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PubMed1984

Cardiovascular diseases and diabetes mellitus in Fiji: analysis of mortality, morbidity and risk factors.

Mortality and hospital admissions due to cardiovascular diseases and diabetes mellitus have been increasing in Fiji steadily over the past 20 years. These diseases were present more frequently in the Indian than the Melanesian population of Fiji, but recently the steepest rise in prevalence rates occurred among the Melanesian population. The underlying conditions that contributed most to increasing mortality and morbidity were hypertension and diabetes mellitus. In 1978, the proportional mortality from diabetes mellitus was 6.0% (9.0% in persons aged >/= 40 years), and that from cardiovascular diseases was 30.3% (39% in those aged >/= 40 years). Ischaemic heart disease was the main cause of mortality and morbidity among the Indian population. This analysis of mortality and morbidity data is supported by the findings of a population survey, which showed that the prevalence rates of diabetes and hypertension in 1980 among urban Melanesians were similar to those among Indians. Urbanization and a modern life-style seem to play an important role in determining the disease pattern in Fiji, which is following the patterns in many industrial countries.

Adult↗
PubMed1994

Severe iron deficiency anaemia in Fiji children.

AIMS: A prospective study to determine the magnitude of the problem of severe iron deficiency anaemia in Fiji children with intercurrent illnesses and their response to the interventions with dietary modifications and iron therapy. METHODS: A total of 2136 consecutive children between 6 months and 12 years of age, who attended a hospital and a health centre in Fiji, for intercurrent illness, during a 9 months period, were screened for severe iron deficiency anaemia (haemoglobin < 70 g/L). RESULTS: Eighty children (3.7%) had severe iron deficiency anaemia. Majority (75%) of children with severe anaemia were younger than 2 years. Dietary and iron therapy were successful in correcting anaemia in all 80 children. CONCLUSIONS: Severe iron deficiency anaemia was common in Fiji children seeking medical attention for intercurrent illness. Simple therapeutic measures, which included dietary advice and iron therapy, were successful in correcting this severe debility in those children.

Age Distribution↗
PubMed1986

Detection of Fiji disease virus in infected sugarcane by nucleic acid hybridization.

Clones of Fiji disease virus were obtained by cDNA synthesis from isolated viral genomic double-stranded RNA. Nick-translated probes made from a mixture of clones specifically detected Fiji disease virus in infected sugarcane galls, leaves and growing tips. This method for detection of Fiji disease virus is extremely sensitive, and can be used as a rapid screening procedure for the virus with very small tissue samples.

DNA↗
PubMed2005

Chest X-ray-confirmed pneumonia in children in Fiji.

OBJECTIVE: To calculate the incidence and document the clinical features of chest X-ray- (CXR-) confirmed pneumonia in children aged between 1 month and 5 years living in Greater Suva, Fiji. METHODS: A retrospective review was undertaken of children aged between 1 month and 5 years with a discharge diagnosis suggesting a lower respiratory tract infection (LRTI) admitted to the Colonial War Memorial Hospital in Suva, Fiji, in the first 10 days of each month from 1 January 2001 to 31 December 2002. Clinical data were collected and CXRs were reread and classified according to WHO standardized criteria for CXR-confirmed pneumonia. FINDINGS: Two hundred and forty-eight children with LRTI met the inclusion criteria. CXRs were obtained for 174 (70%) of these cases, of which 59 (34%) had CXR-confirmed pneumonia. The annual incidence of CXR-confirmed pneumonia was 428 cases per 100,000 children aged between 1 month and 5 years living in Greater Suva. If a similar proportion of the children for whom CXRs were unavailable were assumed to have CXR-confirmed pneumonia, the incidence was 607 per 100,000. The incidence appeared to be higher in Melanesian Fijian than Indo-Fijian children. The case-fatality rate was 2.8% in all children with LRTI, and 6.8% in those with CXR-confirmed pneumonia. CONCLUSION: This is the first study to document the incidence of CXR-confirmed pneumonia in a Pacific Island country, and demonstrates a high incidence. A significant proportion of hospital admissions of children with LRTI are likely to be preventable by the introduction of pneumococcal conjugate vaccine.

