Diarrhoeal disease surveillance in Papua New Guinea : findings and challenges
- Abdad, Mohammad, Soli, Kevin, Pham, Bang, Bande, Grace, Maure, Tobias, Jonduo, Marinjo, Kisa, Debbie, Rai, Glennis, Phuanukoonnon, Suparat, Siba, Peter, Horwood, Paul, Greenhill, Andrew
- Authors: Abdad, Mohammad , Soli, Kevin , Pham, Bang , Bande, Grace , Maure, Tobias , Jonduo, Marinjo , Kisa, Debbie , Rai, Glennis , Phuanukoonnon, Suparat , Siba, Peter , Horwood, Paul , Greenhill, Andrew
- Date: 2020
- Type: Text , Journal article
- Relation: Western Pacific Surveillance and Response Vol. 11, no. 1 (Jan-Mar 2020), p. 6
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- Description: Diarrhoeal diseases are among the leading causes of morbidity and mortality in the Western Pacific Region. However, data on the major causes of infectious diarrhoea are limited in many countries within the Region, including Papua New Guinea. In 2013-2014, we conducted surveillance for acute diarrhoeal illness in four provinces in Papua New Guinea. One rural health clinic from each province participated in the surveillance activity. Samples were sent to central laboratories and batch analysed for bacterial and viral gastrointestinal pathogens that are commonly associated with diarrhoea. Across the four sites, the most commonly detected pathogens were Shigella spp., Campylobacter spp. and rotavirus. In this paper, we report the results of the surveillance activity and the challenges that we faced. The lessons learnt may be applicable to other parts of the Region with a similar socioeconomic status.
- Authors: Abdad, Mohammad , Soli, Kevin , Pham, Bang , Bande, Grace , Maure, Tobias , Jonduo, Marinjo , Kisa, Debbie , Rai, Glennis , Phuanukoonnon, Suparat , Siba, Peter , Horwood, Paul , Greenhill, Andrew
- Date: 2020
- Type: Text , Journal article
- Relation: Western Pacific Surveillance and Response Vol. 11, no. 1 (Jan-Mar 2020), p. 6
- Full Text:
- Reviewed:
- Description: Diarrhoeal diseases are among the leading causes of morbidity and mortality in the Western Pacific Region. However, data on the major causes of infectious diarrhoea are limited in many countries within the Region, including Papua New Guinea. In 2013-2014, we conducted surveillance for acute diarrhoeal illness in four provinces in Papua New Guinea. One rural health clinic from each province participated in the surveillance activity. Samples were sent to central laboratories and batch analysed for bacterial and viral gastrointestinal pathogens that are commonly associated with diarrhoea. Across the four sites, the most commonly detected pathogens were Shigella spp., Campylobacter spp. and rotavirus. In this paper, we report the results of the surveillance activity and the challenges that we faced. The lessons learnt may be applicable to other parts of the Region with a similar socioeconomic status.
Methicillin-resistant staphylococcus aureus in Melanesian children with haematogenous osteomyelitis from the Central Highlands of Papua New Guinea
- Aglua, Izzard, Jaworski, Jan, Drekore, Jimmy, Urakoko, Bohu, Poka, Harry, Michael, Audrey, Greenhill, Andrew
- Authors: Aglua, Izzard , Jaworski, Jan , Drekore, Jimmy , Urakoko, Bohu , Poka, Harry , Michael, Audrey , Greenhill, Andrew
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Pediatrics Vol. 6, no. 10 (2018), p. 8361-8370
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- Description: Background: Methicillin-Resistant Staphylococcus aureus (MRSA) has been an important cause of bone infection since the 1940s. Current guidelines recommend targeted antibiotic use for osteomyelitis treatment informed by microbial sensitivity patterns. However, in settings without microbiology facilities, empirical antibiotic use is common. Unrecognized antibiotic resistance potentiates persistence of MRSA with osteomyelitis progression to chronic forms with complications despite antibiotic treatment. Materials and Methods: A prospective observational study was done to identify common etiological agent (s) in bone infection in Melanesian children (that were admitted to the two surgical and one pediatric wards of the SJNM-KUGH in the Simbu province of Papua New Guinea in 2012 and 2017), observe for presence of antimicrobial resistance, and determine effective antibiotic regimes for treatment of bone pediatric osteomyelitis. Seventy pediatric patients presenting from the community with osteomyelitis were recruited, with bone and non-bone specimens sampled, cultured and isolates tested for resistance to common antibiotics. Results: Staphylococcus aureus (S. aureus) was isolated in 67% (47/70) of collected specimens. Of the 47 isolates, there was 91.5% resistance to penicillin, 85.1% resistance to methicillin, 89.4% resistance to oxacillin, 93.6% resistance to ampicillin and 80.9% resistance to ceftriaxone. S. aureus showed 91.5% sensitivity to gentamycin, 93.6% sensitivity to erythromycin, tetracycline and clindamycin, and 95.7% sensitivity to Co-trimoxazole. Conclusion: MRSA was the leading cause of haematogenous osteomyelitis in Melanesian children. S.aureus was isolated mainly from infected long bones of the lower limbs (79%) of children presenting from the community, suggesting a predominantly community-associated MRSA.
- Authors: Aglua, Izzard , Jaworski, Jan , Drekore, Jimmy , Urakoko, Bohu , Poka, Harry , Michael, Audrey , Greenhill, Andrew
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Pediatrics Vol. 6, no. 10 (2018), p. 8361-8370
- Full Text:
- Reviewed:
- Description: Background: Methicillin-Resistant Staphylococcus aureus (MRSA) has been an important cause of bone infection since the 1940s. Current guidelines recommend targeted antibiotic use for osteomyelitis treatment informed by microbial sensitivity patterns. However, in settings without microbiology facilities, empirical antibiotic use is common. Unrecognized antibiotic resistance potentiates persistence of MRSA with osteomyelitis progression to chronic forms with complications despite antibiotic treatment. Materials and Methods: A prospective observational study was done to identify common etiological agent (s) in bone infection in Melanesian children (that were admitted to the two surgical and one pediatric wards of the SJNM-KUGH in the Simbu province of Papua New Guinea in 2012 and 2017), observe for presence of antimicrobial resistance, and determine effective antibiotic regimes for treatment of bone pediatric osteomyelitis. Seventy pediatric patients presenting from the community with osteomyelitis were recruited, with bone and non-bone specimens sampled, cultured and isolates tested for resistance to common antibiotics. Results: Staphylococcus aureus (S. aureus) was isolated in 67% (47/70) of collected specimens. Of the 47 isolates, there was 91.5% resistance to penicillin, 85.1% resistance to methicillin, 89.4% resistance to oxacillin, 93.6% resistance to ampicillin and 80.9% resistance to ceftriaxone. S. aureus showed 91.5% sensitivity to gentamycin, 93.6% sensitivity to erythromycin, tetracycline and clindamycin, and 95.7% sensitivity to Co-trimoxazole. Conclusion: MRSA was the leading cause of haematogenous osteomyelitis in Melanesian children. S.aureus was isolated mainly from infected long bones of the lower limbs (79%) of children presenting from the community, suggesting a predominantly community-associated MRSA.
Limited impact of neonatal or early infant schedules of 7-valent pneumococcal conjugate vaccination on nasopharyngeal carriage of Streptococcus pneumoniae in Papua New Guinean children: A randomized controlled trial
- Aho, Celestine, Michael, Audrey, Yoannes, Mition, Greenhill, Andrew, Jacoby, Peter, Reeder, John, Pomat, William, Saleu, Gerard, Namuigi, Pioto, Phuanukoonnon, Suparat, Smith-Vaughan, Heidi, Leach, Amanda, Richmond, Peter, Lehmann, Deborah
- Authors: Aho, Celestine , Michael, Audrey , Yoannes, Mition , Greenhill, Andrew , Jacoby, Peter , Reeder, John , Pomat, William , Saleu, Gerard , Namuigi, Pioto , Phuanukoonnon, Suparat , Smith-Vaughan, Heidi , Leach, Amanda , Richmond, Peter , Lehmann, Deborah
- Date: 2016
- Type: Text , Journal article
- Relation: Vaccine Reports Vol. 6, no. (2016), p. 36-43
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- Description: Streptococcus pneumoniae is a leading cause of pneumonia, the most common cause of childhood death. Papua New Guinean children experience high rates of nasopharyngeal pneumococcal colonization within weeks of birth, predisposing them to pneumococcal disease. In a trial to determine the safety and immunogenicity of early infant vaccination with 7-valent pneumococcal conjugate vaccine (7vPCV), we investigated the impact of early schedules on pneumococcal carriage. Infants were randomized at birth to receive 7vPCV in a 0–1–2-month (n = 101) or a 1–2–3-month (n = 105) schedule or no 7vPCV (n = 106). All children received 23-valent pneumococcal polysaccharide vaccine at age 9 months. We cultured nasopharyngeal swabs (NPS) collected at ages 1, 2, 3, 4 weeks and 3, 9, 18 months, and middle ear discharge if present. Pneumococcal serotypes were identified by the Quellung reaction. A total of 1761 NPS were cultured. The prevalence of pneumococcal carriage was 22% at 1 week of age, rising to 80% by age 3 months and remained >70% thereafter, with high-density carriage in 42% of pneumococcuspositive samples. We identified 63 different serotypes; 43% of isolates from controls were 13vPCV serotypes. There were no significant differences in 7vPCV serotype carriage between 7vPCV recipients and controls at any age (22% vs. 31% at 9 months, p = 0.2). At age 9 months the prevalence of non-7vPCV carriage was 17% higher in 7vPCV recipients (48%) than in controls (25%, p = 0.02). More non-7vPCV serotypes were isolated from ear discharge in 16 7vPCV recipients than from 4 controls (48% vs. 25%, p = 0.13). The limited impact of neonatal or accelerated infant 7vPCV schedules on vaccine serotype carriage is probably due to the early onset of dense carriage of a broad range of pneumococcal serotypes. While serotype-independent pneumococcal vaccines are needed in high-risk populations, the underlying environmental factors and sources of infection must be investigated.
