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PubMed1985

Observations on the efficacy of ivermectin in the control of cattle ticks in Zambia.

The efficacy of multiple subcutaneous injections (200 micrograms/kg) of ivermectin in the control of naturally occurring tick infestations on traditionally managed Tonga-IIa (Sanga type) calves and yearlings was assessed in two field trials. In the first trial Boophilus decoloratus infestations were decreased following treatments at monthly intervals. In the second trial, with weekly and two weekly treatment intervals, infestations of Rhipicephalus appendiculatus were controlled less effectively than infestations of Amblyomma variegatum or Hyalomma truncatum. However, no engorging females of any of the tick species were found on treated animals. In treated cattle, significantly greater liveweight gain occurred than can be attributed to the control of tick infestations alone.

Animals↗
PubMed1989

Delayed-type hypersensitivity test for assessing tick-immune status of cattle in Zambia.

Delayed-type hypersensitivity skin reactions were used to assess the tick resistance status of Tonga calves in Zambia. The antigen used in the tests was a homogenate of unfed nymphal Rhipicephalus appendiculatus which had been shown to give protective immunity in guinea pigs to adult female R appendiculatus. There was a significant negative correlation between the intensity of the reactions and the total number of ticks (Amblyomma variegatum, R appendiculatus, Hyalomma truncatum, Boophilus decoloratus and Rhipicephalus species) on the animals.

Animals↗
PubMed2006

Hygiene behaviour of adolescents in the Pacific: associations with socio-demographic, health behaviour and school environment.

This study presents findings on health-related hygiene behaviours of 9,013 adolescents from Vanuatu, Tonga and Pohnpei in the Federal States of Micronesia as part of the Health Behaviour of Pacific Youth Life surveys. We examined the prevalence of and relationship between tooth brushing, hand washing before eating, hand washing after toileting and a range of psychosocial factors such as sociodemographic charac-teristics, health behaviour and school affiliation. The results showed that patterns of prevalence and relationships were consistent for all countries, with weaker associations observed in Pohnpei. In general, adolescents reported moderate levels of optimal hygiene practice. Girls reported significantly more frequent optimal hygiene practice than boys. Logistic regression analysis confirmed that frequent hygiene behaviours were significantly associated with gender, parental occupations and high levels of school affiliation. These findings suggest the need to consider psycho-social and economic factors when examining potential influences on hygiene behaviour to ensure effective interventions.

Adolescent↗
PubMed1980

Psychological problems relating to the educated elite in some Pacific peoples.

The educated elite of many Pacific peoples are exposed both to traditional cultural influences on the one hand and to a Western mode of education and an urban life style on the other. Examples are given of the problems that arise among the Melanesians of Fiji, the Polynesians of Tonga, Western Samoa and the Cook Islands and the Aborigines of Australia from the existence of these two sets of values. Conflict areas include money, property ownership, health care, family boundaries and adoption. The content and form of the conflicts are shaped by the original culture but the basic cause in each case is differential rates of modernization among members of the same ethnic group.

Adolescent↗
PubMed2000

Community knowledge and perceptions about malaria and practices influencing malaria control in Mpumalanga Province, South Africa.

OBJECTIVE: To assess community knowledge and perceptions about malaria and its control in a rural setting. DESIGN: Descriptive cross-sectional survey. SETTING: Tonga district with a population of 116,418, seasonal malaria with an annual incidence of 3,200 cases. SUBJECTS: Female heads of 299 randomly selected households. METHODOLOGY: A total of 299 households were selected from a random sample of 30 clusters. Community knowledge and perceptions about malaria and its control were assessed by interviews with the female head of each of the 299 selected households. RESULTS: Respondents ranked malaria as the third most serious health problem facing the community after TB and AIDS. Seventy-two per cent (214/299) of respondents reported that they knew what malaria disease was and of these, 92.1% (197/214) mentioned mosquito bites as the cause of malaria. The respondents' understanding of the causal role of mosquitoes in malaria was significantly related to their knowledge about disease symptoms (P < 0.001). Reported community compliance with the malaria control programme (MCP) was satisfactory; 86.6% (259/299) of respondents reported that their homes had been sprayed during the past 2 years but 10.0% (30/299) did not know why homes were sprayed. Hospitals or clinics were the facilities where respondents most commonly sought treatment for fever; 66.9% (200/299) reported that they would seek treatment immediately after the onset of high fever. Specific practices such as replastering or washing of inside walls compromised the effectiveness of the MCP. Personal preventive measures were sometimes used against malaria (50.8%, 152/299) and use was positively associated with education level (P = 0.001). Respondents expressed their desire for more information about malaria and their willingness to contribute to the control of malaria in their community. CONCLUSION: The survey collected information which was directly relevant to the development of health education messages to increase community awareness of the problem of malaria, to emphasise the importance of early diagnosis and prompt treatment of malaria, to improve community understanding of the function of indoor residual spraying, and to enlighten the population of the role of mosquitoes in malaria transmission and the availability and benefits of personal protection measures against mosquito bites.

