PHR Reports Paediatric Hospital Reporting Annual Child Morbidity and Mortality Reports The National Health Department’s Child Health Advisory Committee has produced an Annual Morbidity & Mortality Report since 2010. These reports summarise paediatric admissions and outcomes in hospitals in PNG. The reports contain important clinical and public health recommendations for improving child health. Disease Surveillance Case Reporting Forms The World Health Organisation declared Papua New Guinea free of polio and leprosy in 2000. However surveillance is still essential for polio and for other diseases. PNG has a program for reporting of acute flaccid paralysis (for polio surveillance), and acute fever and rash (for measles and rubella surveillance). Reporting forms for these and other notifiable diseases can be downloaded here. Reporting of these diseases requires that health workers know how to identify a suggestive clinical syndrome and take the appropriate test to confirm or exclude the diseases under surveillance. PNG also has surveillance for rheumatic fever and rheumatic heart disease, and severe acute watery diarrhoea (to identify cholera outbreaks). Stronger Communities Begin with Healthier Children

Privacy Policy Privacy Policy Effective Date: 01/06/2025 The Paediatric Society of Papua New Guinea ("we", "our", or "us") is committed to protecting the privacy of our website visitors. This Privacy Policy outlines how we collect, use, and safeguard your personal information when you visit https://pngpaediatricsociety.org . 1. Information We Collect We may collect the following types of information: Personal Information: Such as your name, email address, and professional details if you voluntarily submit them through contact forms, event registrations, or membership applications. Non-Personal Information: Such as your browser type, IP address, device type, and pages visited. This helps us improve website performance and user experience. 2. How We Use Your Information We use the information we collect to: Respond to inquiries and provide requested information Manage membership applications and communications Share updates about society activities, events, and child health resources Improve our website and services Ensure the security and integrity of our website 3. Cookies and Tracking Our website may use cookies to enhance your browsing experience. You can choose to disable cookies through your browser settings, but this may affect some features of the site. 4. Sharing Your Information We do not sell, trade, or rent your personal information. We may share information with trusted third parties only when necessary to operate our website or services, or if required by law. 5. External Links Our website may contain links to external websites. We are not responsible for the content or privacy practices of these third-party sites. We encourage users to read the privacy policies of those websites. 6. Data Security We take reasonable measures to protect your personal data from unauthorized access, misuse, or disclosure. However, no method of internet transmission or electronic storage is 100% secure. 7. Children’s Privacy This website is not intended to collect personal information from children under the age of 13. If we discover such information has been provided without parental consent, it will be deleted promptly. 8. Changes to This Policy We may update this Privacy Policy occasionally. All changes will be posted on this page with a revised effective date. 9. Contact Us If you have any questions or concerns about this Privacy Policy or how your information is handled, please contact us at: Email: info@pngpaediatricsociety.org Website: https://pngpaediatricsociety.org

In Memoriam In Memoriam Dr Alphonse Rongap Dr Wendy Pameh

Annual Child Morbidity & Mortality Repor Annual Child Morbidity and Mortality Reports The National Department of Health and The Paediatric Society of Papua New Guinea produces an Annual Report on Child Morbidity and Mortality. This report is based on the Paediatric Hospital Reporting (PHR) program, which collates and analyses admission and outcome data from all participating hospitals, and a consultative process for making recommendations. The annual reports should be read by all health care workers and health administrators involved in child and adolescent health. It is only by understanding disease burdens and outcomes that we can improve our services. The recommendations cover clinical and public health solutions that would result in many children’s lives being saved each year. Annual Reports 2024 Annual Child Morbidity and Mortality Report 2023 Annual Child Morbidity and Mortality Report 2022 Annual Child Morbidity and Mortality Report 2021 Annual Child Morbidity and Mortality Report 2020 Annual Child Morbidity and Mortality Report 2019 Annual Child Morbidity and Mortality Report 2018 Annual Child Morbidity and Mortality Report 2017 Annual Child Morbidity and Mortality Report 2016 Annual Child Morbidity and Mortality Report 2015 Annual Child Morbidity and Mortality Report 2014 Annual Child Morbidity and Mortality Report 2013 Annual Child Morbidity and Mortality Report 2012 Annual Child Morbidity and Mortality Report 2011 Annual Child Morbidity and Mortality Report