- Authors: Aho, Celestine , Michael, Audrey , Yoannes, Mition , Greenhill, Andrew , Jacoby, Peter , Reeder, John , Pomat, William , Saleu, Gerard , Namuigi, Pioto , Phuanukoonnon, Suparat , Smith-Vaughan, Heidi , Leach, Amanda , Richmond, Peter , Lehmann, Deborah
- Date: 2016
- Type: Text , Journal article
- Relation: Vaccine Reports Vol. 6, no. (2016), p. 36-43
- Full Text:
- Reviewed:
- Description: Streptococcus pneumoniae is a leading cause of pneumonia, the most common cause of childhood death. Papua New Guinean children experience high rates of nasopharyngeal pneumococcal colonization within weeks of birth, predisposing them to pneumococcal disease. In a trial to determine the safety and immunogenicity of early infant vaccination with 7-valent pneumococcal conjugate vaccine (7vPCV), we investigated the impact of early schedules on pneumococcal carriage. Infants were randomized at birth to receive 7vPCV in a 0–1–2-month (n = 101) or a 1–2–3-month (n = 105) schedule or no 7vPCV (n = 106). All children received 23-valent pneumococcal polysaccharide vaccine at age 9 months. We cultured nasopharyngeal swabs (NPS) collected at ages 1, 2, 3, 4 weeks and 3, 9, 18 months, and middle ear discharge if present. Pneumococcal serotypes were identified by the Quellung reaction. A total of 1761 NPS were cultured. The prevalence of pneumococcal carriage was 22% at 1 week of age, rising to 80% by age 3 months and remained >70% thereafter, with high-density carriage in 42% of pneumococcuspositive samples. We identified 63 different serotypes; 43% of isolates from controls were 13vPCV serotypes. There were no significant differences in 7vPCV serotype carriage between 7vPCV recipients and controls at any age (22% vs. 31% at 9 months, p = 0.2). At age 9 months the prevalence of non-7vPCV carriage was 17% higher in 7vPCV recipients (48%) than in controls (25%, p = 0.02). More non-7vPCV serotypes were isolated from ear discharge in 16 7vPCV recipients than from 4 controls (48% vs. 25%, p = 0.13). The limited impact of neonatal or accelerated infant 7vPCV schedules on vaccine serotype carriage is probably due to the early onset of dense carriage of a broad range of pneumococcal serotypes. While serotype-independent pneumococcal vaccines are needed in high-risk populations, the underlying environmental factors and sources of infection must be investigated.
Molecular phylogeny of Burkholderia pseudomallei from a remote region of Papua New Guinea
- Baker, Anthony, Pearson, Talima, Price, Erin, Dale, Julia, Keim, Paul, Hornstra, Heidie, Greenhill, Andrew, Padilla, Gabriel, Warner, Jeffrey
- Authors: Baker, Anthony , Pearson, Talima , Price, Erin , Dale, Julia , Keim, Paul , Hornstra, Heidie , Greenhill, Andrew , Padilla, Gabriel , Warner, Jeffrey
- Date: 2011
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 6, no. 3 (2011), p.
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- Description: Background: The island of New Guinea is located midway between the world's two major melioidosis endemic regions of Australia and Southeast Asia. Previous studies in Papua New Guinea have demonstrated autochthonous melioidosis in Balimo, Western province. In contrast to other regions of endemicity, isolates recovered from both environmental and clinical sources demonstrate narrow genetic diversity over large spatial and temporal scales. Methodology/Principal Findings: We employed molecular typing techniques to determine the phylogenetic relationships of these isolates to each other and to others worldwide to aid in understanding the origins of the Papua New Guinean isolates. Multi-locus sequence typing of the 39 isolates resolved three unique sequence types. Phylogenetic reconstruction and Structure analysis determined that all isolates were genetically closer to those from Australia than those from Southeast Asia. Gene cluster analysis however, identified a Yersinia-like fimbrial gene cluster predominantly found among Burkholderia pseudomallei derived from Southeast Asia. Higher resolution VNTR typing and phylogenetic reconstruction of the Balimo isolates resolved 24 genotypes with long branch lengths. These findings are congruent with long term persistence in the region and a high level of environmental stability. Conclusions/Significance: Given that anthropogenic influence has been hypothesized as a mechanism for the dispersal of B. pseudomallei, these findings correlate with limited movement of the indigenous people in the region. The palaeogeographical and anthropogenic history of Australasia and the results from this study indicate that New Guinea is an important region for the further study of B. pseudomallei origins and dissemination.
- Authors: Baker, Anthony , Pearson, Talima , Price, Erin , Dale, Julia , Keim, Paul , Hornstra, Heidie , Greenhill, Andrew , Padilla, Gabriel , Warner, Jeffrey
- Date: 2011
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 6, no. 3 (2011), p.
- Full Text:
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- Description: Background: The island of New Guinea is located midway between the world's two major melioidosis endemic regions of Australia and Southeast Asia. Previous studies in Papua New Guinea have demonstrated autochthonous melioidosis in Balimo, Western province. In contrast to other regions of endemicity, isolates recovered from both environmental and clinical sources demonstrate narrow genetic diversity over large spatial and temporal scales. Methodology/Principal Findings: We employed molecular typing techniques to determine the phylogenetic relationships of these isolates to each other and to others worldwide to aid in understanding the origins of the Papua New Guinean isolates. Multi-locus sequence typing of the 39 isolates resolved three unique sequence types. Phylogenetic reconstruction and Structure analysis determined that all isolates were genetically closer to those from Australia than those from Southeast Asia. Gene cluster analysis however, identified a Yersinia-like fimbrial gene cluster predominantly found among Burkholderia pseudomallei derived from Southeast Asia. Higher resolution VNTR typing and phylogenetic reconstruction of the Balimo isolates resolved 24 genotypes with long branch lengths. These findings are congruent with long term persistence in the region and a high level of environmental stability. Conclusions/Significance: Given that anthropogenic influence has been hypothesized as a mechanism for the dispersal of B. pseudomallei, these findings correlate with limited movement of the indigenous people in the region. The palaeogeographical and anthropogenic history of Australasia and the results from this study indicate that New Guinea is an important region for the further study of B. pseudomallei origins and dissemination.
Groundwater seeps facilitate exposure to Burkholderia pseudomallei
- Baker, Anthony, Tahani, Donald, Gardiner, Christopher, Bristow, Keith, Greenhill, Andrew, Warner, Jeffrey
- Authors: Baker, Anthony , Tahani, Donald , Gardiner, Christopher , Bristow, Keith , Greenhill, Andrew , Warner, Jeffrey
- Date: 2011
- Type: Text , Journal article
- Relation: Applied and Environmental Microbiology Vol. 77, no. 20 (2011), p. 7243-7246
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- Description: Burkholderia pseudomallei is a saprophytic bacterium which is the causative agent of melioidosis, a common cause of fatal bacterial pneumonia and sepsis in the tropics. The incidence of melioidosis is clustered spatially and temporally and is heavily linked to rainfall and extreme weather events. Clinical case clustering has recently been reported in Townsville, Australia, and has implicated Castle Hill, a granite monolith in the city center, as a potential reservoir of infection. Topsoil and water from seasonal groundwater seeps were collected around the base of Castle Hill and analyzed by quantitative real-time PCR targeting the type III secretion system genes for the presence of B. pseudomallei. The organism was identified in 65% (95% confidence interval [CI], 49.5 to 80.4) of soil samples (n =40) and 92.5% (95% CI, 83.9 to 100) of seasonal groundwater samples (n =40). Further sampling of water collected from roads and gutters in nearby residential areas after an intense rainfall event found that 88.2% (95% CI, 72.9 to 100) of samples (n =16) contained viable B. pseudomallei at concentrations up to 113 CFU/ml. Comparison of isolates using multilocus sequence typing demonstrated clinical matches and close associations between environmental isolates and isolates derived from clinical samples from patients in Townsville. This study demonstrated that waterborne B. pseudomallei from groundwater seeps around Castle Hill may facilitate exposure to B. pseudomallei and contribute to the clinical clustering at this site. Access to this type of information will advise the development and implementation of public health measures to reduce the incidence of melioidosis. © 2011, American Society for Microbiology.