Adolescent↗
PubMed2000

Telehealth in the Pacific Islands: a perspective and update from the Fiji School of Medicine.

The Fiji School of Medicine (FSM) has increased participation with telehealth/telemedicine in general, and specifically with the Pacific Public Health Surveillance Network (PPHSN) and the Western Pacific HealthNet(WPHNet), through the establishment of a WPHNet Centralised Triaging Service (CTS). The FSM Telehealth/Telemedicine Unit (FSMTU) will oversee the development of the CTS which is being closely coordinated with existing clinical consultation services provided through Project Aamai and the Tripler Regional Medical Center (TRMC). While the WPHNet CTS will initially be concerned with distance clinical consultation, the FSM mission encompasses community health and professional health education in a wide range of disciplines. Currently, WPHNet only serves the jurisdictions of the US-associated Pacific islands but with WPHNet CTS there will be an opportunity to include new member jurisdictions that do not have political affiliation with the USA. (e.g. Cook Is, Kiribati, Niue, Samoa, Solomon Is, Tonga, Vanuatu etc). In addition, although Internet technology is expanding rapidly in the region, the capacity for outside communication throughout the Pacific is quite varied. Very remote areas may currently only be able to communicate by using short wave radio. Others have telephone and/or fax while some have E-mail but not full internet capacity. The FSMTU will implement mechanisms to field requests through any of these communication avenues and so the WPHNet CTS will serve as a proxy for regional healthcare providers that do not have internet access.

Fiji↗
PubMed2001

Therapeutic efficacy of sulfadoxine-pyrimethamine in uncomplicated Plasmodium falciparum malaria 3 years after introduction in Mpumalanga.

OBJECTIVES: To assess therapeutic efficacy of sulfadoxine-pyrimethamine (SP) in treatment of uncomplicated Plasmodium falciparum malaria 3 years after introduction in Mpumalanga, South Africa. SETTING: Tonga district with a population of 116,418 and subject to seasonal malaria, with an average annual incidence of 3,200 cases. SUBJECTS: One hundred and nineteen malaria patients presenting to a sentinel surveillance clinic and recruited according to World Health Organisation (WHO) criteria. METHODOLOGY: Patients satisfying WHO inclusion criteria were treated with a single oral dose of SP and the response of infection to treatment in each patient was routinely monitored clinically and parasitologically on days 1, 2, 3, 7, 14, 21, 28 and 42 post-treatment. One hundred and ten patients completed follow-up to day 42 or evidence of clinical or parasitological failure. RESULTS: The cure rate at day 42 was 93.6% (103/110). Two patients (1.8%, RII) were early treatment failures on day 3, while recrudescence (4.5%, RI) occurred in 5 patients on day 28 (N = 3) and on day 42 (N = 2). CONCLUSION: In Mpumalanga P. falciparum remains sensitive to SP, with no significant difference between the baseline cure rate (94.5%) and the cure rate in the present study (93.6%).

Adolescent↗
PubMed2002

Acute gastroenteritis associated with seafood privately imported from the Pacific Islands.