About Us About About the Paediatric Society of Papua New Guinea Established in the 1970s, the Paediatric Society of Papua New Guinea has evolved into a vital professional body committed to improving the health and well-being of children and adolescents across the country and the Pacific region. From its modest beginnings with just 10 to 20 members in the 1980s and 1990s, the Society now boasts a membership of over 80 dedicated professionals. While most members are paediatricians and postgraduate paediatric trainees, the Society also welcomes paediatric nurses, health extension officers, and other child health practitioners, reflecting its inclusive and collaborative approach. The Society plays a pivotal role in shaping the future of child health in Papua New Guinea. It maintains strong partnerships with key institutions such as the National Department of Health and the School of Medicine and Health Sciences at the University of Papua New Guinea. The Society also includes active members from neighboring Pacific Island nations, especially the Solomon Islands and Vanuatu, fostering regional collaboration. Core responsibilities of the Paediatric Society include developing and regularly updating clinical and public health guidelines based on the latest scientific evidence. As the custodian of national paediatric clinical standards, the Society ensures that healthcare providers across the country have access to best-practice protocols. The Society advises the Department of Health on a broad spectrum of child and adolescent health issues, from clinical care and disease prevention to social and environmental health factors. It also plays a critical role in public education, raising awareness on vital topics such as breastfeeding, immunization, nutrition, and school attendance. Further, the Society works closely with medical and nursing education institutions to ensure health training programs align with national child health policies. It supports continuous professional development by organizing training opportunities for paediatricians and child health nurses, helping them maintain up-to-date skills and knowledge. Beyond its technical work, the Society serves as a collegial body, offering professional and peer support to its members, and fostering a shared commitment to the health of future generations. The roles of the Paediatric Society include the following: To develop and maintain standards of paediatric clinical care and public health, according to the latest evidence. The Society is the custodian of clinical guidelines, and ensures they are kept up to date. To provide guidance to the Department of Health on all aspects of child and adolescent health, including clinical practice, quality and safety and outcomes, social, environmental and preventative health, vaccine-preventable diseases, and emerging or neglected child and adolescent health issues. The advice is based on scientific evidence and professional experience and wisdom. To provide advice to the community on important aspects of child health, for example through involvement in public awareness about breastfeeding, immunization, nutrition and school attendance. To work closely with training institutions to provide input on health training curricula, so that nursing, under-graduate medical training and courses for other health workers reflect the national child and adolescent health policies and guidelines. To develop continuing professional development for paediatricians and child health nurses to ensure the maintenance of professional skills, knowledge and standards To be a collegiate society providing professional and peer support to members This web-site contains information relevant to child health in PNG and other Pacific Island countries. COVID-19 Resources COVID-19 Guideline for Paediatric Health Care Workers August 4th 2020 Download Hospital Reporting Program Weekly Paediatric Lectures - 2022 Every child deserves a chance to grow, thrive, and shine — and we’re here to make it happen. Our Mission Our Mission To advance child and adolescent health in Papua New Guinea and the Pacific by: Promoting evidence-based clinical care and public health practices. Providing expert guidance to health authorities and communities. Supporting ongoing education and training for health professionals. Advocating for child health policies that reflect equity, quality, and sustainability. Fostering collaboration among healthcare workers, institutions, and regional partners to strengthen paediatric care at every level. Our Vision A Papua New Guinea where every child and adolescent enjoys the highest standard of health, supported by compassionate care, informed policies, and empowered health professionals. Together, for a Brighter, Healthier Future