- Authors: Baker, Anthony , Tahani, Donald , Gardiner, Christopher , Bristow, Keith , Greenhill, Andrew , Warner, Jeffrey
- Date: 2011
- Type: Text , Journal article
- Relation: Applied and Environmental Microbiology Vol. 77, no. 20 (2011), p. 7243-7246
- Full Text:
- Reviewed:
- Description: Burkholderia pseudomallei is a saprophytic bacterium which is the causative agent of melioidosis, a common cause of fatal bacterial pneumonia and sepsis in the tropics. The incidence of melioidosis is clustered spatially and temporally and is heavily linked to rainfall and extreme weather events. Clinical case clustering has recently been reported in Townsville, Australia, and has implicated Castle Hill, a granite monolith in the city center, as a potential reservoir of infection. Topsoil and water from seasonal groundwater seeps were collected around the base of Castle Hill and analyzed by quantitative real-time PCR targeting the type III secretion system genes for the presence of B. pseudomallei. The organism was identified in 65% (95% confidence interval [CI], 49.5 to 80.4) of soil samples (n =40) and 92.5% (95% CI, 83.9 to 100) of seasonal groundwater samples (n =40). Further sampling of water collected from roads and gutters in nearby residential areas after an intense rainfall event found that 88.2% (95% CI, 72.9 to 100) of samples (n =16) contained viable B. pseudomallei at concentrations up to 113 CFU/ml. Comparison of isolates using multilocus sequence typing demonstrated clinical matches and close associations between environmental isolates and isolates derived from clinical samples from patients in Townsville. This study demonstrated that waterborne B. pseudomallei from groundwater seeps around Castle Hill may facilitate exposure to B. pseudomallei and contribute to the clinical clustering at this site. Access to this type of information will advise the development and implementation of public health measures to reduce the incidence of melioidosis. © 2011, American Society for Microbiology.
A large outbreak of shigellosis commencing in an internally displaced population, Papua New Guinea, 2013
- Benny, Edwin, Mesere, Kelly, Pavlin, Boris, Yakam, Logan, Ford, Rebecca, Yoannes, Mition, Kisa, Debbie, Abdad, Mohammad, Menda, Lincoln, Greenhill, Andrew, Horwood, Paul
- Authors: Benny, Edwin , Mesere, Kelly , Pavlin, Boris , Yakam, Logan , Ford, Rebecca , Yoannes, Mition , Kisa, Debbie , Abdad, Mohammad , Menda, Lincoln , Greenhill, Andrew , Horwood, Paul
- Date: 2014
- Type: Text , Journal article
- Relation: Western Pacific surveillance and response journal : WPSAR Vol. 5, no. 3 (2014), p. 18-21
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- Description: OBJECTIVE: The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community. METHODS: Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak. RESULTS: Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children. DISCUSSION: This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.
- Authors: Benny, Edwin , Mesere, Kelly , Pavlin, Boris , Yakam, Logan , Ford, Rebecca , Yoannes, Mition , Kisa, Debbie , Abdad, Mohammad , Menda, Lincoln , Greenhill, Andrew , Horwood, Paul
- Date: 2014
- Type: Text , Journal article
- Relation: Western Pacific surveillance and response journal : WPSAR Vol. 5, no. 3 (2014), p. 18-21
- Full Text:
- Reviewed:
- Description: OBJECTIVE: The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community. METHODS: Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak. RESULTS: Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children. DISCUSSION: This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.
Childhood pneumonia and meningitis in the Eastern Highlands Province, Papua New Guinea in the era of conjugate vaccines: study methods and challenges
- Blyth, Christopher, Ford, Rebecca, Sapura, Joycelyn, Kumani, Tonny, Masiria, Geraldine, Kave, John, Yuasi, Lapule, Greenhill, Andrew, Hwaihwanje, Ilomo, Lang, Amanda, Lehmann, Deborah, Pomat, William
- Authors: Blyth, Christopher , Ford, Rebecca , Sapura, Joycelyn , Kumani, Tonny , Masiria, Geraldine , Kave, John , Yuasi, Lapule , Greenhill, Andrew , Hwaihwanje, Ilomo , Lang, Amanda , Lehmann, Deborah , Pomat, William
- Date: 2017
- Type: Text , Journal article
- Relation: Pneumonia Vol. 9, no. 1 (2017/03/05 2017), p. 5
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- Description: Background: Pneumonia 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. Methods: A 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. Results: 998 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%. Conclusions: Recruitment 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.
- Authors: Blyth, Christopher , Ford, Rebecca , Sapura, Joycelyn , Kumani, Tonny , Masiria, Geraldine , Kave, John , Yuasi, Lapule , Greenhill, Andrew , Hwaihwanje, Ilomo , Lang, Amanda , Lehmann, Deborah , Pomat, William
- Date: 2017
- Type: Text , Journal article
- Relation: Pneumonia Vol. 9, no. 1 (2017/03/05 2017), p. 5
- Full Text:
- Reviewed:
- Description: Background: Pneumonia 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. Methods: A 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. Results: 998 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%. Conclusions: Recruitment 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.
Lack of effectiveness of 13-valent pneumococcal conjugate vaccination against pneumococcal carriage density in Papua New Guinean infants
- Britton, Kathryn, Pickering, Janessa, Pomat, William, de Gier, Camilla, Greenhill, Andrew
- Authors: Britton, Kathryn , Pickering, Janessa , Pomat, William , de Gier, Camilla , Greenhill, Andrew
- Date: 2021
- Type: Text , Journal article
- Relation: Vaccine Vol. 39, no. 38 (2021), p. 5401-5409
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- Description: Background: Papua New Guinea (PNG) introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in 2014, with administration at 1, 2, and 3 months of age. PCV13 has reduced or eliminated carriage of vaccine types in populations with low pneumococcal carriage prevalence, carriage density and serotype diversity. This study investigated PCV13 impact on serotype-specific pneumococcal carriage prevalence, density, and serotype diversity in PNG infants, who have some of the highest reported rates of pneumococcal carriage and disease in the world. Methods: Nasopharyngeal swabs were collected at 1, 4 and 9 months of age from PCV13-vaccinated infants (n = 57) and age-/season-matched, unvaccinated infants (at approximately 1 month, n = 53; 4 months, n = 57; 9 months, n = 52). Serotype-specific pneumococcal carriage density and antimicrobial resistance genes were identified by qPCR and microarray. Results: Pneumococci were present in 89% of swabs, with 60 different serotypes and four non-encapsulated variants detected. Multiple serotype carriage was common (47% of swabs). Vaccine type carriage prevalence was similar between PCV13-vaccinated and unvaccinated infants at 4 and 9 months of age. The prevalence of non-vaccine type carriage was also similar between cohorts, with non-vaccine types present in three-quarters of samples (from both vaccinated and unvaccinated infants) by 4 months of age. The median pneumococcal carriage density was high and similar at each age group (~7.0 log10 genome equivalents/mL). PCV13 had no effect on overall pneumococcal carriage density, vaccine type density, non-vaccine type density, or the prevalence of antimicrobial resistance genes. Conclusion: PNG infants experience dense and diverse pneumococcal colonisation with concurrent serotypes from 1 month of age. PCV13 had no impact on pneumococcal carriage density, even for vaccine serotypes. The low prevalence of vaccine serotypes, high pneumococcal carriage density and abundance of non-vaccine serotypes likely contribute to the lack of PCV13 impact on carriage in PNG infants. Indirect effects of the infant PCV programs are likely to be limited in PNG. Alternative vaccines with broader coverage should be considered. © 2021 The Authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Andrew Greenhill" is provided in this record**
- Authors: Britton, Kathryn , Pickering, Janessa , Pomat, William , de Gier, Camilla , Greenhill, Andrew
- Date: 2021
- Type: Text , Journal article
- Relation: Vaccine Vol. 39, no. 38 (2021), p. 5401-5409
