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At least 19 recordsLinked to original sources
PubMed2004

Epidemiology of cancer in the Republic of Nauru.

Between November 1998 and December 1999, the Republic of Nauru was one of 8 Micronesian jurisdictions visited by trained medical record abstractors to review all available medical records in order to describe the epidemiology of cancer in Micronesia and to better understand the cancer data and control systems in each entity. There is likely incomplete ascertainment of cancer cases in the Republic of Nauru because of historical events, and the lack of a robust cancer registry and a systematic cancer surveillance system. A national comprehensive cancer control strategic plan and the implementation of that plan would facilitate greater prevention, treatment and control of cancer. The government of Nauru is working towards this end.

Adolescent↗
PubMed1993

Serum insulin and ECG abnormalities suggesting coronary heart disease in the populations of Mauritius and Nauru: cross-sectional and longitudinal associations.

Cross-sectional associations between insulin and ECG abnormalities suggestive of 'possible' and 'probable' coronary heart disease (CHD) in the populations of Nauru (n = 568) and Mauritius (n = 3280) have been examined in both non-diabetic and diabetic subjects. Additionally, the longitudinal relationship between baseline insulin and incident ECG abnormalities has been explored in non-diabetic Nauruans (n = 177) over 5 years. Age-adjusted mean 2-hour serum insulin was generally higher in subjects with ECG abnormalities than those with a normal ECG, but the difference was significant only for non-diabetic Mauritian men (p < 0.01). There was no clear association between prevalence of ECG abnormalities and quintiles of fasting or 2-hr insulin in Mauritians, and in non-diabetic Nauruans there was a non-significant positive association between prevalence of ECG abnormalities and tertiles of 2-hr insulin. Logistic regression analyses showed a slight positive association between 2-hr insulin and ECG abnormalities in non-diabetic Mauritians (p = 0.06 in males, p = 0.09 in females), and non-diabetic male Nauruans (p = 0.054) independent of possible confounders. Fasting insulin was not associated in any group. In longitudinal analyses in Nauruans there were no significant differences in mean baseline fasting or 2-hr serum insulin between subjects who maintained a normal ECG and those who developed abnormalities consistent with 'possible CHD' (there were no changes suggestive of 'probable CHD'). The incidence of ECG changes suggesting 'possible CHD' was slightly higher in the upper tertile of baseline fasting insulin in both sexes and 2-hr insulin in females, but when other factors were accounted for, multiple logistic regression analyses did not support this finding. Data from the populations of Mauritius and Nauru do not support a major role for serum insulin in ECG abnormalities suggestive of CHD.

Adult↗
PubMed1983

HLA antigens and non-HLA chromosome 6 markers in Micronesians from Nauru.

HLA-A, B, C and DR antigen distributions, together with non-HLA chromosome 6 markers C2, BF, C4A, C4B and GLO, were determined in Micronesians from Nauru. Genetic distance analysis showed the close affinity between Nauruans and Filipinos, while linkage disequilibrium values confirmed some ancestral relationship between Nauru and Melanesia. HLA gene frequencies in Nauruan, Filipino and Spanish populations were used to estimate the proportionate contributions of these groups to the present day Chamorros of Guam as 36% Spanish, 17% Filipino and 47% Micronesian.

Adult↗
PubMed1996

Diabetes and nontraumatic lower extremity amputations. Incidence, risk factors, and prevention--a 12-year follow-up study in Nauru.

