Hazards and critical control points for traditional sago starch production in Papua New Guinea: implications for food safety education

Sago starch is an important food in lowland Papua New Guinea (PNG), however cases of severe illness following its consumption have been documented. A hazard analysis of traditional sago starch production and consumption was conducted, based on observations of the preparation process, and findings from sociological and microbiological studies. Hazards identified included common pathogenic bacteria and toxigenic fungi. Critical control points (CPP) were identified at various stages of the production process,\ud including tree selection, starch extraction, sago storage and cooking. Storage methods that promoted spontaneous fermentation were deemed the most important risk reduction process in the production of safe sago starch. The CCPs formed the basis of an education campaign that was developed to provide guidance on how to maximise the safety of sago starch within the cultural and socio-economic context of rural PNG

Spatial distribution of tuberculosis in a rural region of Western Province, Papua New Guinea

Introduction: There is a high burden of tuberculosis (TB) in the Western Province, Papua New Guinea. This study aims to describe the spatial distribution of TB in the Balimo District Hospital (BDH) catchment area to identify TB patient clusters and factors associated with high rates of TB. Methods: Information about TB patients was obtained from the BDH TB patient register for the period 26 April 2013 to 25 February 2017. The locations of TB patients were mapped, and the spatial scan statistic was used to identify high- and low-rate TB clusters in the BDH catchment area. Results: A total of 1568 patients were mapped with most being from the Balimo Urban (n = 252), Gogodala Rural (n = 1010) and Bamu Rural (n = 295) local level government (LLG) areas. In the Gogodala region (Balimo Urban and Gogodala Rural LLGs), high-rate clusters occurred closer to the town of Balimo, while low-rate clusters were located in more remote regions. In addition, closer proximity to Balimo was a predictor of high-rate clustering. Discussion: There is heterogeneity in the distribution of TB in the Balimo region. Active case-finding activities indicated potential underdiagnosis of TB and the possibility of associated missed diagnoses of TB. The large BDH catchment area emphasizes the importance of the hospital in managing TB in this rural region

The epidemiology of melioidosis in the Balimo region of Papua New Guinea

The distribution of Burkholderia pseudomallei was determined in soil collected from a rural district in Papua New Guinea (PNG) where melioidosis had recently been described, predominately affecting children. In 274 samples, 2·6% tested culture-positive for B. pseudomallei. Pulsed-field gel electrophoresis using SpeI digests and rapid polymorphic DNA PCR with five primers demonstrated a single clone amongst clinical isolates and isolates cultured from the environment that was commonly used by children from whom the clinical isolates were derived. We concluded that individuals in this region most probably acquired the organism through close contact with the environment at these sites. Burkholderia thailandensis, a closely related Burkholderia sp. was isolated from 5·5% of samples tested, an observation similar to that of melioidosis-endemic areas in Thailand. This is the first report of an environmental reservoir for melioidosis in PNG and confirms the Balimo district in PNG as melioidosis endemic