Journal articles on the topic 'Awa (Eastern Highlands Province, Papua New Guinea)'

The Papua New Guinea (PNG) species of the water beetle genus Hydraena Kugelann, 1794, are revised, based on the study of 7,411 databased specimens. The two previously named species are redescribed, and 130 new species are described. The species are placed in 32 species groups. High resolution digital images of all primary types are presented (online version in color), scanning electron micrographs of representative species are given, and geographic distributions are mapped. Male genitalia, representative female terminal abdominal segments and representative spermathecae are illustrated. Papua New Guinea Hydraena species are typically found in sandy/gravelly stream margins, often in association with streamside litter; some species are primarily pond or swamp dwelling, and a few species are usually found in the hygropetric splash zone on stream boulders or on rocks at the margins of waterfalls. The geographic distributions of PNG Hydraena are compared with the Areas of Freshwater Endemism recently proposed by Polhemus and Allen (2007), and found to substantially support those areas. Only one species, H. impercepta Zwick, 1977 is known to be found in both Australia and Papua New Guinea. The probable Australian origins of the PNG hydraenid genera Gymnochthebius and Limnebius are discussed. The origins of just a few species of PNG Hydraena appear to clearly be Australia, and of comparatively recent origin, whereas the origins of the remainder remain problematic because of lack of knowledge of the Hydraena fauna in Papua Province, Indonesia, and islands large and small to the west of New Guinea. No endemic genera of Hydraenidae are currently known for New Guinea, whereas 98% of the known species are endemic. New species of Hydraena are: H. acumena (Eastern Highlands Province: Koma River, tributary of Fio River), H. adelbertensis (Madang Province: Adelbert Mts., below Keki), H. akameku (Madang Province: Akameku–Brahmin, Bismarck Range), H. altapapua (Southern Highlands Province: Sopulkul, 30–35 km NE Mendi), H. ambra (Eastern Highlands Province: Wanitabi Valley, nr. Okapa), H. ambripes (Madang Province: Finisterre Mts., Naho River Valley, Budemu), H. ambroides (Eastern Highlands Province: Wanitabi Valley, nr. Okapa), H. apertista (Madang Province: Finisterre Mts., Lower Naho Valley, Hinggia), H. apexa (Eastern Highlands Province: Okapa), H. aquila (Madang Province: Simbai area), H. aulaarta (Western Highlands Province: Kundum), H. austrobesa (Central Province: nr. Port Moresby, Sogeri Plateau, Musgrave River), H. bacchusi (Eastern Highlands Province: Wanitabi Valley, nr. Okapa), H. balkei (Eastern Highlands Province: Akameku–Brahmin, Bismarck Range), H. bicarinova (Eastern Highlands Province: Wanitabi Valley, nr. Okapa), H. bifunda (Morobe Province: c. 7 mi. Lae–Bulolo road), H. biundulata (Morobe Province: Lae–Bulolo road), H. brahman (Madang Province: Ramu Valley, 4.5 km N Brahman), H. bubulla (Madang Province: Akameku–Brahmin, Bismarck Range), H. buloba (Morobe Province: Herzog Mts., Wagau), H. buquintana (Western Highlands Province: Mt. Hagen town area), H. carinocisiva (Eastern Highlands Province: Aiyura), H. carmellita (Morobe Province: Herzog Mts., Wagau), H. cavifrons (Madang Province: Ramu Valley, 4.5 km N Brahman), H. cheesmanae (Central Province: Kokoda), H. clarinis (Madang Province: Sepik Ramu Basin, Kojé Creek), H. colorata (Morobe Province: 5 miles W of Lae, Buins Creek), H. confluenta (Eastern Highlands Province: Umg. [=environs of] Kainantu, Onerunka), H. copulata (Gulf Province: Marawaka, Mala), H. cunicula (Madang Province: Akameku–Brahmin, Bismarck Range), H. decepta (Eastern Highlands Province: Okapa), H. diadema (Eastern Highlands Province: Purosa Valley, nr. Okapa), H. dudgeoni (Madang Province: Sepik Ramu Basin, Kojé Creek), H. einsteini (Central Province: Port Moresby–Brown River road), H. essentia (Eastern Highlands Province: Sepik River Basin, stream beside milestone labelled G-99), H. exhalista (Gulf Province: Marawaka, Mala), H. fasciata (Morobe Province: Herzog Mts., Wagau), H. fascinata (Madang Province: Finisterre Mts., Naho River Valley, nr. Moro), H. fasciolata (Madang Province: Madang, Ohu Village), H. fasciopaca (Madang Province: Keki, Adelbert Mts.), H. fenestella (Morobe Province: Lae-Bulolo road), H. foliobba (Morobe Province: Herzog Mts., Wagau), H. formosopala (East Sepik Province: Prince Alexander Mts., Wewak), H. funda (Central Province: Moitaka, 7 miles N of Port Moresby), H. fundacta (Madang Province: Adelbert Mts., Sewan–Keki), H. fundapta (Central Province: Port Moresby–Brown River road), H. fundarca (Eastern Highlands Province: Okapa), H. fundextra (Morobe Province: Markham Valley, Gusap), H. galea (Eastern Highlands Province: Akameku–Brahmin, Bismarck Range, 700 m), H. herzogestella (Morobe Province: Herzog Mts., Bundun), H. hornabrooki (East Sepik Province: Sepik, main river), H. huonica (Madang Province: Kewensa, Finisterre Range, Yupna, Huon Peninsula), H. ibalimi (Sandaun Province: Mianmin), H. idema (Eastern