Benchmarking↗
PubMed2007

Facets of acculturation and their diverse relations to body shape concern in Fiji.

OBJECTIVE: The present study examines the relation between acculturation and body shape concern in Fiji--a society undergoing rapid social change. METHOD: Data were from two cohorts of ethnic Fijian girls and women collected in 1998 (n = 115). A factor analysis was performed to identify dimensions of acculturation. The association of these with body shape concern was examined with linear regression. RESULTS: Three dimensions of acculturation were identified. Multiple linear regression models demonstrated that each of these dimensions of acculturation had a unique relation to body shape concern. The adjusted R(2) for the fully adjusted model relating acculturation to body concern was 0.63, indicating a substantial degree of shared variation between measures of body shape concern and measures of acculturation. CONCLUSION: Acculturation may have a strong impact on body shape concern in Fiji. However, acculturation is a multidimensional construct and does not likely have a monolithic relation to body shape concern.

Acculturation↗
PubMed1993

Seroepidemiological survey of HTLV-I infection in French Polynesia, Cook Islands and Fiji.

Different population groups of French Polynesia, Cook Islands and Fiji were screened for Human T-Lymphotropic Virus type I (HTLV-I) antibodies. Among 1487 individuals sampled in French Polynesia, twelve were considered Western Blot (WB) indeterminate and one was considered WB-positive for HTLV-I infection. This positive subject originated from France and was a blood donor. Out of 196 Polynesians of the Cook Islands, one was WB-indeterminate. Among populations sampled in Fiji, one of 222 Melanesians was found WB-indeterminate and one of 211 Indians was WB-indeterminate.

Adolescent↗
PubMed2004

Television, disordered eating, and young women in Fiji: negotiating body image and identity during rapid social change.

Although the relationship between media exposure and risk behavior among youth is established at a population level, the specific psychological and social mechanisms mediating the adverse effects of media on youth remain poorly understood. This study reports on an investigation of the impact of the introduction of television to a rural community in Western Fiji on adolescent ethnic Fijian girls in a setting of rapid social and economic change. Narrative data were collected from 30 purposively selected ethnic Fijian secondary school girls via semi-structured, open-ended interviews. Interviews were conducted in 1998, 3 years after television was first broadcast to this region of Fiji. Narrative data were analyzed for content relating to response to television and mechanisms that mediate self and body image in Fijian adolescents. Data in this sample suggest that media imagery is used in both creative and destructive ways by adolescent Fijian girls to navigate opportunities and conflicts posed by the rapidly changing social environment. Study respondents indicated their explicit modeling of the perceived positive attributes of characters presented in television dramas, but also the beginnings of weight and body shape preoccupation, purging behavior to control weight, and body disparagement. Response to television appeared to be shaped by a desire for competitive social positioning during a period of rapid social transition. Understanding vulnerability to images and values imported with media will be critical to preventing disordered eating and, potentially, other youth risk behaviors in this population, as well as other populations at risk.

Adolescent↗
PubMed2000

Maternal infanticides in Fiji.

OBJECTIVE: This essay contributes to the cross-cultural literature on childhood homicides by examining 16 infanticidal homicides that occurred in Fiji over an 11-year period. The results are compared with infanticide studies conducted in other societies. METHOD: Official police data recorded in a Homicide and Manslaughter register are analyzed. These are supplemented by newspaper reports of infanticides and semi-structured interviews conducted with key criminal justice and medical personnel intimately associated with infanticide cases. RESULTS: The findings show that most infanticide defendants were young, poor, Fijian, with little formal education, living with nonparental kin at the time of the crime. The infanticides were precipitated by unwanted pregnancies brought on by nonmarital and extramarital sex. Pregnancy is carried to full gestation without knowledge of family, friends and neighbors of offenders and the infant is killed immediately following birth. CONCLUSIONS: The current findings demonstrate that the patterns of maternal infant killings in Fiji are congruous in many significant ways with those in advanced industrialized societies. It is concluded that additional research in non-Western, nonindustrialized nations is imperative to contribute to the development of sound conclusions about, and remedies for infanticide.

