Barcus MJ; Basri H; Picarima H; Manyakori C; Sekartuti Source: American Journal of Tropical Medicine and Hygiene. 2007 Nov;77(5):984-991. Abstract: Between January 1998 and December 2000, the Jayapura Provincial Public Hospital in northeastern Indonesian New Guinea (Papua) admitted 5,936 patients with a diagnosis of malaria. The microscopic diagnosis at admission was Plasmodium falciparum (3,976, 67%), Plasmodium vivax (1,135, 19%), Plasmodium malariae (8, < 1%), and mixed species infections (817, 14%). Approximately 9% (367) of patients were classified as having severe malaria (277 P. falciparum, 36 P. vivax, 53 mixed infections, and 1 P. malariae) and 88 died (79 P. falciparum/mixed infections and 9 P. vivax). Risk of fatal outcomes among severe malaria patients was indistinguishable between those with falciparum versus vivax malaria (OR = 0.89; P = 0.771). Compared with non-pregnant women, pregnant women showed no higher risk of severe malaria (P = 0.643) or death caused by severe malaria (P = 0.748). This study compares admissions per population (based on census data), parasitemia, morbidity, and mortality among children versus adults, pregnant versus non-pregnant women, and urban/suburban versus rural residents. (author's) Language: English Keywords: INDONESIA | PAPUA NEW GUINEA | RESEARCH REPORT | COMPARATIVE STUDIES | URBAN POPULATION | RURAL POPULATION | HOSPITALS | CLIENTS | WOMEN | PREGNANT WOMEN | MALARIA | LABORATORY EXAMINATIONS AND DIAGNOSES | TERTIARY SECTOR | PARASITIC DISEASES | MORBIDITY | CHILD MORTALITY | RISK FACTORS | Developing Countries | Asia, Southeastern | Asia | Oceania | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Facilities | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Macroeconomic Factors | Economic Factors | Mortality | Population Dynamics | Biology Document Number: 321812 |
| 10. Peer Reviewed Title: Dynamics of asymptomatic Plasmodium vivax infections and duffy binding protein polymorphisms in relation to parasitemia levels in Papua New Guinean children. Author: Cole-Tobian JL; Michon P; Dabod E; Mueller I; King CL Source: American Journal of Tropical Medicine and Hygiene. 2007;77(5):955-962. Abstract: The interaction between Plasmodium vivax Duffy binding protein II (PvDBPII) and human erythrocyte Duffy antigen is necessary for blood stage infections. However, PvDBPII is highly polymorphic. We recently observed that certain recombinant DBPII variants bind better to erythrocytes in vitro. To examine the hypothesis that haplotypes with enhanced binding have increased parasitemia levels, we followed 206 Papua New Guinean children biweekly for six months with a total of 713 P. vivax samples genotyped. Twenty-seven PvDBPII haplotypes were identified, and 3 haplotypes accounted for 57% of the infections. The relative frequencies of dominant haplotypes remained stable throughout the study. There was no significant association with PvDBPII alleles or haplotypes with P. vivax parasitemia. The dominant haplotype (26% of samples), however, corresponded to a high-binding haplotype. Thus, common haplotypes are not likely to have arisen from increased fitness as measured by greater parasitemia levels. The restricted number of common haplotypes increases the feasibility of a PvDBPII-based vaccine. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | STATISTICAL STUDIES | CHILD | PRIMARY SCHOOLS | STUDENTS | BLOOD PROTEINS | IN VITRO | PARASITIC DISEASES | IMMUNITY | ANTIMALARIAL DRUGS | MALARIA | DRUG RESISTANCE | LEUKOCYTOSIS | LABORATORY PROCEDURES | Developing Countries | Oceania | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Schools | Education | Hemic System | Physiology | Biology | Clinical Research | Diseases | Immune System | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hematological Effects | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 321810 |
| 11. Title: Warrior women, the Holy Spirit and HIV / AIDS in rural Papua New Guinea. Author: Dundon A Source: Oceania. 2007 Mar;77(1):29-42. Abstract: This article analyses a group of Gogodala Christian women in the Western Province of Papua New Guinea who are referred to as 'Warrior women' and who pray, sing and call upon the Holy Spirit to cleanse their own bodies and 'turn their eyes', so that they are able to see those who threaten the health and well-being of the wider community. These women have focused primarily on bringing male practitioners of magic - iwai dala - shadowy and powerful men who operate covertly and away from the gaze of others, out into the open. Whilst this has been happening for many years, the spread of HIV and AIDS into the area, fuelled by what many in the area believe is the rise of unrestrained female and male sexuality and the waning of Christian practice and principles, has meant that those perceived to bring harm to the community through their sexual behaviour have become recent targets for Warrior women. HIV/AIDS, referred to in Gogodala as melesene bininapa gite tila gi - the ,sickness without medicine' - is understood as a hidden sickness, one that makes its way through the community without trace until people become visibly ill. Warrior women seek to make both AIDS and those who, through their behaviour, encourage or enable its spread more visible. In the process, however, a small number of them are overcome by the Holy Spirit, so much so that they become daeledaelenapa - mad - their behaviour increasingly characterised by childishness and uncontrolled sexuality. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | RURAL AREAS | WOMEN | CHRISTIANITY | TRADITIONAL HEALERS | GENDER ISSUES | HIV PREVENTION | AIDS PREVENTION | TRANSMISSION | CONDOM USE | Developing Countries | Oceania | Geographic Factors | Population | Demographic Factors | Religion | Sociocultural Factors | Traditional Medicine | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | AIDS | Infections | Risk Reduction Behavior | Behavior Document Number: 321198 |
