Madang, Papua New Guinea

Divine Word University
Madang, Papua New Guinea

Divine Word University is a national Catholic university in Papua New Guinea. It is one of the newest tertiary institutions in the country. It was established as a university by an Act of Parliament in 1996. The university is ecumenical and coeducational, and is under the leadership of the Divine Word Missionaries.Its first educational institution was Divine Word Secondary High School. In 1980, this became Divine Word Institute, established by an Act of Parliament.It is based in Madang on the north coast of Papua New Guinea. On-site accommodation is available in DWU as well as day attendance for local students.Divine Word University has five faculties. These are Arts, Business and Informatics, Education, Health Sciecences, and Theology. In 2012 the former Faculty of Flexible Learning was changed into the Flexible Learning Centre and each of its constituent departments migrated to one of the other faculties for administrative purposes. The University offers undergraduate degrees as well as Masters programs in most faculties, and the PhD. Masters and PhD programs can be done on a full-time basis or off campus in distance mode by occasional attendance and work completion.The university is amalgamating and affiliating with a number of institutions to provide a broader base of education. In April 2002, the College of Allied Health science amalgamated and St Benedict's Teachers College in Wewak, East Sepik Province joined in August, 2003. These institutions are now campuses of DWU. In 2013 the university joined in operating Tabubil Hospital in Tabubil, Western Province. Wikipedia.

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Manning L.,University of Western Australia | Laman M.,University of Western Australia | Laman M.,Papua New Guinea Institute of Medical Research | Rosanas-Urgell A.,Papua New Guinea Institute of Medical Research | And 8 more authors.
PLoS Neglected Tropical Diseases | Year: 2012

Background: There are few detailed etiologic studies of severe anemia in children from malaria-endemic areas and none in those countries with holoendemic transmission of multiple Plasmodium species. Methodology/Principal Findings: We examined associates of severe anemia in 143 well-characterized Papua New Guinean (PNG) children aged 0.5-10 years with hemoglobin concentration <50 g/L (median [inter-quartile range] 39 [33-44] g/L) and 120 matched healthy children (113 [107-119] g/L) in a case-control cross-sectional study. A range of socio-demographic, behavioural, anthropometric, clinical and laboratory (including genetic) variables were incorporated in multivariate models with severe anemia as dependent variable. Consistent with a likely trophic effect of chloroquine or amodiaquine on parvovirus B19 (B19V) replication, B19V PCR/IgM positivity had the highest odds ratio (95% confidence interval) of 75.8 (15.4-526), followed by P. falciparum infection (19.4 (6.7-62.6)), vitamin A deficiency (13.5 (5.4-37.7)), body mass index-for-age z-score <2.0 (8.4 (2.7-27.0)) and incomplete vaccination (2.94 (1.3-7.2)). P. vivax infection was inversely associated (0.12 (0.02-0.47), reflecting early acquisition of immunity and/or a lack of reticulocytes for parasite invasion. After imputation of missing data, iron deficiency was a weak positive predictor (6.4% of population attributable risk). Conclusions/Significance: These data show that severe anemia is multifactorial in PNG children, strongly associated with under-nutrition and certain common infections, and potentially preventable through vitamin A supplementation and improved nutrition, completion of vaccination schedules, and intermittent preventive antimalarial treatment using non-chloroquine/amodiaquine-based regimens. © 2012 Manning et al.

Batty K.T.,Curtin University Australia | Salman S.,University of Western Australia | Moore B.R.,University of Western Australia | Benjamin J.,Papua New Guinea Institute of Medical Research | And 8 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2012