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- Description: Background: Papua New Guinea (PNG) introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in 2014, with administration at 1, 2, and 3 months of age. PCV13 has reduced or eliminated carriage of vaccine types in populations with low pneumococcal carriage prevalence, carriage density and serotype diversity. This study investigated PCV13 impact on serotype-specific pneumococcal carriage prevalence, density, and serotype diversity in PNG infants, who have some of the highest reported rates of pneumococcal carriage and disease in the world. Methods: Nasopharyngeal swabs were collected at 1, 4 and 9 months of age from PCV13-vaccinated infants (n = 57) and age-/season-matched, unvaccinated infants (at approximately 1 month, n = 53; 4 months, n = 57; 9 months, n = 52). Serotype-specific pneumococcal carriage density and antimicrobial resistance genes were identified by qPCR and microarray. Results: Pneumococci were present in 89% of swabs, with 60 different serotypes and four non-encapsulated variants detected. Multiple serotype carriage was common (47% of swabs). Vaccine type carriage prevalence was similar between PCV13-vaccinated and unvaccinated infants at 4 and 9 months of age. The prevalence of non-vaccine type carriage was also similar between cohorts, with non-vaccine types present in three-quarters of samples (from both vaccinated and unvaccinated infants) by 4 months of age. The median pneumococcal carriage density was high and similar at each age group (~7.0 log10 genome equivalents/mL). PCV13 had no effect on overall pneumococcal carriage density, vaccine type density, non-vaccine type density, or the prevalence of antimicrobial resistance genes. Conclusion: PNG infants experience dense and diverse pneumococcal colonisation with concurrent serotypes from 1 month of age. PCV13 had no impact on pneumococcal carriage density, even for vaccine serotypes. The low prevalence of vaccine serotypes, high pneumococcal carriage density and abundance of non-vaccine serotypes likely contribute to the lack of PCV13 impact on carriage in PNG infants. Indirect effects of the infant PCV programs are likely to be limited in PNG. Alternative vaccines with broader coverage should be considered. © 2021 The Authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Andrew Greenhill" is provided in this record**
Divergent Barmah forest virus from Papua New Guinea
- Caly, Leon, Horwood, Paul, Dhanasekaran, VijaykrishnaLynch, Stacey, Greenhill, Andrew, Pomat, William, Rai, Glennis, Kisa, Debbie, Bande, Grace, Druce, Julian, Abdad, Mohammad
- Authors: Caly, Leon , Horwood, Paul , Dhanasekaran, VijaykrishnaLynch, Stacey , Greenhill, Andrew , Pomat, William , Rai, Glennis , Kisa, Debbie , Bande, Grace , Druce, Julian , Abdad, Mohammad
- Date: 2019
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 25, no. 12 (2019), p. 2266-2269
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- Description: We report a case of Barmah Forest virus infection in a child from Central Province, Papua New Guinea, who had no previous travel history. Genomic characterization of the virus showed divergent origin compared with viruses previously detected, supporting the hypothesis that the range of Barmah Forest virus extends beyond Australia. © 2019 Centers for Disease Control and Prevention (CDC). All rights reserved.
- Authors: Caly, Leon , Horwood, Paul , Dhanasekaran, VijaykrishnaLynch, Stacey , Greenhill, Andrew , Pomat, William , Rai, Glennis , Kisa, Debbie , Bande, Grace , Druce, Julian , Abdad, Mohammad
- Date: 2019
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 25, no. 12 (2019), p. 2266-2269
- Full Text:
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- Description: We report a case of Barmah Forest virus infection in a child from Central Province, Papua New Guinea, who had no previous travel history. Genomic characterization of the virus showed divergent origin compared with viruses previously detected, supporting the hypothesis that the range of Barmah Forest virus extends beyond Australia. © 2019 Centers for Disease Control and Prevention (CDC). All rights reserved.
Global diversity and antimicrobial resistance of typhoid fever pathogens : insights from a meta-analysis of 13,000 Salmonella Typhi genomes
- Carey, Megan, Dyson, Zoe, Ingle, Danielle, Amir, Afreenish, Aworh, Mabel, Chattaway, Marie, Chew, Ka, Crump, John, Feasey, Nicholas, Howden, Benjamin, Keddy, Karen, Maes, Mailis, Parry, Christopher, Van Puyvelde, Sandra, Webb, Hattie, Afolayan, Ayorinde, Alexander, Anna, Anandan, Shalini, Andrews, Jason, Ashton, Philip, Basnyat, Buddha, Bavdekar, Ashish, Bogoch, Isaac, Clemens, John, da Silva, Kesia, De, Anuradha, de Ligt, Joep, Diaz Guevara, Paula, Dolecek, Christiane, Greenhill, Andrew
- Authors: Carey, Megan , Dyson, Zoe , Ingle, Danielle , Amir, Afreenish , Aworh, Mabel , Chattaway, Marie , Chew, Ka , Crump, John , Feasey, Nicholas , Howden, Benjamin , Keddy, Karen , Maes, Mailis , Parry, Christopher , Van Puyvelde, Sandra , Webb, Hattie , Afolayan, Ayorinde , Alexander, Anna , Anandan, Shalini , Andrews, Jason , Ashton, Philip , Basnyat, Buddha , Bavdekar, Ashish , Bogoch, Isaac , Clemens, John , da Silva, Kesia , De, Anuradha , de Ligt, Joep , Diaz Guevara, Paula , Dolecek, Christiane , Greenhill, Andrew
- Date: 2023
- Type: Text , Journal article
- Relation: eLife Vol. 12, no. (2023), p.
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- Description: Background: The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks 22 years since the publication of the first Typhi genome, represents the largest Typhi genome sequence collection to date (n=13,000). Methods: This is a meta-analysis of global genotype and antimicrobial resistance (AMR) determinants extracted from previously sequenced genome data and analysed using consistent methods implemented in open analysis platforms GenoTyphi and Pathogenwatch. Results: Compared with previous global snapshots, the data highlight that genotype 4.3.1 (H58) has not spread beyond Asia and Eastern/Southern Africa; in other regions, distinct genotypes dominate and have independently evolved AMR. Data gaps remain in many parts of the world, and we show the potential of travel-associated sequences to provide informal ‘sentinel’ surveillance for such locations. The data indicate that ciprofloxacin non-susceptibility (>1 resistance determinant) is widespread across geographies and genotypes, with high-level ciprofloxacin resistance (=3 determinants) reaching 20% prevalence in South Asia. Extensively drug-resistant (XDR) typhoid has becomedominant in Pakistan (70% in 2020) but has not yet become established elsewhere. Ceftriaxone resistance has emerged in eight non-XDR genotypes, including a ciprofloxacin-resistant lineage (4.3.1.2.1) in India. Azithromycin resistance mutations were detected at low prevalence in South Asia, including in two common ciprofloxacin-resistant genotypes. Conclusions: The consortium’s aim is to encourage continued data sharing and collaboration to monitor the emergence and global spread of AMR Typhi, and to inform decision-making around the introduction of typhoid conjugate vaccines (TCVs) and other prevention and control strategies. © Carey et al. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Andrew Greenhill” is provided in this record**
- Authors: Carey, Megan , Dyson, Zoe , Ingle, Danielle , Amir, Afreenish , Aworh, Mabel , Chattaway, Marie , Chew, Ka , Crump, John , Feasey, Nicholas , Howden, Benjamin , Keddy, Karen , Maes, Mailis , Parry, Christopher , Van Puyvelde, Sandra , Webb, Hattie , Afolayan, Ayorinde , Alexander, Anna , Anandan, Shalini , Andrews, Jason , Ashton, Philip , Basnyat, Buddha , Bavdekar, Ashish , Bogoch, Isaac , Clemens, John , da Silva, Kesia , De, Anuradha , de Ligt, Joep , Diaz Guevara, Paula , Dolecek, Christiane , Greenhill, Andrew
- Date: 2023
- Type: Text , Journal article
- Relation: eLife Vol. 12, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks 22 years since the publication of the first Typhi genome, represents the largest Typhi genome sequence collection to date (n=13,000). Methods: This is a meta-analysis of global genotype and antimicrobial resistance (AMR) determinants extracted from previously sequenced genome data and analysed using consistent methods implemented in open analysis platforms GenoTyphi and Pathogenwatch. Results: Compared with previous global snapshots, the data highlight that genotype 4.3.1 (H58) has not spread beyond Asia and Eastern/Southern Africa; in other regions, distinct genotypes dominate and have independently evolved AMR. Data gaps remain in many parts of the world, and we show the potential of travel-associated sequences to provide informal ‘sentinel’ surveillance for such locations. The data indicate that ciprofloxacin non-susceptibility (>1 resistance determinant) is widespread across geographies and genotypes, with high-level ciprofloxacin resistance (=3 determinants) reaching 20% prevalence in South Asia. Extensively drug-resistant (XDR) typhoid has becomedominant in Pakistan (70% in 2020) but has not yet become established elsewhere. Ceftriaxone resistance has emerged in eight non-XDR genotypes, including a ciprofloxacin-resistant lineage (4.3.1.2.1) in India. Azithromycin resistance mutations were detected at low prevalence in South Asia, including in two common ciprofloxacin-resistant genotypes. Conclusions: The consortium’s aim is to encourage continued data sharing and collaboration to monitor the emergence and global spread of AMR Typhi, and to inform decision-making around the introduction of typhoid conjugate vaccines (TCVs) and other prevention and control strategies. © Carey et al. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Andrew Greenhill” is provided in this record**
Respiratory viral pathogens associated with lower respiratory tract disease among young children in the highlands of Papua New Guinea
