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PubMed1992

Long-term efficacy of single-dose mass treatment with diethylcarbamazine citrate against diurnally subperiodic Wuchereria bancrofti: eight years' experience in Samoa.

A single-dose of diethylcarbamazine citrate (DEC, 6 mg per kg body weight) was administered in three mass treatment campaigns to > 80% of the estimated total Samoan population (160,000) in 1982, 1983, and 1986. The effect of the drug was evaluated before and after each campaign by conducting four blood surveys covering 9600 to 13,700 people from 26-34 villages on each occasion. The drug reduced the prevalence of Wuchereria bancrofti microfilariae from 5.6% to 2.5% (a 55% reduction), while the transmission potential (the estimated mosquito infection rate if everyone is equally exposed to mosquito bites) dropped from 2.18 to 0.67 (a 70% reduction). The total number of microfilariae in the Samoan population is estimated to have been reduced by 80%. A spaced, single-dose treatment with DEC at a 1-2-year interval therefore seems to be an effective control measure against diurnally subperiodic W. bancrofti.

Adolescent↗
PubMed1992

Giant hemangioma of the liver. An observation from Samoa Islands.

Hemangioma of the liver is a benign tumor of vascular origin. Most of them are less than 2-3 cm in diameter and remain asymptomatic. Although hemangioma is the most frequent benign tumor of the liver large symptomatic hemangiomas, so-called 'giant' hemangiomas, are rare. In this paper a case of 'giant' hepatic hemangioma measuring 15 cm in diameter, seen in a middle aged Samoan woman, is presented. Clinical, pathological and therapeutical features are discussed.

Adult↗
PubMed1985

Filariasis transmission in Samoa. II. Some factors related to the development of microfilariae in the intermediate host.

The developmental period of microfilariae of sub-periodic Wuchereria bancrofti in laboratory-bred Aedes polynesiensis and Ae. samoanus was shorter in the warm season (December to May) than in the cool season (June to November). In the warm season the microfilariae reached the 'sausage' stage in three days, cylindrical second stage in seven days and the infective stage in 12 days after the infecting meal. During the cool season the incubation period was extended to 14 days. Microfilariae persisting in a carrier recently treated with diethylcarbamazine citrate readily infected Ae. polynesiensis and Ae. samoanus and developed into the infective stage, but the proportion which became infected was significantly less than the proportion infected on an untreated carrier having comparable microfilarial density. Under the conditions of the experiments the survival of infected Ae. polynesiensis and Ae. samoanus was dependent on physical conditions. The average level of infective worm burden did not appear to affect the mortality of the vectors.

Adolescent↗
PubMed1985

Filariasis transmission in Samoa. I. Relation between density of microfilariae and larval density in laboratory-bred and wild-caught Aedes (Stegomyia) polynesiensis (Marks) and wild-caught Aedes (Finlaya) samoanus (Gruenberg).

Transmission experiments of laboratory-bred and wild-caught Aedes polynesiensis and wild-caught Ae. samoanus on carriers with different levels of microfilaraemia showed that the percentage of mosquitoes infected, the average number and range of larvae found in each infected mosquito were directly proportional to the microfilarial densities in the carrier at the time of feeding. There was no difference between the results for laboratory-bred and wild-caught mosquitoes. Aedes polynesiensis fed on low carriers (around 20 Mf ml-1 and less) gave an average infection rate of 4.9%. Each infected mosquito harboured only one larva. A plot of the probit of percentage Ae. polynesiensis positive against the logarithm of microfilarial density showed a linear relationship. Using the regression line, at 95% confidence interval, a microfilarial density of 1 ml-1 would give an infection rate of 0.22-2.51%, a density of 0.1 Mf ml-1 an infection rate of 0.01-1.0%. The concentrating capacity of Ae. polynesiensis ranged from 0.70 to 4.74. As microfilaria densities decreased, concentration increased. The microfilarial intake, the subsequent worm burden and concentrating capacity were less in Ae. samoanus than Ae. polynesiensis. There was no evidence of any association between microfilarial density and concentration in Ae. samoanus.

Adolescent↗
PubMed2006

The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic development in the Samoan archipelago.