Adolescent↗
PubMed1987

Sequels to screening for hypertension and diabetes mellitus in Fiji.

We evaluated the outcome of a case-finding programme resulting from an epidemiological survey on diabetes and cardiovascular risk factors by re-interviewing 318 persons who had been found to have hypertension and/or diabetes mellitus in a population survey carried out in Fiji 1.5 years earlier in 1980. At re-examination, 34% of the hypertensive patients and 43% of the diabetic patients were not aware of their diagnosis. However, the proportion of treated hypertensive people was tripled and that of diabetic patients doubled. It was not possible to identify the characteristics of the persons who were missed in the follow-up. Many persons who were unaware of their condition regularly used, however, the existing health services available. On the other hand, several initially treated cases had no proper follow-up. More careful planning and development of comprehensive community-based programmes for hypertension and diabetes are needed in Fiji. Simple population screening for hypertension and diabetes may result in an extra work load and limit the available health care resources so that the overall outcome is not satisfactory.

Adult↗
PubMed1984

The presence of Angiostrongylus cantonensis in Viti Levu, Fiji.

Wild rats and molluscs were examined for Angiostrongylus cantonensis infection on Viti Levu, Fiji. A. cantonensis were recovered from 29.6% (16/54) of Rattus rattus and 59.5% (25/42) of R. exulans. A. cantonensis-like larval nematodes were found in all of four slugs, Laevicaulis alte, and ten of 20 unidentified land snails. The larvae developed to adult A. cantonensis in the pulmonary arteries of laboratory rats 40 to 42 days after ingestion. This is the first record of A. cantonensis in Fiji.

Angiostrongylus↗
PubMed2002

Synaptobothrioides sardinellae n. g., n. sp. (Digenea: Hemiuridae) from the blacktip sardinella Sardinella melanura (Clupeidae) off Fiji, and records of two other hemiuroids in Fijian waters.

Synaptobothrioides sardinellae n. g., n. sp. is described from Sardinella melanura off Fiji. The new genus differs from other plerurine hemiurid genera in having entire or angular, rather than lobed to digitiform, vitelline masses. It appears closest to Synaptobothrium, but differs in the lack of a presomatic pit and the presence of tegumental plications. Lecithochirium kawakawa from Euthynnus affinis and Thulinia microrchis from Siganus spinus are reported from off Fiji.

Animals↗
PubMed1996

Epidemiology of spinal cord paralysis in Fiji: 1985-1994.

This descriptive analytical ten year (1985-1994) retrospective study assessed the pattern of spinal cord paralysis (SCP) in the Fiji Islands utilising medical rehabilitation hospital data. Fiji Islands is an archipelago of 300 islands in the south western Pacific with a multi-ethnic population of over three quarters of a million. Rehabilitation of all SCP is provided at the Medical Rehabilitation Unit (MRU). Data was collected from medical records of new SCP (n = 140) admitted to MRU and analysed with Epi Info 5 assessing associations between cause and other variables. The incidence of new SCP admitted to the MRU was 18.7/million/year. There were 75 (53.6%) traumatic and 65 (46.4%) non-traumatic SCP. The incidence varied according to gender and ethnicity with Fijian male being at the highest (41.85) risk. Amongst traumatic SCP, 38.7% were due to falls, 25.3% motor vehicle accidents, 20% sports, 8% shallow water dive and 4% each deep sea diving and others, whereas among non-traumatic SCP, 52.3% were due to unknown causes, 32.3% infections, 9.2% neoplasms and 6.2% others. The male/female ratio was 4:1. The 16-30 year age group accounted for 35% of SCP. 31% had tetraplegia and 52.1% had complete lesions. The subset of the sample who experienced traumatic SCP were more likely to be employed, aged between 16-30 years at the time of paralysis and to have complete tetraplegia. Those who experienced incomplete paraplegia were more likely to be unemployed, aged 46-60 years and educated to primary level at the time of paralysis. There was a high proportion of complete spinal lesion when compared with other studies. The incidence of secondary complications such as pressure sores and UTI was also found to be high when compared with other studies. The results support the view that young Fijian males are most prone to sustaining traumatic spinal cord paralysis, and that there is a high incidence of secondary preventable complications. The need for preventative measures and adequate rehabilitation are emphasised.