Highlands Province: Umg. [=environs of] Onerunka, Ramu River), H. impala (Central Province: nr. Port Moresby, Sogeri Plateau, Musgrave River), H. incisiva (Morobe Province: Herzog Mts., Wagau), H. incista (Western Highlands Province: Simbai, Kairong River), H. infoveola (Gulf Province: Marawaka, Mala), H. inhalista (Madang Province: Finisterre Mts., Naho River Valley, Damanti), H. inplacopaca (Eastern Highlands Province: Waisa, nr. Okapa), H. insandalia (Eastern Highlands Province: Headwaters of Fio River, 0.5 km downstream of river crossing on Herowana/Oke Lookout path, ca. 4.5 km N of Herowana airstrip), H. intensa (Morobe Province: Lae–Bulolo road), H. johncoltranei (National Capital District, Varirata NP), H. jubilata (Madang Province: Finisterre Mts., Naho River Valley, Budemu), H. koje (Madang Province: Sepik Ramu Basin, Kojé Creek), H. koma (Eastern Highlands Province: Koma River, tributary of Fio River, 100 m downstream of rattan bridge crossing, ca. 3.8 km S by E of Herowana airstrip), H. labropaca (Central Province: nr. Port Moresby, Sogeri Plateau, Musgrave River), H. lassulipes (Morobe Province: Herzog Mts., Wagau), H. limbobesa (Gulf Province: Marawaka, near Ande), H. maculopala (Madang Province: Madang, Ohu Village), H. manulea (Morobe Province: Lae, Buins Creek), H. manuloides (Central Province: Port Moresby–Brown River road), H. marawaka (Gulf Province: Marawaka, Mala), H. mercuriala (Sandaun Province: May River), H. mianminica (Sandaun Province:May River), H. nanocolorata (Madang Province: Sepik Ramu Basin, Kojé Creek), H. nanopala (Madang Province: Sepik Ramu Basin, Kojé Creek), H. nitidimenta (Eastern Highlands Province: Koma River, tributary of Fio River, at rattan bridge crossing, ca. 2.6 km N by W of Herowana airstrip), H. okapa (Eastern Highlands Province: Wanitabi Valley, nr. Okapa), H. ollopa (Western Highlands Province: Kundum), H. otiarca (Morobe Province: Herzog Mts., Wagau, Snake River), H. owenobesa (Morobe Province: ca. 10 km S Garaina Saureri), H. pacificica (Morobe Province: Huon Pen., Kwapsanek), H. pala (Morobe Province: Lae–Bulolo road, Gurakor Creek), H. palamita (Central Province: nr. Port Moresby, Sogeri Plateau, Musgrave River), H. paxillipes (Morobe Province: Lae–Bulolo road, Patep Creek), H. pectenata (Madang Province: Finisterre Mts., Naho River Valley, Damanti), H. pegopyga (Madang Province: Ramu Valley, 3 km N Brahman), H. penultimata (Sandaun Province: May River), H. perpunctata (Madang Province: Sepik Ramu Basin, Kojé Creek), H. pertransversa (Eastern Highlands Province: Clear stream, summit of Kassem Pass at forest level), H. phainops (Morobe Province: Lae–Bulolo road, Patep Creek), H. photogenica (Eastern Highlands Province: Goroka, Mt. Gahavisuka), H. picula (Eastern Highlands Province: Goroka, Daulo Pass), H. pilulambra (Eastern Highlands Province: Clear stream, summit of Kassem Pass at forest level), H. pluralticola (Morobe Province: c. 7 miles Lae–Bulolo road), H. processa (Morobe Province: Herzog Mts., Wagau), H. quadriplumipes (Madang Province: Aiome area), H. quintana (Morobe Province: Markham Valley, Lae–Kainantu road, Erap R), H. ramuensis (Madang Province: Ramu Valley, 6 km N Brahman), H. ramuquintana (Madang Province: Ramu Valley, 6 km N Brahman), H. receptiva (Morobe Province: Lae–Bulolo road), H. remulipes (Morobe Province: Herzog Mts., Wagau), H. reticulobesa (Madang Province: Finisterre Mts., Naho River Valley, Moro), H. sagatai (Sandaun Province: Abau River), H. saluta (Madang Province: Finisterre Mts., Naho River Valley, Damanti), H. sepikramuensis (Madang Province: Ramu Valley, Sare River, 4 km N Brahman), H. sexarcuata (Eastern Highlands Province: Akameku–Brahmin, Bismarck Range), H. sexsuprema (Madang Province: Finisterre Mts., Naho River Valley, Damanti), H. spinobesa (Madang Province: Finisterre Mts., Naho River Valley, Budemu), H. striolata (Oro Province: Northern District, Tanbugal Afore village), H. supersexa (Eastern Highlands Province: Okapa), H. supina (Eastern Highlands Province: Wanitabi Valley, nr. Okapa), H. tarsotricha (Morobe Province: Herzog Mts., Wagau, Snake River), H. tetana (Eastern Highlands Province: Okapa), H. thola (Central Province: Port Moresby– Brown River road), H. tholasoris (Morobe Province: Markham Valley, Gusap, c. 90 miles NW of Lae), H. thumbelina (Madang Province: Finisterre Mts., Naho River Valley, Damanti), H. thumbelipes (Sandaun Province: Mianmin), H. tibiopaca (Morobe Province: ridge between Aseki–Menyamya), H. torosopala (Madang Province: Keki, Adelbert Mts.), H. torricellica (Morobe Province: Torricelli Mts., village below Sibilanga Stn.), H. transvallis (Madang Province: Finisterre Mts., Naho River Valley, Damanti), H. trichotarsa (Morobe Province: Lae–Bulolo road), H. tricosipes (Morobe Province: Herzog Mts., Wagau), H. tritropis (Madang Province: Sepik Ramu Basin, Kojé Creek), H. tritutela (Morobe Province: ca. 10 km S Garaina Saureri), H. ulna (Morobe Province: Herzog Mts., Wagau), H. variopaca (Eastern Highlands Province: Wanitabi Valley, nr. Okapa), H. velvetina (Eastern Highlands Province: Purosa Valley, nr. Okapa).