- Chidlow, Glenys, Laing, Ingrid, Harnett, Gerald, Greenhill, Andrew, Phuanukoonnon, Suparat, Siba, Peter, Pomat, William, Shellam, Geoffrey, Smith, David, Lehmann, Deborah
- Authors: Chidlow, Glenys , Laing, Ingrid , Harnett, Gerald , Greenhill, Andrew , Phuanukoonnon, Suparat , Siba, Peter , Pomat, William , Shellam, Geoffrey , Smith, David , Lehmann, Deborah
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Clinical Virology Vol. 54, no. 3 (2012), p. 235-239
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- Description: Background: Acute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG). However, comprehensive studies of the viral aetiology of ALRI have not been conducted in PNG for almost 30 years. Objectives: To determine the viruses associated with ALRI among children living in the PNG highlands using sensitive molecular detection techniques. Study design: Pernasal swabs were collected routinely between 1 week and 18 months of age and also during episodes of ALRI, as part of a neonatal pneumococcal conjugate vaccine trial. A tandem multiplex real-time PCR assay was used to test for a comprehensive range of respiratory viruses in samples collected from 221 young children. Picornavirus typing was supported by DNA sequence analysis. Results: Recognized pathogenic respiratory viruses were detected in 198/273 (73%) samples collected from children with no evidence of ALRI and 69/80 (86%) samples collected during ALRI episodes. Human rhinoviruses (HRV) species A, B and C were detected in 152 (56%) samples from non-ALRI children and 50 (63%) samples collected during ALRI episodes. Partial structural region sequences for two new species C rhinoviruses were added to the GenBank database. ALRI was associated with detection of adenovirus species B (p< 0.01) or C (p< 0.05), influenza A (p< 0.0001) or respiratory syncytial virus (p< 0.0001). Multiple viruses were detected more often during ALRI episodes (49%) than when children displayed no symptoms of ALRI (18%) (p< 0.0001). Conclusions: The burden of infection with respiratory viruses remains significant in young children living in the PNG highlands.
- Authors: Chidlow, Glenys , Laing, Ingrid , Harnett, Gerald , Greenhill, Andrew , Phuanukoonnon, Suparat , Siba, Peter , Pomat, William , Shellam, Geoffrey , Smith, David , Lehmann, Deborah
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Clinical Virology Vol. 54, no. 3 (2012), p. 235-239
- Full Text:
- Reviewed:
- Description: Background: Acute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG). However, comprehensive studies of the viral aetiology of ALRI have not been conducted in PNG for almost 30 years. Objectives: To determine the viruses associated with ALRI among children living in the PNG highlands using sensitive molecular detection techniques. Study design: Pernasal swabs were collected routinely between 1 week and 18 months of age and also during episodes of ALRI, as part of a neonatal pneumococcal conjugate vaccine trial. A tandem multiplex real-time PCR assay was used to test for a comprehensive range of respiratory viruses in samples collected from 221 young children. Picornavirus typing was supported by DNA sequence analysis. Results: Recognized pathogenic respiratory viruses were detected in 198/273 (73%) samples collected from children with no evidence of ALRI and 69/80 (86%) samples collected during ALRI episodes. Human rhinoviruses (HRV) species A, B and C were detected in 152 (56%) samples from non-ALRI children and 50 (63%) samples collected during ALRI episodes. Partial structural region sequences for two new species C rhinoviruses were added to the GenBank database. ALRI was associated with detection of adenovirus species B (p< 0.01) or C (p< 0.05), influenza A (p< 0.0001) or respiratory syncytial virus (p< 0.0001). Multiple viruses were detected more often during ALRI episodes (49%) than when children displayed no symptoms of ALRI (18%) (p< 0.0001). Conclusions: The burden of infection with respiratory viruses remains significant in young children living in the PNG highlands.
Whole genome sequence analysis of Salmonella Typhi in Papua New Guinea reveals an established population of genotype 2.1.7 sensitive to antimicrobials
- Dyson, Zoe, Malau, Elisheba, Horwood, Paul, Ford, Rebecca, Siba, Valentine, Yoannes, Mition, Pomat, William, Passey, Megan, Judd, Louise, Ingle, Danielle, Williamson, Deborah, Dougan, Gordon, Greenhill, Andrew, Holt, Kathryn
- Authors: Dyson, Zoe , Malau, Elisheba , Horwood, Paul , Ford, Rebecca , Siba, Valentine , Yoannes, Mition , Pomat, William , Passey, Megan , Judd, Louise , Ingle, Danielle , Williamson, Deborah , Dougan, Gordon , Greenhill, Andrew , Holt, Kathryn
- Date: 2022
- Type: Text , Journal article
- Relation: PLoS Neglected Tropical Diseases Vol. 16, no. 3 (2022), p.
- Full Text:
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- Description: Background Typhoid fever, a systemic infection caused by Salmonella enterica serovar Typhi, remains a considerable public health threat in impoverished regions within many low-and middle-income settings. However, we still lack a detailed understanding of the emergence, population structure, molecular mechanisms of antimicrobial resistance (AMR), and transmission dynamics of S. Typhi across many settings, particularly throughout the Asia-Pacific islands. Here we present a comprehensive whole genome sequence (WGS) based overview of S. Typhi populations circulating in Papua New Guinea (PNG) over 30 years. Principle findings Bioinformatic analysis of 86 S. Typhi isolates collected between 1980–2010 demonstrated that the population structure of PNG is dominated by a single genotype (2.1.7) that appears to have emerged in the Indonesian archipelago in the mid-twentieth century with minimal evidence of inter-country transmission. Genotypic and phenotypic data demonstrated that the PNG S. Typhi population appears to be susceptible to former first line drugs for treating typhoid fever (chloramphenicol, ampicillin and co-trimoxazole), as well as fluoroquinolones, third generation cephalosporins, and macrolides. PNG genotype 2.1.7 was genetically con-served, with very few deletions, and no evidence of plasmid or prophage acquisition. Genetic variation among this population was attributed to either single point mutations, or homologous recombination adjacent to repetitive ribosomal RNA operons. Significance Antimicrobials remain an effective option for the treatment of typhoid fever in PNG, along with other intervention strategies including improvements to water, sanitation and hygiene (WaSH) related infrastructure and potentially the introduction of Vi-conjugate vaccines. However, continued genomic surveillance is warranted to monitor for the emergence of AMR within local populations, or the introduction of AMR associated genotypes of S. Typhi in this setting. © The Authors.
- Authors: Dyson, Zoe , Malau, Elisheba , Horwood, Paul , Ford, Rebecca , Siba, Valentine , Yoannes, Mition , Pomat, William , Passey, Megan , Judd, Louise , Ingle, Danielle , Williamson, Deborah , Dougan, Gordon , Greenhill, Andrew , Holt, Kathryn
- Date: 2022
- Type: Text , Journal article
- Relation: PLoS Neglected Tropical Diseases Vol. 16, no. 3 (2022), p.
- Full Text:
- Reviewed:
- Description: Background Typhoid fever, a systemic infection caused by Salmonella enterica serovar Typhi, remains a considerable public health threat in impoverished regions within many low-and middle-income settings. However, we still lack a detailed understanding of the emergence, population structure, molecular mechanisms of antimicrobial resistance (AMR), and transmission dynamics of S. Typhi across many settings, particularly throughout the Asia-Pacific islands. Here we present a comprehensive whole genome sequence (WGS) based overview of S. Typhi populations circulating in Papua New Guinea (PNG) over 30 years. Principle findings Bioinformatic analysis of 86 S. Typhi isolates collected between 1980–2010 demonstrated that the population structure of PNG is dominated by a single genotype (2.1.7) that appears to have emerged in the Indonesian archipelago in the mid-twentieth century with minimal evidence of inter-country transmission. Genotypic and phenotypic data demonstrated that the PNG S. Typhi population appears to be susceptible to former first line drugs for treating typhoid fever (chloramphenicol, ampicillin and co-trimoxazole), as well as fluoroquinolones, third generation cephalosporins, and macrolides. PNG genotype 2.1.7 was genetically con-served, with very few deletions, and no evidence of plasmid or prophage acquisition. Genetic variation among this population was attributed to either single point mutations, or homologous recombination adjacent to repetitive ribosomal RNA operons. Significance Antimicrobials remain an effective option for the treatment of typhoid fever in PNG, along with other intervention strategies including improvements to water, sanitation and hygiene (WaSH) related infrastructure and potentially the introduction of Vi-conjugate vaccines. However, continued genomic surveillance is warranted to monitor for the emergence of AMR within local populations, or the introduction of AMR associated genotypes of S. Typhi in this setting. © The Authors.