OBJECTIVE: To measure the 12-year incidence (1982-1994) of nontraumatic lower extremity amputations (LEAs) in Nauruans, a population at high risk for NIDDM, and to determine the risk factors for amputation in Nauruans with diabetes. RESEARCH DESIGN AND METHODS: Amputation data were abstracted from operating theater records in Nauru, hospital databases in Australia, and Nauru government records. Baseline characteristics of a cohort of 1,564 Nauruans aged > or = 20 years examined during a population-based survey in 1982 were used to determine risk factors for first LEAs. RESULTS: Over this 12-year period, 46 first LEAs were performed on people with NIDDM, of whom 30 were members of the 1982 study cohort. The incidence of first LEAs in Nauruans aged > or = 25 years with NIDDM was 8.1 per 1,000 person-years in the study cohort and an estimated 7.6 per 1,000 person-years nationally. Amputations were associated significantly with lower BMI, lower blood pressure, higher fasting plasma glucose (FPG) level, and longer mean duration of diabetes at baseline, but levels of other risk factors, including cigarette smoking, plasma triglycerides, and plasma cholesterol, were also elevated in amputees. There were no amputations among individuals with baseline FPG levels < 7.8 mmol/l, irrespective of diabetes duration. FPG, baseline diabetes duration, and male sex were independent risk factors for first amputation using the Cox proportional hazards model. There was a decrease in the incidence of amputations after the commencement of a national foot care health education and prevention campaign in June 1992. CONCLUSIONS: The incidence of LEAs in diabetic Nauruans was higher than in other populations after adjusting for age and duration. Given the apparent success of the Nauruan footcare program in reducing amputation rates, other populations with high rates of NIDDM and LEAs should consider population-wide prevention strategies.

Adult↗
PubMed1983

Genetics of diabetes in Nauru: effects of foreign admixture, HLA antigens and the insulin-gene-linked polymorphism.

Genetic factors play a major role in predisposition to diabetes in the Micronesian population of Nauru. In people aged 60 years and older, 83% of full-blooded Nauruans were diabetic compared with 17% of those with ancestral foreign admixture, as detected by HLA typing. HLA distributions also showed a small increased risk for early onset of diabetes (less than 46 years) associated with HLA-Bw22 (Bw56). Variation in the restriction fragment length of DNA near the insulin gene was found, but was not associated with diabetes. The distribution in fragment lengths, previously reported in Caucasoids, was observed in healthy Polynesians, Melanesians and Micronesians.

Adult↗
PubMedDate not supplied

The high incidence of diabetes mellitus in the micronesian population of Nauru.

As a follow-up to surveys conducted three years ago among the Micronesian population of Nauru, the incidence and prevalence of diabetes mellitus was studied in 433 subjects aged 20 years and older. The diagnosis of diabetes was based on a 2-h plasma glucose of 200 mg/dl (11.1 mmol/l), enabling comparison with the Rochester, U.S.A., (Caucasian) and Pima (American Indian) studies. In both sexes the prevalence rate rose steadily with age, and the overall prevalence was 24% for both sexes. The overall incidence rate was 15.4 per 1,000 person-years. However, males had almost twice the incidence of the females (20.2% vs 11.5%). The incidence rate of diabetes in Nauruans was considerably higher than that found in Rochester and was second to that of the Pimas as the highest rate reported in the literature.

Adult↗
PubMed2001

Restaurant-associated outbreak of Salmonella typhi in Nauru: an epidemiological and cost analysis.

Typhoid fever is endemic in the South Pacific. We investigated an outbreak in Nauru. Through interviews and medical records, we identified 50 persons with onset between 1 October 1998 and 10 May 1999, of fever lasting > or = 3 days and one other symptom. Salmonella Typhi was isolated from 19 (38%) cases. Thirty-two (64%) patients were school-aged children, and 17 (34%) were in four households. Case-control studies of (a) culture-confirmed cases and age- and neighbourhood-matched controls; and (b) household index cases and randomly selected age-matched controls implicated two restaurants: Restaurant M (matched OR [MOR] = 11, 95% confidence interval [CI] = 1.3-96) and Restaurant I (MOR = 5.8, 95% CI = 1.2-29). Food-handlers at both restaurants had elevated anti-Vi antibody titres indicative of carrier state. The annual incidence was 5.0/1000 persons. Outbreak-associated costs were $46,000. Routine or emergency immunization campaigns targeting school-aged children may help prevent or control outbreaks of typhoid fever in endemic disease areas.

Adolescent↗
PubMed1985

Factors associated with the development of diabetes in the Micronesian population of Nauru.

