Health-related effects, consequences, and results of social change in the Pacific.
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Prior laboratory studies and field observations suggested that it might be possible to reduce the size of the population of, or eliminate, Aedes polynesiensis by the introduction of Aedes albopictus. The former mosquito is the principal vector of nonperiodic filariasis caused by Wuchereria bancrofti and the latter is a closely related species refractory to the development of human filariae. The practicability of such competitive displacement was studied by a field trial on a remote coral atoll where there was an established population of A. polynesiensis. Three strains of Al albopictus were liberated at separate localities on the atoll and their fate was followed for 4 years. One strain disappeared within 12 months after release and the other two disappeared within 48 months. It was not clear whether A. albopicuts failed to become established because the strains were unsuitable, the general environment was inappropriate, or A. polynesiensis was present in such numbers that A. albopictus rarely succeded in mating with its own species.
Clinical observations on ciguatera were collected between 1964 and 1977 on 3,009 patients from several South Pacific island groups. Patients generally presented with neurologic symptoms such as parasthesia, vertigo, and ataxia, in addition to gastrointestinal symptoms such as diarrhea, abdominal pain, nausea, and vomiting. Patients with this illness usually became symptomatic less than 24 hours after ingestion of the fish and most patients (76.8%) developed symptoms in less than 12 hours. Significant differences in certain symptoms were noted between Melanesian and Polynesian ethnic groups, suggesting a susceptibility difference, or a difference in the nature of the toxin found in different areas of the Pacific. Being poisoned multiple times appeared to result in a clinically more severe illness than disease observed in patients experiencing ciguatera for the first time.
Two cases are reported which illustrate important epidemiological aspects of lymphatic filariasis--prolonged longevity of the adult parasite and the possibility of transmission by individuals with ultra-low level microfilaremia. These cases demonstrate that people can remain carriers of microfilariae in the peripheral blood for many years without reinfection, and even those with a low level microfilaremia can constitute a significant reservoir of mosquito infection. Such cases represent one of the most serious obstacles to the eradication of lymphatic filariasis in regions where control is based on chemotherapy.
A sudden outbreak of skin ulcers occurred in the Cook Islands beginning in early 1976. Information from the outbreak indicated that ulcers were most consistent with the clinical entity of tropical ulcer. A retrospective analysis was undertaken to determine the clinical and epidemiological features of the outbreak. The ulcers occurred most commonly in males in the 10--14 and 15--19 age groups. Antecedent trauma appeared to initiate the ulcer. Most ulcers were solitary, occurred on the lower limbs, and healed leaving a pigmented scar. The ulcers responded well to penicillin. The cause of the ulcers was not established, but gram-negative, pleomorphic bacilli were consistently observed in ulcer biopsies.
An epidemic of Ross River virus infection occurred in the Cook Islands early in 1980 and affected the majority of the inhabitants of Rarotonga, the most populated island in the group. This represents the easternmost extension of the virus which, until 1979, was believed limited to Australia, New Guinea, and the Solomon Islands. The clinical manifestations of Ross River disease, predominantly polyarthritis, did not differ significantly from those observed previously in Australia. However, unlike the experience in Australia, where Ross River virus has never been isolated from a patient with polyarthritis, the agent was recovered from the serum of one-half of approximately 100 such patients with serologically proven infections. It is not known if this latter observation is the result of a change in the virus, the different virus isolation technique employed, or other factors. It was found that the incubation period of the disease could be as short as 3 days--much less than previously suspected. Ross River virus was isolated from six pools of Aedes polynesiensis mosquitoes collected in nature and it appeared that this species was the most probable vector on Rarotonga. In view of the widespread distribution of Ae. polynesiensis on islands, in the eastern Pacific it would not be surprising if Ross River virus occurs in other previously unaffected areas in the future.
In a retrospective study of 60 cases of leptospirosis, the association of thrombocytopenia and acute renal failure as previously reported was confirmed. However, increased mortality, in our experience, was not associated with either thrombocytopenia or acute renal failure.
An epidemic of Ross River virus (RRV) infection occurred in the Cook Islands in early 1980, and infected about 70% of the adult population of Rarotonga, the most populous island of the group. In July 1981, 80 mothers were identified as having been in the first trimester of pregnancy during the outbreak. Fifty-two of the at-risk mothers along with 63 of the offspring were ultimately examined. Of these 52 mothers, 39 (75%) were found to have serological evidence of RRV infection. Of the 63 infants located, 52 were examined serologically. None of the infants examined had serological evidence of RRV infection. There was no difference in age, size, or malformation rate in the offspring of the serologically positive or serologically negative mothers. These studies do not support an earlier report that RRV causes intrauterine infection.
Viruses isolated during 1979 and 1980 from patients with polyarthritis in New Caledonia and Wallis and Futuna Islands have been found to be more closely related to Ross River virus than any other regional Alphavirus. On the basis of virulence in suckling mice the majority of these isolates were found to be more closely related to the NB5092 strain of Ross River virus than to the prototype T48 strain.
We report the isolation of microsatellites from an enriched library of genomic repeated sequences, using a biotin-labeled oligonucleotide bound to streptavidin-coated magnetic particles. Four microsatellites were obtained from a partial library of 120 recombinant clones. This more efficient and rapid method to obtain these specific repeated sequences is preferred to the conventional isolation procedure based on the construction of a genomic library. Microsatellite markers would be promising molecular tools for the study of genetic variability of mosquito populations. Analyses of genetic structure and gene flow would provide information on the distance, direction and rate of dispersal of genes in Aedes aegypti populations. Knowledge on gene dispersal patterns is required to develop vector control strategies.
In the context of contemporary New Zealand, this paper discusses the need for occupational therapy to substantiate its claims of being a holistic profession with particular reference to the Maori, the indigenous people of New Zealand (referred to by the Maori as Aotearoa). In this era of accountability and consumer choice, occupational therapists need to more effectively meet the cultural needs of their clients through an understanding of both the material and nonmaterial aspects of their cultures. However, for New Zealand occupational therapists, cultural sensitivity is not enough to contribute to changing the diminished life chances of the Maori. It is proposed in this paper that the Model of Human Occupation (Kielhofner, 1985; Kielhofner & Burke, 1980), when combined with the work of radical community educators such as Freire (1972), could provide the sociopolitical dimension to New Zealand practice. The Model of Human Occupation is examined in light of current occupational therapy practice in New Zealand. It is argued that this model, when accompanied by a broader understanding of the sociopolitical processes informing monoculturalism, could be seen as a suitable framework for understanding cultural differences in New Zealand and could assist in the move toward providing culturally appropriate occupational therapy for indigenous peoples such as the Maori.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Group comparisons of blood pressure and indices of obesity and salt intake from epidemiological studies conducted in the Pacific early in the 1980s are presented. The comparisons were of a rural-urban type, and showed a trend for a lower prevalence of hypertension and for lower mean blood pressures in adults from rural areas, compared with urban populations. Rural residents were also slimmer and appeared to have a lower salt intake than did urban dwellers. These findings give possible support to the role of adiposity and salt intake in the genesis of essential hypertension.