Nutrition, infection and child growth in Papua New Guinea

Growth patterns of populations in Papua New Guinea (PNG) have traditionally shown considerable variation, with the greatest difference lying between coastal and highland populations. While genetic differences in explaining these patterns cannot be excluded, the generally poor growth relative to western growth references is largely due to the complex interactive effects of undernutrition and infection. The effects of diet, nutrition and infection on the nutritional status of a child vary with age, the general disease ecology and the type and extent of exposure to it, patterns of infant and young child feeding, and types of food consumed. There are two possible ways in which the relationship between undernutrition and infection can begin; one in which poor nutritional status leads to impaired immunocompetence and reduced resistance to infection, and the other in which exposure to infectious disease can lead to a range of factors that reduce food intake, absorption of nutrients, or increase nutrient requirements. In PNG prior to, and at early stages of modernisation, primary malnutrition is likely to have been the usual initiating factor in the onset of growth faltering due to undernutrition-infection interactions. However, the possibility that infection may have been the initiating event in some societies cannot be excluded. This would have happened by way of early dietary supplementation of infants with foods of minor nutritional significance, which could have acted as a vehicle for the introduction of infectious disease to the child. With modernisation and adoption of primary health care principles, earlier supplementation of infant diet than was previously the case became common in PNG. This has lead to general improvements in growth and nutritional status. However, in populations where undernutrition is still common, infection has become more important than primary malnutrition as the initiator of growth faltering due to undernutrition-infection interactions.     

Alpha-thalassemia in Papua New Guinea

Summary A study of the distribution of -thalassemia in Papua New Guinea (PNG) was carried out by DNA analysis. A total of 664 DNA samples were screened for -thalassemia 2 and -thalassemia 1 caused respectively by either deletion of one or both of the duplicated -globin genes. -Thalassemia 2 was detected in high frequencies in coastal and lowland regions where malaria has been holo- to hyperendemic but in low frequencies in non-malarious highland regions. The highest frequency was observed in the north coast of PNG. The distribution of -thalassemia 2 seems to be in accordance with other conditions such as ovalocytosis and G6PD deficiency which are also prevalent in this population, suggesting that they may interact in protection against malaria. However, it appears to be negatively correlated with -thalassemia and -thalassemia 1, the latter being extremely rare in this population. Analysis of the types and subtypes of the single -globin gene deletion revealed a predominance of the –^4.2 type in general, except in some regions in the south where the –^3.7 type is prevalent. The –^3.7 I subtype is the common form of the –^3.7 deletion in the PNG mainland. The –^3.7 III subtype, previously reported to be unique in Melanesians and Polynesians, was detected in an offshore island of PNG. However, this subtype is very rare in Melanesians from the PNG mainland.     

Measurement of child mortality in association with a multipurpose birth certificate programme in the Southern Highlands Province of Papua New Guinea.

A simple and inexpensive method for monitoring child mortality in association with birth registration was introduced into the Southern Highlands of Papua New Guinea. Eight thousand two hundred and one newborn infants were registered in 1988, approximately 77% of all children born in that year. The risk of death by age 2 was determined from reports given by the mother on the present status of a previously born child at the time of a recent delivery or during clinic registration of the current birth. This was 91 per 1000 for the province and corresponds to a risk of death by age 1 of 77/1000 by extrapolation using standard lifetables. This method was validated by comparison with a continuing demographic surveillance system covering 30,000 people in the western part of the province. The new birth certificate has been an incentive to increase supervised delivery rates and to generate a register that can be used to increase vaccination coverage.     

Culture and Class in Papua New Guinea

Mangrove Man: Dialogics of Culture in the Sepik Estuary. David Lipset. New York: Cambridge University Press, 1997. 335 pp.
Emerging Class in Papua New Guinea: The Telling of Difference. Deborah B. Gewertz and Frederick K. Errington. New York: Cambridge University Press, 1999. 179 pp.     

