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At least 19 recordsLinked to original sources
PubMed1990

Surgery in Tuvalu: a 10-year review.

A total of 1084 surgical procedures was performed during the first 10 years of independence in the small Pacific island nation of Tuvalu. Visiting surgical teams performed 29% of these. Obstetrical and gynaecological operations, eye and abdominal operations counted for more than half of the total number of operations; of the individual operations, cataract extraction, tubal ligation and appendicectomy were the most common. After local anaesthesia, epidural, spinal or ketamine anaesthesia, respectively, were performed more often than general anaesthesia. During the 10-year period, only 12 patients were sent overseas for surgical treatment. Of the estimated 110 patients needing surgical treatment in Tuvalu each year, the great majority can be managed with present facilities. Regular visits by an eye and a plastic surgery team are useful, and a small number of selected patients need surgical treatment overseas. The adequate treatment of surgical emergencies from outer islands in an island community with great distances and poor communications remains the biggest challenge for surgical services in the future.

Anesthesiology↗
PubMed1981

The influence of variation in obesity in the sex difference in the prevalence of abnormal glucose tolerance in Tuvalu.

The prevalence of abnormal glucose tolerance in the Polynesian population of Funafuti, Tuvalu (formerly the Ellice Islands) is much higher in females than males. However, the women are more obese than the men. Adjusting for obesity reduced the relative risk of abnormal glucose tolerance between males and females but the differences remained statistically significant. It is concluded that differences in the extent of obesity in the male and female population of Tuvalu explain part (but not all) of the differences in prevalence of impaired glucose tolerance in Funafutians.

Adolescent↗
PubMedDate not supplied

New species of Balantidium and Paracichlidotherus (Ciliophora) inhabiting the intestines of four surgeonfish species from the Tuvalu Islands, Pacific Ocean.

Four species of adult herbivorous surgeonfishes (Family Acanthuridae) were collected from the remote South-Pacific island system of Tuvalu. Their intestinal contents were examined, and of four populations of ciliated protists, two new species were discovered and are described. Ciliates were examined after protargol staining and, in some cases, scanning electron microscopy. Members of each population were examined and 10 characters measured for the balantidia, and 13 for the paracichlidotherids. A new Balantidium is described which has an unusually large dextr-oral field of cilia. A new species of Paracichlidotherus was discovered which has a macronucleus significantly smaller and well anteriad the cytoplasmic portion of the oral polykinetids relative to the type species.

Animals↗
PubMed1982

Oral health in Tuvalu.

Current WHO methods were employed to estimate the prevalence of oral pathology, dentofacial anomalies, periodontal disease, caries and prosthetic status as well as treatment needs in Tuvalu, a newly emergent nation in the South Pacific. Fluorosis was endemic but other disorders of teeth, mucosa or bone were extremely rare and the presence of dentofacial anomalies was very low. Periodontal disease was "moderate" at 15 years of age but seemed to be a predisposing factor in caries from the late teens onward. Comparison with a survey 8 years previously indicated that caries rates had risen from "very low" to "low" at 12 years of age but treatment services had improved markedly. More than half of person in the 55-64 year age group required full maxillary and mandibular dentures whilst 10% already possessed them.

Adolescent↗
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

Hyperinsulinaemia in youth is a predictor of type 2 (non-insulin-dependent) diabetes mellitus.

