Papua and New Guinea medical journal
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National data for diarrhoeal disease in children can only be used as a very rough guide to morbidity and mortality, since they are based on incomplete reporting. Furthermore, when only one diagnosis per attendance, admission or cause of death is recorded, the true importance of diarrhoea as a cause of morbidity and mortality may be obscured. This may in part explain discrepancies between figures recorded in national and hospital statistics and those recorded in detailed studies of diarrhoeal admissions. ⋯ They should not be used, and may be harmful, in the absence of these indications. Persistent diarrhoea--lasting more than 14 days--is associated with a high mortality and severe malnutrition. It is therefore important that children whose diarrhoea is prolonged for more than 7 days are managed appropriately, using the standard guidelines.
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Taenia solium cysticercosis has been recognized as a public health problem in Indonesian Irian Jaya since its unfortunate introduction in a number of infected pigs imported from Bali. From its original point of introduction in 1971, the infection has spread from the Wissel Lakes area to other places within Irian Jaya. The present situation at the border between Irian Jaya and Papua New Guinea (PNG) is difficult to assess accurately but, in light of the flow of refugees and the traditional rights of movement of people with their pigs in the border area, PNG populations are now at risk. ⋯ A rigorous survey of Irianese refugees at the border and surrounding areas in PNG using recently developed immunodiagnostic procedures such as the EITB (enzyme immunoelectrotransfer blot) for detecting human and pig cysticercosis and the dipstick ELISA (enzyme-linked immunosorbent assay) for identifying T. solium carriers, coupled with careful assessment of medical history and clinical and stool examination, is, however, required. Such a study would allow evaluation of the prevalence of cysticercosis and taeniasis in Irian Jayan refugees residing in camps in PNG. The study would also determine the extent to which the parasite has spread easterly and, importantly, whether cysticercosis/taeniasis has crossed the border and is endemic in PNG, thereby constituting a potentially serious public health problem.
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The perinatal and maternal outcomes of 65 symphysiotomies and 108 caesarean sections carried out after failed trial of assisted delivery at the Port Moresby General Hospital between 1988 and 1994 were retrospectively analyzed. There were no significant differences in perinatal outcomes between the treatment groups. ⋯ There are many advantages of symphysiotomy, particularly in developing countries, following a failed trial of assisted delivery, provided the indications for it are strictly met. Obstetricians experienced in the technique are able to apply it at the optimal time, with long-term benefit to their patients, who thereby avoid the risks of pregnancy subsequent to caesarean section.
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Comparative Study
The clinical competency of community health workers in the eastern highlands province of Papua New Guinea.
A case study of the clinical competency of community health workers employed in the Eastern Highlands Province of Papua New Guinea was conducted in March 1993. Of the 79 who graduated from the Onamuga Community Health Worker Training School between 1989 and 1992, only 24 were currently employed in the province. Current knowledge and clinical competency were compared with results on completion of basic community health worker training. ⋯ If CHWs' skills are to be maintained, certainly good supervision, inservice training and adequate logistic support are needed, but so also is a change in management thinking. The CHW has been trained specifically to improve the access to essential primary health care services of people living in rural areas, especially in preventive and maternal and child health care. If in practice the CHW is not given the opportunity to practise and hence maintain these skills, the whole logic of the CHW training scheme will need to be reexamined.