| 12. Title: Epilogue: Homegrown in PNG -- rural responses to HIV and AIDS. Author: Hammar L Source: Oceania. 2007 Mar;77(1):72-94. Abstract: A three-years-long, multi-sited, multi-method study conducted throughout Papua New Guinea by the Institute of Medical Research revealed a staggering prevalence of sexually transmitted disease (STD) that threatens an already fragile political -economy and health services delivery system. Logistics, methodological complexities, and political and especially religious sensitivities hampered conduct of such research. Extremely little HIV social research has been allowed to inform interventions or serosurveillance protocols. Well intended but ill-conceived international initiatives have promoted a normative AIDS paradigm that misconstrues HIV transmission risk, incites greater fear, increases stigma, and promotes anti-condom rhetoric. This collection 'HIV/AIDS in Rural Papua New Guinea' presents a sustained series of ethnographically based accounts of rural responses. In this epilogue I situate the importance of those responses in a discussion of the great divide between the lived realities of HIV infection and AIDS related suffering on the one hand, and the discursive practices and policies of media, public health, international donors and NGOs on the other. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | RURAL AREAS | PREVALENCE | RESPONDENTS | SEXUALLY TRANSMITTED DISEASES | PUBLIC HEALTH | SEXUALITY | GENDER ISSUES | DISEASES | POLICY | Developing Countries | Oceania | Geographic Factors | Population | Measurement | Research Methodology | Surveys | Sampling Studies | Studies | Reproductive Tract Infections | Infections | Health | Personality | Psychological Factors | Behavior | Sociocultural Factors | Political Factors Document Number: 321200 |
13.  Peer Reviewed Title: The demographic impact of the HIV / AIDS epidemic in Papua New Guinea, 1990-2030. Author: Hayes G Source: Asia-Pacific Population Journal. 2007 Dec;22(3):11-30. Abstract: The first case of human immunodeficiency virus (HIV) infection in Papua New Guinea was detected in the capital in 1987. After a relatively short period during which the epidemic was concentrated in certain "high-risk" groups, the disease spread throughout the country and by 2005 had become a "generalized epidemic" - with a 1 per cent HIV prevalence rate among adults aged 15-49. The most recent (2007) estimates suggest that the adult prevalence rate has risen to 1.6 per cent, confirming that the epidemic is continuing to grow rapidly. The scale of the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic in the country has reached the point where future demographic patterns are likely to be affected, possibly severely. Among the demographic impacts to be expected based on the experience of other countries with generalized epidemics are an increase in the number of deaths, particularly among young adults leading in turn to reduced life expectancy. The rate of population growth will drop as a higher death rate reduces the rate of natural increase. The number of births can also be expected to decline owing to the impaired fecundity of HIV positive women. Changes to the age structure follow from the concentration of excess AIDS mortality in the young adult age groups. (excerpt) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | ESTIMATION TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | PREVALENCE | EXCESS MORTALITY | DEMOGRAPHIC IMPACT | Developing Countries | Oceania | Research Methodology | Viral Diseases | Diseases | Measurement | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 326114 |
| 14. Peer Reviewed Title: Caregivers' acceptance of using artesunate suppositories for treating childhood malaria in Papua New Guinea. Author: Hinton RL; Auwun A; Pongua G; Oa O; Davis TM Source: American Journal of Tropical Medicine and Hygiene. 2007 Apr;76(4):634-640. Abstract: Community-based interventions using artemisinin-derived suppositories may potentially reduce malaria-related childhood mortality. However, their sociocultural acceptability is unknown in Papua New Guinea and a formal examination of caregiver's attitudes to rectal administration was needed to inform effective deployment strategies. Caregivers (n = 131) of children with uncomplicated malaria were questioned on their prior experience with, and attitudes to, rectal administration and then offered artesunate suppositories as treatment of their child. The 29% who refused this alternative were further questioned to determine their reasons for this refusal. Lack of spousal approval and fear of side effects were the most common reasons for refusal. Sixty-six percent of caregivers agreed to self-administer suppositories, which were perceived as effective (99%), safe (96%), and fast-acting (91%), but problematic to administer to a struggling child (56%). Shame, embarrassment, and hygiene were not significantconcerns. Acceptability of rectal administration should be relatively high in Papua New Guinea. However, deployment must be accompanied by health education that addresses the practical aspects of administration, is appropriate for the illiterate, and is directed at fathers as well as mothers. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | QUESTIONNAIRES | CHILD | FAMILY AND HOUSEHOLD | MALARIA | CHILD MORTALITY | PREVENTION AND CONTROL | INTERVENTIONS | ANTIMALARIAL DRUGS | ADMINISTRATION AND DOSAGE | PROGRAM ACCEPTABILITY | Developing Countries | Oceania | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Parasitic Diseases | Diseases | Mortality | Population Dynamics | Programs | Organization and Administration | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation Document Number: 315140 |