Parasitic zoonoses in Papua New Guinea

Relatively few species of zoonotic parasites have been recorded in humans in Papua New Guinea. A greater number of potentially zoonotic species, mostly nematodes, occur in animals but are yet to be reported from humans. Protozoa is the best represented group of those infecting man, with Giardia duodenalis, Cryptosporidium parvum, Cyclospora cayetanesis, Toxoplasma gondii, Sarcocystis spp., Entamoeba polecki, Balantidium coli and, possibly, Blastocystis hominis. The only zoonotic helminths infecting humans include the trematode Paragonimus westermani, the cestodes Hymenolepis nana, H. diminuta and the sparganum larva of Spirometra erinacea, and the nematodes Trichinella papuae and Angiostrongylus cantonensis and, possibly, Ascaris suum. Other groups represented are Acanthocephala (Macracanthorhynchus hirudinaceus)), insects (Chrysomya bezziana, Cimex sp., Ctenocephalides spp.), and mites (Leptotrombidium spp. and, possibly Sarcoptes scabiei, and Demodex sp.). One leech (Phytobdella lineata) may also be considered as being zoonotic. The paucity of zoonotic parasite species can be attributed to long historical isolation of the island of New Guinea and its people, and the absence until recent times of large placental mammals other than pig and dog. Some zoonotic helminths have entered the country with recent importation of domestic animals, in spite of quarantine regulations, and a few more (two cestodes, one nematode and one tick) are poised to enter from neighbouring countries, given the opportunity. Improvement in water supplies, human hygiene and sanitation would reduce the prevalence of many of these parasites, and thorough cooking of meat would lessen the risk of infection by some others.     

Health research in Papua New Guinea

The Papua New Guinea Institute of Medical Research (PNGIMR) is one of the most respected health research institutions in the developing world, and its studies of the local health problems of PNG have consistently had international relevance. This article examines the structural and philosophical factors that have enabled the success of the PNGIMR, and presents the PNGIMR approach to research as a potential model for other disease-endemic countries. An overview of PNGIMR research into malaria and filariasis is given with selected examples as an introduction to a Trends in Parasitology series on health research in Papua New Guinea.     

Hegemony and Voice in Papua New Guinea

Constructing Inequality: The Fabrication of a Hierarchy of Virtue Among the Etoro . Raymond C. Kelly.
Voices of Conflict . Andrew Strathern.     

The seasonal factors influencing child malnutrition on the Nembi Plateau,Papua New Guinea

A sample of children from the Nembi Plateau, Papua New Guinea, is monitored for nutritional status, episodes of sickness and disease, diets, work activity of mothers, and weight changes; and health and census records are examined for seasonal patterns of disease, deaths, birth, and birth weights. A seasonal pattern in birth weight reinforced by a seasonal pattern in growth performance and compounded by a seasonal pattern of disease suggests that the time of year in which a child is born is important to the child's growth and health. Yields, labor, and ritual surrounding the gardens give rise to the seasonal pattern of events that impinge upon the health of children.     

Forest and Demons in the Papua New Guinea Highlands

The Wola people of the Southern Highland Province of Papua New Guinea believe that two kinds of demon spirit inhabit the montane forests of their region. They call them saem and iybtit. When people are attacked by these frightening creatures, they are injured or fall sick, and may die; their relatives perform rituals to drive the demons away and promote their recovery. The attitude of the Wola towards demon spirits expresses something of their ambivalent and enigmatic attitudes towards the forest that covers large areas of their region. They are neither innate conservationists nor reckless destroyers of forest, but something more equivocal, an antipathetic combination of both.     

Malaria vectors of Papua New Guinea

Understanding malaria transmission in Papua New Guinea (PNG) requires exact knowledge of which Anopheles species are transmitting malaria and is complicated by the cryptic species status of many of these mosquitoes. To identify the malaria vectors in PNG we studied Anopheles specimens from 232 collection localities around human habitation throughout PNG (using CO₂ baited light traps and human bait collections). A total of 22,970 mosquitoes were individually assessed using a Plasmodium sporozoite enzyme-linked immunosorbent assay to identify Plasmodiumfalciparum, Plasmodiumvivax and Plasmodiummalariae circumsporozoite proteins. All mosquitoes were identified to species by morphology and/or PCR. Based on distribution, abundance and their ability to develop sporozoites, we identified five species as major vectors of malaria in PNG. These included: Anophelesfarauti, Anopheleshinesorum (incriminated here, to our knowledge, for the first time), Anophelesfarauti 4, Anopheleskoliensis and Anophelespunctulatus. Anopheleslongirostris and Anophelesbancroftii were also incriminated in this study. Surprisingly, An. longirostris showed a high incidence of infections in some areas. A newly identified taxon within the Punctulatus Group, tentatively called An. farauti 8, was also found positive for circumsporozoite protein. These latter three species, together with Anopheleskarwari and Anophelessubpictus, incriminated in other studies, appear to be only minor vectors, while Anophelesfarauti 6 appears to be the major vector in the highland river valleys (>1500 m above sea level). The nine remaining Anopheles species found in PNG have been little studied and their bionomics are unknown; most appear to be uncommon with limited distribution and their possible role in malaria transmission has yet to be determined.     