Artemisinin-naphthoquine (ART-NQ) is a coformulated antimalarial therapy marketed as a single-dose treatment in Papua New Guinea and other tropical countries. To build on limited knowledge of the pharmacokinetic properties of the components, especially the tetra-aminoquinoline NQ, we studied ART-NQ disposition in Papua New Guinea children aged 5 to 12 years with uncomplicated malaria, comparing a single dose (15 and 6 mg/kg of body weight) administered with water (group 1; n = 13), a single dose (22 and 9 mg/kg) with milk (group 2) (n = 17), and two daily doses of 22 and 9 mg/kg with water (group 3; n = 16). The plasma NQ concentration was assayed by high-performance liquid chromatography, and the plasma ART concentration was assayed using liquid chromatography-mass spectrometry. Population-based multicompartment pharmacokinetic models for NQ and ART were developed. NQ disposition was best characterized by a three-compartment model with a mean absorption half-life (t 1/2) of 1.0 h and predicted median maximum plasma concentrations that ranged as high as 57 μg/liter after the second dose in group 3. The mean NQ elimination t 1/2 was 22.8 days; clearance relative to bioavailability (CL/F) was 1.1 liters/h/kg; and volume at steady state relative to bioavailability (V ss/F) was 710 liters/kg. Administration of NQ with fat (8.5 g; 615 kJ) versus water was associated with 25% increased bioavailability. ART disposition was best characterized by a two-compartment model with a mean CL/F (4.1 liters/h/kg) and V/F (21 liters/kg) similar to those of previous studies. There was a 77% reduction in the bioavailability of the second ART dose (group 3). NQ has pharmacokinetic properties that confirm its potential as an artemisinin partner drug for treatment of uncomplicated pediatric malaria. Copyright © 2012, American Society for Microbiology. All Rights Reserved.

PubMed | Tokyo Women's Medical University, Juntendo University, South Eastern Kenya University, University of Ryukyus and 9 more.
Type: Journal Article | Journal: Antimicrobial agents and chemotherapy | Year: 2016

The emergence and spread of artemisinin-resistant Plasmodium falciparum is of huge concern for the global effort toward malaria control and elimination. Artemisinin resistance, defined as a delayed time to parasite clearance following administration of artemisinin, is associated with mutations in the Pfkelch13 gene of resistant parasites. To date, as many as 60 nonsynonymous mutations have been identified in this gene, but whether these mutations have been selected by artemisinin usage or merely reflect natural polymorphism independent of selection is currently unknown. To clarify this, we sequenced the Pfkelch13 propeller domain in 581 isolates collected before (420 isolates) and after (161 isolates) the implementation of artemisinin combination therapies (ACTs), from various regions of endemicity worldwide. Nonsynonymous mutations were observed in 1% of parasites isolated prior to the introduction of ACTs. Frequencies of mutant isolates, nucleotide diversity, and haplotype diversity were significantly higher in the parasites isolated from populations exposed to artemisinin than in those from populations that had not been exposed to the drug. In the artemisinin-exposed population, a significant excess of dN compared to dS was observed, suggesting the presence of positive selection. In contrast, pairwise comparison of dN and dS and the McDonald and Kreitman test indicate that purifying selection acts on the Pfkelch13 propeller domain in populations not exposed to ACTs. These population genetic analyses reveal a low baseline of Pfkelch13 polymorphism, probably due to purifying selection in the absence of artemisinin selection. In contrast, various Pfkelch13 mutations have been selected under artemisinin pressure.

Hombhanje F.W.,Divine Word University | Huang Q.,China Pharma
Pharmaceuticals | Year: 2010

With the rapidly spreading resistance of Plasmodium falciparum to available non-artemisinin antimalarial drugs, new and novel pharmaceuticals are needed. ARCO® is a new generation ACT, one of several artemisinin-based combinations developed in China to counter antimalarial drug resistance. ARCO® is a derivative of two independently developed antimalarials, artemisinin and naphthoquine phosphate, which were combined to form the artemisinin-naphthoquine combination. Both artemisinin and naphthoquine drugs have proven to be efficacious, safe and well tolerated as monotherapies. The artemisinin- naphthoquine combination offers a novel advantage over existing ACTs: it can be administered as a single oral dose (or a 1-day treatment). Several therapeutic studies conducted recently indicate that a single oral dose administration of artemisinin- naphthoquine combination is equally effective and safe as the 3-day treatment with artemether-lumefantrine combination and other existing ACTs. This would make ARCO® the next generation ACT for the treatment of uncomplicated falciparum malaria. © 2010 by the authors; licensee MDPI, Basel, Switzerland.