| 15. Peer Reviewed Title: Low prevalence of an acute phase response in asymptomatic children from a malaria-endemic area of Papua New Guinea. Author: Imrie H; Fowkes FJ; Michon P; Tavul L; Reeder JC Source: American Journal of Tropical Medicine and Hygiene. 2007 Feb;76(2):280-284. Abstract: Levels of C-reactive protein (CRP), a classic marker for the acute phase response (APR), were measured in children with asymptomatic malaria infection in the Amele region of Papua New Guinea (PNG). Despite the presence of parasitemia, the prevalence of CRP levels consistent with an APR (CRP > 10 µg/mL) was very low (< 10%). Splenomegaly was significantly associated with increased parasitemia (P < 0.001) and CRP levels (P < 0.001), highlighting the importance of splenomegaly as an indicator of recent high density infection in this population. Multivariate analysis showed that CRP levels were significantly associated with splenomegaly, fever, hemoglobin, and age (P = 0.002). CRP levels also increased with increasing parasitemia (P < 0.001) but remained < 3.5 µg/mL. The low levels of CRP indicate that children in the Amele modulate inflammation associated with malaria. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | CHILDREN | MALARIA | TRANSMISSION | PREVALENCE | AGE DISTRIBUTION | LABORATORY PROCEDURES | Developing Countries | Oceania | Research Methodology | Sampling Studies | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Infections | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 312003 |
| 16. Title: Sovasova and the problem of sameness: Converging interpretive frameworks for making sense of HIV and AIDS in the Trobriand Islands. Author: Lepani K Source: Oceania. 2007 Mar;77(1):12-28. Abstract: This article considers how different models of sexuality and disease converge and interact to co-produce understanding of HIV and AIDS, and the implications of inter-cultural communication for effective HIV prevention in diverse settings. In the Tobriands Islands of Papua New Guinea, the phenomenon of sovasova, or chronic illness that manifests when members of the same matrilineal clan have sexual relations, is a persuasive and problematic form of cultural knowledge that directly influences comprehensions of HIV and AIDS. As a social proscription, sovasova underscores cultural ideations about the importance of social exchange and the corporeal mixing of difference in sexual relationships. Trobrianders recognize clear signs and symptoms that herald the onset of sovasova, which are similar to descriptions of AIDS-related illness - weight loss, nausea, and malaise. Affected people use various herbal and magical treatments to effectively manage sovasova, and people can avoid the sickness altogether bysimply not having sex with a fellow clan member. The cultural resources available for treatment allow people to regard transgression as a safe possibility, albeit socially undesirable. The broad comparisons that Trobrianders draw between sovasova and AIDS create tensions as people contemplate HIV prevention based on the cultural model of sexual disorder and the valued capacity and efficacy of sexuality in maintaining relations of difference. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | EPIDEMIOLOGY | KINSHIP NETWORKS | INDIGENOUS POPULATION | SEX BEHAVIOR | HIV INFECTIONS | AIDS | FATIGUE | SIGNS AND SYMPTOMS | TRADITIONAL MEDICINE | Developing Countries | Oceania | Public Health | Health | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Behavior | Viral Diseases | Diseases | Medicine | Health Services | Delivery of Health Care Document Number: 321197 |
| 17. Title: CYP2B6 983T>C polymorphism is prevalent in West Africa but absent in Papua New Guinea: Implications for HIV / AIDS treatment. Author: Mehlotra RK; Bockarie MJ; Zimmerman PA Source: British Journal of Clinical Pharmacology. 2007 Sep;64(3):391-395. Abstract: The aims were to determine the prevalence of the novel CYP2B6 functional polymorphism 983T>C in Papua New Guinea where HIV/AIDS poses a significant health problem. We genotyped Papua New Guineans (PNG, n = 174), West Africans (WA, n = 170), and North Americans (NA, n = 361). The polymorphism was absent in PNG, while its overall frequency was 4.7% in WA. Among NA, the polymorphism was present in African-Americans (7.5%) and Hispanic-Americans (1.1%) but not in Caucasian-Americans and Asian-Americans. Haplotype analysis indicated that 983T>C was present alone as the CYP2B6*18 allele in WA and African-Americans. Significant interethnic differences occur at the CYP2B6 locus, which may influence treatment outcomes with efavirenz. (author's) Language: English Keywords: PAPUA NEW GUINEA | AFRICA, SUB SAHARAN | RESEARCH REPORT | GENETIC TECHNIQUES | COMPARATIVE STUDIES | EPIDEMIOLOGIC METHODS | PERSONS LIVING WITH HIV/AIDS | ETHNIC GROUPS | CHROMOSOME ABNORMALITIES | HIV INFECTIONS | PREVALENCE | ANTIRETROVIRAL THERAPY | Developing Countries | Oceania | Africa | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Studies | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Cultural Background | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Measurement | HIV Document Number: 320485 |