A longitudinal study of 266 adult residents of the Pacific Island of Nauru (1975-1976 and 1982) has shown an annual incidence of noninsulin-dependent diabetes of 1.6 per cent per annum. Factors associated with the subsequent development of glucose intolerance were determined by means of regression techniques. The two-hour, post-load plasma glucose concentration was the factor most consistently associated with subsequent glucose intolerance. Other predictors were found to vary in their importance between the sexes. In males, the fasting plasma triglyceride concentration and blood pressure showed a weaker association, and body mass index was of marginal significance. In contrast, in females, two-hour plasma insulin concentration, plasma uric acid concentration, body mass index, and fasting plasma glucose concentration showed a significant association. These findings are discussed in light of the results of similar studies in other populations.

Adult↗
PubMed1985

Mortality patterns in the modernized Pacific Island nation of Nauru.

Nauru is a small phosphate-rich independent island country situated in the Central Pacific. The population is Micronesian and was estimated to be 4,680 in mid-1981. An analysis of mortality data for the years 1976-81 indicates a high adult male mortality due to accidents, injuries, cardiovascular disease, and diabetes. The life expectancy estimate at birth for men was 49 years, and for women 62 years. The male life expectancy is among the lowest in the region. The considerable adult male mortality appears to be related to the rapidly acquired affluence and the ready availability of motorcycles, cars, imported foods, tobacco, and alcohol. The data suggest that modernization of the economy in Pacific Island nations can lead to new and serious public health problems.

Accidents↗
PubMed1989

Prevalence and risk factors for micro- and macroalbuminuria in diabetic subjects and entire population of Nauru.

Rates of elevated urinary albumin concentration, defined as microalbuminuria (30-299 micrograms/ml) and macroalbuminuria (greater than or equal to 300 micrograms/ml), were determined on random morning urine specimens in the population of Nauru, which has a high prevalence of non-insulin-dependent diabetes mellitus. The prevalence of elevated urinary albumin levels in the total Nauruan population was very high: 26 and 30% of men and women, respectively, had microalbuminuria, whereas 13% of both sexes had macroalbuminuria. Of the subjects with macroalbuminuria, 66% had diabetes. The prevalence increased with worsening glucose tolerance; 26% of subjects with normal glucose tolerance had either micro- or macroalbuminuria, increasing to 43% of subjects with impaired glucose tolerance, 63% of newly diagnosed diabetic subjects, and 75% of previously diagnosed diabetic subjects. Associations between elevated urinary albumin concentration and putative risk factors were assessed for both the total population (n = 1184) and the diabetic subgroup alone (n = 318). Fasting plasma glucose and hypertension were the most important independent correlates for the whole population, whereas plasma creatinine was also important in diabetic subjects. Age at onset and duration of diabetes were not found to be significantly associated with elevated albumin concentration. In subjects with normal glucose tolerance, hypertension and hyperuricemia were the most important associated factors. These results suggest that blood glucose, blood pressure, and possibly obesity and plasma uric acid are important modifiable risk factors for both micro- and macroalbuminuria in this population.

Adult↗
PubMed1981

Plasma lipid peroxide levels in an urbanized Micronesian population--Nauru.

Plasma lipid peroxide levels of 419 inhabitants of Nauru, where a high prevalence of obesity is occurring, were measured. The plasma lipid peroxide level was 4.03 +/- 1.94 nmol/ml in subjects 20-24 years and rose to a peak of 5.78 +/- 3.21 in subjects 35-44 years. The values obtained with Nauruans are significantly higher than those of healthy Japanese people and the peak found in the former was shifted to a younger age than in the Japanese.

Adult↗
PubMed1978

Studies on hepatitis B surface antigen and antibody in Nauru. II. Distribution amongst Gilbert and Ellice (Tuvalu) islanders.

The age-specific prevalence of hepatitis B surface antigen (HBsAg) and antibody was studied in a random sample of Gilbert and Ellice islanders over the age of 10 years living in Nauru. While approximately 82% of each group showed evidence of past infection with hepatitis B virus (HBV) the carriage rate of HBsAg was significantly lower in the Polynesian Ellice islanders (7.5%) than in the Micronesian Gilbertese (26.3%) and indigenous Nauruans (14.7%). These findings suggest that Micronesian and Polynesian populations may differ in the response to infection with HBV.