Abstract Background Recent economic growth in Papua New Guinea (PNG) would suggest that the country may be experiencing an epidemiological transition, characterized by a reduction in infectious diseases and a growing burden from non-communicable diseases (NCDs). However, data on cause-specific mortality in PNG are very sparse, and the extent of the transition within the country is poorly understood. Methods Mortality surveillance was established in four small populations across PNG: West Hiri in Central Province, Asaro Valley in Eastern Highlands Province, Hides in Hela Province and Karkar Island in Madang Province. Verbal autopsies (VAs) were conducted on all deaths identified, and causes of death were assigned by SmartVA and classified into five broad disease categories: endemic NCDs; emerging NCDs; endemic infections; emerging infections; and injuries. Results from previous PNG VA studies, using different VA methods and spanning the years 1970 to 2001, are also presented here. Results A total of 868 deaths among adolescents and adults were identified and assigned a cause of death. NCDs made up the majority of all deaths (40.4%), with the endemic NCD of chronic respiratory disease responsible for the largest proportion of deaths (10.5%), followed by the emerging NCD of diabetes (6.2%). Emerging infectious diseases outnumbered endemic infectious diseases (11.9% versus 9.5%). The distribution of causes of death differed across the four sites, with emerging NCDs and emerging infections highest at the site that is most socioeconomically developed, West Hiri. Comparing the 1970–2001 VA series with the present study suggests a large decrease in endemic infections. Conclusions Our results indicate immediate priorities for health service planning and for strengthening of vital registration systems, to more usefully serve the needs of health priority setting.

