Dataset Information

Effect of Climate Factors on the Childhood Pneumonia in Papua New Guinea: A Time-Series Analysis.

ABSTRACT: This study aimed to assess the association between climate factors and the incidence of childhood pneumonia in Papua New Guinea quantitatively and to evaluate the variability of the effect size according to their geographic properties. The pneumonia incidence in children under five-year and meteorological factors were obtained from six areas, including monthly rainfall and the monthly average daily maximum temperatures during the period from 1997 to 2006 from national health surveillance data. A generalized linear model was applied to measure the effect size of local and regional climate factor. The pooled risk of pneumonia in children per every 10 mm increase of rainfall was 0.24% (95% confidence interval: -0.01%-0.50%), and risk per every 1 °C increase of the monthly mean of the maximum daily temperatures was 4.88% (95% CI: 1.57-8.30). Southern oscillation index and dipole mode index showed an overall negative effect on childhood pneumonia incidence, -0.57% and -4.30%, respectively, and the risk of pneumonia was higher in the dry season than in the rainy season (pooled effect: 12.08%). There was a variability in the relationship between climate factors and pneumonia which is assumed to reflect distribution of the determinants of and vulnerability to pneumonia in the community.

SUBMITTER: Kim J

PROVIDER: S-EPMC4772233 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Effect of Climate Factors on the Childhood Pneumonia in Papua New Guinea: A Time-Series Analysis.

Kim Jinseob J Kim Jong-Hun JH Cheong Hae-Kwan HK Kim Ho H Honda Yasushi Y Ha Mina M Hashizume Masahiro M Kolam Joel J Inape Kasis K

International journal of environmental research and public health 20160215 2

This study aimed to assess the association between climate factors and the incidence of childhood pneumonia in Papua New Guinea quantitatively and to evaluate the variability of the effect size according to their geographic properties. The pneumonia incidence in children under five-year and meteorological factors were obtained from six areas, including monthly rainfall and the monthly average daily maximum temperatures during the period from 1997 to 2006 from national health surveillance data. A ...[more]

PMID: 26891307

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Project description:BackgroundPneumonia and meningitis are common causes of severe childhood illness in Papua New Guinea (PNG). The etiology of both clinical conditions in PNG has not been recently assessed. Changes in lifestyle, provision and access to healthcare, antimicrobial utilization and resistance, and the national childhood vaccination schedule necessitate reassessment.MethodsA prospective case-control study was undertaken, enrolling children <5 years of age to determine the contemporary etiology of clinically defined moderate or severe pneumonia or suspected meningitis. Cases were identified following presentation for inpatient or outpatient care in Goroka town, the major population centre in the Eastern Highlands Province. Following enrolment, routine diagnostic specimens including blood, nasopharyngeal swabs, urine and (if required) cerebrospinal fluid, were obtained. Cases residing within one hour's drive of Goroka were followed up, and recruitment of healthy contemporaneous controls was undertaken in the cases' communities.Results998 cases and 978 controls were enrolled over 3 years. This included 784 cases (78.6%) with moderate pneumonia, 187 (18.7%) with severe pneumonia and 75 (7.5%) with suspected meningitis, of whom 48 (4.8%) had concurrent pneumonia. The median age of cases was 7.8 months (Interquartile range [IQR] 3.9-14.3), significantly lower than community controls, which was 20.8 months (IQR 8.2-36.4). Half the cases were admitted to hospital (500/998; 50.1%). Recruitment of cases and controls and successful collection of diagnostic specimens improved throughout the study, with blood volume increasing and rates of blood culture contamination decreasing. The overall case fatality rate was 18/998 (1.8%). Of cases eligible for follow-up, outcome data was available from 76.7%. Low but increasing coverage of Haemophilus influenzae type B conjugate vaccines on the national schedule was observed during the study period: three dose DTPw-HepB-Hib coverage in children >3 months increased from 14.9 to 43.0% and 29.0 to 47.7% in cases and controls (both p?<?0.001). Despite inclusion in the national immunization program in 2014, 2015 PCV13 three-dose coverage in cases and controls >3 months was only 4.0 and 6.5%.ConclusionsRecruitment of large numbers of pediatric pneumonia and meningitis cases and community controls in a third-world setting presents unique challenges. Successful enrolment of 998 cases and 978 controls with comprehensive clinical data, biological specimens and follow up was achieved. Increased vaccine coverage remains an ongoing health priority.

