STRIVE PNG: using a partnership-based approach in implementation research to strengthen surveillance and health systems in Papua New Guinea.

Successful implementation research requires effective and equitable relationships between policy-makers, researchers and implementers to effect evidence-based systems change. However, mainstream research grant models between Global North and Global South institutions often (unintentionally) reinforce power imbalances between partners, which result in missed opportunities for knowledge and learning exchange between policy-makers, researchers and implementers.This case study, centred on the STRIVE PNG project, describes how a partnership-based approach has been used to establish, maintain and review effective and equitable relationships between 13 partner organizations (independent research institutes, government health agencies and public health laboratories) to strengthen surveillance and health systems in Papua New Guinea (PNG).

Surveillance of molecular markers of Plasmodium falciparum artemisinin resistance (kelch13 mutations) in Papua New Guinea between 2016 and 2018.

Plasmodium falciparum resistance to artemisinin-based combination therapy (ACT) is a global threat to malaria control and elimination efforts. Mutations in the P. falciparum kelch13 gene (Pfk13) that are associated with delayed parasite clearance have emerged on the Thai-Cambodian border since 2008.

Medical Students at the School of Medicine and Health Sciences, University of Papua New Guinea: Predictors of Performance and Student Backgrounds.

Background: Papua New Guinea, a lower middle income country with a population of around 8.5 million, the majority of whom live in rural areas, produces far fewer than the number of medical graduates required to meet the WHO-recommended doctor/population ratio. The School of Medicine and Health Sciences is under pressure to increase its output and ensure the graduates are able to function in rural settings.

Validation of a Dried Blood Spot Ceftriaxone Assay in Papua New Guinean Children with Severe Bacterial Infections.

Dried blood spot (DBS) antibiotic assays can facilitate pharmacokinetic (PK) studies in situations where venous blood sampling is logistically and/or ethically challenging. In this study, we aimed to demonstrate the validity of a DBS ceftriaxone assay in a PK study of children with severe illness from Papua New Guinea (PNG), a setting in which health care resources are limited and anemia is common. Using a previously validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay, serial plasma and DBS ceftriaxone concentrations were measured in PNG children aged 5 to 10 years with acute bacterial meningitis or severe pneumonia.

Evaluation of Xpert MTB/RIF assay in children with presumed pulmonary tuberculosis in Papua New Guinea.

Background: The Gene Xpert MTB/ RIF assay (Xpert) is used for rapid, simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance. This study examined the accuracy of Xpert in children with suspected pulmonary tuberculosis (PTB).

Methods: Children admitted to Port Moresby General Hospital with suspected PTB were prospectively enrolled between September 2014 and March 2015.

Severe malnutrition in children in Papua New Guinea: effect of a multi-faceted intervention to improve quality of care and nutritional outcomes.

Background And Aims: Severe malnutrition remains a major problem in Papua New Guinea; it is associated with 11% of paediatric hospital admissions and 33% of all child deaths, with a case fatality rate around 20%. This article aims to evaluate the effectiveness of a multi-faceted intervention for improving care for children with severe malnutrition.

Methods: Severe malnutrition was defined as weight-for-age (WFA) <-3 Z-scores with severe wasting or mid upper arm circumference <115 mm or generalised oedema owing to malnutrition.

Risk factors for malnutrition in children at Port Moresby General Hospital, Papua New Guinea: a case-control study.

Fifty children admitted for malnutrition were age matched with 50 admitted for other reasons. These children were more likely to be female (p = 0.003), born low birth weight (p = 0.

Evaluation of an interferon-gamma release assay in children with suspected tuberculosis in Papua New Guinea.

There are few data from tuberculosis (TB) endemic settings of the performance and outcome predictors of the QuantiFERON-TB Gold in Tube assay (QFT) in children with suspected TB. A prospective cross-sectional study was conducted in Papua New Guinea children with suspected TB evaluated at Port Moresby General Hospital (Port Moresby, Papua New Guinea). Two hundred sixteen children were enrolled including 106 probable TB, 87 possible TB and 23 without TB.

Papua New Guinea: real progress towards MDG 4 and real challenges.

With a mortality rate in the under-5 s of 93 per 1000 live births reported in the 1996 Demographic and Health Survey (DHS), Papua New Guinea (PNG) was at the time one of only four countries with stalled progress in child survival, and seemed destined to fail its national Millennium Development Goal (MDG) 4 target. However, accurate estimates have shown reductions in under-5 and infant mortality rates of 19% and 17% respectively, over 10 years from 1996 to 2006. In that period PNG adopted an integrated and coordinated approach to child health that includes all the essential interventions outlined in the Lancet's child survival series, under a framework consistent with the Western Pacific Regional Child Survival Strategy, associated with significant improvements in leadership and coordination of child health services by paediatricians at the provincial and national level.

The aetiology, clinical presentations and outcome of febrile encephalopathy in children in Papua New Guinea.