AbstractOribius species are small flightless weevils endemic to the island of New Guinea and far northern Cape York, Australia. The adults feed externally on leaves, developing fruit and green bark, but their impact as pests and general host use patterns are poorly known. Working in Eastern Highlands Province, Papua New Guinea, we carried out structured host use surveys, farmer surveys, shade-house growth trials and on-farm and on-station impact trials to: (i) estimate the host range of the local Oribius species; (ii) understand adult daily activity patterns; (iii) elucidate feeding habits of the soil dwelling larvae; and (iv) quantify the impacts of adult feeding damage. Oribius inimicus and O. destructor accounted for nearly all the Oribius species encountered locally, of these two O. inimicus was the most abundant. Weevils were collected from 31 of 33 plants surveyed in the Aiyura Valley, and a combination of farmer interviews and literature records provided evidence for the beetles being pestiferous on 43 crops currently or previously grown in the Highlands. Adult weevils had a distinct diurnal pattern of being in the upper plant canopy early in the morning and, to a lesser extent, again late in the afternoon. For the remainder of the day, beetles resided within the canopy, or possibly off the plant. Movement of adults between plants appeared frequent. Pot trials confirmed the larvae are root feeders. Quantified impact studies showed that the weevils are damaging to a range of vegetable and orchard crops (broccoli, capsicum, celery, French bean, Irish potato, lettuce, orange and strawberry), causing average yield losses of around 30–40%, but up to 100% on citrus. Oribius weevils pose a significant and, apparently, growing problem for Highland's agriculture.

The aims of this descriptive study were to confirm the high incidence of subacute sclerosing panencephalitis (SSPE) previously reported from Papua New Guinea (PNG) and to relate SSPE to previous measles vaccination and measles illness. From February 1997 to April 1999 we diagnosed a total of 55 patients with SSPE at Goroka Base General Hospital in Eastern Highlands Province (EHP) of PNG. The diagnosis was based on high cerebrospinal fluid and serum measles virus antibody titres with progressive neurological disorder and myoclonic jerks. Of these 55 patients 42 were from EHP, including 32 whose onset was in the 2-year period 1997–1998. The annual incidence of SSPE in EHP in these 2 years was 98 per million population under 20 years of age, the highest ever reported. This incidence was more than ten times higher than the highest incidence in the prevaccine era reported from elsewhere. The mean age of onset of SSPE was 7·7 years (range 2·8–14·8 years) and the interval between measles and the onset of SSPE, where known, had a mean of 5·9 years and a range of 2·5–11·1 years. Among the SSPE patients 19 had a documented history of measles vaccination. Eight of these 19 also had documentation of previous measles illness; of these, seven were vaccinated after the development of measles and one was vaccinated 20 days before measles illness. Two non-SSPE children received vaccination twice which was documented and subsequently developed measles which was also substantiated by documentation. Two patients with SSPE yielded amplified nucleotide sequences of measles virus that were different from any of the vaccine strains. We found no evidence to implicate measles vaccination in the development of SSPE.

As a cultural anthropologist who specializes in gender and sexuality research in Papua New Guinea (PNG), I was honored to become Senior Research Fellow of the Operational Research Unit (ORU) at the Papua New Guinea Institute of Medical Research (IMR) in Goroka, capital of Eastern Highlands Province. I now head the Anthropology Section thereof. Although I am the only anthropologist there, even our new behavioral health nursing officer can't seem to get enough tape transcription and use of Atlas.ti, a qualitative data software program! The anthropology bug that bit me long ago was spawned by qualitative parents. It infected me with a missionary zeal about qualitative methods and perspectives that I have tried to instill in our new ORU as we have taken on exciting new projects. As well, I have returned four times to the site of Ph.D. dissertation research I conducted over one decade ago—Daru, capital of PNG's Western Province. Adding to this, on August 2, 2003, I got married PNG-style (yep—bridewealth, pigs, and everything), to my longtime companion (Urakume Mahala, nee Cassandra Lee) who also fell in love with PNG.

