Standard Treatment for  
                  Common Illnesses of Children  
                       in Papua New Guinea 
                                      
                                      
                                      
          
                                      
                               A MANUAL FOR 
                    NURSES, COMMUNITY HEALTH WORKERS, 
                   HEALTH EXTENSION OFFICERS, AND DOCTORS 
                                      
                                      
                                      
                                  th
                                10  Edition 
                                   2016 
                                      
                                      
                                      
                                      
                                      
                                      
                                      
                                      
          
          
                                      
                                      
                                      
                            
                                    1 
          
         TALK WITH THE MOTHER AND IF POSSIBLE THE FATHER 
         Always: 
              -  Discuss the child’s illness and treatment with the parents 
              -  Discuss good nutrition 
              -  Discuss family planning 
              -  Ask the mother to always bring the Child Health Record Book 
                whenever the child comes to a health centre or hospital. 
          
         IMMUNISATION 
         Use every opportunity to immunise every child who is due or overdue 
         for vaccines. The only exception is in the case of a child with a fever 
                 °
         above 38 C who should not be given Pentavalent (Triple Antigen, 
         Hepatitis B and Hib) or pneumococcal vaccines. Measles/Rubella 
         vaccine should be given even if the child has a fever or is sick. 
          
         SHORTAGE OF MEDICINES  
         If you run out of any of the medicines in this book, contact the CEO of 
         your Provincial Health Authority, or hospital manager urgently. They 
         will try to get them for you or tell you what to use instead. 
          
         ON ADMISSION 
              -  Weigh every child 
              -  Record the weight and age 
              -  Mark the weight on the weight chart 
              -  Record mid-upper arm circumference (MUAC) 
              -  Treat any malnutrition 
              -  Immunise the child and the other members of the family if 
                they are due or overdue for immunisation.  
          
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     RECENT CHANGES IN IMMUNISATION AND POSSIBLE 
     DEVELOPMENTS DURING THE LIFE OF THIS EDITION 
     Health Department policies are updated as new knowledge, new 
     medicines and new vaccines become available.  It is almost inevitable 
     that new policies will be introduced during the life of the present 
     edition of this handbook, such as changes in immunization schedule 
     (polio, measles) 
      
     POLIO VACCINE 
     In April, 2016 trivalent OPV (tOPV) was replaced with the new bivalent 
     OPV (bOPV) and a dose of inactivated polio virus vaccine (IPV) was 
     introduced. All children should be receiving bOPV at one, two and 
     three months and a dose of IPV also at 3 months. This marks major 
     progress towards the eradication of Polio. It is anticipated that in 2018 
     or 2019, bOPV will be withdrawn and replaced with IPV, so children 
     will then receive IPV at one, two and three months.  
      
     MEASLES and RUBELLA VACCINE 
     There are 2 changes with the measles vaccine.  Firstly - the measles 
     vaccine is now combined with the rubella vaccine (MR) as of 2015. 
     The second change is that children should receive an additional 
     measles vaccination at 18 months. This means children should receive 
     MR vaccine at 6, 9, and 18 months to avoid future epidemics.  
      
     Possible Developments: It is possible that in the next few years the 
     Human Papilloma Virus (HPV) may be introduced to be given to older 
     school age children.  
      
     CHILD FRIENDLY TB MEDICINE 
     A new paediatric friendly fixed-dosed combination (FDC) TB medicine 
     has been developed.  It contains the same 3 drugs (rifampicin, 
     isoniazid, pyrazinamide) but it is dosed better for children, comes in a 
     liquid, and tastes better.  It will become available throughout the 
     country in 2016 and 2017.  See TB section for more details. 
               
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            Standard Treatment for  
          Common Illnesses of Children  
            in Papua New Guinea 
                     
                     
                     
                     
                     
              A MANUAL FOR NURSES,  
             COMMUNITY HEALTH WORKERS,  
          HEALTH EXTENSION OFFICERS AND DOCTORS 
                     
                     
      
                 10th Edition 
                   2016 
                     
                     
                     
                     
                     
      
      
      
                     
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