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26 records · Page 2Linked to original sources
PubMed1992

Socioeconomic impacts and management ciguatera in the Pacific.

The inshore fisheries resource is important to the health and culture of many of the inhabitants of Pacific Island countries (PIC). Ciguateric fishes (mainly demersal reef fishes) cause a range of distressing and often debilitating gastrointestinal neurological and cardiovascular disturbances. Consequently, ciguatera limits the utilisation of this otherwise over-exploited resource. For many victims, the symptoms suffered during the chronic phase of ciguatera (lasting weeks, months and occasionally years) are exacerbated upon consumption of certain foods, particularly non-toxic fishes. After each outbreak, victims and members of their social-network experience a transient increase in perception of the risk of eating reef fish. The impact of ciguatera is greatest in atoll island countries where fish is the primary source of protein (it also has a major impact and to facilitate the management of ciguatera in PIC, regular information is required that quantifies: (i) the true incidence of ciguatera; (ii) the extent and way in which different communities avoid ciguatera; and (iii) the adverse impact ciguatera has on health, the workforce, trade and tourism. Over the last 15 years (based on SPEHIS data to 1990), some countries recorded a decrease in the ciguatera problem (New Caledonia, Marshall Is.), other countries an increase (Kirbati, Tuvalu, French Polynesia), while still other countries recorded an increase followed by a decrease in ciguatera (Tokelau, American Samoa, Western Samoa, Fiji and Vanuatu). There may also be seasonal trends in the incidence of ciguatera in some countries e.g. Fiji. Management options presently implementable in PIC include: (i) treatment with i.v. mannitol; (ii) provision of timely advise on the location and status of ciguatera "hot spots" in each country that would allow affected communities to react objectively to the risk posed by ciguatera; and (iii) modification of human behaviour and aspirations to reduce the impact of increasing population, pollution and development (e.g. causeways) pressures.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1980

Blood pressure studies in two Pacific populations with varying degrees of modernisation.

The prevalence of hypertension and the change in blood pressure with age were investigated in a Polynesian population (Tuvalu), and in a Micronesian population (Nauru) in the South Pacific region. Hypertension was present in 27.2 percent of the Nauruans and 11.1 percent of the Tuvaluans. Both population groups also showed a rise in mean blood pressure with increasing age--a phenomenon apparently absent in traditional-living populations of the world but present in western societies.

Adolescent↗
PubMed1993

Obstetrics and the general surgeon.

From a small Pacific island country of Tuvalu, an analysis of 132 obstetric and gynecologic patients operated upon by one general surgeon during a 20.5 month period from 1988 to 1989 was performed. The operations comprised 50 percent of all surgical procedures and were associated with complicated pregnancy and delivery in 48 percent of the patients, birth control and infertility in 34 percent and gynecologic neoplasms, infections and bleeding ex utero in 18 percent. There was no mortality and 11 patients had lesser complications. Of the 38 cesarean sections, 76 percent were emergency operations. The main indications for cesarean section were dystocia in 55 percent of the patients and previous cesarean section in 24 percent. There was no maternal mortality. The complication rate was 13 percent and included two neonatal deaths. The cesarean birth rate during the study period was 7.6 percent, a nearly fivefold increase from the previous 9.5 years. With other factors remaining unchanged, the increase in cesarean birth rate corresponded to a decrease in neonatal death rate from 35.7 to 15.7 per 1,000 live-born infants. It is concluded that a considerable share of work of a general surgeon in developing countries consists of obstetric and gynecologic procedures. This should be taken into consideration when training and recruiting surgeons for that kind of work. A general surgeon with obstetric experience can perform cesarean section with an acceptable morbidity rate and should not hesitate to do it whenever labor does not progress as expected. The decision to operate can be based on physical examination with close cooperation with the midwife. In developing countries, increasing cesarean birth rates alone seem to reduce considerably the neonatal death rates.

Adolescent↗
PubMed1996

Expanded programme on immunization (EPI) immunization schedules in the WHO Western Pacific Region, 1995.

There are 36 countries/areas in this Region; Mongolia was transferred to the Western Pacific Region in 1995. No data are available from the Cook Islands, Nauru, and New Caledonia (Tables 1-3). BCG is used in all but 6 countries/areas (American Samoa, Australia, Guam, New Zealand, Northern Mariana Islands and Palau). Most countries/areas give BCG at birth; Japan gives it at 3 months, the Republic of Korea at 4 weeks, and Samoa at 5 years of age. Nine countries give 2 doses of BCG and 4 give 3 doses, up to 15 years of age. Mongolia gives 4 doses up to 18 years of age. Diphtheria-pertussis-tetanus (DPT) vaccine is used as a primary series of 3 doses in all countries/areas; 17 countries give 1 to 3 booster doses of DPT vaccine in the first year of life or later. Diphtheria-tetanus (DT) booster doses are given in Brunei Darussalam, Mongolia and New Zealand. Td is also given in New Zealand. Oral poliovirus vaccine (OPV) is used in a primary series of 3 doses simultaneously with DPT vaccine in all countries/areas. Eight countries/areas use an additional dose of OPV at birth (Cambodia, Fiji, Hong Kong, Kiribati, Lao People's Democratic Republic, Marshall Islands, Papua New Guinea and Tuvalu). A booster dose of OPV in the second year of life is used in 9 countries/areas and a booster dose of OPV is given to schoolchildren in 16 countries/areas. Measles vaccine is given in all countries/areas from 8-15 months of age usually in the form of monovalent measles vaccine, except in Macau. In 4 countries/areas, it is given in the form of measles-mumps-rubella (MMR) vaccine (Guam, Hong Kong, Palau and Singapore). The 2-dose policy is implemented in 4 countries/areas (American Samoa, New Zealand, Palau, and Samoa). In Australia and Palau, the second dose is given as MMR vaccine. The age at the second dose varies from 4 to 13 years of age. Rubella vaccine is given in 4 countries/areas to girls between 10 and 14 years of age (Fiji, French Polynesia, Japan and Macau). In Hong Kong, it is not specified if only girls receive rubella vaccine. In Australia and New Zealand, rubella vaccine is given to seronegative women immediately after delivery. Hepatitis B is used in all but 7 countries/areas (Cambodia, China, Guam, Kiribati, Lao People's Democratic Republic, Tokelau and Viet Nam). All countries which give hepatitis B vaccine use 3 primary doses in infancy, the first dose being given at birth in 23 countries/areas. In Australia and Japan, this vaccine is given to groups at risk. Tetanus toxoid (TT) is used for pregnant or nonpregnant women of childbearing age. It is used in 14 countries/areas, but in Australia and Palau the target group is schoolchildren. The schedules include 2-5 doses of TT.

Adolescent↗