Research 2022 Research 2022 Diploma of Child Health Feasibility of using a Neonatal Early Warning System in Neonates, in Port Moresby General Hospital Special Care Nursery. Dr Roy Iga Neonatal Early Warning Systems DCH 2022 Introduction Worldwide there are about 2.4 million babies that die before the 28 days of life. In Papua New Guinea, case fatality rate for neonates is 5.9% in 2021. As part of improving, quality care for neonates, recommendations were made to use color coded observational charts to assist in providing care for sick children. Even though, In Papua New Guinea there is a color-coded chart formulated and used for children, there are none specifically tailored for neonates. This study seeks to investigate the feasibility of using a Neonatal Early Warning System (NEWS) to identify neonates at risk and to promptly escalate care. Method An observational study was conducted to find out if a NEWS can be used to identify neonates at risk by using current vital observation techniques of nurses in PMGH, SCN. A color-coded observation chart was adapted from the Plymouth Hospital Neonatal Early Warning System chart, and used to collect data over an 8-week period (01 May 2022 to 30 June 2022). 157 patients were recruited in the study and followed up in the first 72 hours of life. Neonates were grouped into two groups, those that have triggers (had vitals that fell in the red zone) and stable group (had vitals that did not fall in the red zone). Results Of the 157 patients recruited 45.86% (n=72) were stable, and 54.14% (n=85) had triggers, that prompt a response. In the group that had triggers 55.29% (n=55) had appropriate interventions done, whilst 44.71% (n=38) did not have the appropriate intervention. It was also found that neonates that had fall in the red zone (triggers) were more likely to die in the first 72 hours of life as compared to neonates who did not have triggers. Conclusion NEWS is a tool that can be used to identify neonates at risk for unfavorable outcomes, however there has to be proper training of its use and knowledge of escalation of care, before implementing it in SCN. A qualitative study on the need for age-appropriate adolescent health care in Alotau Provincial Hospital Dr Leilani Suwari Adolescent health needs in Milne Bay Province DCH 2022 Introduction The adolescent population makes up 22.7% of the total population of Papua New Guinea (PNG). The lack of appropriate health and social services for adolescents in PNG, results in their marginalization. The care of sick adolescents admitted to hospitals in Papua New Guinea should be shared between the paediatric and adult medical units. The current cut-off age for admission to a paediatric ward is 12 years old while the adult wards admit 18 years and above. The management of chronic cases such as congenital or acquired heart problems, epilepsy, cerebral palsy, and multiple congenital abnormalities in this age gap is also an issue. There is currently no allocated ward space and appropriate facilities for sick adolescents in hospitals within PNG. Alotau Provincial Hospital, is no exception to this fact. Hospitals in PNG should support appropriate clinical care of sick adolescents by the introduction of an adolescent unit. This study aims to explore the perceptions of adolescents towards the quality of health care received, in Alotau Provincial Hospital. Methodology A qualitative-observational study was carried out from 26/04/22 – 11/08/22, amongst all adolescents (persons aged 10 – 19 years) admitted to a ward, or receiving out-patient care in Alotau Provincial Hospital, i.e. Paediatric Ward, Paediatric Consultation Clinic, Paediatric TB Clinic, Internal Medicine Ward, Surgical Ward, Obstetrics & Gynaecology Ward, and Antenatal Clinic. Data was collected via semi-structured interviews with participants of the study; and contextual data, obtained from their medical charts. Data analysis was done using the method of Thematic data analysis. Informed verbal consent was obtained from each participant and guardian – of children < 18 years of age; at the beginning of the interviews. Results A total of 57 adolescents were interviewed, 32 adolescents had a negative first impression of the hospital; whilst 25 of them felt the opposite way. 46 adolescents preferred an adolescent-friendly setting, as opposed to their current setting (n = 11); stating that it would allow for positive peer-interaction (n=14), improve their experience in the hospital (n=33), and improve the quality of health care received (n=2). Conclusion This study shows that adolescents are able to perceive the need for adolescent-friendly health services and advocate for improvement in the quality of health care received Master of Medicine Re-presentation of neonatal sepsis to the children’s ward in Port Moresby General Hospital Dr Venao Seta Neonatal Sepsis in PMGH MMed 2022 Introduction This study investigated the incidence of admissions of neonatal sepsis to the wards and further expanded on trying to identify what the common reasons of these presentations were. The study was conducted from November 2021 to April 2022. It was instigated by an observation where there was a rise in admissions of neonates following delivery at the PMGH. This study aimed to find the incidence of NNS admissions to the wards in PMGH. 2) To identify main admitting diagnosis of NNS. Methods Full admissions and consents were done for any neonate admitted via the Childrens’ Emergency Department. Data was collected using a data collection form that attained information on antenatal and delivery history; details of care at home; reason for current presentation and findings of examinations that may suggest sources of infection. Patient outcomes (discharge/died) were included. Results A total of 132 children were recruited to this study. 