Wellsh B.M.,Port Moresby General Hospital | Kuzma J.M.,Divine Word University
American Journal of Emergency Medicine | Year: 2016

Background Pediatric forearm fractures are a common presentation in emergency departments in Papua New Guinea. Often these children undergo "blind" closed reduction with reduction adequacy assessed by standard radiographs. This study aims to demonstrate the safety and efficacy of ultrasound (US) in guiding closed reduction of pediatric forearm fractures in a resource-limited setting. Methods We recruited consecutive children with closed forearm fractures requiring reduction. A US scanner was used to visualize and aid fracture reductions. The outcome measures were the rate of successful reductions (ie, adequate alignment without the need for a second procedure or further surgical intervention), length of stay in hospital, and adverse events during each procedure and at follow-up after 6 weeks. Results Of 47 children recruited, there were 44 (94%) successful reductions, whereas 3 (6%) required repeated reduction. The mean (SD) length of stay in hospital of the successful cases was 8.77 (3.66) hours. Two patients had tight plaster casts during early follow-up which were immediately addressed. Of the 44 successful cases, only 38 were retrieved for the final review. No further adverse events were observed in the latter. Conclusions This small-scale study has demonstrated the safe and efficacious use of US-guided close reduction of pediatric forearm fractures in a low-resource setting. Using US, real-time visualization of reduction efforts can reassure the clinician in decision making, thus reducing the rate of repeated reductions and allowing shorter hospital stay. © 2015 Elsevier Inc. All rights reserved.

Phillips G.A.,St Vincents Hospital | Phillips G.A.,University of Melbourne | Hendrie J.,Austin Hospital | Atua V.,Modilon Hospital | And 2 more authors.
EMA - Emergency Medicine Australasia | Year: 2012

Background: Divine Word University (DWU) is an emerging national university of Papua New Guinea (PNG) based in the provincial capital of Madang, providing training for Health Extension Officers (HEOs). HEOs form the backbone of healthcare delivery in PNG as clinicians, public health officers and health centre managers. Both campus-based and clinical teaching at the nearby Modilon Hospital is limited because of significant resource constraints. Objective: This article describes a visiting clinical lecturer programme in which Australasian emergency physicians and emergency registrars deliver teaching to HEO students at DWU and Modilon Hospital. Methods: Volunteer doctors are briefed pre-departure and given prepared educational tools. Visits are from 2 weeks to 3 months, and include the possibility of accredited training for emergency registrars through the Australasian College for Emergency Medicine. DWU provides secure accommodation and assistance with travel and visa logistics. Tasks for visiting lecturers include delivering campus-based teaching on emergency medicine (EM) topics, structured and opportunistic bedside tutorials, and clinical teaching and assistance with ED care alongside local EM clinicians. Discussion: Programme evaluation has relied on qualitative feedback, which has been positive from all stakeholders. Visiting lecturers gain teaching skills and insights into the challenges of emergency healthcare delivery in an international, resource-constrained setting. Local staff receive assistance and support as well as learning new teaching skills. Students receive increased interactive learning opportunities. Conclusion: This programme provides positive models of both emergency care capacity building in a resource-constrained setting and training in international EM for Australasian clinicians. © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Background: Despite the well-recognized effectiveness of exclusive breastfeeding for the first six months of an infant life for reducing infant mortality, adherence to this practice is not widespread in the developing world. Although several studies on infant nutrition practices have been conducted in urban settings of Papua New Guinea (PNG), there is only scant information on infant feeding practices in rural settings. Therefore, this study aimed to investigate knowledge, attitude and practice associated with exclusive breastfeeding in various locations in rural PNG.Methods: A mixed method study using interviews based on a semi-structured questionnaire (n = 140) and Focus Group Discussions (FGDs) was conducted among mothers in rural PNG between August and September 2012. Participants were selected using convenience sampling. Included in the study were both primiparous and multiparous mothers with a child below the age of two years. Content analysis was used for qualitative data and descriptive statistics were used for quantitative data.Results: Whereas most women indicated breastfeeding as a better way to feed babies, knowledge of the reasons for its superiority over infant formula was generally poor. Only 17% of mothers practiced exclusive breastfeeding for the first six months postpartum. Our study showed that the size of the gap between exclusive breastfeeding practice and global recommendations was striking. Taking into account the low educational profile of the participants, the disparity may be explained by the fact that most of the mothers in this study had no formal education on infant feeding.Conclusions: This study showed a lack of understanding of the importance of and poor adherence to exclusive breastfeeding for the first six months postpartum among rural mothers. As exclusive breastfeeding promotion has been proved to be one of most effective ways to improve infant survival, more attention should be given to it, especially targeting the large proportion of women who missed formal education on infant feeding in school. A proper community-based program including the tools for monitoring its implementation and effectiveness needs to be developed to transform policy recommendations into action in rural PNG. © 2013 Kuzma; licensee BioMed Central Ltd.

