Papua New Guinea. Yaws problems assessed.

The present status of yaws in Papua New Guinea cannot be determined because of the lack of data. Because yaws was deemed under control as a result of the nationwide total mass treatment campaign in the late 1950s and limited regional effort in the late 1970s, the health department lost interest in yaws and pursued other diseases. Individual reports from certain areas of Papua New Guinea have provided the only information on yaws since 1978. These reports concentrated on outbreaks on Karkar Island in the Madang Province and indicated the possibility of a recurrence of yaws. It was not until early 1984, when further reports became available from other provinces in the country, that the national health department renewed its interest in yaws. Monthly reports are currently being collected from hospitals, health centres, and aid posts throughout the country. This effort was started in 1984, however, and no conclusions are available. The initiation of a nationwide survey seems inevitable at this stage. For this to be made possible, capital and appropriate manpower are needed.

Endemic tinea imbricata--a study on Goodenough Island, Papua New Guinea.

Tinea imbricata was studied in 102 patients on Goodenough Island, Papua New Guinea. Trichophyton concentricum was isolated from 98 skin samples. Seven different clinical patterns of infection were distinguished: concentric, lamellar, lichenified , plaque-like, annular, palmar/plantar, onychomycosis. Hypopigmentation was a prominent feature of the infection. The disease was most common in male children or adult women. Relapse after therapy, including oral griseofulvin, in patients remaining in the area was the rule. There was no evidence to suggest that those affected were abnormally susceptible to skin infections. An ineffective immune response to the infection may well explain the high relapse rate after treatment and the extensive nature of the lesions. Other susceptibility factors, such as a genetic predisposition, may also be involved and account for the high prevalence of the infection in this area.

Immune responses of patients with tinea imbricata.

Tinea imbricata is a chronic dermatophyte infection caused by Trichophyton concentricum affecting large areas of the skin surface. Spontaneous improvement is unusual and relapse after apparently successful treatment is common. In this study in Papua New Guinea it was found that a high proportion of infected patients had immediate-type hypersensitivity (52%) or negative responses (46%) to intradermal trichophytin. The majority of patients failed to develop delayed-type hypersensitivity on skin testing or as assessed in vitro by leucocyte migration inhibition. However, 78% of patients investigated had antibody to T. concentricum. The relevance of T-lymphocyte hyporeactivity to persistence of the infection is discussed.