Locally acquired Hansen's disease in north Queensland.

Hansen's disease (leprosy) is rare in Australia and usually imported from endemic areas. We report a 23-year-old white male with multibacillary leprosy who had lived all his life in North Queensland and initially appeared to have no risk factors. However, historical records revealed his grandfather to have been infected; because of stigma, this was unknown to the patient. As Hansen's disease has an incubation period of years, isolated cases may still occur as a result of previous endemicity in Queensland.

Pattern of leprosy in Queensland, Australia, 1855-1990.

Leprosy was first diagnosed in Queensland in 1855. From then until 1990, 929 patients with the disease were notified. The pattern of notification has varied with the passage of time, and with the changing pattern of migration into Queensland. In the early days, Chinese, Melanesians and Caucasians featured prominently. The first Aboriginal notification was in 1892. In the latter part of this century, significant numbers of Torres Strait Islanders and migrants from South East Asia have been recorded. Among Caucasians, the incidence peaked in the decade 1931-1940, although the prevalence rate in this population remains much higher than in Caucasians. The control of leprosy is at a high level in Queensland today, but there is a continuing low level of new case reporting, many of them imported.

Smoking habits and associated factors in school children.

A questionnaire survey in a high school has shown that Maori girls now smoke more than any other group and that nonMaori girls smoke more than nonMaori boys. Smoking was related to parental smoking, and there was strong peer influence. Social status was an important determinant of smoking habit among nonMaori children. There appeared to be an association between smoking and alcohol intake among the Maori students.

Treatment of lobar pneumonia in Papua New Guinea: short course chemotherapy with penicillin or chloramphenicol.

In an attempt to reduce the costs of treatment we treated 203 patients with clinical lobar pneumonia either with penicillin or chloramphenicol for periods of up to 24 hours after remission of fever (mean 2.4 days). The results show that for patients with moderately severe pneumonia short-course treatment is as effective as the more traditional treatment. Patients with severe pneumonia may respond to such treatment but require careful evaluation before stopping treatment.

The prognosis of lobar pneumonia in the Papua New Guinea Highlands.

Lobar pneumonia, usually caused by pneumococci is the commonest cause for admission to hospitals in Papua New Guinea (PNG). The mortality rate is less than 3%. In a survey of 275 adults (mean age: 36 years) admitted to Goroka hospital in the Highlands of New Guinea with this diagnosis, adverse prognostic factors observed on admission were: age over 40 years, multilobar disease, anaemia (Hb less than 11g/d1) and history of illness commencing more than 7 days before presentation. Additional adverse factors demonstrated after admission included the presence of type 3 pneumococcus and bacteraemia. It is suggested that in the Highlands of PNG initial admission of ambulant patients with lobar pneumonia should be generally restricted to those with any of the first 4 factors.

Tuberculosis at Goroka Hospital.

All adult tuberculosis patients admitted to Goroka Hospital in the Highlands of Papua New Guinea (PNG) were studied retrospectively for 1979 and prospectively during 1980-81. Of 66 patients, 47 (71.2%) had laboratory confirmation of the diagnosis. Of those patients with pulmonary tuberculosis, 23.2% were from the Highlands and 70% from the coast.

Elderly ailing Highlanders of Papua New Guinea.

A retrospective case-control study of 100 elderly patients admitted to Goroka Hospital was undertaken. Chronic disease with cor pulmonale was the commonest condition diagnosed in this group (22%) and lobar pneumonia was the commonest infection (17%). Cancer occurred in only 5% of subjects, and in all of these patients, hepatocellular carcinoma was diagnosed. No cases of degenerative cardiovascular disease were observed. Mean hospital stay was 12.9 days.

Schistosomiasis and human behaviour.

Research on schistosomiasis has been mainly a biological and biomedical endeavor. Yet water and man-water contact are of fundamental importance in understanding the epidemiology of schistosomiasis. A review of water contacts and human behaviour in schistosome endemic areas shows that children in general have more and longer water contact than adults, and that such water contact is often greatest during the middle of the day, at a time when cercarial shedding from snails is at their peak. Control of schistosomiasis must take human behaviour into account. Indiscriminate mollusciciding without the cooperation and understanding of villagers is bound to fail.