Karthikeyan P.,Divine Word University | Ramalingam K.P.,Divine Word University
Disability and Rehabilitation | Year: 2012

Purpose: This article is intended to focus on the need for the use of rehabilitation services, for children with meningitis in Papua New Guinea, which is one of largest developing country in The Pacific with diverse culture and landscape. Meningitis is the fifth leading disease that results in disability in the country. The first line of treatment is usually antibiotics, administration of vaccination is also recommended. Currently community based rehabilitation workers and Physiotherapist offer the rehabilitation services. There is a need for the other rehabilitation professionals and appropriate education to the CBR workers, caregivers for providing effective Rehabilitation. Method: Articles related to meningitis were recruited through various electronic database such as Ovid SP, MEDLINE, CINHAL, Google Scholar and HINARI and EBSCOhost for full text. The search includes journal articles, editorials, research reports, systematic reviews and books. Results: The neurological sequelae resulting from meningitis are increasing. There is a need for Hib vaccination to reduce the rate of mortality. Physiotherapists are new professionals that emerged since 2006 and are assisting in reducing the motor and neurological disability. Conclusions: A multidisciplinary approach is required to manage the child with meningitis. Adequate knowledge, resources and assistance about the condition among the health professionals, carers and teachers would enable the children to achieve the quality of life. Implications for Rehabilitation Meningitis is a neurological disorder resulting from mild to severe neurological sequelea. The need for availability of cephalosporin is required to reduce the consequence of disease. Multidisciplinary approach will reduce the rate of disability resulting from meningitis. © 2012 Informa UK, Ltd.

Suwamaru J.K.,Divine Word University
Studies in Health Technology and Informatics | Year: 2012

Access to basic healthcare in many parts of Papua New Guinea (PNG) remains a challenge partly because the majority of the population is thinly scattered across a geographically rugged country. The major health problems in PNG pertain to malaria, tuberculosis and diarrheal diseases while HIV has reached epidemic levels. The proliferation of the mobile phone technology in PNG has been unprecedented since the introduction of competition in the sector in July 2007. Users in rural areas now access the mobile phone signal making it their preferred form of modern communications medium. This paper introduces an SMS-based HIV/AIDS education, awareness and information dissemination model for a predominantly rural-based PNG society. © 2012 The authors and IOS Press.

PubMed | Papua New Guinea Institute of Medical Research, University of Western Australia, Curtin University Australia and Divine Word University
Type: Journal Article | Journal: Drugs | Year: 2016

Naphthoquine is a 4-aminoquinoline antimalarial drug first synthesised in China in 1986 but which was not developed for clinical use until the late 1990s. Early in vitro parasite sensitivity and in vivo efficacy data, together with a long terminal elimination half-life (up to 23days), suggested that it could be used as monotherapy for uncomplicated falciparum and vivax malaria, but is now marketed as a single-dose, fixed co-formulation with artemisinin in a milligram per kilogram ratio of 1:2.5. This form of artemisinin combination therapy (ACT) has also shown high cure rates, especially in two randomised trials in which, consistent with World Health Organization recommendations for all ACTs, it was administered daily for 3days rather than as single dose for Plasmodium falciparum and P. vivax infections (28-day adequate clinical and parasitological response 98.4%). Although detailed safety monitoring has been performed in a minority of subjects, >4000 healthy volunteers and patients with malaria have been exposed to naphthoquine without any documented significant toxicity. As with other 4-aminoquinolines, naphthoquine is associated with prolongation of the electrocardiographic QT interval but not with cardiac or neurological events. It has been administered to children as young as 4months of age but, due to a lack of pharmacokinetic, efficacy and toxicity data in young infants and in pregnant/lactating women, it should not be used in these vulnerable patient groups.With the emergence of parasite resistance to other ACTs, naphthoquine partnered with a potent artemisinin derivative may prove a viable alternative treatment for uncomplicated malaria.

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