Introduction: Diarrhoea remains a major cause of illness in Papua New Guinea (PNG); however, little is known about its aetiology. As a result of the cholera outbreak that spread throughout PNG in 2009-2011, we conducted diarrhoeal surveillance in Eastern Highlands Province. Methodology: Following informed consent and a brief questionnaire, participants provided a stool sample or duplicate rectal swabs. Samples were tested for common bacterial pathogens Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp. and Yersinia enterocolitica using established culture methods. Enteric parasites were detected using microscopy. Results: A total of 216 participants were enrolled; where age was recorded, 42% were under 5 years of age, 6.7% were 5 to 17 years of age and 51.3% ≥18 years of age. One or more pathogens were detected in 68 (31.5%) participants, with Shigella (primarily S. flexneri) being the most commonly isolated (47 of 216 participants). Enteric parasites were detected in 23 of the 216 participants, occurring as a co-infection with another pathogen in 12 of 23 cases. No Vibrio cholerae was detected. Shigella isolates were commonly resistant to ampicillin, tetracycline, co-trimoxazole and chloramphenicol. Conclusions: Shigellae, specifically S. flexneri, are important pathogens in the highlands of PNG. While most studies in low-income settings focus on childhood aetiology, we have demonstrated the importance of Shigella in both children and adults. Enteric parasites remain present and presumably contribute to the burden of gastrointestinal illness. While improvements in sanitation and hygiene would help lower the burden of all aetiologies of infectious diarrhoea, additional control strategies targeting Shigella may also be warranted.

Bandicoots in the family Peroryctidae in New Guinea are widespread and relatively abundant, but little is known of their ecology. We present the first detailed study on the ecology of the kalubu bandicoot (Echymipera kalubu) and observations on Raffray’s bandicoot (Peroryctes raffrayanus), from mid-montane forest in Papua New Guinea. Both species were primarily nocturnal and utilised a range of habitats including those modified by human activity, although Raffray’s bandicoot was more frequently encountered in less disturbed areas. Male kalubu bandicoots were larger than females, with larger animals having larger short-term home ranges and evidence for intrasexual territoriality. Mean short-term home-range size was 2.8 ha (MCP, n = 10), with an estimated population density of ~85 animals km–2 in the study area. Female kalubu bandicoots attained sexual maturity at ~400 g and 67% of mature females were reproductively active with an average of 1.5 young per litter. Both species were hunted, but their density, rate of reproduction and use of modified habitats suggest that they were able to withstand current hunting levels.

Background: Appropriate antenatal education services that increase men’s involvement in pregnancy and childbirth is crucial for improving maternal and child health outcomes. However, in Papua New Guinea (PNG), men’s involvement in antenatal education services remains inadequate. This study aimed to describe experiences of men’s involvement in antenatal education services and identify factors that facilitate or restrict their involvement. Methods: A qualitative study was conducted among 17 men who have attended antenatal care (ANC) and involved in antenatal education sessions with their wives. Semi-structured and face-to-face interviews were employed to obtain detailed descriptions of men’s experiences and their perception of antenatal health education services, including factors that influenced their involvement. Data is generated from interviews. The findings are informed by the thematic analysis. Results: Three key themes that emerged were: (1) perception of ANC as women’s domain, (2) knowledge of antenatal education services, and (3) accessing of antenatal education services. Factors influencing men’s involvement were: strict gender roles, being responsible for pregnancy and spousal communication. Lack of knowledge, dissatisfaction with antenatal services, and lack of capacity to involve men were other reasons further observed. Conclusion: This study found negative perceptions; poor maternal knowledge and socio-cultural norms, inadequate information dissemination and poor men-friendly services influenced men’s involvement. Suggestions to strengthen men’s involvement require gender-inclusive and culturally appropriate antenatal education programs.