3 died (CFR 2.2%) whilst the rest recovered and discharged (n=129). The incidence in this study was about 2%. The main reasons for admissions to the wards were due to pneumonia (69), skin sepsis (28), cord sepsis (15), presumed sepsis (14) and abscesses (3). We saw more children with late onset sepsis (n=108) Most of the mothers were booked and were delivered at PMGH (n=120). Conclusions The incidence rate of 2% may not be entirely reflective of the true picture of NNS within the hospital due to the small sample size. Pneumonia was still a leading cause of admission in this study. This is also true for admissions in the older paediatric population as indicated in the Child Health Mortality report for 2021. Most of these presentations were of late onset sepsis; this finding reflects conditions and care of the newborn at home. A visit to individual households would have added more value to this study. We recommend the following: 1) A similar study be done nation-wide with more emphasis on risk factors of neonatal sepsis at the household and community level. This would provide a preventative approach to reducing neonatal sepsis at household and community levels thus reducing late onset sepsis to a certain degree. 2) There should be more emphasis for staff to advocate on KMC and essential early newborn care as in this study we identified that only 3% (n=4) out of the 132 recruited were told about and practised KMC. Survey of paediatric palliative care at Port Moresby General Hospital Dr Villa Watch Paediatric Palliative Care MMed 2022 Paediatric palliative care as defined by the World Health Organization involves the child’s body, mind, and spirit, but also involves supporting the family. Palliative Care starts from diagnosis and continues whether child is receiving curative treatment or not. As clinicians, identifying and relieving the child’s physical, psychosocial, and spiritual distress is imperative. This study aims to identify the characteristics of children admitted to the Paediatric Ward of the Port Moresby General Hospital with palliative care needs and how parents and health care workers view the palliative care services provided to these children. Data will be collected from the child’s admission chart and will be analysed using frequency and percentages while in-depth interviews will be carried out on parents and health care workers using semi-structured questionnaires which will be analysed using thematic analysis. The results will be useful in improving palliative care for children admitted with life-threatening and life-limiting illnesses in our setting. A cohort of children with HIV in Papua New Guinea during an era of anti-retroviral transition. Dr Gordon Pukai HIV and ART in children MMed 2022 Introduction 2019-2021 was an era of transition of anti-retroviral therapy from non-nucleoside reverse transcriptase inhibitor (NNRTI) based therapy to the new dolutegravir (DTG) based treatment. This study was conducted to observe the difference in the clinical and virological outcomes in the children with the new DTG and Lopinavir-ritonavir (LPVr) regimes as compared to their previous NNRTI-based ART regimens at Port Moresby General Hospital. Methods The participants were 60 children living with HIV who were followed at the Well Baby Clinic at PMGH. A survey form was filled included infants and children less than 18 years old. Results At enrollment in the study, 25 children had moderate malnutrition; 27 children had severe malnutrition; only 8 were well nourished. Fifty-three of the 60 were on an NNRTI based regimen. 2 were on a triple-NRTI based regimen, and 5 were on a lopinavir-ritonavir based regimen. 52 children underwent viral load testing and 37 had viral load levels >1000 copies per ml. Only 15 had adequate viral suppression with viral load <1000 copies per ml. Thirty-nine children out of 60 had clinical failure as defined by WHO. Of the 37 who had viral load >1000, all had evidence of clinical failure. Of the 54 children tested post change to the new ART regimen, 49 (90.7%) had viral load levels <1000. 5 had viral load >1000. 41 children had a reduction in their viral load after changing treatment, 1 had an increase, and in 5 the viral load was unchanged. Conclusion The DTG- based regimen provides adequate reconstitution of immunity, an effective reduction in the viral load and good clinical improvement. The outcome of low birth weight babies in Vanuatu Dr Annette Garai Low birth weight babies in Vanuatu MMed 2022 Background Low birth babies (LBW) are a fragile cohort. Medical technology has increased survival of these babies. In Vanuatu, improving their outcomes and survival is a significant health challenge. The objective of this study was to prospectively document the outcomes of LBW babies admitted to Special Care Nursery (SCN). Recording the mother’s experiences of caring for a LBW baby was a secondary objective. Methods This is a prospective descriptive cohort study compromising of 49 recruits weighing less than 2.5kg