Streptococcus pneumoniae and Haemophilus influenzae in paediatric meningitis patients at Goroka General Hospital, Papua New Guinea : Serotype distribution and antimicrobial susceptibility in the pre-vaccine era
- Greenhill, Andrew, Phuanukoonnon, Suparat, Michael, Audrey, Yoannes, Mition, Orami, Tilda, Smith, Helen, Murphy, Denise, Blyth, Christopher, Reeder, John, Siba, Peter, Pomat, William, Lehmann, Deborah
- Authors: Greenhill, Andrew , Phuanukoonnon, Suparat , Michael, Audrey , Yoannes, Mition , Orami, Tilda , Smith, Helen , Murphy, Denise , Blyth, Christopher , Reeder, John , Siba, Peter , Pomat, William , Lehmann, Deborah
- Date: 2015
- Type: Text , Journal article
- Relation: BMC Infectious Diseases Vol. 15, no. 485 (2015), p. 1-8
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- Description: Background: Bacterial meningitis remains an important infection globally, with the greatest burden in children in low-income settings, including Papua New Guinea (PNG). We present serotype, antimicrobial susceptibility and outcome data from paediatric meningitis patients prior to introduction of Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines (PCVs) in PNG, providing a baseline for evaluation of immunisation programs. Methods: Cerebrospinal fluid (CSF) was collected from children admitted to Goroka General Hospital with suspected meningitis between 1996 and 2005. Culture and sensitivity was conducted, and pneumococci and H. influenzae were serotyped. Laboratory findings were linked to clinical outcomes. Results: We enrolled 1884 children. A recognised pathogen was identified in 375 children (19.9%). Streptococcus pneumoniae (n = 180) and Hib (n = 153) accounted for 88.8% of pathogens isolated. 24 different pneumococcal serogroups were identified; non-PCV types 2, 24 and 46 accounted for 31.6% of pneumococcal meningitis. 10- and 13-valent PCVs would cover 44.1% and 45.4% of pneumococcal meningitis respectively. Pneumococcal isolates were commonly resistant to penicillin (21.5%) and 23% of Hib isolates were simultaneously resistant to ampicillin, co-trimoxazole and chloramphenicol. The case fatality rate in patients with a recognised bacterial pathogen was 13.4% compared to 8.5% in culture-negative patients. Conclusions: If implemented in routine expanded programme of immunisation (EPI) with high coverage, current PCVs could prevent almost half of pneumococcal meningitis cases. Given the diversity of circulating serotypes in PNG serotype replacement is of concern. Ongoing surveillance is imperative to monitor the impact of vaccines. In the longer term vaccines providing broader protection against pneumococcal meningitis will be needed. © 2015 Greenhill et al.
- Authors: Greenhill, Andrew , Phuanukoonnon, Suparat , Michael, Audrey , Yoannes, Mition , Orami, Tilda , Smith, Helen , Murphy, Denise , Blyth, Christopher , Reeder, John , Siba, Peter , Pomat, William , Lehmann, Deborah
- Date: 2015
- Type: Text , Journal article
- Relation: BMC Infectious Diseases Vol. 15, no. 485 (2015), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: Bacterial meningitis remains an important infection globally, with the greatest burden in children in low-income settings, including Papua New Guinea (PNG). We present serotype, antimicrobial susceptibility and outcome data from paediatric meningitis patients prior to introduction of Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines (PCVs) in PNG, providing a baseline for evaluation of immunisation programs. Methods: Cerebrospinal fluid (CSF) was collected from children admitted to Goroka General Hospital with suspected meningitis between 1996 and 2005. Culture and sensitivity was conducted, and pneumococci and H. influenzae were serotyped. Laboratory findings were linked to clinical outcomes. Results: We enrolled 1884 children. A recognised pathogen was identified in 375 children (19.9%). Streptococcus pneumoniae (n = 180) and Hib (n = 153) accounted for 88.8% of pathogens isolated. 24 different pneumococcal serogroups were identified; non-PCV types 2, 24 and 46 accounted for 31.6% of pneumococcal meningitis. 10- and 13-valent PCVs would cover 44.1% and 45.4% of pneumococcal meningitis respectively. Pneumococcal isolates were commonly resistant to penicillin (21.5%) and 23% of Hib isolates were simultaneously resistant to ampicillin, co-trimoxazole and chloramphenicol. The case fatality rate in patients with a recognised bacterial pathogen was 13.4% compared to 8.5% in culture-negative patients. Conclusions: If implemented in routine expanded programme of immunisation (EPI) with high coverage, current PCVs could prevent almost half of pneumococcal meningitis cases. Given the diversity of circulating serotypes in PNG serotype replacement is of concern. Ongoing surveillance is imperative to monitor the impact of vaccines. In the longer term vaccines providing broader protection against pneumococcal meningitis will be needed. © 2015 Greenhill et al.
Antibiotic resistant Shigella is a major cause of diarrhoea in the Highlands of Papua New Guinea
- Greenhill, Andrew, Guwada, Carlton, Siba, Valentine, Michael, Audrey, Yoannes, Mution, Wawarie, Yolandah, Ford, Rebecca, Siba, Peter, Horwood, Paul
- Authors: Greenhill, Andrew , Guwada, Carlton , Siba, Valentine , Michael, Audrey , Yoannes, Mution , Wawarie, Yolandah , Ford, Rebecca , Siba, Peter , Horwood, Paul
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Infection in Developing Countries Vol. 8, no. 11 (2014), p. 1391-1397
- Full Text:
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- Description: 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. © 2014 Greenhill et al.
- Authors: Greenhill, Andrew , Guwada, Carlton , Siba, Valentine , Michael, Audrey , Yoannes, Mution , Wawarie, Yolandah , Ford, Rebecca , Siba, Peter , Horwood, Paul
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Infection in Developing Countries Vol. 8, no. 11 (2014), p. 1391-1397
- Full Text:
- Reviewed:
- Description: 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. © 2014 Greenhill et al.
Characterization of the gut microbiota of Papua New Guineans using reverse transcription quantitative PCR
- Greenhill, Andrew, Tsuji, Hirokazu, Ogata, Kiyohito, Natsuhara, Kazumi, Morita, Ayako, Soli, Kevin, Larkins, Jo-Ann, Tadokoro, Kiyoshi, Odani, Shingo, Baba, Jun, Naito, Yuichi, Tomitsuka, Eriko, Nomoto, Kriko, Siba, Peter, Horwood, Paul, Umezaki, Masahiro
- Authors: Greenhill, Andrew , Tsuji, Hirokazu , Ogata, Kiyohito , Natsuhara, Kazumi , Morita, Ayako , Soli, Kevin , Larkins, Jo-Ann , Tadokoro, Kiyoshi , Odani, Shingo , Baba, Jun , Naito, Yuichi , Tomitsuka, Eriko , Nomoto, Kriko , Siba, Peter , Horwood, Paul , Umezaki, Masahiro
- Date: 2015
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 10, no. 2 (2015), p. 1-15
- Full Text:
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- Description: There has been considerable interest in composition of gut microbiota in recent years, leading to a better understanding of the role the gut microbiota plays in health and disease. Most studies have been limited in their geographical and socioeconomic diversity to high-income settings, and have been conducted using small sample sizes. To date, few analyses have been conducted in low-income settings, where a better understanding of the gut microbiome could lead to the greatest return in terms of health benefits. Here, we have used quantitative real-time polymerase chain reaction targeting dominant and sub-dominant groups of microorganisms associated with human gut microbiome in 115 people living a subsistence lifestyle in rural areas of Papua New Guinea. Quantification of Clostridium coccoides group, C. leptum subgroup, C. perfringens, Bacteroides fragilis group, Bifidobacterium, Atopobium cluster, Prevotella, Enterobacteriaceae, Enterococcus, Staphylococcus, and Lactobacillus spp. was conducted. Principle coordinates analysis (PCoA) revealed two dimensions with Prevotella, clostridia, Atopobium, Enterobacteriaceae, Enterococcus and Staphylococcus grouping in one dimension, while B. fragilis, Bifidobacterium and Lactobacillus grouping in the second dimension. Highland people had higher numbers of most groups of bacteria detected, and this is likely a key factor for the differences revealed by PCoA between highland and lowland study participants. Age and sex were not major determinants in microbial population composition. The study demonstrates a gut microbial composition with some similarities to those observed in other low-income settings where traditional diets are consumed, which have previously been suggested to favor energy extraction from a carbohydrate rich diet. © 2015 PLOS ONE.