AIMS: To investigate a potential link between consumption of food privately imported from the Pacific Islands and presentation with acute gastroenteritis to Middlemore Hospital Emergency Department. METHODS: This was a three month prospective observational case study that included patients aged greater than fifteen years presenting with acute gastroenteritis and a history of food privately imported from the Pacific Islands. Data included case demographics, symptoms, island of food origin and food type. Stool and blood samples were collected and analysed. RESULTS: Of 358 patients who presented to Middlemore Emergency Department during the study period with gastroenteritis, 34 (9.4%) had a history of consumption of food privately imported from the Pacific Islands. The seafood came from Tonga (23 cases), Samoa (10 cases) or Niue (1 case). The implicated seafood was shellfish (28 cases), jellyfish (2 cases), fish intestine (2 cases), seaweed or seaslug (1 case each). Fourteen patients (41%) provided stool samples; all were culture positive for Vibrio parahaemolyticus (VPH). CONCLUSIONS: This case series confirms a link between acute VPH gastroenteritis and consumption of seafood privately imported from the Pacific Islands. A number of public health initiatives to reduce the burden of VPH gastroenteritis among Auckland's Pacific Islanders have commenced. The Ministries of Health, Agriculture and Forestry are considering tighter controls or banning food privately imported from the Pacific Islands.

Adolescent↗
PubMed2004

The Global International Waters Assessment for the Pacific Islands: aspects of transboundary, water shortage, and coastal fisheries issues.

Aspects of transboundary, water shortage, and fisheries issues are discussed in the context of the recently completed Global International Waters Assessment (GIWA) for the Pacific Islands. The region encompasses some 30 million km2 and approximately 12% of the world's ocean space, and features great geographic, demographic and developmental diversity. Global change, especially sea level rise and sea surface temperature increases, is the dominant transboundary concern as it impacts all aspects of life. Water shortage and unsustainable fishing issues are selected for discussion, as they will dominate the region into the foreseeable future, and they are illustrated with examples from Fiji, Kiribati, and Tonga. The environmental impacts are exacerbated by socioeconomic issues such as high population growth rates, urban drift, the breakdown of traditional life styles and the rapid adoption of the cash economy. Policy options that may assist in addressing these issues are proposed.

Animals↗
PubMed2005

Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria.

OBJECTIVES: To assess the therapeutic efficacy of sulfadoxinepyrimethamine (SP) after 5 years of use as first-line treatment of uncomplicated Plasmodium falciparum malaria, and thus guide the selection of artemisinin-based combination therapy in Mpumalanga, South Africa. DESIGN: An open-label, in vivo therapeutic efficacy study of patients with uncomplicated P. falciparum malaria treated with a single oral dose of SP, with response to treatment monitored clinically and parasitologically on days 1, 2, 3, 7, 14, 21, 28 and 42. SETTING: Mangweni and Naas public health care clinics, Tonga district in rural Mpumalanga. SUBJECTS, OUTCOME MEASURES AND RESULTS: Of 152 patients recruited sequentially, 149 (98%) were successfully followed up for 42 days. One hundred and thirty-four patients (90%) demonstrated adequate clinical and parasitological response. Of the 15 patients (10%) who failed treatment, 2 (1.3%) had an early treatment failure, and polymerase chain reaction confirmed recrudescent infection in all 13 patients (8.7%) who had late parasitological (N = 11) or clinical (N = 2) failure. Gametocyte carriage was prevalent following SP treatment (84/152) and this has increased significantly since implementation in 1998 (relative risk 2.77 (confidence interval 1.65 - 4.66); p = 0.00004). CONCLUSION: Asexual P. falciparum parasites in Mpumalanga remain sensitive to SP, with no significant difference between the baseline cure rate (94.5%) at introduction in 1998, and the present 90% cure rate (p = 0.14). However, since gametocyte carriage has increased significantly we recommend that SP be combined with artesunate in Mpumalanga to reduce gametocyte carriage and thus decrease malaria transmission and potentially delay antimalarial resistance.

Adolescent↗
PubMed1992

WHO programme for the prevention of rheumatic fever/rheumatic heart disease in 16 developing countries: report from Phase I (1986-90). WHO Cardiovascular Diseases Unit and principal investigators.