from April to August 2019. Patients were followed up at six and twelve months post discharge and their outcomes recorded. A qualitative study was conducted to identify experiences and challenges the mothers faced in caring for a LBW baby. Results Thirty-nine babies followed up. Thirty-four patients gained good weight in their first six months of life. At 12 months post discharge, 19 babies had pallor, 17 had normal head ultrasound scan, and 1 baby had retinal detachment. Most babies achieved their developmental milestones by 12 months. Mothers identified stress as a common risk factor for their premature delivery. Conclusions This study outlined the outcomes of LBW babies in Vanuatu and highlighted issues of concerns by their mothers. It is vital that all LBW babies are followed up well after discharge from SCN. Equally important is the support for mothers of LBW babies to achieve better outcomes. Procedural sedation for paediatric CT scans Dr Benji Daur Sedation for CT scans in children MMed 2022 Introduction Computerized Topography (CT) scans have been an important diagnostic tool since its introduction in the 1970s. The success of Paediatric CT scans are complicated by anxious uncooperative children and the administration of sedation has proven beneficial in improving success of completing the procedure. The primary aim of this study is to evaluate the safety and effectiveness of procedural sedation protocols provided by paediatric clinicians who are not trained anaesthetists for Paediatric CT scans in Port Moresby General Hospital (PMGH). Secondary aims include identifying complications and factors that could influence success of oral chloral hydrate and intravenous diazepam. Methods A prospective observational analysis of procedural sedations for CT scans between September 2020 to June 2021. Port Moresby General Hospital CT scan room. Results 99 sedation events were included in this cohort. 49 patients received oral chloral hydrate and 50 received intravenous diazepam prior to the procedure. 11 failed sedations occurred most noticeable from the diazepam group (Fisher’s exact p=0.008). Complications included vomiting (3) and over-sedation (4) in the chloral hydrate group. Significant factors that influence success include the drug used and ASA of patient prior to study. Conclusions This study has proven that paediatric clinical staff can provide safe and effective procedural sedation for children who require CT scans in hospital with oral chloral hydrate and intravenous diazepam. Children and adolescents admitted with Covid-19 infection at the Port Moresby General Hospital Dr Justin Kali Covid-19 in children and adolescents MMed 2022 Introduction COVID-19 is a global pandemic which has infected and killed millions of people throughout the world. Healthcare systems have faced are lot of challenges in fighting this disease and scientists are conducting studies to investigate this killer disease. Numerous case reports and studies have been done on the clinical characteristics, outcomes, and treatment of COVID-19 however the studies done in children are limited. There is no study on COVID-19 in children in Papua New Guinea. The aim of this study is to describe the clinical characteristics and outcomes of children and adolescents admitted with a positive test of COVID-19 at the Port Moresby General Hospital. Method This study is a retrospective descriptive study of children and adolescence admitted to the Port Moresby General Hospital who has tested positive for Covid-19 over a period of 6 months. The study mainly looked at their clinical characteristics and outcomes. Data was extracted from (1) PMGH laboratory COVID-19 data and (2) Admission charts according to a modified form derived from case information forms (CIF). Results Sixty patients tested positive for COVID-19 during the 6 months and were sick enough to be admitted to the paediatric isolation wards. The median age was 17 months. The most common symptoms were fever in 53 (18.5%), cough 47(16.4%), poor feeding 44 (15.3%) and dyspnoea 39 (13.6%). The most common clinical signs on examination were chest indrawing 35 (44.9%), nasal flaring/grunting 19 (24.4%) and pallor 15 (19.2%). Five (6.4%) had reduced level of consciousness and 2 (2.6%) had signs of shock. Clinical diagnosis saw nearly half of the patients admitted for COVID-19 pneumonia alone 28 (46.7%) and the other 33 (55.2%) was COVID-19 with other diagnosis. Twenty-eight (46.7%) of the COVID-19 patients had comorbidities. Most COVID-19 cases were mild 45 (75.0%) and 5 (8.3%) had severe COVID-19. 50 (83.3%) patients received empirical antibiotics and systemic corticosteroids. Eleven patients died (case fatality rate 18.3%), 4 (6.7%) absconded and 4 (6.7%) left hospital at their own risk. Of the 11 children that died, all had COVID-19 pneumonia, 1 (1.7%) also had multisystem inflammatory syndrome and 3 children (5.1%) had significant comorbidities that contributed to their deaths. Conclusions The clinical characteristics of children infected with COVID-19 were similar to other studies done in other countries. Most of the COVID-19 cases were mild. Children with comorbidities infected with COVID-19 have increased risk of mortality.