Adolescent↗
PubMed2001

Dietary patterns and risk factors of diabetes mellitus among urban indigenous women in Fiji.

The dietary patterns of indigenous Fijians are changing rapidly. Dietary relationships in regard to the prevalence of diabetes are poorly studied in Fiji. A survey was conducted to show the relationship of dietary patterns and other lifestyle factors for the development of diabetes among urban indigenous women in Fiji. A sample of 200 Fijian women aged 30-39 who agreed to participate were interviewed by the use of semiquantitative food frequency, 3 day-24 h recall study. Physical activity and ceremonial dietary customs were also taken into consideration. Anthropometry included measurements of height, weight, waist and hip. Total percentage bodyfat measurements and glycosuria tests were also conducted. The results showed high rates of obesity manifested in high percentage bodyfat, high body mass index (BMI) and high waist and hip ratio (WHR). The mean 24 h dietary intake exhibited a moderate intake of protein, high intake of fat and a low intake of carbohydrate. The carbohydrate reduction was a result from the decline in consumption of traditional staples. Consumption of cereals and related products favored the high intake of butter and margarine and also encouraged the use of cooking oil in frying varieties of flour products. The daily intake of anti-oxidant vitamins of beta-carotene and vitamin E were low, however there was a high intake of vitamin C. The food frequency study revealed cassava, bread and sugar were consumed daily as the main carbohydrate foods. Fish and meat were the most frequently consumed protein foods. The main beverage was sweet tea with whole-cream milk. Butter, margarine, coconut cream, cheap lamb flaps and cooking oil provided the main sources of fat. Levels of physical activity included high sedentary lifestyles with a high rate of subjects being overweight and obese. Ceremonial dietary customs showed a high consumption of meat and fish. Fruits were rarely consumed. Glycosuria existed among the age group under study. The impact of dietary transition, coupled with dietary excesses and physical inactivity, seem to be potential risk factors of diabetes among the indigenous women in the urban area.

Adult↗
PubMed1992

Labour circulation and the village economy in Fiji.

The author examines circular labor migration in Fiji. "This paper is organized into five sections. The first section provides a brief discussion of two major perspectives of labour circulation in developing countries. The second section presents the state of the Fijian village in the context of the current pattern of uneven development in Fiji. The practice of labour circulation by Fijian villagers is dealt with in the third section. In the last two sections, issues concerning the maintenance of the polarized pattern and the preservation of the village mode of production are discussed."

Demography↗
PubMed2004

Ethnicity and fetal growth in Fiji.

BACKGROUND: Indigenous Fijians and the descendants of Asian Indians constitute the two major ethnic groups in Fiji. There are differences between the two groups in perinatal outcomes. AIMS: To study fetal growth patterns in the two ethnic groups and to ascertain the influence, if any, of ethnicity on fetal growth. METHODS: A longitudinal study was carried out on women with sure dates, regular cycles, no known risk factor complicating pregnancy and having their first antenatal examination before 20 weeks. Symphysis-fundal height, biparietal diameter, abdominal circumference and femur length were measured by the same observer at recruitment and at follow-up visits until delivery. Infant measurements were recorded soon after birth. RESULTS: Indian babies were on average 795 g lighter, had 5.5 days shorter mean length of gestation and slower growth of biparietal diameter and abdominal circumference when compared to Fijian babies. Ethnicity of the mother was significantly associated with the difference in growth even after adjusting for other factors known to influence fetal growth. CONCLUSION: Given the ethnic differences in fetal growth and maturation, it would be appropriate to use ethnicity-specific standards for perinatal care in Fiji.