Background: Febrile encephalopathy, defined as fever, seizures and/or altered consciousness, is a common presentation in children in tropical developing countries. Outcomes range from complete recovery through varying degrees of neurological disability which slowly resolve or remain permanent to death from either the acute illness or complications. Whilst bacterial meningitis accounts for a proportion of children affected, the aetiology in many remains unclear but includes malaria and probably viral encephalitis.

The management of paediatric patients in a general Emergency Department in Papua New Guinea.

Children less than 13 years of age account for 27% of the case mix at the Emergency Department (ED) of the Port Moresby General Hospital (PMGH). The ED is busy, usually overcrowded, understaffed and under-equipped, resulting in less than optimal patient management. Children are a highly vulnerable group of patients and have the potential to deteriorate rapidly.

Reference values for pulse oximetry in healthy children in coastal Papua New Guinea.

We expected oxygen saturation (SpO2) in children in coastal Papua New Guinea (PNG) to be higher than in PNG highlands children. Therefore, SpO2 was documented to determine the reference values of SpO2 in neonates and young children; 149 healthy neonates and 100 healthy infants and children < 5 years old were studied in Port Moresby. SpO2 ranged from 93% to 100% in both groups.

Immune response to measles vaccine in 6 month old infants in Papua New Guinea.

Objective: To assess the efficacy of the current measles immunization schedule in Papua New Guinea, which is to give the first dose at 6 months of age and the second at 9 months.

Methods: Humoral immune response study of 140 Papua New Guinean infants at 6 months of age, measuring measles IgG antibodies by enzyme immunoassay before and 85 days after the 6-month dose of measles vaccine.

Results: After vaccination at 6 months, 35.

Knowledge and attitudes about infant feeding among nulliparous and parous women in Port Moresby: a comparative study.

Knowledge of the advantages of breastfeeding, the disadvantages of bottle feeding and the Papua New Guinean legislation to protect breastfeeding was determined in a comparative study of nulliparous and parous women attending the Antenatal Clinic of Port Moresby General Hospital. A high proportion (40%) of both groups had had experience of bottle feeding. Whilst the large majority (94%) of the women indicated that breastfeeding was the best way to feed babies, knowledge of the reasons for its superiority over bottle feeding and of the dangers of bottle feeding was poor in both groups.

Urinary tract infection in infants and young children presenting with fever without a focus in Port Moresby.

A prospective study was undertaken to document the importance of urinary tract infection (UTI) as a cause of fever without a focus (FWF) in children less than 3 years of age presenting to the Children's Outpatients Department (COPD) of Port Moresby General Hospital (PMGH). 98 children, 55 males and 43 females, with a median age of 17 months and an interquartile range of 5-31.25 months, were recruited.

Operation Open Heart in PNG, 1993-2006.

Objective: To report on the 'Operation Open Heart' (OOH) cardiac surgical program in Papua New Guinea (PNG). To document the short-term surgical outcome, the experience gained and the skill transfer from the visiting team members to their PNG counterparts.

Methodology: Analysis of the database compiled from the records of the patients who were operated on by the visiting cardiothoracic surgical team.

A comparison of booked and unbooked mothers delivering at the Port Moresby General Hospital: a case-control study.

A case-control study of unbooked mothers delivering at the maternity unit of the Port Moresby General Hospital was undertaken over a period of 7 months. 48 mothers who had no antenatal attendances during pregnancy were recruited with 96 booked controls. Reasons for non-attendance, understanding of the importance of antenatal clinics and socioeconomic and demographic factors were recorded to assess likely risk factors for non-attendance.

The management of children with cancer in Papua New Guinea: a review of children with cancer at Port Moresby General Hospital.

In the period of three and a half years between January 1998 and June 2001, 64 children with cancer were seen at the Paediatric Unit of Port Moresby General Hospital (PMGH). 62 children presented for the first time, whilst 2 were under review, having started treatment in 1996. The male:female ratio was 1.

Can clinical signs predict hypoxaemia in Papua New Guinean children with moderate and severe pneumonia?

Pulse oximetry was performed on 77 children admitted with acute lower respiratory tract infections (ALRI) to the children's ward in Port Moresby General Hospital, Papua New Guinea over a 4-month period in 2002. Clinical findings were correlated with different levels of hypoxaemia, <93%, <90% and <85%. Cyanosis, head nodding and drowsiness were good predictors of hypoxia but lacked sensitivity.

The medium-to-long-term outcome of Papua New Guinean children after cardiac surgery.

This study reports the medium-to-long-term outcome in Papua New Guinean (PNG) children selected to undergo cardiac surgery at the Royal Alexandra Hospital for Children in Sydney, Australia between 1978 and 1994. Follow-up ranged from 4 to 20 (median 11) years. The cohort comprised 125 children who had surgery and 31 who were initially selected in PNG for surgery but who on further investigation were found to be unsuitable.