Adolescent↗
PubMed1992

GM and KM allotypes and GM RFLP allogenotypes in Micronesians from Nauru.

Immunoglobulin allotypes of the GM and KM systems were determined in a sample of Micronesian subjects from Nauru. Four GM haplotypes were identified in the sample: GM*1,3 23 5, 10,11,13,14, GM*1,17 23' 21, GM*1,3 23' 5,10,11,13,14, and GM*1,2,17 23' 21, although the last of these may have been introduced by non-Micronesian admixture. The frequency of the KM*1 allele is 0.115 +/- 0.033, which is slightly lower than reported in Micronesians from the Caroline Islands. RFLPs generated by the enzymes Taq I and Pvu II and detected by a Hu gamma 4 probe were related to GM phenotypes. The haplotypes GM*1,3 +/- 23 5,10,11,13,14 were strongly associated with a Taq I 5.0-kb band. The presence and absence of the allotype G2M 23 were marked by a Pvu II 7.0 + 2.0 kb pair and a Pvu II 9.0-kb fragment, respectively. GM*1,17 23' 21 was strongly associated with a Pvu II 5.0 + 2.7 kb pair. The different relationships between GM haplotypes and Hu gamma 4 RFLPs in Micronesians and Caucasians indicate that a universal GM allogenotyping procedure cannot yet be developed; instead, population-specific procedures are necessitated by differences in GM allotype arrangements between populations.

Gene Frequency↗
PubMed1980

Cholera on Nauru. Possible non-point source transmission.

An outbreak of Vibrio cholerae, serotype Ogawa, biotype El Tor, was experienced on the coral atoll of Nauru in the central Pacific. Primary water-borne transmission was unlikely because the population was supplied with water from individual rainwater catchment tanks and surveillance of the tanks of patients and persons with asymptomatic infection showed no evidence of contamination with V. cholerae. A matched pair, case-control study suggested a food-borne point source for transmission also was unlikely. The principal mode of transmission was not established, but spread of cholera appeared to be by a route other than common source contamination of water or food.

Adolescent↗
PubMed1988

Nauru.

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Conservation of Natural Resources↗
PubMed1989

Population history of Nauru: a cautionary tale.

"Available records relating to Nauruan population attributes are critically evaluated to develop a reconstructed population history of this native Micronesian people. Historical evidence consists of documentation of the effects of diseases and modern warfare and more recent behavioral changes traceable to altered economic conditions. Unpredictable and dramatic fluctuations in population characteristics throughout the historic period are revealed, precluding the use of standard population models. Even structural similarities at widely separated time periods are shown to be insufficient evidence of stable population conditions, a cautionary finding for paleodemographers, archaeologists, and others working throughout the Pacific."

Behavior↗
PubMed1984

The natural history of impaired glucose tolerance in the Micronesian population of Nauru: a six-year follow-up study.

A longitudinal study of 266 randomly selected non-diabetic Nauruans (215 normal subjects, 51 with impaired glucose tolerance) has permitted the natural history of impaired glucose tolerance to be studied in this Micronesian population. Nauruans are known to suffer from a very high prevalence of abnormal glucose tolerance. The subjects were first examined in 1975-1976, and a follow-up examination was performed in 1982. Of the subjects with impaired glucose tolerance, 26% developed diabetes during the study period (4% per annum) compared with 7% of normal subjects (1% per annum). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (odds ratio 3.6, 95% confidence interval 1.4-9.1). Of those with impaired glucose tolerance on initial examination, 39% were normoglycaemic at follow-up. In subjects with impaired glucose tolerance, of nine factors examined only plasma glucose concentration at the time of the initial examination was consistent in predicting progression to diabetes, when the data were examined by both univariate and multivariate methods. Both 2-h and fasting plasma glucose values were useful predictors. Thus, Nauruans with impaired glucose tolerance have a higher risk of subsequent diabetes than their normoglycaemic counterparts, after controlling for age and obesity. Nevertheless, the prognosis of impaired glucose tolerance is unpredictable as a substantial proportion of such subjects return to normality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