Adult↗
PubMed1992

Dental caries and periodontal disease in Fiji.

A national oral survey was conducted in Fiji in 1985/86. The results showed that the prevalence of caries was generally low and most commonly affected pit and fissure surfaces. Comparisons with previous surveys in 1948 and 1965 showed that the prevalence had fallen in primary teeth but remained relatively constant in permanent teeth. There were significant variations in prevalence between residential locations but not between ethnic groups. Periodontal disease was found to be a major public health problem. Except for the percentage of young children with caries-free dentitions, the current status of oral health in Fiji was generally better than that proposed in the WHO goals for the year 2000. The training of dental hygienists to help in the prevention of both dental caries and periodontal disease is discussed.

Adolescent↗
PubMed2004

Attitude toward and knowledge about mental illness in Fiji islands.

BACKGROUND: There is a dearth of information on the extent of knowledge about mental illness and attitudes toward the mentally ill in Fiji. AIMS: This study aimed to explore these aspects, and also to determine the factors influencing them. METHOD: Market vendors, peri-urban dwellers, white-collar and health workers from Greater Suva were interviewed. The interview schedule used elicited socio-demographic characteristics, knowledge of, and attitudes toward, mental illness. RESULTS: A majority of the subjects attributed the cause of mental illness to substance abuse, believed in the diversity of mental illness, considered hospital as an important source of help and acknowledged the effectiveness of medication. Less than one-fifth of the subjects were willing to marry or employ mentally ill persons. About 42% of the sample would be deterred by embarrassment from seeking help. Educational attainment was correlated with knowledge about mental illness, except with knowledge about early mental symptoms (p < 0.01). Prestigious occupation, single marital status, female gender, younger age and urban dwelling were associated with positive disposition toward the mentally ill (p < 0.01). Race was not significantly influential on almost all attitudinal variables. CONCLUSION: Health education is capable of positively influencing knowledge about, and attitudes toward, mental illness in Fiji.

Adolescent↗
PubMed2006

Pneumococcal nasopharyngeal carriage and patterns of penicillin resistance in young children in Fiji.

BACKGROUND: Little is known about nasopharyngeal carriage and the patterns of antibiotic resistance of pneumococci in Pacific nations. We set out to document pneumococcal nasopharyngeal carriage and associated risk factors, antimicrobial resistance and serotypes in healthy children in Fiji. METHODS: A cross-sectional survey of healthy children aged 3-13 months was conducted. Nasopharyngeal (NP) swabs were collected from each child and processed according to standard methods. Antimicrobial resistance was determined by disk diffusion and confirmed by E-testing. Serotyping was performed by the Quellung reaction. RESULTS: Of 440 consecutive NP swabs taken, 195 were S. pneumoniae-positive (carriage rate 44.3%). Higher rates were found in the indigenous Fijian population. Penicillin non-susceptibility was found in 11.4% of isolates, with one isolate demonstrating high-level resistance. Cotrimoxazole resistance was common (20.3%) and no isolates were chloramphenicol-resistant. Multi-drug resistance was uncommon. The commonest serotypes were 6A (13.2%), 23F (8.3%), 19F (7.4%) and 6B (6.2%). Thirty per cent were included in the 7-valent pneumococcal conjugate vaccine (PCV), 54.3% if cross-reacting strains were included. Being indigenous Fijian or having symptoms of acute respiratory infection were independent risk factors for carriage. CONCLUSIONS: Pneumococcal NP carriage is common in Fijian children. Penicillin resistance has been documented for the first time in Fiji and, as a result, first-line treatment for meningitis has been altered. Being indigenous Fijian is a risk factor for disease, although the reasons for this are unclear. A low proportion of carriage serotypes are covered by the existing 7-valent PCV.

Carrier State↗