Early in economic development there are positive associations between socioeconomic status (SES) and cardiovascular disease (CVD) risk factors, and in the most developed market economy societies there are negative associations. The purpose of this report is to describe cross-sectional and longitudinal associations between indicators of SES and CVD risk factors in a genetically homogenous population of Samoans at different levels of economic development. At baseline 1289 participants 25-58yrs, and at 4-year follow-up, 963 participants were studied in less economically developed Samoa and in more developed American Samoa. SES was assessed by education, occupation, and material lifestyle at baseline. The CVD risk factors, obesity, type-2 diabetes and hypertension were measured at baseline and 4-year follow-up, and an index of any incident CVD risk factor at follow-up was calculated. Sex and location (Samoa and American Samoa) specific multivariable logistic regression models were used to test for relationships between SES and CVD risk factors at baseline after adjustment for age and the other SES indicators. In addition an ordinal SES index was constructed for each individual based on all three SES indicators, and used in a multivariable model to estimate the predicted probability of CVD risk factors across the SES index for the two locations. In both the models using specific SES measures and CVD risk factor outcomes, and the models using the ordinal SES index and predicted probabilities of CVD risk factors, we detected a pattern of high SES associated with: (1) elevated odds of CVD risk factors in less developed Samoa, and (2) decreased odds of CVD risk factors in more developed American Samoa. We conclude that the pattern of inverse associations between SES and CVD risk factors in Samoa and direct associations in American Samoa is attributable to the heterogeneity across the Samoas in specific exposures to social processes of economic development and the natural history of individual CVD risk factors. The findings suggest that interventions on non-communicable diseases in the Samoas must be devised based on the level of economic development, the socio-economic context of risk factor exposures, and individual characteristics such as age, sex and education level.

Adult↗
PubMed1994

Genetic characterization of American and Western Samoans.

The Samoan islands were politically separated into American Samoa and Western Samoa in the early 1900s. Economic modernization is far more extensive in American Samoa. However, the Samoan archipelago has maintained a remarkable degree of sociocultural homogeneity, including intermarriage. The sociocultural exchanges presumably led to genetic homogeneity between the two Samoas. Detailed genetic comparisons and characterizations of Samoans are scanty, however. As part of a multidisciplinary study of modernization and cardiovascular risk factors in adults, we analyzed nine hypervariable nuclear DNA (HVR) and four serum protein polymorphisms in the two Samoan groups. The average heterozygosities at both DNA and serum protein loci are comparable in the two groups. As expected, the HVR loci reveal a high degree of variability (heterozygosity 30-87%) compared with the serum protein loci (heterozygosity 1-52%). A large proportion of alleles at the HVR loci, ranging from 50% to 100%, are shared between American and Western Samoa. With the exceptions of the D1S80 locus in American Samoa and the D13S118 locus in Western Samoa, the genotype distributions at all loci conform to their respective Hardy-Weinberg expectations. Sporadic occurrence of the F13B*2 allele at the F13B locus in Samoans indicates a low level of European admixture because this allele is unique to Europeans. The calculated zero values of kinship coefficients and standard genetic distances indicate minimal population differentiation between the two Samoan groups.

Alleles↗
PubMed2006

Farming and adiposity in Samoan adults.

Samoans are experiencing some of the highest prevalences of obesity and associated health conditions in the world. Sustainable interventions are needed to prevent further increases in obesity. This study describes the cross-sectional association between farm work and adiposity among 754 adults residing in American Samoa in 2002 and 957 adults residing in Samoa in 2003. Adiposity was measured by body mass index (BMI) and percent body fat (% BF), based on bioelectrical impedance. Regression models adjusted for the effects of age, education, occupation (in women), and material lifestyle (MLS), and the clustering within households due to the family design of the parent study. After controlling for these variables, participation in farm work was associated with a significantly lower BMI and % BF in men of all ages residing in American Samoa, women >or=45 years residing in American Samoa, and women 18-44 years residing in Samoa, and a significantly lower BMI in men 18-44 years residing in Samoa. These results suggest that farm work plays an important role in regulating body size and fatness of adult Samoans and may be ideal for interventions in the Samoan archipelago.

Adolescent↗
PubMedDate not supplied

Growth patterns of height and weight among three groups of Samoan preadolescents.