Isolates of papaya ringspot virus (PRSV) were obtained from plants of pumpkin (Cucurbita spp.) or cucumber (Cucumis sativus) showing mosaic symptoms growing at Zage in Goroka District in the Eastern Highland Province of Papua New Guinea (PNG) or Bagl in the Mount Hagen District, Western Highlands Province. The samples were sent to Australia on FTA cards where they were subjected to High Throughput Sequencing (HTS). When the coding regions of the six new PRSV genomic sequences obtained via HTS were compared with those of 54 other complete PRSV sequences from other parts of the world, all six grouped together with the 12 northern Australian sequences within major phylogroup B minor phylogroup I, the Australian sequences coming from three widely dispersed locations spanning the north of the continent. Notably, none of the PNG isolates grouped with genomic sequences from the nearby country of East Timor in phylogroup A. The closest genetic match between Australian and PNG sequences was a nucleotide (nt) sequence identity of 96.9%, whereas between PNG and East Timorese isolates it was only 83.1%. These phylogenetic and nt identity findings demonstrate genetic connectivity between PRSV populations from PNG and Australia. Recombination analysis of the 60 PRSV sequences available revealed evidence of 26 recombination events within 18 isolates, only four of which were within major phylogroup B and none of which were from PNG or Australia. Within the recombinant genomes, the P1, Cl, NIa-Pro, NIb, 6K2, and 5′UTR regions contained the highest numbers of recombination breakpoints. After removal of nonrecombinant sequences, four minor phylogroups were lost (IV, VII, VIII, XV), only one of which was in phylogroup B. When genome regions from which recombinationally derived tracts of sequence were removed from recombinants prior to alignment with nonrecombinant genomes, seven previous minor phylogroups within major phylogroup A, and two within major phylogroup B, merged either partially or entirely forming four merged minor phylogroups. The genetic connectivity between PNG and northern Australian isolates and absence of detectable recombination within either group suggests that PRSV isolates from East Timor, rather than PNG, might pose a biosecurity threat to northern Australian agriculture should they prove more virulent than those already present.

Zucchini yellow mosaic virus (ZYMV) isolates were obtained in Papua New Guinea (PNG) from cucumber (Cucumis sativus) or pumpkin (Cucurbita spp.) plants showing mosaic symptoms growing at Kongop in the Mount Hagen District, Western Highlands Province, or Zage in the Goroka District, Eastern Highlands Province. The samples were blotted onto FTA cards, which were sent to Australia, where they were subjected to high-throughput sequencing. When the coding regions of the nine new ZYMV genomic sequences found were compared with those of 64 other ZYMV sequences from elsewhere, they grouped together, forming new minor phylogroup VII within ZYMV’s major phylogroup A. Genetic connectivity was lacking between ZYMV genomic sequences from PNG and its neighboring countries, Australia and East Timor; the closest match between a PNG and any other genomic sequence was a 92.8% nucleotide identity with a sequence in major phylogroup A’s minor phylogroup VI from Japan. When the RDP5.2 recombination analysis program was used to compare 66 ZYMV sequences, evidence was obtained of 30 firm recombination events involving 41 sequences, and all isolates from PNG were recombinants. There were 21 sequences without recombination events in major phylogroup A, whereas there were only 4 such sequences within major phylogroup B. ZYMV’s P1, Cl, N1a-Pro, P3, CP, and NIb regions contained the highest evidence of recombination breakpoints. Following removal of recombinant sequences, seven minor phylogroups were absent (I, III, IV, V, VI, VII, and VIII), leaving only minor phylogroups II and IX. By contrast, when a phylogenetic tree was constructed using recombinant sequences with their recombinationally derived tracts removed before analysis, five previous minor phylogroups remained unchanged within major phylogroup A (II, III, IV, V, and VII) while four formed two new merged phylogroups (I/VI and VIII/IX). Absence of genetic connectivity between PNG, Australian, and East Timorese ZYMV sequences, and the 92.8% nucleotide identity between a PNG sequence and the closest sequence from elsewhere, suggest that a single introduction may have occurred followed by subsequent evolution to adapt to the PNG environment. The need for enhanced biosecurity measures to protect against potentially damaging virus movements crossing the seas separating neighboring countries in this region of the world is discussed.

Abstract Background Pneumonia is the leading cause of death in young children globally and is prevalent in the highlands of Papua New Guinea (PNG). We investigated clinical predictors of severe pneumonia to inform local treatment guidelines in this resource-limited setting. Methods Between 2013 and 2020, prospective studies were undertaken enrolling children <5 years presenting with pneumonia to health-care facilities in Goroka Town, Eastern Highlands Province. Physical examination findings and blood cultures were collected. Logistic regression analyses were performed to determine predictors of hypoxaemia (oxygen saturation <90% on presentation), bacteraemia and death. Results There were 2067 cases of pneumonia, hypoxaemia was detected in 36.1%. Bacteraemia was identified in 47/1943 (2.4%) blood cultures. Of 1444 children followed up, 18 (1.2%) died. Central cyanosis (odds ratio 3.82, 95% CI 2.55-5.71) and reduced breath sounds (2.77, 2.17-3.53) independently predicted hypoxaemia; altered consciousness (21.44, 3.91-117.48), bronchial breathing (10.49, 2.01-54.63) and apnoea (2.54, 1.26-5.14) independently predicted bacteraemia; and altered consciousness (20.95, 2.32-189.00), reduced skin turgor (14.43 (4.79-43.49) and central cyanosis (5.96, 2.13-16.66) independently predicted death. Conclusions In children with pneumonia in the PNG highlands, those with central cyanosis, apnoea, bronchial breathing, altered consciousness or reduced skin turgor are at greatest risk of severe outcomes. Ongoing training of health care workers is essential to ensure these signs are recognised and appropriate management promptly instituted. Key messages Prompt recognition of signs of severity is likely to lead to better outcomes for children in PNG with pneumonia. These findings will inform future modifications to local treatment guidelines.

