A survey of Papua New Guinean private medical practitioners.

A postal survey of all Papua New Guinean private medical practitioners was conducted to ascertain their practice characteristics, how well they kept up with current medical knowledge and whether they were interested in contributing to public sector medicine. Replies were received from 44% of the doctors, who mostly represented the younger age group of graduates. The majority of the responders had entered private practice since 1981, were self-employed and made little use of existing opportunities for keeping up to date with medical knowledge. The average number of patients seen in a day showed a normal distribution with a peak at 20-29 patients per day. Over 75% of the responders stated that they would be willing to work for the government health services on a sessional basis at an average minimum hourly rate of K40. Financial reasons were given as the main justification for leaving government service. When asked whether they would return to full-time public service if doctors' terms and conditions improved, the private practitioners were evenly divided. Those interested in returning would expect an average annual salary of approximately K30,000 per annum. In this paper we argue that private medical care has so far been allowed to develop without guidance and controls, and little use has been made of it to support government health services. Escalating shortages of financial and human resources have now made it imperative to find innovative ways of developing both services in harmony with each other so that private medical services for the mostly urban minority will not grow to the detriment of public medical services for the rural majority.

Acetylator phenotype and short-course chemotherapy for tuberculosis in Papua New Guinea.

In Papua New Guinea the slow acetylator phenotype is unusual and peripheral neuropathy during isoniazid therapy is uncommon. Acetylator status and other factors influencing isoniazid-induced peripheral neuropathy are discussed, and statistics from Papua New Guinea are presented. The relevance of acetylator phenotype to other side-effects of isoniazid is less well defined. Prophylactic pyridoxine supplementation during short-course chemotherapy for tuberculosis is not generally necessary in the daily 'A' regimen, but should be maintained in the twice-weekly (high-dose isoniazid) 'B' regimen for adults and children over 20 kg.

Splenomegaly in Papua New Guineans and in Japanese living in Papua New Guinea: report of research and exchange program of Osaka University with the South Pacific region.

Sizes of spleen and liver were studied by measuring spleen index calculated by multiplying the maximal length by the maximal width of the spleen and liver length at right mid-clavicular line below the costal margin using ultrasonography in 26 Papua New Guineans and in 25 Japaneses living in Papua New Guinea. In Papua New Guinean, spleen index and liver length were 77.4 +/- 9.9 cm2 and 5.4 +/- 0.7 cm, respectively. Their spleen index correlated inversely (p < 0.05) with hemoglobin level. In Japanese, spleen index and liver length were 24.5 +/- 2.1 cm2 and 0.8 +/- 0.3 cm, respectively and spleen index correlated positively with the duration of stay in Papua New Guinea (p < 0.05). These results indicate that the clinical and subclinical infections acquired in P.N.G. may play some role on the development of splenomegaly. Malaria is the prime suspect for the high prevalence of observed splenomegaly in both studied groups.