| 18. Peer Reviewed Title: The risk of malarial infections and disease in Papua New Guinean children. Author: Michon P; Cole-Tobian JL; Dabod E; Schoepflin S; Igu J Source: American Journal of Tropical Medicine and Hygiene. 2007 Jun;76(6):997-1008. Abstract: In a treatment re-infection study of 206 Papua New Guinean school children, we examined risk of reinfection and symptomatic malaria caused by different Plasmodium species. Although children acquired a similar number of polymerase chain reaction-detectable Plasmodium falciparum and P. vivax infections in six months of active follow-up (P. falciparum = 5.00, P. vivax = 5.28), they were 21 times more likely to develop symptomatic P. falciparum malaria (1.17/year) than P. vivax malaria (0.06/year). Children greater than nine years of age had a reduced risk of acquiring P. vivax infections of low-to-moderate (>150/µL) density (adjusted hazard rate [AHR] = 0.65 and 0.42), whereas similar reductions in risk with age of P. falciparum infection was only seen for parasitemias > 5,000/µL (AHR = 0.49) and symptomatic episodes (AHR = 0.51). Infection and symptomatic episodes with P. malariae and P. ovale were rare. By nine years of age, children have thus acquired almost complete clinical immunity to P. vivax characterized by a very tight control of parasite density, whereas the acquisition of immunity to symptomatic P. falciparum malaria remained incomplete. These observations suggest that different mechanisms of immunity may be important for protection from these malaria species. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | CHILDREN | MALARIA | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | ANTIMALARIAL DRUGS | TREATMENT | RISK FACTORS | INFECTIONS | INCIDENCE | AGE FACTORS | Oceania | Developing Countries | Youth | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Biology | Measurement | Research Methodology Document Number: 317461 |
| 19. Title: Rebuilding health systems and providing health services in fragile states. Author: Newbrander W Source: Cambridge, Massachusetts, Management Sciences for Health [MSH], 2007. 40 p. (MSH Occasional Paper No. 7USAID Contract No. GHA-I-00-04-00002-00) Abstract: The international community has compelling humanitarian, political, security, and economic reasons to become engaged in fragile states. Health is an entry point for engagement because people living in fragile states are disproportionately affected by major health problems such as high maternal and child mortality, AIDS, and malaria, and improvements in health services help strengthen civil society and restore legitimacy to governments. Effective engagement with fragile states depends on donor coordination and an understanding of health system challenges to inform the design of health programs and selection of interventions. Planning requires considering allocation (what health services are to be delivered), production (how the services will be organized), distribution (who will receive them), and financing. The criteria for selecting interventions to expand access to health services are their impact on major health problems, effectiveness, the possibility of scale-up, equity, and sustainability. There are various options for donor financing and models of engagement with fragile states, but this support should always combine short-term relief with longer-term development. Stakeholders should aim not only to save and protect lives but also use their commitment over the long run to shore up nations' ability to deliver good-quality services to their citizens. (author's) Language: English Keywords: DEVELOPING COUNTRIES | PAPUA NEW GUINEA | ZIMBABWE | DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA | SUMMARY REPORT | SOCIAL CHANGE | HEALTH SERVICES | MIGRATION | VIOLENCE | NATIONAL SECURITY | DISEASES | DEATH RATE | WAR | SOCIAL WELFARE | DELIVERY OF HEALTH CARE | NEEDS | FUNDS | IMPLEMENTATION | CAPACITY BUILDING | STANDARDS | GOVERNMENT PROGRAMS | Oceania | Africa, Southern | Africa, Sub Saharan | Africa | Asia, Eastern | Asia | Sociocultural Factors | Health | Population Dynamics | Demographic Factors | Population | Behavior | Political Factors | Mortality | Economic Factors | Financial Activities | Programs | Organization and Administration | Program Sustainability | Research Methodology Document Number: 322397 |
