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Biomedical subjects

S A Finau

Publications and source records attributed to S A Finau.

36 records · Page 2Linked to original sources

Health and nutritional status of Tongan preschool children after Cyclone Isaac.

A post-cyclone assessment of the health and nutritional status of preschool children at Ha'apai, Tonga Is, showed lower disease incidence and an unchanged pattern of illness. Height and weight measurements indicated nutrition problems to be chronic and perhaps unrelated to the effects of the disaster. This study supports the hypothesis that natural disasters do not generate new diseases or necessarily lead to disease outbreaks.

Adult↗

Review of the village health worker pilot scheme in Tonga.

The village health worker (VHW) pilot scheme in Tonga was reviewed three months after implementation. The scheme was acceptable to the regional health workers and the communities the VHW were serving. There were demands from most for the VHW for the community to have more than one VHW, build a clinic, and to increase the emphasis on curative medicine. There was no demand for a health prevention or promotional role. The rate of recorded illnesses has increased but health seeking behaviour remained unchanged. This scheme has provided an opening for the Ministry of Health to implement equalizing strategies to merge the practice and the political rhetoric of primary health care and community participation.

Child↗

Hypertension among urban and rural Tongans.

A cross-sectional study of urban and rural Tongans showed the prevalence of hypertension to be 8.4%. Hypertension occurred more often in urban men than in women. Systolic blood pressure (BP) showed a significant increase with age in all groups, except among rural men. Multivariant discriminant analysis identified the characteristics that were associated with a raised BP. The independent variables were selected for entry into the analysis on the basis of their power to separate BP categories, using Rao's V as the generalized measure of distance between groups. Age and body build (BMI or Fatsum) accounted for most differences between normotensive and hypertensive persons, especially in women. The fasting plasma glucose level was a significant discriminating characteristic for both men and women. The packed red cell volume was the most powerful single discriminating characteristic in men and the serum triglyceride level in women. The use of each characteristic to classify individuals by BP category may help clinicians to use cross-sectional data when deciding on the treatment of raised BP.

Adult↗

Food consumption pattern during a drought in Tonga.

Seven and eight year old primary school children were interviewed to rapidly assess food consumption patterns during a drought in Tonga. Of the 158 children interviewed, 11 (7%) reported hunger in their households and four (2.4%) reported one meal per day. Carbohydrate consumption was high but protein and vegetables were low. This simple study provided crude but useful and timely information for decision making.

Child↗

Marketing and primary health care: an approach to planning in a Tongan village.

Expensive health facilities have failed to meet most health needs. This perceived failure has been interpreted as failure of scientific medicine with subsequent alienation of health facilities. It is therefore necessary to develop primary health care (PHC) programmes shaped around the life patterns of the population it serves. This paper discusses the similarity between marketing concept and providing PHC, and as it was applied to development planning in a village of the Kingdom of Tonga. The issues, circumstances, and approaches discussed, reflect what is desirable from the villagers' viewpoint. In the absence of epidemiological data, there was greater reliance on the villagers' observations to rank priorities. The process of arriving at the final objectives used the marketing approach to provide direction and guideline for discussions for the problems. Marketing can be of assistance in the search for more acceptable and accessible health service and will help to focus on the communities' perspective of their total needs.

Adult↗

Ageing in the South Pacific. Physical changes with urbanization.

The process of ageing, the place the elderly hold in the South Pacific societies and the care they receive as they move from adult independence to geriatric dependence varies considerably in different Pacific Polynesian populations. This provides unusual opportunity to examine the physical changes of ageing in people of the same broad genetic make-up exposed to environmental changes brought about by urbanization. Epidemiological surveys carried out since 1962 among New Zealand Maoris, Tongans, Cook Island Maoris in Rarotonga and Pukapuka, and Tokelauans living in Tokelau and following migration to New Zealand, provide the main data base for this presentation. The pattern of blood pressure, body weight, serum lipids and clinical disorders show considerable variation which relate most closely to the adoption of westernized life-style and moving into an urban environment. Analysis of the ECG pattern, in Pukapukans, in whom blood pressure shows only a minor increase with age, compared with age and sex-matched subjects studied in Newcastle, England provide insights into the ageing heart. An examination of mortality based on risk factors at entry shows an inverse relationship of serum cholesterol to total mortality in New Zealand Maori men and women, in Tokelau men but not women. Increasing systolic blood pressure was related to mortality in New Zealand Maori men, Tokalau men and Caucasian women, but not in the other race sex groups. The pattern of ageing and risk factors must clearly be examined in individual populations because while death is the end the pathways vary.

Adult↗

Kava, alcohol and tobacco consumption among Tongans with urbanization.

The prevalence of kava (Piper methysticum), alcohol and tobacco consumption in Nuku'alofa (urban) and Foa (rural) are described. Current kava consumption was males 48% and females 1%. Prevalence was significantly higher among rural males. Current alcohol consumption was almost exclusive to the urban population and predominantly male, but only 2 (1%) rural males were current alcohol consumers. 169 (84.0%) of the rural males were irregularly or had ceased consuming alcohol. Tobacco consumption also showed a significant male predominance. There was a significantly higher total tobacco consumption in the urban population. Concordance of the three habits was evident among males with 27 concordant positive (expected = 5.98) and 46 concordant negative (expected = 6.60). It appears that kava, a traditional Pacific beverage may have lost ground to alcohol as urban Tongans adopt a more cosmopolitan life style. Kava, if proved relatively harmless, may be promoted as a less unhealthy alternative to tobacco and alcohol.

Adult↗

Hepatocellular carcinoma and liver pathology in tonga.

All liver histology records from Tonga during 1970-79 were reviewed, including 42 biopsy and one necropsy specimens. Primary hepatocellular carcinoma was the histological diagnosis in 13 (30 percent). The age standardised incidence rate for confirmed cases are: males 2.9 and females 1.5 per 100 000. These are unremarkable compared to some reported rates, but many of these areas have included a high percentage of unconfirmed cases. Other diagnosis included cirrhosis (14), cholangiocarcinoma (2), metastatic carcinoma (2), cholangitis (2), hepatic fibrosis (2), and actinomycosis (1). The difficulties of diagnosis and areas for further studies are discussed.

Adolescent↗

Human brucellosis in Tonga.

The first cases of human brucellosis in Tonga are discussed with emphasis on a general review of the disease. The need for awareness and animal screening is highlighted.

Adolescent↗

Malaria in Tonga: an imported case.

A case of falciparum malaria in Tonga occurring in a tourist is reported and discussed with the emphasis on awareness of imported diseases to the Pacific.

Antimalarials↗

Pacific health: an analysis for training new leaders.

History, economics, culture, and politics have created health systems that can no longer meet the health challenges in the Pacific. An analysis of the health situations in the region revealed health trends, health service deficiencies and the various issues that need to be addressed. The morbidity and mortality experience in the Pacific has been approaching that of the developed countries. The contributing factors to diseases and death have been changing but other health issues, such as matters pertaining to environmental sanitation, management, health information, food and nutrition, ethnic pluralism, colonialism, and technological arrogance, may exacerbate these experiences. To appropriately meet these constraints, the health services need reorientation. However, these need new types of health leadership. Doctors, being the most socially acceptable and politically powerful, should be trained for this new leadership role. This training must be guided by the biopsychosocial model to produce community health physicians. This is being undertaken at the Pacific Basin Medical officer Training Program, Pohnpei. It is characterized by an integrated, community-oriented, student-centered, career-ladder and competency-based approach. The graduates will then provide the leadership and catalyst for the needed health service reorientation.

Community Medicine↗