scholarly journals Does test-based prescription of evidence-based treatment for malaria improve treatment seeking and satisfaction? Findings of repeated cross-sectional surveys in Papua New Guinea

2018 ◽  
Vol 3 (6) ◽  
pp. e000915 ◽  
Author(s):  
Justin Pulford ◽  
Olga P M Saweri ◽  
Caroline Jeffery ◽  
Peter M Siba ◽  
Ivo Mueller ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Response Time ◽  
Treatment Response ◽  
Papua New Guinea ◽  
Symptom Onset ◽  
Febrile Illness ◽  
New Guinea ◽  
Treatment Seeking ◽  
Cross Sectional ◽  
High Satisfaction

IntroductionThe presumptive treatment of febrile illness with antimalarial medication is becoming less common in low-income and middle-income countries as access to reliable diagnostic tests improves. We explore whether the shift towards test-based antimalarial prescription, and the introduction of highly efficacious artemisinin combination therapies (ACTs), reduces critical delays in seeking treatment for febrile illness or increases patient satisfaction.MethodsWe conducted countrywide repeat, cross-sectional surveys in 118 randomly selected primary healthcare services in Papua New Guinea. The clinical case management of 1765 consecutively presenting febrile patients was observed and exit interviews were completed at discharge. This was done prior to implementation of test-based ACT prescription (2011) and at 12 (2012) and 60  months (2016) postimplementation. We conducted multiple logistic regressions. Treatment response time was dichotomised as <24  hours from symptom onset vs 24+ hours. Satisfaction was dichotomised as a ‘high’ vs ‘low’ rating based on participant response to a visual, 7-point Likert-type scale.Results62% (322/517) of febrile patients reported seeking treatment within 24  hours of symptom onset in 2011 compared with 53% (230/434) in 2012 and 42% (339/814) in 2016. Adjusted ORs for reporting a treatment response time <24  hours in the postimplementation surveys were 0.77 (95% CI 0.48 to 1.26) and 0.45 (95% CI 0.31 to 0.65), respectively when compared with the preimplementation period. 53% (230/533) of febrile patients reported ‘high’ satisfaction with the service received in 2011 compared with 32% (143/449) in 2012 and 35% (278/803) in 2016. Adjusted ORs for reporting high satisfaction in the postimplementation surveys were 0.52 (95% CI 0.32 to 0.85) and 0.65 (95% CI 0.39 to 1.10), respectively when compared with the preimplementation period.ConclusionNationwide implementation of test-based ACT prescription in Papua New Guinea has increased the likelihood of critical treatment seeking delays and decreased patient satisfaction with the service received.

scholarly journals Genome Sequence Analysis of First Ross River Virus Isolate from Papua New Guinea Indicates Long-Term, Local Evolution

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 482
Author(s):  
Alice Michie ◽  
John S. Mackenzie ◽  
David W. Smith ◽  
Allison Imrie
Keyword(s):  
Papua New Guinea ◽  
Large Scale ◽  
Solomon Islands ◽  
Febrile Illness ◽  
New Guinea ◽  
Recent Common Ancestor ◽  
Ross River Virus ◽  
Most Recent Common Ancestor ◽  
Mean Time

Ross River virus (RRV) is the most medically significant mosquito-borne virus of Australia, in terms of human morbidity. RRV cases, characterised by febrile illness and potentially persistent arthralgia, have been reported from all Australian states and territories. RRV was the cause of a large-scale epidemic of multiple Pacific Island countries and territories (PICTs) from 1979 to 1980, involving at least 50,000 cases. Historical evidence of RRV seropositivity beyond Australia, in populations of Papua New Guinea (PNG), Indonesia and the Solomon Islands, has been documented. We describe the genomic characterisation and timescale analysis of the first isolate of RRV to be sampled from PNG to date. Our analysis indicates that RRV has evolved locally within PNG, independent of Australian lineages, over an approximate 40 year period. The mean time to most recent common ancestor (tMRCA) of the unique PNG clade coincides with the initiation of the PICTs epidemic in mid-1979. This may indicate that an ancestral variant of the PNG clade was seeded into the region during the epidemic, a period of high RRV transmission. Further epidemiological and molecular-based surveillance is required in PNG to better understand the molecular epidemiology of RRV in the general Australasian region.

scholarly journals Increase in the proportion of Plasmodium falciparum with kelch13 C580Y mutation and decline in pfcrt and pfmdr1 mutant alleles in Papua New Guinea

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoko Yoshida ◽  
Masato Yamauchi ◽  
Ryosuke Morikawa ◽  
Francis Hombhanje ◽  
Toshihiro Mita
Keyword(s):  
Plasmodium Falciparum ◽  
Papua New Guinea ◽  
New Guinea ◽  
Therapeutic Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
In The Wild ◽  
Nationwide Surveillance ◽  
Greater Mekong Subregion ◽  
C580y Mutation

