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Birth defects in a rural province in Papua New Guinea
  1. Anna Toti1,
  2. Beryl Vetuna2,
  3. Veronica Kalit2,
  4. Trevor Duke3,4
  1. 1Port Moresby General Hospital, Port Moresby, National Capital District, Papua New Guinea
  2. 2Paediatrics, Rabaul Provincial Hospital, Rabaul, East New Britain, Papua New Guinea
  3. 3Child Health, University of Papua New Guinea, Waigani, Papua New Guinea
  4. 4Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Prof Trevor Duke; trevor.duke{at}


Background Globally, birth defects are the fourth most common cause of neonatal mortality. They cause substantial morbidity, and often long-term disability. Despite this, the impact of birth defects on public health has received little attention in low- and middle-income countries.

Aims To report the types, incidence and geographic distribution of birth defects in the East New Britain Province of Papua New Guinea.

Methods Data were collected over 3 years on newborns with birth defects seen at Rabaul Hospital, born anywhere in the province. Each affected newborn was examined, the anomaly diagnosed and classified. The exact home location was recorded to understand geospatial distribution. To calculate incidence, data were collected on all newborns with a congenital anomaly in a cohort of 2000 consecutive live births at Rabaul Hospital in 2019.

Results Over 3 years, 2018–2020, 137 newborns with birth defects were identified, born in any part of the province. Congenital heart defects, hydrocephalus, microcephaly, craniofacial anomalies, imperforate anus, trachea-oesophageal fistula and diaphragmatic hernia were the most common anomalies. Eight cases of Down syndrome and other chromosomal anomalies were identified. The incidence in 2019 was 14 per 1000 live births. Geographic mapping showed the highest number of cases in the region on the Gazelle Peninsula, the area around the active volcanos.

Conclusions This study provides insights into the incidence and types of birth defects in a rural island province and showed it was possible to map geospatial distribution to further explore epidemiology.

  • Neonatology
  • Paediatrics
  • Epidemiology
  • Global Health

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors AT was the main investigator. AT, TD, BV and VK planned the study method. AT conducted the study for her master's thesis, supervised by TD, BV and VK. AT gathered the data and did the initial analysis. AT and TD wrote the paper, and it was reviewed by BV and VK. AT and TD are guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.