| 20. Peer Reviewed Title: Southeast Asian ovalocytosis and pregnancy in a malaria-endemic region of Papua New Guinea. Author: O'Donnell A; Raiko A; Clegg JB; Weatherall DJ; Allen SJ Source: American Journal of Tropical Medicine and Hygiene. 2007 Apr;76(4):631-633. Abstract: The band 3 deletion for southeast Asian ovalocytosis (SAO) occurs commonly in southeast Asia and the western Pacific. Southeast Asian ovalocytosis is associated with protection against cerebral malaria in children and therefore could reduce sequestration of erythrocytes parasitized by Plasmodium falciparum in the brain microvasculature. Sequestration of parasitized erythrocytes in the placenta accounts for much of the pathology of malaria during pregnancy. Therefore, we investigated the effect of SAO on malaria during pregnancy in the malaria-hyperendemic north coastal region of Papua New Guinea. The frequency of SAO in 927 women attending hospital for delivery was 8.7% (95% confidence interval = 6.9-10.5). Markers of fertility, the frequency of miscarriages and stillbirths, maternal anemia, placental and peripheral malaria at delivery, and birth weight were similar in women with and without SAO. In summary, although we can not exclude an interaction between SAO and malaria during pregnancy, we found no evidence that it provided a clinical benefit in this population. (author's) Language: English Keywords: PAPUA NEW GUINEA | SUMMARY REPORT | CLIENTS | PREGNANCY | MALARIA | ANEMIA | HEMOGLOBIN LEVEL | ABORTION, SPONTANEOUS | FETAL DEATH | PREGNANCY COMPLICATIONS | PREGNANCY OUTCOMES | LOW BIRTH WEIGHT | Developing Countries | Oceania | Program Activities | Programs | Organization and Administration | Reproduction | Parasitic Diseases | Diseases | Hemic System | Physiology | Biology | Mortality | Population Dynamics | Demographic Factors | Population | Birth Weight | Body Weight Document Number: 315139 |
| 21. Title: Prevention of mother to child transmission of HIV infection in Pacific countries. Author: Rupali P; Condon R; Roberts S; Wilkinson L; Voss L Source: Internal Medicine Journal. 2007 Apr;37(4):216-223. Abstract: A generalized epidemic of HIV infection has been evolving in Papua New Guinea over the last decade, whereas in other Pacific Island countries and territories (PICT) HIV transmission has generally been less widespread. Programmes to detect HIV infection in pregnant women and to prevent mother to child transmission (MTCT) during either delivery or breastfeeding can decrease the incidence of infection in infants. The limited health infrastructure present in some PICT may delay the implementation of effective programmes to decrease MTCT of HIV. We used a standardized questionnaire to survey health-care providers in 22 PICT for information on the epidemiology of HIV infection and strategies used during 2004 to prevent MTCT of HIV infection in their country. We supplemented these survey responses with data obtained from regional organizations supporting national responses to HIV. We obtained responses from 21 PICT. The reported prevalence of known HIV infection was >150 per 100 000 persons in Papua New Guinea, approximately 100 per 100 000 persons in French Polynesia, Guam, New Caledonia and Tuvalu and < 50 per 100 000 persons in the remaining 14 PICT. Other than in Papua New Guinea, where an estimated 500 pregnant women had HIV infection diagnosed in 2004, reported HIV infection among pregnant women was rare. Ten PICT reported that an HIV antibody test was offered as a routine component of antenatal care and 11 reported that antiretroviral medications were available for the prevention of MTCT of HIV infection. The prevalence of HIV infection differs greatly between PICT with a varying risk of MTCT of HIV infection. Successful prevention of MTCT of HIV infection throughout the PICT will require improved uptake of antenatal HIV antibody testing and better access to antiretroviral medications. (author's) Language: English Keywords: PAPUA NEW GUINEA | OCEANIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | INFANT | PROVIDERS WITH CLIENTS | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV TESTING | ANTENATAL CARE | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Maternal Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 317599 |
| 22. Peer Reviewed Title: Men's extramarital sexuality in rural Papua New Guinea. Author: Wardlow H Source: American Journal of Public Health. 2007 Jun;97(6):1006-1014. Abstract: Married women in rural Papua New Guinea are at risk for HIV primarily because of their husbands' extramarital relationships. Labor migration puts these men in social contexts that encourage infidelity. Moreover, many men do not view sexual fidelity as necessary for achieving a happy marriage, but they view drinking and "looking for women" as important for male friendships. Although fear of HIV infection is increasing, the concern that men most often articulated about the consequences of extramarital infidelity was possible violent retaliation for "stealing" another man's wife. Therefore, divorced or separated women who exchange sex for money are considered to be "safe" partners. Interventions that promote fidelity will fail in the absence of a social and economic infrastructure that supports fidelity. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | KAP SURVEYS | QUALITATIVE RESEARCH | RURAL POPULATION | MEN | SEXUAL PARTNERS | CURRENTLY MARRIED | MALE ROLE | EXTRAMARITAL SEX BEHAVIOR | HIV TRANSMISSION | RISK BEHAVIOR | LABOR MIGRATION | ALCOHOL USE AND ABUSE | PERCEPTION | Developing Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Marital Status | Nuptiality | Social Behavior | HIV Infections | Viral Diseases | Diseases | Migration | Population Dynamics | Psychological Factors Document Number: 313537 |