- Authors: Greenhill, Andrew , Tsuji, Hirokazu , Ogata, Kiyohito , Natsuhara, Kazumi , Morita, Ayako , Soli, Kevin , Larkins, Jo-Ann , Tadokoro, Kiyoshi , Odani, Shingo , Baba, Jun , Naito, Yuichi , Tomitsuka, Eriko , Nomoto, Kriko , Siba, Peter , Horwood, Paul , Umezaki, Masahiro
- Date: 2015
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 10, no. 2 (2015), p. 1-15
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- Description: There has been considerable interest in composition of gut microbiota in recent years, leading to a better understanding of the role the gut microbiota plays in health and disease. Most studies have been limited in their geographical and socioeconomic diversity to high-income settings, and have been conducted using small sample sizes. To date, few analyses have been conducted in low-income settings, where a better understanding of the gut microbiome could lead to the greatest return in terms of health benefits. Here, we have used quantitative real-time polymerase chain reaction targeting dominant and sub-dominant groups of microorganisms associated with human gut microbiome in 115 people living a subsistence lifestyle in rural areas of Papua New Guinea. Quantification of Clostridium coccoides group, C. leptum subgroup, C. perfringens, Bacteroides fragilis group, Bifidobacterium, Atopobium cluster, Prevotella, Enterobacteriaceae, Enterococcus, Staphylococcus, and Lactobacillus spp. was conducted. Principle coordinates analysis (PCoA) revealed two dimensions with Prevotella, clostridia, Atopobium, Enterobacteriaceae, Enterococcus and Staphylococcus grouping in one dimension, while B. fragilis, Bifidobacterium and Lactobacillus grouping in the second dimension. Highland people had higher numbers of most groups of bacteria detected, and this is likely a key factor for the differences revealed by PCoA between highland and lowland study participants. Age and sex were not major determinants in microbial population composition. The study demonstrates a gut microbial composition with some similarities to those observed in other low-income settings where traditional diets are consumed, which have previously been suggested to favor energy extraction from a carbohydrate rich diet. © 2015 PLOS ONE.
Wave 2 strains of atypical Vibrio cholerae El Tor caused the 2009-2011 cholera outbreak in Papua New Guinea
- Greenhill, Andrew, Mutreja, Ankur, Bulach, Dieter, Belousoff, Matthew, Jonduo, Marinjho, Collins, Deirdre, Kas, Monalisa, Wapling, Johanna, Seemann, Torsten, Lafana, Alice, Dougan, Gordon, Brown, Mark, Horwood, Paul
- Authors: Greenhill, Andrew , Mutreja, Ankur , Bulach, Dieter , Belousoff, Matthew , Jonduo, Marinjho , Collins, Deirdre , Kas, Monalisa , Wapling, Johanna , Seemann, Torsten , Lafana, Alice , Dougan, Gordon , Brown, Mark , Horwood, Paul
- Date: 2019
- Type: Text , Journal article
- Relation: Microbial genomics Vol. 5, no. 3 (2019), p. 1-5
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- Description: Vibrio cholerae is the causative agent of cholera, a globally important human disease for at least 200 years. In 2009-2011, the first recorded cholera outbreak in Papua New Guinea (PNG) occurred. We conducted genetic and phenotypic characterization of 21 isolates of V. cholerae, with whole-genome sequencing conducted on 2 representative isolates. The PNG outbreak was caused by an atypical El Tor strain harbouring a tandem repeat of the CTX prophage on chromosome II. Whole-genome sequence data, prophage structural analysis and the absence of the SXT integrative conjugative element was indicative that the PNG isolates were most closely related to strains previously isolated in South-East and East Asia with affiliations to global wave 2 strains. This finding suggests that the cholera outbreak in PNG was caused by an exotic (non-endemic) strain of V. cholerae that originated in South-East Asia.
- Authors: Greenhill, Andrew , Mutreja, Ankur , Bulach, Dieter , Belousoff, Matthew , Jonduo, Marinjho , Collins, Deirdre , Kas, Monalisa , Wapling, Johanna , Seemann, Torsten , Lafana, Alice , Dougan, Gordon , Brown, Mark , Horwood, Paul
- Date: 2019
- Type: Text , Journal article
- Relation: Microbial genomics Vol. 5, no. 3 (2019), p. 1-5
- Full Text:
- Reviewed:
- Description: Vibrio cholerae is the causative agent of cholera, a globally important human disease for at least 200 years. In 2009-2011, the first recorded cholera outbreak in Papua New Guinea (PNG) occurred. We conducted genetic and phenotypic characterization of 21 isolates of V. cholerae, with whole-genome sequencing conducted on 2 representative isolates. The PNG outbreak was caused by an atypical El Tor strain harbouring a tandem repeat of the CTX prophage on chromosome II. Whole-genome sequence data, prophage structural analysis and the absence of the SXT integrative conjugative element was indicative that the PNG isolates were most closely related to strains previously isolated in South-East and East Asia with affiliations to global wave 2 strains. This finding suggests that the cholera outbreak in PNG was caused by an exotic (non-endemic) strain of V. cholerae that originated in South-East Asia.
Clonal origins of Vibrio cholerae O1 El Tor strains, Papua New Guinea, 2009-2011
- Horwood, Paul, Collins, Deirdre, Jonduo, Marinjho, Rosewell, Alexander, Dutta, Samir, Dagina, Rosheila, Ropa, Berry, Siba, Peter, Greenhill, Andrew
- Authors: Horwood, Paul , Collins, Deirdre , Jonduo, Marinjho , Rosewell, Alexander , Dutta, Samir , Dagina, Rosheila , Ropa, Berry , Siba, Peter , Greenhill, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 17, no. 11 (2011), p. 2063-2065
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- Description: We used multilocus sequence typing and variable number tandem repeat analysis to determine the clonal origins of Vibrio cholerae O1 El Tor strains from an outbreak of cholera that began in 2009 in Papua New Guinea. The epidemic is ongoing, and transmission risk is elevated within the Pacific region.
- Authors: Horwood, Paul , Collins, Deirdre , Jonduo, Marinjho , Rosewell, Alexander , Dutta, Samir , Dagina, Rosheila , Ropa, Berry , Siba, Peter , Greenhill, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 17, no. 11 (2011), p. 2063-2065
- Full Text:
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- Description: We used multilocus sequence typing and variable number tandem repeat analysis to determine the clonal origins of Vibrio cholerae O1 El Tor strains from an outbreak of cholera that began in 2009 in Papua New Guinea. The epidemic is ongoing, and transmission risk is elevated within the Pacific region.
Spatio-temporal epidemiology of the cholera outbreak in Papua New Guinea, 2009-2011
- Horwood, Paul, Karl, Stephan, Mueller, Ivo, Jonduo, Marinjho, Pavlin, Boris, Dagina, Rosheila, Ropa, Berry, Bieb, Sibauk, Rosewell, Alexander, Umezaki, Masahiro, Siba, Peter, Greenhill, Andrew
- Authors: Horwood, Paul , Karl, Stephan , Mueller, Ivo , Jonduo, Marinjho , Pavlin, Boris , Dagina, Rosheila , Ropa, Berry , Bieb, Sibauk , Rosewell, Alexander , Umezaki, Masahiro , Siba, Peter , Greenhill, Andrew
- Date: 2014
- Type: Text , Journal article
- Relation: BMC Infectious Diseases Vol. 14, no. 1 (2014), p.
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- Description: Background: Cholera continues to be a devastating disease in many developing countries where inadequate safe water supply and poor sanitation facilitate spread. From July 2009 until late 2011 Papua New Guinea experienced the first outbreak of cholera recorded in the country, resulting in > 15,500 cases and > 500 deaths. Methods: Using the national cholera database, we analysed the spatio-temporal distribution and clustering of the Papua New Guinea cholera outbreak. The Kulldorff space-time permutation scan statistic, contained in the software package SatScan v9.2 was used to describe the first 8 weeks of the outbreak in Morobe Province before cholera cases spread throughout other regions of the country. Data were aggregated at the provincial level to describe the spread of the disease to other affected provinces. Results: Spatio-temporal and cluster analyses revealed that the outbreak was characterized by three distinct phases punctuated by explosive propagation of cases when the outbreak spread to a new region. The lack of road networks across most of Papua New Guinea is likely to have had a major influence on the slow spread of the disease during this outbreak. Conclusions: Identification of high risk areas and the likely mode of spread can guide government health authorities to formulate public health strategies to mitigate the spread of the disease through education campaigns, vaccination, increased surveillance in targeted areas and interventions to improve water, sanitation and hygiene.
