Pandemic influenza in Papua New Guinea: a modelling study comparison with pandemic spread in a developed country

Milne, George J; Baskaran, Pravin; Halder, Nilimesh; Karl, Stephan; Kelso, Joel

The present study shows that larger numbers of transmissions occur within households due to the larger household sizes in countries such as PNG. Furthermore, low-income countries generally have population health profiles not seen in developed countries, including the prevalence of diseases such as malaria, tuberculosis and HIV. [49] Antiviral treatment of influenza cases co-infected with such diseases may be an appropriate intervention strategy given the poorer health outcomes which co-morbidity may impose. [12] The provision and use of antiviral agents will have challenges not faced by industrialised countries, due to the cost of providing an antiviral stockpile and subsequent distribution of antivirals in countries which have health systems already stretched to capacity. [15] The importance of suitable pandemic influenza preparedness plans for low-income countries is recognized by the WHO [50, 51]. Disease transmission models will play a role in guiding policy makers in determining the effectiveness of possible pandemic countermeasures. History tells us that low-income countries are likely to be more affected, yet almost all models deal with mitigation strategies for developed nations with good health infrastructure and low prevalence of endemic diseases. These countries have poorer access to antiviral drug and vaccine-based interventions and higher extant disease burdens, compared to developed countries. For the reasons, development of appropriate intervention strategies focused on countries such as PNG needs to occur.