The programme was initiated in 1984 by WHO in close collaboration with the International Society and Federation of Cardiology (ISFC). Sixteen countries in five WHO Regions participated: Mali, Zambia and Zimbabwe (in Africa); Bolivia, El Salvador and Jamaica (in the Americas); Egypt, Iraq, Pakistan and Sudan (in the Eastern Mediterranean); India, Sri Lanka and Thailand (in South-East Asia); and China, the Philippines and Tonga (in the Western Pacific). The programme was planned for implementation in three phases: pilot study and control programme in a selected area, control programmes in all the selected communities, and their extension to the whole country. In Phase I, a total of 1,433,710 schoolchildren were screened and 3135 cases of rheumatic fever/rheumatic heart disease (RF/RHD) were found, giving a prevalence of 2.2 per 1000 (higher in the African and Eastern Mediterranean regions); 33,651 recently identified or already known cases were registered; completion of secondary prophylaxis was irregular but averaged 63.2% coverage; percentages of adverse reactions (0.3%) and recurrence of acute RF (0.4%) were very small; 24,398 health personnel and teachers were trained. Health education activities were organized for patients, their relatives, and the general public in hundreds of health education sessions. Thousands of pamphlets, brochures and posters were distributed, and health education programmes were broadcast on radio and television. The quality of care for RF/RHD patients improved under the programme, which has been expanded to other areas.

Adolescent↗
PubMed2005

Modernisation, migration and nutritional health of Pacific Island populations.

The emergence of obesity and fatness across the second part of the 20th century has been documented for a number of Pacific Island populations. While dietary change and reduced physical activity levels associated with economic modernisation have been identified as the key factors fuelling the emergence of obesity, it is argued here that increasing numbers of Pacific Island migrants in the United States, New Zealand, France and Australia have provided the basis for the acceleration of the modernisation process by way of remittances, and the transmission of ideas of economic opportunity and change. Potential for migration for the Pacific Island nations is estimated from available data on population growth, total fertility rates and total mortality rates. Pacific Islander migrants form approximately one quarter of the total global Pacific Islander population, the majority of whom are from Tonga, Fiji, French Polynesia, and the Federated States of Micronesia. Per capita energy and fats and meat intake for the period 1961 to 2000 is described for five Pacific Island nations, showing that, in general, energy intakes have increased, as have the energy densities of the diets consumed. Thus the increase in mean body mass index observed in Pacific Islanders in the second half of the twentieth century can in general be attributed to dietary change associated with greater food and energy intake, and with increased consumption of fatty foods and meat, most of which are imports.

Activities of Daily Living↗
PubMed1987

A program to provide hepatitis B immunoprophylaxis to infants born to HBsAg-positive Asian and Pacific Island women.

Between January 1, 1984, and December 31, 1985, there were 545 women from Asia and the Pacific Islands who gave birth to a total of 572 infants at Highland General Hospital in Oakland, California (accounting for 20% of all deliveries at that hospital). For countries having more than ten women giving birth during the study period, the percentage of women screened prenatally for HBs antigen (Ag) ranged from a high of 100% (Laos) to a low of 54% (Philippines). HBsAg-positivity rates ranged from a high of 21% (Tonga) to a low of 0% (India). A total of 52 infants was born to 49 HBsAg-positive mothers, and 40 (77%) of the infants received hepatitis B immune globulin (HBIG) within 12 hours of birth. While 80% of the infants received HBIG and at least one dose of hepatitis B vaccine, only 35% received the recommended schedule of HBIG and three doses of vaccine.

Asia↗
PubMed1973

Cross-breeding of Aedes (S.) polynesiensis Marks with an autogenous species of the A. scutellaris group.

An autogenous species belonging to the Aedes (Stegomyia) scutellaris subgroup was found on the island of Tafahi, Kingdom of Tonga. A subcolony was established at Johns Hopkins University, Baltimore, Md., USA, where cross-breeding experiments were conducted with the Samoan strain of A. polynesiensis. The cross between Tafahi females and A. polynesiensis males produced viable hybrid progeny, which were inbred through five generations. The reciprocal cross was not successful. F(1) Tafahi x A. polynesiensis hybrid males were backcrossed successfully to Tafahi females, but of the many eggs produced by backcrossing these F(1)TP males to A. polynesiensis females, only 0.7% hatched. Of the eggs produced by the F(2)TP male x A. polynesiensis female backcross, about 7% were viable. The results indicate a close genetic relationship between the Tafahi species and A. polynesiensis. The one-directional compatibility observed suggests the existence of cytoplasmic factors for sterility, which might eventually be useful in the control of members of the A. scutellaris complex.