Constitution Constitution Content is being reviewed and will be available in future.

Discover the history of the PNG Paediatric Society and its journey in advancing child health, paediatric care, and medical training in Papua New Guinea. History On the 40th Anniversary of the PNG Paediatric Society, Dr Mobumo Kiromat summarised the history and achievements of the Society. History of the Paediatric Society 40th Anniversary Dr Mobumo Kiromat

Health Policies Child Health Policies Child and Adolescent Health Plan 2021-2030 In June 2022 the 3rd edition of the Child and Adolescent Health Plan was launched by the Paediatric Society of Papua New Guinea and partners, in a meeting in Sogeri. The plan outlines the priority areas and activities in line with the National Health Plan 2021-02030, and adds practical detail. The Child and Adolescent Health Plan is for use by paediatricians and Provincial Health Authorities (PHAs) to guide their annual activity plans; and to inform health workers, the community and the Government’s partners about child and adolescent health needs and approaches being adopted. The Plan is in line with the WHO Child and Adolescent Health Redesign, and includes a life-course approach, more emphasis on preventative health, school health, adolescent health, community and social paediatrics, mental health, and chronic diseases. The Plan also updates the program recommendations on HIV, TB, pneumonia, malaria, diarrhoea, and newborn care. PNG Child and Adolescent Health Policy and Plan 2021-2030 WHO Standards for Care of Children and Adolescents in Health Facilities In 2018 WHO published standards for paediatric care in hospitals. These standards are universal and holistic. They include clinical standards aligned to WHO guidelines, and go beyond this to require child- and family-centred care, better environments to care for children, and attention to prevention of disease and protection of children’s rights. WHO Standards for Improving Quality of Health Care for Children and Adolescents 2018 School Health Policy School Health Policy 2016 Child Protection Legislation Lukautim Pikinini (Child) Act 2009 International Code of Marketing of Breast Milk Substitutes International code of marketing of breast milk substitutes WHO 1981 The World Health Assembly Code was ratified by the PNG parliament in the Infant Feeding Act, whereby the sale of feeding bottles, cups, teats and dummies is strictly controlled, and there is a ban on advertising these products as well as breastmilk substitutes. Adolescent Health Policy Youth and adolescent health policy 2014 Nurturing Children, Supporting Families, Empowering Professionals

Research 2021 Research 2021 Diploma of Child Health Dr Geraldine Lagani Paediatric referrals from Gerehu Hospital Dr Shedrick Wadigi Child injuries in Angau Hospital Dr Dorothy Namba Antibiotic audit in Mt Hagen Master of Medicine Dr Mathilda Aloich Polio vaccine in Sandaun Province Dr Tina Yarong Knowledge and Perceptions of HIV among parents in Port Moresby Dr Andree Zumanu Intravenous cannula complications in children at Port Moresby Hospital Dr Anna Toti Birth defects in Rabaul Dr Winnie Sadua Thiamine status of malnourished children in Port Moresby

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Research 2020 Research 2020 Master of Medicine Dr Edwina Baleo. Parents’ perspectives of adolescent sexual reproductive health in Port Moresby A study of parental perception on adolescent sexual reproductive health in Port Moresby, Papua New Guinea. The study demonstrated that there is a need for parental support in improving adolescent sexual reproductive health of young people, as revealed by lack of awareness of adolescent sexuality rights, poor knowledge depth and communication capacity among parents interviewed. While parents were aware that adolescence was an important stage in a child’s life, during which guidance in decision making relating to sexuality is paramount, their depth of understanding of the aspects of sexuality that require attention in a child’s life were limited, including an obligation to ensure contraceptives are encouraged and made available to their children. Most parents based their preventative measures on messages of abstinence which has shown to be an ineffective preventative method. Hence there is a need for comprehensive sexual and reproductive health education amongst parents and adolescents in Port Moresby. Dr Ian Kintwa. Factors associated with mortality in children with acute malnutrition at the Mt Hagen General Hospital in 2019 A prospective study of 150 children with severe malnutrition, investigating clinical and laboratory risk factors for death, measurable at the time of presentation. Children with a capillary refill greater than 3 seconds, tachypnoea, hypoxaemia, reduced conscious level and dysnatraemia (hypernatremia or hyponatremia) were significantly more likely to die. 13 children had prolonged capillary refill the odds ratio for death was 9. 