The present study assesses spatio-temporal rainfall variability of the most highlands to the coastal zones, comprising of eight provinces, of PNG. The variability investigation was carried out over for a period of 50 years starting from the year 1968 to 2018. After testing and checking for serial autocorrelation in the data series, Mann-Kendal non-parametric statistical evaluation was carried out to investigate rainfall trends and variability. Sen’s method was also used to investigate the magnitude of change in millimeters (mm) per year. Furthermore, the ArcGIS spatial analysis tools were used for the calculation of mean rainfall and to carry out spatial investigation. The assessments were carried out on an annual and seasonal basis within each designated study zone. CRU TS 4.03 gridded rainfall data on a 0.50 x 0.50 spatial resolution was used as an input data for trend as well as variability investigation. The CRU gridded station wise analysis was carried out to understand the variability at each specific location. From the assessments, it was found out that a higher rainfall is observed in the Eastern parts of Morobe, Southern Highlands region and central to northern part of Madang Province, while a low rainfall was observed in Goroka, the Western part of Morobe, Simbu, Western Highlands, Jiwaka and Enga province. From the trend investigation, it was observed that more grid stations show an increasing trend than a decreasing trend. On annual assessments, the significant decreasing trend is observed in the Enga and SH province, while significantly increasing trend is observed in the whole parts of Madang, and to the northern part of EH and Simbu Province. From overall assessments, it was found out that, there has been an increasing trend since 1968 up to the present.

Abstract Background Menarche, the first menstruation, is a significant developmental milestone for females. In Papua New Guinea (PNG), menarche is an important socio-cultural event marking transition from girlhood to womanhood. PNG is a culturally and linguistically diverse nation, with wide-ranging socio-cultural beliefs and practices around menarche. This study explored post-menarcheal women’s understanding about body changes and menarche, preparation for menarche, and related cultural beliefs and practices at menarche. Methods A constructivist grounded theory study was conducted with 98 female participants who originated from four PNG provinces: Eastern Highlands Province; East Sepik Province; Milne Bay Province; and National Capital District. The participants were purposively and theoretically sampled, with 10 focus group discussions and six individual interviews conducted using a semi-structured interview guide for data collection. Focus group discussions and interviews were voice recorded and transcribed. Data were inductively analyzed using initial, intermediate and advanced coding, memos and constant comparative methods to develop a theoretical model that explains women’s experiences at menarche. Interview participants also identified actions required to improve future experiences of girls at menarche in PNG. Results A grounded theory comprising the core category of ‘Making of a Strong Woman’ and four interconnecting categories (‘Having Baby Sense’; ‘Beginning of Learning’; ‘Intensifying Learning’; and ‘Achieving Womanhood’) was constructed. ‘Urban’ and ‘Rural’ represented both geographical and socio-cultural intervening conditions that influence the experiences of girls at menarche. Experiences of young women at menarche were rooted in socio-cultural beliefs and practices. Women reported being physically and emotionally distressed and unprepared at onset of menarche. Mothers were considered important support, however, their ability to adequately prepare their daughters is limited by shame and secrecy. Despite these limitations, cultural practices at menarche provided an opportunity for intensive preparation of girls for womanhood. Conclusion Limited pre-menarcheal awareness of the meaning of body changes and menarche of girls was linked to culture of shame and secrecy about open discussion on sexuality. However, traditional cultural practices provide an opportunity for collective support and focused learning for girls. Findings from this study have implications for broader sexual and reproductive health education programs in addressing menstrual health and hygiene in PNG, and the Pacific.