Aedes↗
PubMedDate not supplied

[Arboviral diseases in South-West Pacific islands (author's transl)].

Islands of the south-west Pacific area belong to the melanesian group, excepted Niue, Tonga, Wallis and Futuna which are polynesian. Through New Guinea, there is a geographic relation to the eastern part of Australia, rich of 42 arbovirus types. Dengue and Ross River fever are the most important arboviral diseases in the region; both affect islanders after introduction of virus by travellers to localities where efficient vectors are present. Dengue types 1, 2 and 4 were isolated from man and from mosquitoes in this area. Successive outbreaks, transmitted by Aedes aegypti or by Ae. polynesiensis, resulted in thousands of cases with a few fatal hemorrhagic forms. Ross River virus, responsible of epidemic polyarthritis, evaded in 1979, from Australia to Fidji, Wallis, Futuna and New Caledonia. Suspected vectors are Aedes vigilax and Culex annulirostris. Aedes aegypti and Ae. polynesiensis are also possible carriers. Murray Valley encephalitis virus caused severe outbreaks in Australia and fatal cases in New Guinea; it is a possible invader when Culex annulirostris is abundant. Expansion of arboviral diseases is a major epidemiological problem in south-west Pacific islands. Research work on pathogeny and vectors control must be intensified in this area.

Animals↗
PubMed1982

Microevolution and migration in the Pacific.

Archaeological, linguistic, and ethnocultural studies suggest the Pacific was colonized by two, or possibly three, genetically distinct groups of people. Australoids moved first into New Guinea and Australia, followed by Papuan-speaking people, who penetrated as far as Santa Cruz in the Solomons. Austronesian speakers began their migrations 6,000 years ago and mixed with preexisting populations to a varying extent until they finally reached the unpopulated islands. Here, in Samoa and Tonga, they developed the cradle of Polynesian culture, which spread to the central Pacific and from there north to Hawaii and west to New Zealand. Detailed genetic studies have indicated that, in New Guinea, geographical propinquity is an important determinant of genetic similarity between populations. A wider survey indicates, however, that Austronesian speakers have more in common, despite great geographical separation than is true for Papuan speakers. In the Banks and Torres Islands and the Solomons, Polynesian "Outliers" can be differentiated from other Melanesian island populations, while for the Pacific as a whole it is shown that Amerindian populations cluster with north Mongoloids and Polynesian populations cluster with south Mongoloids, with Australian Aborigines and New Guinea Papuans maintaining separate identities. It is concluded that Polynesians originated from a south Mongoloid population, losing a number of specific marker genes along their migratory path, and becoming modified genetically before establishing themselves in the Polynesian centre of dispersal.

Australia↗
PubMedDate not supplied

A study of dental caries in rural and an urban primary school of Zambia.

320 children, 160 from a rural and 160 from an urban primary school were examined for dental caries. The urban children were found to have twice as much caries as their rural counterparts. Their D.M.F./df indices were also much higher. No significant sex difference was noted. The tribal distribution shows that the Tonga are the most susceptible tribe while the Lenje have the least caries. The relationship between caries and brushing habits, as well as consumption of confectionary was established. The commonest teeth affected and their relationship to age was also noted. It was concluded that urbanization has definitely contributed to the higher caries prevalence in the urban school children. Although the situation is not as bad as in the West, if it remains unchecked, 90% of the population may have caries in another 15 years.

Adolescent↗
PubMed1994

Rhesus polymorphism in New Caledonia. II. Genetic comparison with other Oceanians.

Rhesus haplotype frequencies computed for 804 and 546 Wallisians from New Caledonia are compared to the data collected for 13 Oceanian samples belonging to the same Austronesian linguistic family. Genetic distances are computed between the 15 populations and used for a principal coordinate analysis. Kanaks are genetically close to Fidjians, while the Wallisian sample share a high genetic similarity with the Tonga islanders. The results obtained for the whole area including the Wallis homeland for the Wallisian sample indicate a tight relationship between geographical and genetic differentiations in the Pacific, supported by a high correlation coefficient between the two distance matrices. However, the observed patterns are better explained by the history of migrations reconstructed from archaeological and linguistic data than by a pure isolation-by-distance model.

Black People↗