18 children had hypoxaemia and the odds ratio for death was 30. 20 children had a GCS<13 and the odds ratio for death was 56. 28 children had dysnatraemia and the odds ratio for death was 4. To reduce acute malnutrition mortality, children presenting with capillary refill greater than 3 seconds, hypoxaemia, reduced conscious level or dysnatraemia should be identified promptly and given special attention. Clinical and laboratory features of children with malnutrition in Mt Hagen MMed 2020 Dr Violet Nigiria. “Tied for life”: Children with thalassaemia receiving blood transfusions in Port Moresby in 2020 A descriptive longitudinal-qualitative review of thalassaemia patients receiving blood transfusions in Port Moresby general Hospital in Papua New Guinea was carried out. 21 patients who were receiving blood transfusions and their parents were interviewed. There are important impacts of thalassemia on quality of life, as seen in school attendances and self-perception to illnesses. The genuine sacrifices and burden faced by the family were substantial. Issues faced by these families included their knowledge of thalassaemia, end of life discussions, parental concerns, family coping strategies and aspects of positivity about their illness. Most children were from southern coasts of Papua New Guinea. The affected families sacrificed a lot and migrated near hospitals that have blood bank services. Regular blood transfusions had increased the patient’s life span, however this can be improved further by regular monitoring of post-transfusion haemoglobin to maintain a hyper-transfusion state, combined with the introduction of chelation agent. Papua New Guinea need to develop prevention strategies of any birth defects by having the health policy makers aware of the global and local toll of birth defects with associated disabilities and family burdens and develop a genetic screening services for selected birth defects in hospitals, for risk assessment, genetic counselling and education of the family so reliable database for the country can be collected. Finally, provision of holistic and comprehensive care for patients and families with thalassaemia is essential including other children with birth defects. Thalassaemia in children at Port Moresby Hospital MMed 2020 Dr Joseph Ande. Approach to the diagnosis of tuberculosis meningitis in children admitted to the Port Moresby General Hospital In Papua New Guinea childhood TB is a large burden and contributes substantially to child mortality, malnutrition and impaired neurological and cognitive development. Diagnosing tuberculous (TB) meningitis or central nervous system TB in low resource setting is very challenging. The study assessed the current practice of diagnosing children admitted to Port Moresby General Hospital in 2020. 50 children who were admitted with a diagnosis of CNS TB with no underlying prior cerebral lesions were enrolled in this study. The data were collected by interviewing the parents or guardians and from the admission charts. The median age was 45 months. The CSF microscopy result showed the typical picture of CNS TB or TB Meningitis with a very high lymphocytes with very high protein and normal glucose. More than 50% of the population studied had chest x-ray changes suggestive of TB. Gene x-pert detected more mycobacterium TB in CSF more than other samples collected for testing. Based on these results a standardised algorithm in diagnosing TBM in PNG can be designed to further improve detection, management and prevent comorbidities and deaths relating to TBM. Diagnosis of tuberculous meningitis in children MMed 2020 Diploma of Child Health Dr Thomas Johns. The prevalence and risk factors for malnutrition in children attending outpatient clinics in Goroka town In this study, amongst children attending urban clinics in Goroka, 14% had malnutrition. The risk factors associated with malnutrition were; village delivery and residence in a rural area. Other characteristics linked to higher probability of malnutrition were among children who resided in a settlement area, were being raised by a single parent, were adopted, lived in homes where the primary water source was from river supply, and partially vaccinated child and introduction of first feed less than 6 months. However these were not significant. Improvements to reducing rates of malnutrition