| 23. Title: "Turning sex into a game": Gogodala men's response to the AIDS epidemic and condom promotion in rural Papua New Guinea. Author: Wilde C Source: Oceania. 2007 Mar;77(1):58-71. Abstract: Rugby league is the national sport of Papua New Guinea and the game's huge popularity and international profile has been used in recent condom promotion campaigns in the nation's fight against the HIV/AIDS epidemic. In this paper, I argue that the promotion of condom use through rugby league requires a national campaign strategy that includes understandings of condom use and masculinity at the rural level. I demonstrate this through a study of Gogodala men's understandings of the epidemic and condom use in Western Province. The Gogodala are a Christian-based society and many blame the national condom promotion strategy for an increase in promiscuity and for 'turning sex into a game'. Condom availability in this rural area continues to be restricted to a family planning program that promotes Christian values and excludes unmarried men. I explore the male condom dilemma where young men are more concerned with avoiding accusations that their sexual behaviour puts them at risk of contracting HIV despite acknowledging the preventative value of using condoms. In this context young men disassociate themselves from the disease and condom use through a process of calculated risk or risk minimisation. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | RURAL AREAS | CHRISTIANITY | MEN | SPORTS | CONDOM USE | HIV INFECTIONS | AIDS | PROMOTION | CONTRACEPTION | TRANSMISSION | KNOWLEDGE | CRIME | PROGRAM ACCESSIBILITY | Developing Countries | Oceania | Geographic Factors | Population | Religion | Sociocultural Factors | Demographic Factors | Social Behavior | Behavior | Risk Reduction Behavior | Viral Diseases | Diseases | Marketing | Economic Factors | Family Planning | Infections | Social Problems | Program Evaluation | Programs | Organization and Administration Document Number: 321199 |
| 24. Peer Reviewed Title: Are insecticide-treated bednets more protective against Plasmodium falciparum than Plasmodium vivax-infected mosquitoes? Author: Bockarie MJ; Dagoro H Source: Malaria Journal. 2006 Feb 21;5:15. Abstract: The outcomes of insecticide-treated bednet (ITN) interventions for malaria control in Papua New Guinea tend to suggest a differential protective effect against Plasmodium falciparum and Plasmodium vivax. Little is known about the impact of ITNs on the relative abundance of mosquitoes infected with either P. falciparum or P. vivax. This paper describes the biting cycle of P. falciparum and P. vivax-infected mosquitoes and the impact of an ITN intervention on the proportion of mosquitoes infected with either parasite species. Entomological investigations were performed in East Sepik (ESP) and New Ireland Provinces (NIP) of PNG. Mosquitoes were collected using the all-night (18:00 - 06:00) landing catch and CDC light-trap methods and species specific malaria sporozoite rates were determined by ELISA. The distribution of sporozoite positive mosquitoes in three four-hour periods (18:00-22:00, 22:00-02:00 & 02:00-06:00) showed that a higher proportion of P. vivax-infected mosquitoes were biting before people retired to bed under the protection of bednets. In the intervention village, the 308 mosquitoes collected before ITNs were introduced included eight (2.0%) P. falciparum-positive and four (1.0%) P. vivax-positive specimens, giving a parasite ratio of 2:1. The sporozoite rate determined from 908 mosquitoes caught after ITNs were introduced showed a significant decrease for P. falciparum (0.7%) and a slight increase for P. vivax (1.3%), resulting in a post intervention parasite ratio of 1:2. In the East Sepik Province, where ITNs were not used, P. falciparum remained the dominant species in 12 monthly mosquito collections and monthly P. falciparum:P. vivax formula varied from 8:1 to 1.2:1. These findings suggest that people sleeping under treated bednets may be more exposed to P. vivax than P. falciparum-infected mosquitoes before going to sleep under the protection of bednets. This difference in the biting behaviour of mosquitoes infected with different malaria parasites may partly explain the change in the P. falciparum:P. vivax formula after the introduction of ITNs. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | MALARIA | MALARIA PREVENTION | PREVENTION AND CONTROL | PARASITE CONTROL | CLIMATE | BED NETS | Oceania | Developing Countries | Parasitic Diseases | Diseases | Public Health | Health | Environment Document Number: 300246 |
| 25. Peer Reviewed Title: Flashback to the 1960s: utility of archived sera to explore the origin and evolution of Plasmodium falciparum chloroquine resistance in the Pacific. Author: Chan CW; Lynch D; Spathis R; Hombhanje FW; Kaneko A Source: Acta Tropica. 2006 Aug;99(1):15-22. Abstract: The increasing frequencies of Plasmodium falciparum strains that are resistant to chloroquine (CQ) and other antimalarials are resulting in a global resurgence of malaria morbidity and mortality. CQ resistance (CQR) is associated with multiple mutations in the P. falciparum chloroquine resistance transporter (pfcrt) gene. The mode and tempo of the accumulation of substitutions leading to these complex CQR haplotypes remain speculative due to the dearth of samples temporally spanning the evolution of drug resistance. The origin and evolution of the CQR alleles of Papua New Guinea (PNG) is particularly ambiguous. It remains unclear whether the pfcrt haplotype in PNG resulted from an independent origin of a CQR haplotype identical in sequence to the South American haplotype, or if this haplotype originated in South America and recombined into a Southeast Asian-derived genome. We