Peter Heywood

Avoiding neonatal death: an intervention study of umbilical cord care

During a study of pregnancy in a poor rural tropical area, a high prevalence of neonatal fever and umbilical cord infection was detected. Interim analysis showed that this was associated with subsequent development of neonatal sepsis. Therefore an intervention was introduced in two stages. In the first stage, acriflavine spirit and new razor blades were supplied to mothers, along with instructions for use, through antenatal clinics. In the second stage, when excessive cord bleeding was reported, umbilical cord clamps were added to the pack. The packs were associated with reduction of serious morbidity in the neonatal period. The study demonstrates the importance of umbilical cord care in the aetiology of life threatening neonatal morbidity in village births in a developing country and the effect of a simple intervention in reducing morbid episodes in the neonate.

Twenty-Five Years Of Dietary Change In Simbu Province, Papua New Guinea

This study was carried out to assess the changes in food and nutrient intake which had taken place over a 25‐year period in which there had been rapid economic change from a solely subsistence economy to one in which there is now substantial cash income. The results indicate that protein intake has increased in all age groups and that energy intake has increased in younger age groups but not in adults. The contribution of the traditional staple, sweet potato, to the intake of energy and protein has decreased, whilst that of store bought foods, particularly cereals and fish, has increased markedly. It is concluded that economic development and involvement in the cash economy have resulted in an improvement in protein and energy intakes but that these same changes are leading to dependency on imported foods.

Behavioral effects of iron supplementation in infants in Madang, Papua New Guinea

The effect of iron supplementation on attending behavior of 96 1-y-old infants was assessed in a double-blind, randomized, controlled trial of iron dextran in Papua New Guinea. The treatment group received an injection of iron dextran at 2 mo; the controls received a placebo injection. Because many children had malarial parasitemia at testing, presence of malaria was used in the analysis. A significant interaction was found between iron and malaria infection on total fixation time: iron-supplemented groups and placebo-treated parasitemic children showed significantly higher total fixation scores than did placebo-treated aparasitemic children. Blood analysis of iron status showed similar results, with lowest iron status evident in the placebo-treated aparasitemic group. There was no effect of treatment on rate of habituation or dishabituation. Supplemental iron treatment has a significant effect on attention but the direction of the effect depends on the presence of malaria infection.

Cultural aspects of early childhood growth and nutrition among the Amele of lowland Papua New Guinea.

Childhood malnutrition in Papua New Grinea has often been attributed to inadequate practices. Combining the methods of ethnography and nutrition, this study assesses the impact of beliefs and practices concerning breast feeding and supplementation on infant and toddler growth among the Amele of Lowland Madang Province. Results indicate a clear role for notions about lactation and the proper timing of appropriate foods in growth retardation of young children. Conceptualizing developmental stages emically instead of etically is a useful approach to gathering data for nutrition education programs.

Growth and nutrition in Papua New Guinea

There is considerable variation within Papua New Guinea in physical traits such as stature, weight, body morphology and the growth rates of children. The degree to which these differences are due to genetic and/or environmental factors is uncertain and this leads to difficulties in assessing nutritional status. The significance of the growth patterns observed and evidence from one highland province that there have been improvements in the growth of children in the last 25 years, which are associated with dietary changes involving an increase in consumption of imported foods, are assessed in terms of the relationship between nutritional status and prospective risk of death. There are limits to the extent ot which “adaptations”, such as reduced body size, are successful. As nutritional status improves so will survival leading to increased pressure on resources and, possibly, to an increase in the biological variability of the population.

The mineral content of commonly consumed Malawian and Papua New Guinean Foods

Abstract The calcium, phosphorus, zinc, copper, manganese, magnesium, sodium, and potassium contents of 44 Malawian foods and 18 Papua New Guinean foods were analyzed using flame atomic absorption spectrophotometry and X-ray fluorescence procedures. The mineral content (mg/100 g edible portion) of these foods ranged from trace amounts (maize flour) to 3292 (crabs) for Ca; 7 (sago) to 1702 (dry matemba) for P; 0.08 (sago) to 25.4 (usipa) for Zn; 0.01 (sago) to 3.0 (locust) for Cu; 0.03 (yam, pumpkin, duck egg) to 3.92 (tulip) for Mn; 6 (pancakes) to 259 (crabs) for Mg; trace amounts (cereals, sago) to 578 (crabs) for Na; 16 (sago) to 1397 (dry kidney bean) for K. Animal products had the highest content of most minerals analyzed. The mineral content of the dietary staples tended to below.