Fertility and family planning in Papua New Guinea

This paper examines some of the data on fertility, family size and family planning from a survey conducted between November 1979 and March 1980 in 8 provinces both in rural and urban areas of Papua New Guinea (PNG). The sample consisted of 6283 male and female respondents; a total of 3986 females in the age group 15-49 and 2297 males between the ages of 20 and 54 were interviewed. About 9% of the rural and 5.4% of the urban female respondents were pregnant at the time of the interview. The higher number of pregnancies recorded for the rural population, compared to the urban, is due to longer duration of marriage and higher mean age. Both rural and urban respondents have similar attitudes to the ideal number of children. 4 and 6 children were indicated as an ideal number for the urban and rural population, respectively. The results indicate that economic pressures are being felt within the family in both urban and rural areas, and that the costs of raising children are clearly perceived, at least among the educated. Nonetheless, the majority of the population desires large numbers of children, the main reason being economic security in old age. It is also evident that the people have a negative attitude to modern methods of contraception because they are not well informed about them. The most frequently stated reason, the harmful effects on the health of the mother and future offspring, is probably one of the obstacles to their more widespread use. Though there is physical accessibility to family planning services for most urban and about 1/2 of the rural dwellers, the problems of non-use are mainly of a sociological and psychological nature. The problems include the attitude of husbands to their wives' use of contraceptives, reinforcement of culturally acceptable behavior by the extended family and community members, and the desire for more children. Although the levels of contraceptive awareness are relatively high, the overall impression is that the practice of modern contraception in both the rural and urban areas is low. Despite the rural-urban differences in educational and income levels, living conditions, and the availability of family planning services, awareness and current use are only slightly higher among the urban respondents. For family planning programs to have more impact in reducing the high fertility levels, a much more intensive program of activites is needed for the country at large.     

Female fecundity in highland Papua New Guinea

Demographers often assume that interpopulation variation in birth spacing is attributable primarily to behavioral differences (e.g., in breastfeeding, coital frequency, or contraceptive practice), and that the contribution of physiological factors is negligible. This assumption may be correct, but it should be tested, especially in light of recent evidence that there may be more variation in ovarian function among human populations than was previously believed. In this paper, we apply a stochastic model of the determinants of fecundability (the monthly probability of conception) to endocrinological data collected among the Gainj, a tribal population in highland Papua New Guinea. Based on previous research, the Gainj are known to have age patterns of ovarian function that differ markedly from the Western norms. When account is taken of the late menarche, early menopause, and long ovarian cycles that appear to characterize Gainj women, mean apparent fecundability across the female reproductive span is reduced by about 27 per cent (from 0.316 to 0.235), and the mean waiting time to next apparent conception is increased by just over one month. Thus, despite the fact that Gainj women differ from Western women with respect to reproductive physiology by as much as or more than any other known population, the demographic impact of these differences appears to be slight.     

Reflecting on Loss in Papua New Guinea

This article takes up the conundrum of conducting anthropological fieldwork with people who claim that they have ‘lost their culture,’ as is the case with Suau people in the Massim region of Papua New Guinea. But rather than claiming culture loss as a process of dispossession, Suau claim it as a consequence of their own attempts to engage with colonial interests. Suau appear to have responded to missionization and their close proximity to the colonial-era capital by jettisoning many of the practices characteristic of Massim societies, now identified as ‘kastom.’ The rejection of kastom in order to facilitate their relations with Europeans during colonialism, followed by the mourning for kastom after independence, both invite consideration of a kind of reflexivity that requires action based on the presumed perspective of another.     

Research partnerships with local communities: two case studies from Papua New Guinea and Australia

Partnerships between scientists and local communities can increase research capacity and data delivery while improving management effectiveness through enhanced community participation. To encourage such collaboration, this study demonstrates how these partnerships can be formed, drawing on two case studies in coral reef ecosystems in very different social settings (Papua New Guinea and Australia). In each case, steps towards successfully engaging communities in research were similar. These included: (1) early engagement by collaborating organizations to build trust, (2) ensuring scientific questions have direct relevance to the community, (3) providing appropriate incentives for participation, and (4) clear and open communication. Community participants engaged in a variety of research activities, including locating and capturing fishes, collecting and recording data (weight, length and sex), applying external tags, and removing otoliths (ear bones) for ageing and elemental analysis. Research partnerships with communities enhanced research capacity, reduced costs and, perhaps more importantly, improved the likelihood of long-term community support for marine protected areas (MPAs).