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.     

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.     

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.     

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.     

A Place against Time: Land and Environment in the Papua New Guinea Highlands

Place against Time: Land and Environment in the Papua New Guinea Highlands. Paul Sillitoe. London: Harwood Academic Publishers, 1996. 438 pp.     

The Burden of Drug-Resistant Tuberculosis in Papua New Guinea: Results of a Large Population-Based Survey

Background

Reliable estimates of the burden of multidrug-resistant tuberculosis (MDR-TB) are crucial for effective control and prevention of tuberculosis (TB). Papua New Guinea (PNG) is a high TB burden country with limited information on the magnitude of the MDR-TB problem.

Methods

A cross-sectional study was conducted in four PNG provinces: Madang, Morobe, National Capital District and Western Province. Patient sputum samples were tested for rifampicin resistance by the Xpert MTB/RIF assay and those showing the presence of resistance underwent phenotypic susceptibility testing to first- and second-line anti-TB drugs including streptomycin, isoniazid, rifampicin, ethambutol, pyrazinamide, ofloxacin, amikacin, kanamycin and capreomycin.

Results

Among 1,182 TB patients enrolled in the study, MDR-TB was detected in 20 new (2.7%; 95% confidence intervals [CI] 1.1–4.3%) and 24 previously treated (19.1%; 95%CI: 8.5–29.8%) TB cases. No case of extensively drug-resistant TB (XDR-TB) was detected. Thirty percent (6/20) of new and 33.3% (8/24) of previously treated cases with MDR-TB were detected in a single cluster in Western Province.

Conclusion

In PNG the proportion of MDR-TB in new cases is slightly lower than the regional average of 4.4% (95%CI: 2.6–6.3%). A large proportion of MDR-TB cases were identified from a single hospital in Western Province, suggesting that the prevalence of MDR-TB across the country is heterogeneous. Future surveys should further explore this finding. The survey also helped strengthening the use of smear microscopy and Xpert MTB/RIF testing as diagnostic tools for TB in the country.     

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.     

A new aero-aquatic hyphomycete from Papua New Guinea and Australia

An aero-aquatic hyphomycete with setose synnemata and scolecospores with a central isthmus is described.     

The epidemiology of malaria in Papua New Guinea

Papua New Guinea (PNG) is a patchwork of different ecological zones, inhabited by human populations of exceptional cultural and linguistic diversity. This results in complex variations in vector ecology and malaria epidemiology. Malaria is the main cause of morbidity in many health facilities in lowland areas, but it is absent in much of the highlands. All four human malaria species occur, but endemicity varies widely, with Plasmodium falciparum locally reaching holo-endemic levels that are rarely found outside sub-Saharan Africa. The high frequency of Plasmodium vivax is an important difference to most African situations. PNG is therefore a prime location for studies of interactions between different parasite species, and of the biology of local human genetic adaptation and its implications for malaria morbidity and mortality.     

Pre-capitalist modes of production in Papua New Guinea

Conclusion In the articulation-of-modes-of-production literature there is a tendency to treat conceptual structures as if they had lives of their own. Thus modes of production are sometimes portrayed as meeting, intertwining, and reproducing like giant organisms animated by ineluctable laws of motion. But these structures and categories are primarily the products of thought. As such, they cannotdo anything, and they possess no motivational capacity whatsoever. They are simply analytical tools, more-or-less useful in explaining how and why history unfolded in the way it did.The categories and relationships suggested in this paper represent a preliminary attempt to make some sense of pre-contact change in Papua New Guinea. Their adequacy or otherwise will be determined ultimately through more rigorous engagements with the empirical evidence than is possible here.Terence Wesley-Smith is Assistant Professor, University of Hawaii at Monoa, Center for Pacific Islands Studies.     

Molecular parasitology of malaria in Papua New Guinea

Research into the molecular biology of infectious diseases is mostly associated with well-developed countries. But in the midst of tropical Papua New Guinea, highly sophisticated molecular research has being conducted over years to understand and fight malaria and other tropical diseases. Here, we review such research carried out at the Papua New Guinea Institute of Medical Research. This Institute has considerably shaped research on molecular epidemiology through its analysis of the diversity and structure of the Plasmodium falciparum population. In addition, research has been conducted on human host factors and, more recently, the molecular analysis of drug resistance and the underlying molecular mechanisms of host-parasite interactions have been investigated.     

Hunting for Conservation in the Papua New Guinea Highlands

The animals of the Papua New Guinea highlands are relatively defenceless. People not only value their meat, hunters sharing catch with kin, but also formally transact several creatures in the all-important socio-political exchanges that characterise their social life. The local sedentary population is dense, yet it has not hunted species to extinction regardless of their value and vulnerability to predation. This paper seeks an answer in the context of socio-political exchange values that inform social status. It uses data from a survey of animal skull trophies displayed in a sample of houses in the Was valley of the Southern Highlands Province to investigate connections between hunting and social standing - exchange status, kin group affiliation and age - with a view to elucidating tacit conservation behaviour which agencies concerned to protect biodiversity might profitably consider given current participatory rhetoric.     

Insect trypanosomatids in Papua New Guinea: high endemism and diversity

The extreme biological diversity of Oceanian archipelagos has long stimulated research in ecology and evolution. However, parasitic protists in this geographic area remained neglected and no molecular analyses have been carried out to understand the evolutionary patterns and relationships with their hosts. Papua New Guinea (PNG) is a biodiversity hotspot containing over 5% of the world's biodiversity in less than 0.5% of the total land area. In the current work, we examined insect heteropteran hosts collected in PNG for the presence of trypanosomatid parasites. The diversity of insect flagellates was analysed, to our knowledge for the first time, east of Wallace's Line, one of the most distinct biogeographic boundaries of the world. Out of 907 investigated specimens from 138 species and 23 families of the true bugs collected in eight localities, 135 (15%) were infected by at least one trypanosomatid species. High species diversity of captured hosts correlated with high diversity of detected trypanosomatids. Of 46 trypanosomatid Typing Units documented in PNG, only eight were known from other geographic locations, while 38 TUs (~83%) have not been previously encountered. The widespread trypanosomatid TUs were found in both widely distributed and endemic/sub-endemic insects. Approximately one-third of the endemic trypanosomatid TUs were found in widely distributed hosts, while the remaining species were confined to endemic and sub-endemic insects. The TUs from PNG form clades with conspicuous host-parasite coevolutionary patterns, as well as those with a remarkable lack of this trait. In addition, our analysis revealed new members of the subfamilies Leishmaniinae and Strigomonadinae, potentially representing new genera of trypanosomatids.