HIV/AIDS atigma: main barrier to VCT and other health services in four suburban villages in National Capital District, Papua New Guinea

The HIV/AIDS stigma, fear and discrimination have been linked with poor participation in Voluntary Counselling and Testing (VCT) programs. Cultural factors, attitudes and behaviours strongly influence the spread of HIV/AIDS and these have been extensively studied in several sub-Sahara African countries. Similar studies in Papua New Guinea are scanty. This study investigates the extents of HIV/AIDS-Stigma, fear, discrimination and other psychological factors as barriers to the access of VCT and other services in four suburban villages in the National Capital District, Papua New Guinea. The study sites were Baruni, Hanuabada, Pari and Kilakila villages. A semi-structured questionnaire comprising of closed and open ended questions was administered to respondents selected randomly. Groups were selected for focus group discussions. Gender stratification was used to ensure that views of both men and women were equally represented. A total of 333 respondents comprising of 166 (49.8%) males, and 167 (50.2 %) females participated in the survey. Self-stigmatization as a major barrier to VCT was indicated by 90.7% of all the respondents. Gender based differences were not statistically significant. Discrimination by relatives and friends was indicated by 74.8% respondents; 79.0% of respondents would discriminate HIV/AIDS-infected people. A total of 42.0% respondents indicated the possibility of rejection from close relationships. The likelihood of dismissal from workplace was indicated by 68.5% of respondents. Lack of support from health providers (67.0%) and fear of HIV test result (61.6%) were other barriers to VCT indicated by respondents. This study recommends the need to heighten awareness of VCT and to eliminate stigma and fear in order to control the HIV/AIDS pandemic.

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

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.

Pneumonia in Goilala

The clinical syndrome of pneumonia in adults in Port Moresby, the capital city of Papua New Guinea, has changed from the 1970s to the present. The severe lobar pneumonia commonly diagnosed in young adult men, characteristically from Goilala and living in settlements in Port Moresby, is no longer seen. Today pneumonia in adults is likely to be milder and bronchopneumonic in type. Possible explanations for the change include changes in immunity and in the bacteria found in the environment and carried in the nasopharynx of recent immigrants to the city. A change in treatment-seeking behaviour together with the wide availability of oral antibiotics is considered to be the most likely cause of the altered clinical syndrome that we have observed.