- Authors: Horwood, Paul , Karl, Stephan , Mueller, Ivo , Jonduo, Marinjho , Pavlin, Boris , Dagina, Rosheila , Ropa, Berry , Bieb, Sibauk , Rosewell, Alexander , Umezaki, Masahiro , Siba, Peter , Greenhill, Andrew
- Date: 2014
- Type: Text , Journal article
- Relation: BMC Infectious Diseases Vol. 14, no. 1 (2014), p.
- Full Text:
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- Description: Background: Cholera continues to be a devastating disease in many developing countries where inadequate safe water supply and poor sanitation facilitate spread. From July 2009 until late 2011 Papua New Guinea experienced the first outbreak of cholera recorded in the country, resulting in > 15,500 cases and > 500 deaths. Methods: Using the national cholera database, we analysed the spatio-temporal distribution and clustering of the Papua New Guinea cholera outbreak. The Kulldorff space-time permutation scan statistic, contained in the software package SatScan v9.2 was used to describe the first 8 weeks of the outbreak in Morobe Province before cholera cases spread throughout other regions of the country. Data were aggregated at the provincial level to describe the spread of the disease to other affected provinces. Results: Spatio-temporal and cluster analyses revealed that the outbreak was characterized by three distinct phases punctuated by explosive propagation of cases when the outbreak spread to a new region. The lack of road networks across most of Papua New Guinea is likely to have had a major influence on the slow spread of the disease during this outbreak. Conclusions: Identification of high risk areas and the likely mode of spread can guide government health authorities to formulate public health strategies to mitigate the spread of the disease through education campaigns, vaccination, increased surveillance in targeted areas and interventions to improve water, sanitation and hygiene.
Health challenges of the pacific region : Insights from history, geography, social determinants, genetics, and the microbiome
- Horwood, Paul, Tarantola, Arnaud, Goarant, Cyrille, Matsui, Mariko, Klement, Elise, Umezaki, Masahiro, Navarro, Severine, Greenhill, Andrew
- Authors: Horwood, Paul , Tarantola, Arnaud , Goarant, Cyrille , Matsui, Mariko , Klement, Elise , Umezaki, Masahiro , Navarro, Severine , Greenhill, Andrew
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Frontiers in Immunology Vol. 10, no. (2019), p. 1-16
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- Description: The Pacific region, also referred to as Oceania, is a geographically widespread region populated by people of diverse cultures and ethnicities. Indigenous people in the region (Melanesians, Polynesians, Micronesians, Papuans, and Indigenous Australians) are over-represented on national, regional, and global scales for the burden of infectious and non-communicable diseases. Although social and environmental factors such as poverty, education, and access to health-care are assumed to be major drivers of this disease burden, there is also developing evidence that genetic and microbiotic factors should also be considered. To date, studies investigating genetic and/or microbiotic links with vulnerabilities to infectious and non-communicable diseases have mostly focused on populations in Europe, Asia, and USA, with uncertain associations for other populations such as indigenous communities in Oceania. Recent developments in personalized medicine have shown that identifying ethnicity-linked genetic vulnerabilities can be important for medical management. Although our understanding of the impacts of the gut microbiome on health is still in the early stages, it is likely that equivalent vulnerabilities will also be identified through the interaction between gut microbiome composition and function with pathogens and the host immune system. As rapid economic, dietary, and cultural changes occur throughout Oceania it becomes increasingly important that further research is conducted within indigenous populations to address the double burden of high rates of infectious diseases and rapidly rising non-communicable diseases so that comprehensive development goals can be planned. In this article, we review the current knowledge on the impact of nutrition, genetics, and the gut microbiome on infectious diseases in indigenous people of the Pacific region.
- Authors: Horwood, Paul , Tarantola, Arnaud , Goarant, Cyrille , Matsui, Mariko , Klement, Elise , Umezaki, Masahiro , Navarro, Severine , Greenhill, Andrew
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Frontiers in Immunology Vol. 10, no. (2019), p. 1-16
- Full Text:
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- Description: The Pacific region, also referred to as Oceania, is a geographically widespread region populated by people of diverse cultures and ethnicities. Indigenous people in the region (Melanesians, Polynesians, Micronesians, Papuans, and Indigenous Australians) are over-represented on national, regional, and global scales for the burden of infectious and non-communicable diseases. Although social and environmental factors such as poverty, education, and access to health-care are assumed to be major drivers of this disease burden, there is also developing evidence that genetic and microbiotic factors should also be considered. To date, studies investigating genetic and/or microbiotic links with vulnerabilities to infectious and non-communicable diseases have mostly focused on populations in Europe, Asia, and USA, with uncertain associations for other populations such as indigenous communities in Oceania. Recent developments in personalized medicine have shown that identifying ethnicity-linked genetic vulnerabilities can be important for medical management. Although our understanding of the impacts of the gut microbiome on health is still in the early stages, it is likely that equivalent vulnerabilities will also be identified through the interaction between gut microbiome composition and function with pathogens and the host immune system. As rapid economic, dietary, and cultural changes occur throughout Oceania it becomes increasingly important that further research is conducted within indigenous populations to address the double burden of high rates of infectious diseases and rapidly rising non-communicable diseases so that comprehensive development goals can be planned. In this article, we review the current knowledge on the impact of nutrition, genetics, and the gut microbiome on infectious diseases in indigenous people of the Pacific region.
A high burden of asymptomatic gastrointestinal infections in traditional communities in Papua New Guinea
- Horwood, Paul, Soli, Kevin, Maure, Tobias, Naito, Yuichi, Morita, Ayako, Natsuhara, Kazumi, Tadokoro, Kiyoshi, Baba, Jun, Odani, Shingo, Tomitsuka, Eriko, Igai, Katsura, Larkins, Jo-Ann, Siba, Peter, Pomat, William, McBryde, Emma, Umezaki, Masahiro, Greenhill, Andrew
- Authors: Horwood, Paul , Soli, Kevin , Maure, Tobias , Naito, Yuichi , Morita, Ayako , Natsuhara, Kazumi , Tadokoro, Kiyoshi , Baba, Jun , Odani, Shingo , Tomitsuka, Eriko , Igai, Katsura , Larkins, Jo-Ann , Siba, Peter , Pomat, William , McBryde, Emma , Umezaki, Masahiro , Greenhill, Andrew
- Date: 2017
- Type: Text , Journal article
- Relation: American Journal of Tropical Medicine and Hygiene Vol. 97, no. 6 (2017), p. 1872-1875
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- Description: Stool samples were collected from 148 healthy adults living a traditional subsistence lifestyle in Papua New Guinea and screened for enteric pathogens using real-time RT-PCR/PCR assays. Enteric pathogens were detected in a high proportion (41%) of individuals. Clear differences were observed in the detection of pathogens between highland and lowland communities. In particular, there was a marked difference in detection rates of norovirus GII (20% and 0%, respectively) and Shigella sp. (15% and 0%, respectively). Analysis of the relationship between enteric pathogen carriage and microbial community composition of participants, using box plots to compare specific normal flora population numbers, did not suggest that gut microbial composition was directly associated with pathogen carriage. This study suggests that enteric pathogens are common in healthy individuals in Papua New Guinean highland communities, presumably acting as a reservoir of infection and thus contributing to a high burden of gastrointestinal illnesses.
- Authors: Horwood, Paul , Soli, Kevin , Maure, Tobias , Naito, Yuichi , Morita, Ayako , Natsuhara, Kazumi , Tadokoro, Kiyoshi , Baba, Jun , Odani, Shingo , Tomitsuka, Eriko , Igai, Katsura , Larkins, Jo-Ann , Siba, Peter , Pomat, William , McBryde, Emma , Umezaki, Masahiro , Greenhill, Andrew
- Date: 2017
- Type: Text , Journal article
- Relation: American Journal of Tropical Medicine and Hygiene Vol. 97, no. 6 (2017), p. 1872-1875
- Full Text:
- Reviewed:
- Description: Stool samples were collected from 148 healthy adults living a traditional subsistence lifestyle in Papua New Guinea and screened for enteric pathogens using real-time RT-PCR/PCR assays. Enteric pathogens were detected in a high proportion (41%) of individuals. Clear differences were observed in the detection of pathogens between highland and lowland communities. In particular, there was a marked difference in detection rates of norovirus GII (20% and 0%, respectively) and Shigella sp. (15% and 0%, respectively). Analysis of the relationship between enteric pathogen carriage and microbial community composition of participants, using box plots to compare specific normal flora population numbers, did not suggest that gut microbial composition was directly associated with pathogen carriage. This study suggests that enteric pathogens are common in healthy individuals in Papua New Guinean highland communities, presumably acting as a reservoir of infection and thus contributing to a high burden of gastrointestinal illnesses.