Abstract Background The C580Y mutation in the Plasmodium falciparum kelch13 gene is the most commonly observed variant in artemisinin-resistant isolates in the Greater Mekong Subregion (GMS). Until 2017, it had not been identified outside the GMS, except for Guyana/Amazonia. In 2017, three parasites carrying the C580Y mutation were identified in Papua New Guinea (PNG). As the C580Y allele rapidly spread in the GMS, there is concern that this mutant is now spreading in PNG. Methods In 2020, a cross-sectional survey was conducted at two clinics in Wewak, PNG. Symptomatic patients infected with P. falciparum were treated with artemether plus lumefantrine following a national treatment policy. Blood samples were obtained before treatment, and polymorphisms in kelch13, pfcrt, and pfmdr1 were determined. Parasite positivity was examined on day 3. The results were compared with those of previous studies conducted in 2002, 2003, and 2016–2018. Results A total of 94 patients were included in this analysis. The proportion of C580Y was significantly increased (2.2% in 2017, 5.7% in 2018, and 6.4% in 2020; p = 4.2 × 10–3). A significant upward trend was observed in the wild-type proportion for pfcrt (1.9% in 2016 to 46.7% in 2020; p = 8.9 × 10–16) and pfmdr1 (59.5% in 2016 to 91.4% in 2020; p = 2.3 × 10–6). Among 27 patients successfully followed on day 3, including three with C580Y infections, none showed positive parasitaemia. Conclusions Under the conditions of significant increases in pfcrt K76 and pfmdr1 N86 alleles in PNG, the increase in kelch13 C580Y mutants may be a warning indicator of the emergence of parasites resistant to the currently used first-line treatment regimen of artemether plus lumefantrine. Therefore, nationwide surveillance of molecular markers for drug resistance and assessment of its therapeutic effects are important.

Rapid assessment of avoidable blindness in Papua New Guinea: a nationwide survey

2018 ◽  
Vol 103 (3) ◽  
pp. 338-342 ◽  
Author(s):  
Ling Lee ◽  
Fabrizio D'Esposito ◽  
Jambi Garap ◽  
Geoffrey Wabulembo ◽  
Samuel Peter Koim ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
Refractive Error ◽  
Rapid Assessment ◽  
New Guinea ◽  
Nationwide Survey ◽  
Population Based ◽  
Vision Impairment ◽  
Cross Sectional ◽  
National Capital ◽  
Uncorrected Refractive Error

ObjectiveTo estimate the prevalence and main causes of blindness and vision impairment in people aged 50 years and older in Papua New Guinea (PNG).DesignNational cross-sectional population-based survey in National Capital District (NCD), Highlands, Coastal and Islands regions.MethodsAdults aged 50 years and above were recruited from 100 randomly selected clusters. Each participant underwent monocular presenting and pinhole visual acuity (VA) assessment and lens examination. Those with pinhole VA<6/12 in either eye had a dilated fundus examination to determine the primary cause of reduced vision. Those with obvious lens opacity were interviewed on barriers to cataract surgery.ResultsA total of 4818 adults were examined. The age-adjusted and sex-adjusted prevalence of blindness (VA <3/60), severe vision impairment (SVI, VA <6/60 but ≥3/60), moderate vision impairment (MVI, VA <6/18 but ≥6/60) and early vision impairment (EVI, VA <6/12 but ≥6/18) was 5.6% (95% CI 4.9% to 6.3%), 2.9% (95% CI 2.5% to 3.4%), 10.9% (95% CI 9.9% to 11.9%) and 7.3% (95% CI 6.6% to 8.0%), respectively. The main cause of blindness, SVI and MVI was cataract, while uncorrected refractive error was the main cause of EVI. A significantly higher prevalence of blindness, SVI and MVI occurred in the Highlands compared with NCD. Across all regions, women had lower cataract surgical coverage and spectacle coverage than men.ConclusionsPNG has one of the highest reported prevalence of blindness globally. Cataract and uncorrected refractive error are the main causes, suggesting a need for increased accessible services with improved resources and advocacy for enhancing eye health literacy.

scholarly journals Strengthening routine immunization in Papua New Guinea: a cross-sectional provincial assessment of front-line services

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christopher J. Morgan ◽  
Olga P. M. Saweri ◽  
Nicholas Larme ◽  
Elizabeth Peach ◽  
Pele Melepia ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
New Guinea ◽  
Routine Immunization ◽  
Front Line ◽  
Cross Sectional

scholarly journals Women's knowledge of maternal danger signs during pregnancy: Findings from a cross-sectional survey in Papua New Guinea

Midwifery ◽  
2019 ◽  
Vol 72 ◽  
pp. 7-13 ◽  
Author(s):  
LM Vallely ◽  
R Emori ◽  
H Gouda ◽  
S Phuanukoonnon ◽  
CSE Homer ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
New Guinea ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Danger Signs ◽  
Women's Knowledge ◽  
Women’S Knowledge

scholarly journals Socio-economic status and behavioural and cardiovascular risk factors in Papua New Guinea: A cross-sectional survey

PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0211068 ◽  
Author(s):  
Patricia Rarau ◽  
Justin Pulford ◽  
Hebe Gouda ◽  
Suparat Phuanukoonon ◽  
Chris Bullen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Papua New Guinea ◽  
Economic Status ◽  
New Guinea ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Socio Economic Status

Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross-sectional survey

Sexual Health ◽  
2016 ◽  
Vol 13 (5) ◽  
pp. 420 ◽  
Author(s):  
Lisa M. Vallely ◽  
Pamela Toliman ◽  
Claire Ryan ◽  
Glennis Rai ◽  
Johanna Wapling ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Pregnant Women ◽  
Papua New Guinea ◽  
Trichomonas Vaginalis ◽  
New Guinea ◽  
Antenatal Clinic ◽  
Asia Pacific ◽  
Cross Sectional ◽  
Sexually Transmissible Infections

Background Papua New Guinea (PNG) is estimated to have among the highest prevalences of HIV and sexually transmissible infections (STIs) of any Asia-Pacific country, and one of the highest burdens of maternal syphilis globally. The prevalence of curable STIs, such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), among pregnant women in PNG is relatively unknown. Methods: A cross-sectional bio-behavioural survey to investigate the epidemiology of CT, NG, TV and other STIs among pregnant women in three provinces of PNG was undertaken. Women aged 18–35 years attending their first antenatal clinic visit were invited to participate. Participants completed a short interview and provided self-collected vaginal specimens for CT, NG and TV laboratory-based nucleic acid amplification tests and a venepuncture specimen for laboratory testing for syphilis and Herpes simplex virus type-2 (HSV-2) serology. Routine antenatal assessment was conducted according to national guidelines, including HIV counselling and testing and point-of-care syphilis screening. Results: A total of 765 women were enrolled. Overall, 43% (95% confidence interval (CI): 39.2–46.4) had one or more of CT, NG or TV infection. CT was the most prevalent STI (22.9%, 175/765; 95% CI: 19.9–25.9), followed by TV (22.4%, 171/765; 95% CI: 19.4–25.4), and NG (14.2%, 109/765; 95% CI: 11.7–16.7). The prevalence of active syphilis was 2.2% (17/765; 95% CI: 1.2–3.3), HSV-2 was 28.0% (214/765; 95% CI: 24.8–31.2) and HIV, 0.8% (6/765; 95% CI: 0.2–1.4). Prevalences were highest among primigravid women, women aged <25 years, and among those in Central Province. Conclusion: High prevalences of curable genital STIs were observed among women attending routine antenatal clinic services in PNG. These infections have been associated with adverse pregnancy outcomes and could be important contributors to poor maternal and neonatal health in this setting.

scholarly journals Determinants that Influence the Quality of Outstanding Services on Patient Satisfaction in dr. H. Moh. Anwar General Hospital Sumenep District

2021 ◽  
Vol 5 (1) ◽  
pp. 185-194
Author(s):  
Susiyati Susiyati ◽  
Katmini Katmini
Keyword(s):  
Patient Satisfaction ◽  
Health Services ◽  
Service Quality ◽  
Response Time ◽  
General Hospital ◽  
Linear Regression Analysis ◽  
P Value ◽  
Outpatient Services ◽  
Cross Sectional

Quality hospital services are always a hope for every user of health services and along with the development of science and technology, people are increasingly critical in assessing health services. The purpose of this study was to analyze the effect of loyalty and response time on the quality of outpatient services and patient satisfaction in General Hospital dr. H. Moh. Anwar, Sumenep Regency. The design of this research is an observational quantitative study with a cross sectional approach with the focus of the research directed at analyzing the effect of loyalty and response time on the quality of outpatient services and patient satisfaction in General Hospital dr. H. Moh. Anwar, Sumenep Regency. The total population is 271 respondents and a sample of 109 respondents is taken by the Accidental Sampling technique. The findings showed that most of the respondents had sufficient category loyalty as many as 56 respondents (51.4%). Most of the respondents rated the response time in the medium category as many as 56 respondents (51.4%). Most of the respondents have a moderate category of service quality as many as 55 respondents (50.5%). Most respondentssatisfied as many as 65 respondents (59.6%). Based on the results of the Linear Regression analysis of the service quality variable on utilization, it shows that the p-value <0.05 then H0 is rejected and H1 is accepted, so it can be concluded that there is an influence of loyalty and response time on the quality of outpatient services and patient satisfaction in General Hospital dr. H. Moh. Anwar, Sumenep Regency. It is expected that respondents can provide constructive input and criticism so that the services provided can be in accordance with what is expected.

Sign in / Sign up

Export Citation Format

Share Document