The Samoan population affords an excellent opportunity to study the influences of modernization and migration on growth. Moreover, since Samoan adults in some settings have very high rates of obesity, the childhood precursors to obesity can be studied among Samoans. This study reports the results of a survey of 786 Samoan children between 5.5 and 11.5 years of age living in traditional, modern or migrant situations. It was found that the children from Western Samoa (traditional) were significantly shorter, lighter and lighter for height than their counterparts in American Samoa (modern) and Hawaii (migrant). The major influence on height and weight appears to be modernization (Western versus American Samoa), with migration (American Samoa versus Hawaii) playing only a small incremental role (significant only for weight among boys). The influences of modernization are likely to be exerted through changes in diet and activity among the children. Modernization and migration are associated with obesity among Samoan adults, and this pattern also seems to be established in preadolescents.

Age Factors↗
PubMedDate not supplied

Longitudinal association of cardiovascular reactivity and blood pressure in Samoan adolescents.

OBJECTIVE: The longitudinal association between blood pressure (BP) reactivity to a video game and resting BP 3 to 4 years later was investigated in 83 Samoan adolescents from American and (Western) Samoa as part of a multidisciplinary study of cardiovascular disease (CVD) risk in modern Samoans. METHODS: Participants ranged in age from 11 to 14 years at baseline, in 1992 to 1993, and 14 to 18 years at follow-up in 1996. Video game BP reactivity was defined as the residual score of the regression of the maximum BP during the video game on the minimum resting BP before the video game. The predictive effect of baseline video game BP reactivity on follow-up resting BP was tested using regression models with baseline resting BP, baseline body mass index (BMI), and age as covariates. RESULTS: Systolic BP reactivity to the video game at baseline was significantly, p=.04, and independently associated with resting systolic BP 3 to 4 years later. Samoan adolescents who had higher systolic BP reactivity scores at baseline had significantly higher resting systolic BP at follow-up after adjustment for the significant effects of baseline resting systolic BP, age, and BMI. There were no interactions between sex and reactivity or between residence, American Samoa or (Western) Samoa, and reactivity in the models, indicating that the effects of systolic BP reactivity in early adolescence on later adolescent resting systolic BP were similar in the entire study sample. CONCLUSIONS: Video game cardiovascular reactivity seems to assess aspects of psychophysiological arousal and prospective CVD risk in Samoan adolescents of both sexes residing in both Samoas, and may be useful for understanding the role of psychosocial stress and health in modernizing societies.

Adolescent↗
PubMedDate not supplied

Predictors of indigenous healer use among Samoans.

OBJECTIVE: To determine the utilization of alternative modalities of care (i.e., indigenous healers or fofo) by Samoans, the indigenous peoples of the US Territory of American Samoa and examine predictors (i.e., socio-demographic, access to care, health status, culture-specific beliefs about disease etiology and treatment, and intentions to use healers) of utilization of fofo. DESIGN: A cross-sectional design, with systematic, random sampling procedures. SUBJECTS: 1,834 adult Samoan men and women residing in American Samoa, Hawaii, and Los Angeles. OUTCOME MEASURE: Prevalence and predictors of utilization of fofo. Multivariate logistic regression was performed to determine independent predictors of utilization of fofo. RESULTS: The prevalence of use of fofo across the three study sites was 41.0%. The following variables emerged as significant predictors of use of fofo: older age (odds ratio [OR] = 1.60; 95% confidence interval [CI] = 1.25-2.06), resident of American Samoa (OR = 1.69, CI = 1.29-2.21), belief that indigenous healers can treat cancer (OR = 1.79, CI = 1.40-2.30), belief that some illnesses afflict only Samoans (OR = 2.15, CI = 1.72-2.70), and greater intentions to use a fofo (OR = 2.27, CI = 1.81-2.85). Some of the more common medical conditions for which Samoans used fofo were biomedically defined musculoskeletal and neurologic problems, and Samoan sicknesses (ma'i Samoa). CONCLUSIONS: Population-based estimates of use of alternative modalities of care by Samoans are comparable to that reported for the general US population. However, the predictors of utilization of indigenous healers are more likely to be culture-specific health beliefs about disease etiology and treatment. There is a need to better understand Samoan traditional medicine and help-seeking behavior and explore whether indigenous Samoan healers can assist in the delivery of clinically proven and culturally sensitive health interventions to positively impact both disease management and preventative behaviour in this minority Polynesian population.

Adult↗