sequenced a segment of pfcrt exon 2 from 398 plasmid clones derived from archival human sera collected in the Pacific before and after the first reported cases of CQ treatment failure (n = 251) and modern samples (n = 147). None of the 251 pfcrt plasmid clones from nine archival samples displayed the C72S or the K76T mutations that are characteristic of CQR strains. In contrast, these two amino acid substitutions were present in all 147 pfcrt plasmid clones from five samples collected between 2001 and 2003; thus, the archival samples represent the baseline parasite genetic diversity before the evolution of CQR strains. We are currently expanding our analyses to include additional samples from the series described here and from series collected in the 1970s and the 1980s to evaluate the geographic origin of CQR strains in the Pacific and the validity of the sequential point mutation accumulation model of CQR evolution. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | DATA ANALYSIS | MALARIA | DRUG RESISTANCE | ANTIMALARIAL DRUGS | PRE-POST TESTS | Developing Countries | Oceania | Research Methodology | Parasitic Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 307799 |
| 26. Title: Still making their own rules: Ongoing impunity for police beatings, rape and torture in Papua New Guinea. Author: Coursen-Neff Z Source: New York, New York, Human Rights Watch, 2006 Oct. 52 p. (Human Rights Watch Vol. 18, No. 13(C)) Abstract: We recommend that the government of Papua New Guinea take the following immediate steps. First, the government should strengthen the internal affairs directorate of the police, penalize officers who do not cooperate with it, and investigate alleged abuses and delays in implementing dismissal orders. It should also improve the speed and efficiency with which cases of criminal action by police are sent to the public prosecutor. This problem will not diminish unless perpetrators are prosecuted. Second, the government should make greater and more creative efforts to improve the capacity of the Ombudsman Commission to address police violence. The Police Commissioner should conclude the memorandum of understanding currently being negotiated with the commission giving the latter oversight over the most serious internal police disciplinary cases. The government should allocate additional resources for the commission to take on human rights cases. In the medium term, the government should consider the creation of a police ombudsman as recommended by the 2004 administrative review of police. A long-term measure could be the establishment of a national human rights commission, which is currently stalled. Papua New Guinea should, in the meantime, make every effort to strengthen existing accountability mechanisms. Third, the government should strengthen and expand the juvenile justice system throughout the country. The police should better cooperate with the juvenile policy monitoring unit, which in turn should rigorously monitor police treatment of children. The police should also establish and fully support additional juvenile reception centers throughout the country. They should give the final approval necessary to enable the already-trained juvenile court officers to start working, and these officers should become independent advocates for children who are in conflict with the law. The police should also hold shift officers-in-charge to their responsibility for ensuring that children are not physically abused,are separated from adults, and are provided medical care when needed. All magistrates and judges should monitor for police violence, and visit places where children are detained. Fourth, the government should improve access for victims of police violence to medical, legal, counseling, and other support services. (excerpt) Language: English Keywords: PAPUA NEW GUINEA | PROGRESS REPORT | RECOMMENDATIONS | EVALUATION | POLICE | SEX WORKERS | PRISONERS | CHILDREN | VIOLENCE | RAPE | SEXUAL ABUSE | CHILD ABUSE | DELIVERY OF HEALTH CARE | CONDOM USE | HUMAN RIGHTS | Developing Countries | Oceania | Corrections Officers | Government | Political Factors | Sociocultural Factors | Sex Behavior | Behavior | Crime | Social Problems | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Risk Reduction Behavior Document Number: 320365 |
| 27. Peer Reviewed Title: Muscle cell injury, haemolysis and dark urine in children with falciparum malaria in Papua New Guinea. Author: O’Donnell A; Weatherall DJ; Taylor AM; Reeder JC; Allen SJ Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2006 Sep;100(9):817-825. Abstract: During a prospective study of red cell variants and severe malaria in children, a surprising observation was the occurrence of dark urine. Children were grouped according to urine findings: 22 had dark urine that contained a haem protein (Group I), 93 had urine of normal colour that contained a haem protein (Group II) and 236 had normal urine (Group III). To investigate the cause of dark urine, haemolysis and muscle cell injury were assessed. Intravascular haemolysis was greater in Group I than in Groups II and III. However, anaemia was more severe in Group III and is likely to have resulted mainly from extravascular haemolysis. Median plasma myoglobin concentrations were greater in Groups I and II than Group III (P = 0.00060). Plasma myoglobin was greater in children with cerebral malaria, hyperlactataemia and those who died but was not associated with acidosis. Urine myoglobin was greater in Group I than Groups II and III (P = 0.00054). It is likely that both haemoglobin and myoglobin contributed to dark urine. The association between muscle cell injury and coma suggests sequestration of parasitized red cells as a common underlying pathology. In malaria, hyperlactataemia may result directly from breakdown of muscle protein as well as tissue hypoxia. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | PROSPECTIVE STUDIES | CHILD | MALARIA | ANEMIA | EXAMINATIONS AND DIAGNOSES | Oceania | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 302782 |