Project description:BackgroundTo control and eventually eliminate vivax malaria, radical treatment with primaquine (PQ) is essential after completion of blood-stage treatment. Although in many malaria-endemic countries, village health volunteers (VHVs) are engaged in diagnostic treatment of malaria in remote communities, they principally provide blood-stage treatment. In such a situation, access to PQ following blood-stage treatment can be a barrier to complete treatment. However, studies on access to PQ treatment have been scarce and limited in health facility-based settings. This study aimed to identify factors associated with access to PQ treatment in rural Papua New Guinea (PNG) from the community case management perspective.MethodsA community-based, cross-sectional survey was conducted to collect sociodemographic information on children under 15 years of age, their households, and their caretakers in East Sepik Province, PNG. Data collection lasted from February to March, 2015. Information on the diagnoses of potential non-falciparum malaria and prescription of PQ in preceding year (January to December 2014) were obtained from child health-record books. Then, multilevel logistic regression model was used to determine the factors associated with formal health facility visits for PQ treatment among children with potential non-falciparum malaria.ResultsOf 420 episodes diagnosed as potential non-falciparum malaria, 46 (11%) were immediately given PQ. The rest were instructed to visit formal health facilities (HFs) for PQ, and the patients obtained PQ during the second visit to HFs was 44%. Consequently, the overall proportion of PQ prescription was 50%. Logistic regression analysis suggested that among the patients who were instructed to visit HFs for PQ treatment, the initial visit to VHV and higher transportation costs to HF were inversely associated with PQ prescription during the second visit to an HF.ConclusionsFew children received PQ treatment during the second visit to HFs following diagnosis of potential non-falciparum malaria. These findings suggest a need to establish a policy to reduce structural and economic barriers and improve rural inhabitant access to PQ treatment.

Project description:BackgroundSince 2004, the Global Fund-supported National Malaria Control Programme of Papua New Guinea (PNG) has been implementing country-wide free long-lasting insecticidal net (LLIN) distribution campaigns. In 2009, after the first distribution, only 32.5% of the population used a LLIN, mainly due to an insufficient number of nets available. This study investigated changes in mosquito net ownership and use following the continued free distribution of LLINs across PNG.MethodsFive villages from each province and 30 households from each village were randomly sampled in a country-wide household survey in 2010/11. A structured questionnaire administered to household heads recorded information on mosquito net ownership and use alongside household characteristics. Revised ownership and access indicators were applied in the analysis to reveal coverage gaps.ResultsThe survey covered 1,996 households in 77 villages. Ownership of at least one LLIN was reported by 81.8% of households, compared to 64.6% in 2009 (P?=?0.002). Sufficient LLINs to cover all household members (one net per two people) were found in 41.3% of the households (21.4% in 2009, P?<?0.001). Of all household members, 61.4% had access to a LLIN within their household (44.3% in 2009 P?=?0.002), and 48.3% slept under a LLIN (32.5% in 2009, P?=?0.001). LLIN use in children under five years amounted to 58.2%, compared to 39.5% in 2009 (P?<?0.001). Significant regional differences in coverage and changes over time were observed. A recent LLIN distribution was a key determinant of LLIN ownership (adj. OR?=?3.46) while families in high quality houses would frequently not own a LLIN (adj. OR?=?0.09). Residents were more likely to use LLINs than household guests (OR?=?2.04).ConclusionsRepeated LLIN distribution has led to significant increases in mosquito net ownership and use with few regional exceptions. Additional nets are required in areas where access is low, while major efforts are required to encourage the use of existing nets in region where access is high but use remains low. Complementary vector control approaches should also be considered in such settings.

Dataset Information

Effect of Climate Factors on the Childhood Pneumonia in Papua New Guinea: A Time-Series Analysis.

Publications

Effect of Climate Factors on the Childhood Pneumonia in Papua New Guinea: A Time-Series Analysis.

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