can be achieved greatest through changes in socioeconomic status of women, ensuring children have a supervised delivery in a health facility where they are provided adequate counselling for basic nutrition amongst other necessary basic health advice, improving accessibility of primary health care to women and children has the potential to reduce the rates of malnutrition that we see in the province and the nation as a whole. Malnutrition in urban clinics in Goroka DCH 2020 Dr Tracey Jeff. The severity and duration of hypoxemia in children with pneumonia in Mount Hagen Hospital Pneumonia and bronchiolitis are the commonest cause of admission to the paediatric ward in Mt Hagen General Hospital associated with hypoxemia for the patients aged 1 month to 5 years. Many patients with pneumonia and bronchiolitis patients presenting with hypoxaemia seem to require longer hospital stay being on oxygen, and this is more commonly seen in the highlands. This study aimed to determine the time taken for hypoxaemia to resolve in children aged 1 month to 5 years, with pneumonia or bronchiolitis at Mount Hagen Hospital Western Highlands Province, Papua New Guinea, and to study the factors predicting prolonged hypoxaemia (SpO2<90% for more than 7 days) and the effect of comorbidities. Among 152 patients, 70 had clinical pneumonia, 20 had clinical bronchiolitis, and the rest had acute lower respiratory infection indistinguishable between pneumonia and bronchiolitis. The median SpO2 in air on admission was 78% (IQR 66-83%). The median days to resolution of hypoxemia was 2.5 days (IQR 1.5 to 5 days), 19.1% still required oxygen at 7 days, and hypoxaemia in all patients had resolved by 18 days. Hypoxaemia was more likely to be prolonged for those with underlying comorbidities. Most children who have just pneumonia or bronchiolitis do not require prolonged hospital stay for supplemental oxygen, while some do but their hypoxaemia resolves within 3 weeks. Better understanding of associated comorbidities and their management will help improve education on the use of oxygen therapy, understand disease progression and complexity and improve management of children with hypoxaemia. Severity and duration of hypoxaemia in children with pneumonia in Mt Hagen DCH 2020 Dr Vanessa Binene. Oxygen saturation reference values measured by pulse oximetry among children living at high altitude in Wabag The use of pulse oximetry is now common in most clinical settings throughout PNG, and it is recognized as a fifth vital sign. The purpose of this research was to determine a reference value of healthy individuals from the age of 1 to 60 months living in Wabag District at about 2300m above sea level, and to determine any factors that can contribute to a lower oxygen saturation in children living that this altitude. There were 266 subjects analysed, the data were normally distributed. The lowest measured SpO2 was 82% and the highest 99% with a mean of 94.8% (SD 2.8%). The 95% CI was 94.5% to 95.1%. Younger children had a lower mean SpO2 than older children living at this altitude, which suggests physiological adaptation to altitude over time, even beyond infancy. Sleep had a lowering effect on arterial oxygen saturation, and babies in bilums whether awake or asleep had lower SpO2 compared to other children. While the clinical significance of this is uncertain, certain young babies may be more at risk of hypoxia and adverse events if asleep in a bilum, and if parents also smoke, and this requires further research. Normal oxygen saturations in children in Enga DCH 2020 Dr Ruth Jaye. Bacteria causing intravenous cannula-related thrombophlebitis and fever, and antibiotic resistance patterns, among paediatric patients at Angau Hospital Thrombophlebitis and fever secondary to the use of intravenous cannula (IVC) is a common occurrence in children at Angau Hospital, and might be a cause of nosocomial infection and avoidable morbidity and mortality. This study was done to identify the causative organisms by doing cultures on IVC tips and identifying the antibiotic sensitivity and resistance of bacteria isolated. The study included children who had IVC during their hospital admission. All IVC tips were collected using a sterile procedure (wearing sterile gloves, sterile scissors to cut the cannula tip, and transport media). Cultures were done on all IVC tips and antibiotic sensitivities done on all isolates. The organisms in the IVC tips that are responsible for causing thrombophlebitis were identified, Gram negative bacteria were most common, especially Escherichia coli and Klebsiella species. These bacteria were resistant to many standard antibiotics.