Diarrhoeal disease surveillance in Papua New Guinea: findings and challenges

Abstract@#Diarrhoeal diseases are among the leading causes of morbidity and mortality in the Western Pacific Region. However, data on the major causes of infectious diarrhoea are limited in many countries within the Region, including Papua New Guinea. In 2013–2014, we conducted surveillance for acute diarrhoeal illness in four provinces in Papua New Guinea. One rural health clinic from each province participated in the surveillance activity. Samples were sent to central laboratories and batch analysed for bacterial and viral gastrointestinal pathogens that are commonly associated with diarrhoea. Across the four sites, the most commonly detected pathogens were Shigella spp., Campylobacter spp. and rotavirus. In this paper, we report the results of the surveillance activity and the challenges that we faced. The lessons learnt may be applicable to other parts of the Region with a similar socioeconomic status.

Tuberculosis knowledge in Hiri (Central Province), Asaro (Eastern Highlands Province) and Karkar Island (Madang Province) of Papua New Guinea

@#Tuberculosis (TB) continues to be a serious public health problem in Papua New Guinea (PNG). A key element in the prevention and control of TB is for people to have the correct, appropriate and relevant information regarding TB and its prevention and treatment. In PNG, there is no published information about the knowledge of TB among the general population. An understanding of people’s knowledge of various aspects of TB is important in developing interventions to address the burden of TB. This study aimed to assess the knowledge of TB among the local population in PNG. We used a cross-sectional study to understand people’s levels of knowledge regarding TB in three sites in PNG: Hiri, Asaro and Karkar Island. A total of 1034 people aged 15 years and above participated in this study from May to December 2013. Our study showed different levels of TB knowledge between sites 79% of respondents in Hiri, 27% in Asaro and 23% in Karkar correctly identified TB bacteria as the leading cause of TB. The only site at which respondents gave four correct symptoms of TB was Hiri (7%). Coughing out air droplets was identified as the main mode of transmission by 84% of respondents in Hiri, 33% in Asaro and 71% in Karkar. A tiny proportion of the participants in Hiri (4%) knew the three correct ways of TB prevention. Despite the availability of free TB treatment only 45% of respondents in Hiri, 18% in Asaro and 46% in Karkar knew about it. In Hiri, 58% of the participants knew the TB treatment duration of 6-9 months, compared with 36% in Asaro and 33% in Karkar. A health facility was the most common source of TB information in all three sites. Providing accurate and relevant information about TB through public health education strategies is urgently required to help in addressing the current TB crisis

Barriers to measles immunization: the beliefs and attitudes of caregivers in Goroka, Eastern Highlands Province, Papua New Guinea

In Papua New Guinea, measles remains a public health problem and the majority of measles cases occur in non-immunized children. In Goroka, measles vaccine coverage for the 9-month-old group was 44%. The parents or caregivers are important in measles prevention as children's immunization depends on their compliance. This study aimed to determine the factors that hinder caregivers from having their children vaccinated for measles prevention in the Goroka District, Eastern Highlands Province. A cross-sectional study was conducted in July-August 2003, using pre-constructed questionnaires and interviews. There was a total of 120 respondents who were caregivers or parents of children whose ages ranged from 6 to 12 months and who attended health care centres where immunization services were provided. The main reasons for not bringing their children to clinic for immunization were: limited access to health centres, especially to maternal and child health (MCH) clinics; too long a waiting time at the clinic; concern that too many injections were being given to their children; the side-effects of the vaccine; being sent away and asked to come back the next day for immunization; and a bad reception from health workers. Funerals or election-related events in the area also affected the attendance at the clinic. In order to improve the vaccine coverage, the use of a mobile MCH clinic should be re-established. Health workers should utilize the opportunities to pass on necessary information on immunization to caregivers, as well as being mindful to use communication that will prevent misunderstanding by the mothers. It is important for all health workers to recognize that their performance and attitude can greatly improve the overall vaccine coverage in Papua New Guinea.