| 28. Title: Parvovirus infection, malaria and anemia in the tropics -- a new hidden enemy? [editorial] Author: Pasvol G Source: Journal of Infectious Diseases. 2006 Jul 15;194(2):141-142. Abstract: Anemia takes an exacting toll on the lives of individuals, particularly children living in tropical areas where malaria is endemic. In such areas, there is general agreement that the major causes of anemia are malaria, iron deficiency, hookworm infection, and the hemoglobinopathies, especially sickle-cell disease. In general, anemia is caused by factors that decrease hemoglobin production and those that lead to increased blood loss. In this respect, iron deficiency represents a major cause of decreased hemoglobin production, whereas worm infection (via fecal blood loss), hemoglobinopathies, and malaria (mainly via hemolysis) relate to blood loss. Parvovirus B19 (B19) infection in humans is unique in that it can specifically and abruptly lead to a transitory cessation of erythropoiesis. Parvovirus has specificity for red blood cell precursors and can totally suppress erythropoiesis for ~3--7 days. The bone marrow of patients with B19 infection reveals an absence of maturing erythroid precursors, together with the presence of giant pronormoblasts that are pathognomonic for the cytopathic effect of the virus. Reticulocyte counts in volunteers exposed to B19 infection decrease to zero. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | PAPUA NEW GUINEA | CRITIQUE | CHILDREN | INFECTIONS | VIRAL DISEASES | MALARIA | ANEMIA | PARASITIC DISEASES | CLIMATE | GEOGRAPHIC FACTORS | Africa | Developing Countries | Oceania | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Environment Document Number: 301933 |
| 29. Title: 'Mainstreaming' HIV in Papua New Guinea: putting gender equity first. Author: Seeley J; Butcher K Source: Gender and Development. 2006 Mar;14(1):105-114. Abstract: Papua New Guinea (PNG) has a rapidly worsening HIV and AIDS epidemic. Gender-based violence is common and is, in part, fuelling the spread of HIV. We argue that the situation in PNG illustrates very clearly why 'mainstreaming' HIV into all aspects of development simply cannot happen without serious attention to gender inequities. We describe a scheme in the oil palm industry in PNG that specifically targets women to ensure that they benefit from playing a part in the harvesting of oil palm. This scheme is not only giving women economic independence but is also reducing conflict and gender-based violence and in so doing can begin to contribute to the arresting of the spread of HIV. (author's) Language: English Keywords: PAPUA NEW GUINEA | PROGRESS REPORT | EVALUATION | WOMEN IN DEVELOPMENT | LABOR FORCE | AGRICULTURAL WORKERS | GENDER RELATIONS | HIV PREVENTION | VIOLENCE | RAPE | INEQUALITIES | PRIVATE SECTOR | EMPLOYMENT | WOMEN'S EMPOWERMENT | MICROECONOMIC FACTORS | Developing Countries | Oceania | Economic Development | Economic Factors | Human Resources | Gender Issues | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Behavior | Crime | Social Problems | Socioeconomic Factors | Macroeconomic Factors | Women's Status Document Number: 315265 |
| 30. Title: The demography of a New Guinea highlands valley. Author: Sillitoe P Source: Asian Population Studies. 2006 Nov;2(3):271-294. Abstract: Relatively little is known about demographic processes in the Highlands of Papua New Guinea, although since the reports of the first ethnographers, population growth has been thought a significant issue. This paper analyses a series of population surveys conducted over 24 years in a Wola-speaking community of the Was valley of the Southern Highlands Province. It seeks to put a standard demographic investigation of births, deaths and migration in cultural and historical context. Polygynous marriage arrangements, male fears of menstrual pollution and attitudes to extra-marital affairs impact on birth rates. The periodic occurrence of El Nino induced food shortages and 'tribal fighting' affect death rates. Migration patterns are influenced both by traditional arrangements, such as families living on two territories, and recent changes, such as towns that offer new employment opportunities. Although the population is expanding, there is currently no problem with resources. (author's) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | DEMOGRAPHIC ANALYSIS | CULTURE | MIGRATION | POPULATION CHARACTERISTICS | DEMOGRAPHY | ETHNIC GROUPS | MARRIAGE PATTERNS | ATTITUDES | EMPLOYMENT STATUS | Oceania | Developing Countries | Research Methodology | Sociocultural Factors | Population Dynamics | Demographic Factors | Population | Social Sciences | Science | Cultural Background | Marriage | Nuptiality | Psychological Factors | Behavior | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 314513 |
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