Mortality in a rural area of Madang province Papua New Guinea.

As part of a multi-disciplinary research programme undertaken by the Papua New Guinea Institute of Medical Research near the town of Madang, northern PNG, a three-year study of mortality was conducted in a rural population of approximately 16,500 people. From early 1982 the area was under continuous demographic surveillance which continued for the three years of the study. All deaths which occurred in this period were investigated by interviewing relatives of the deceased and examining any available health service records. Respiratory diseases were the commonest cause of death, with pneumonia accounting for 20% of deaths in children under 10 years of age, and pneumonia and chronic obstructive lung disease (COLD) together accounting for a third of all deaths. Deaths from COLD were more common in the study population than in PNG hospitals and health centres. The proportion of deaths caused by malaria in children under 10 years was estimated to be between 4 and 17%. Mortality rate in the first year of life were determined by following up a cohort of 1015 births occurring in the first 20 months of the study. Of the 1002 live births, 46 died in the first 12 months of life, giving an infant mortality rate of 45.9% live births. Other mortality and demographic rates were consistent with data reported from the 1980 PNG National Census, suggesting that the study population belonged to an advantaged rural area. Demographic features found in this population were a high birth rate, a relatively low crude death rate, and a rate of natural population increase of 2.8% per annum. The methodological difficulties associated with the measurement of malaria mortality have important implications for the evaluation of future malaria vaccines. The methods employed in this study are critically discussed, and recommendations made for future studies.

Linear growth of children in Papua New Guinea in relation to dietary, environmental and genetic factors

Linear growth rates in rural Papua New Guinea vary widely by environmental zone. The 1982/83 National Nutrition Survey was a stratified cluster sample survey including questions on diet and anthropometry of children under five years of age. Regression analyses including 25,022 children from this survey show that variation in stature by altitude and precipitation level can largely be accounted for by differences in the fat and protein contents of village diets. Differences in linear growth rate between children living on different landforms show less relationship with diet. Genetic distances based on Class I HLA gene frequencies were calculated for 29 populations. Population mean recumbent lengths were estimated adjusted for age, diet, and environmental variables. The differences between populations in these average lengths were calculated. No significant correlation was found between genetic distances and differences in length. Genetic differences between ancestral populations as tracked by the HLA system do not appear to be an important factor contributing to variation in linear growth of Papua New Guinean children.

Birthweight and Gestation of Village Deliveries in Papua New Guinea

This study investigates the birthweight, gestational age, and body proportions of home births in a malarious area of Papua New Guinea. A population based cohort of pregnant women was followed longitudinally through pregnancy. Within the first few days of birth anthropometric measures were taken and a gestational age assessment made. Of the 121 live singleton infants, forty per cent were low birthweight and the preterm rate was 4 per cent. Infants appeared to be proportionally growth retarded. Low birthweight was associated with short maternal stature, and preterm delivery maternal illness. Mean birthweight derived from hospital statistics of babies born to women from the same area was higher than the mean derived from this population based study.

The selenium content of staple foods from Malawi and Papua New Guinea

Abstract Selected samples of raw and cooked staple foods from the Zomba district of Malawi, East Africa (n = 37), and the Wosera subdistrict of Papua New Guinea (n = 19) were analyzed for selenium by instrumental neutron activation analysis, using the short-lived 77Se ( t 1 2 = 17.4 s ) isotope. Food samples, previously dried and ground, were irradiated at a neutron flux of 5 × 1012 neutrons · CM−2 · s−1 using an irradiation/decay/count protocol of 30, 7, and 30 s, respectively. Selenium concentrations were determined by recording the net counts of the 162-keV γ rays emitted by 77Se within the samples. Selenium content was expressed per 100 g of raw or cooked edible portion, on a wet weight basis. Of the Malawian staple foods, animal products such as fish had the highest selenium concentrations (11.1 to 73.2 μg/ 100 g), followed by duck eggs (19.5 μg/ 100 g). Cereals had selenium concentrations ranging from 2.0 to 12.9 μg/100 g; legumes ranged from 0.7 to 6.4μg/100 g; fruits and vegetables were low (0.2 to 1.2 μg/100 g). The staple foods analyzed from Papua New Guinea were mostly plant-based and low in selenium ranging from 0.1 μg Se/100 g for sago to 3.3 μg/100 g for pumpkin tips. Breadfruit seeds, however, contained 10.7 μg Se/100 g. The selenium content of the Malawian foods resembled that of comparable foods grown in countries where the soil is low in selenium. The analyzed staple foods of Papua New Guinea were generally low in selenium.