This study aimed to compare plasma insulin concentrations across the age-range from childhood to old age in the populations of Nauru and Tuvalu, and to assess their relationship to the incidence of impaired glucose tolerance and diabetes in young Nauruans. The studies, performed in 1975 and 1976, found that Nauru had a higher prevalence of Type 2 (non-insulin-dependent) diabetes mellitus than Tuvalu. Both studies included subjects of 8-29 years of age (n = 320 in Nauru, n = 318 in Tuvalu) and on these subjects glucose tolerance status, body mass index and fasting and 2-h (post 75 g glucose load) plasma insulin concentrations were determined. In Nauru, follow-up surveys in 1982 and 1987 included many of the subjects first seen in 1975/1976, allowing the incidence and natural history of glucose intolerance to be studied. Within the group of subjects with normal glucose tolerance, there was no effect of age on plasma insulin distributions in either population. However, in both populations, 8-19 year old subjects with normal glucose tolerance had higher body mass index-adjusted geometric mean fasting and 2-h insulin concentrations than older age-groups (p less than 0.001 for fasting insulin). Body mass index-adjusted geometric mean 2-h plasma insulin was higher in subjects with abnormal glucose tolerance relative to those with normal glucose tolerance in both populations. In Nauruans, 2-h insulin levels at baseline were predictive of impaired glucose tolerance and Type 2 diabetes in 1982, and fasting and 2-h insulin levels predicted development of Type 2 diabetes in 1987.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Vitamin A deficiency in the South Pacific.

UNLABELLED: Vitamin A deficiency is a major cause of morbidity, mortality and blindness among children. Although vitamin A deficiency is known to affect many children in developing countries, the magnitude of the problem in the South Pacific region is unclear. METHODS: Five cross-sectional surveys for vitamin A deficiency were conducted between 1989 and 1992 in the Republic of Kiribati, Tuvalu, the Republic of Vanuatu, Solomon Islands and the Cook Islands. RESULTS: In total, 10,673 children between the ages of 6 and 72 months were examined for clinical signs of vitamin A deficiency (nightblindness and xerophthalmia). The prevalence of xerophthalmia was 14.76% in the Republic of Kiribati, 1.55% in Solomon Islands, 0.59% in the Cook Islands, 0.28% in Tuvalu, and 0.11% in Vanuatu. The most common clinical findings were Bitot's spots followed by nightblindness. Xerophthalmia were more common among boys (Kiribati P < 0.001, Solomon Islands P = 0.03) and tended to occur in older preschool children (P < 0.0001). CONCLUSIONS: These studies suggest that vitamin A deficiency is a public health problem in the Republic of Kiribati and Solomon Islands.

Child↗
PubMedDate not supplied

Nutrient intake in a partly westernized isolated Polynesian population: the Funafuti survey.

Dietary data were obtained from 110 adult Polynesians (indigenous Funafutians) during a diabetes epidemiologic survey in Tuvalu. Funafuti (the main island of Tuvalu) was chosen as representative of partly urbanized population that has seen progressive socioeconomic changes in the previous 30 yr. The distribution of calories in the Funafuti diet is almost identical to that reported in the urbanized Micronesian population of Nauru and in Caucasian populations. Prevalence of diabetes was found to be five times higher than that reported in caucasian populations. Similarly, the prevalence of hypertension was 11% (equal to Caucasian figures), whereas hypertension is virtually unknown in traditional-living populations. Prevalence of diabetes, and degree of obesity, is significantly greater in women than in men. It is possible that this Polynesian group may have a genetic susceptibility to diabetes, which may have been unmasked by change from a traditional to western life-style. Marked obesity is now a characteristic of many Polynesian and Micronesian populations, and must rank as a major causative factor for the diabetes and hypertension explosion.

Adult↗
PubMed2000

The Pacific Islands Internet Project (PIIP) in UNDP, Suva.

The Pacific Islands Internet Project (PIIP) aims to expose interested parties to emerging technologies by creating initial, core national Internet-based information systems, and by training users on how to take advantage of such systems for sustainable development purposes. PIIP works closely with Small Islands Development States Network SIDSNET (http://www.sidsnet.org) and Asia and Pacific Development Information Programme APDIP (http://www.apdip.net), both UNDP initiatives in this field. The Target Beneficiaries are 15 countries in the sub-region including Tuvalu, Niue and Tokelau which are still without Internet access. PIIP will assist these three countries in their connectivity needs and all other countries in other components of the project. Priority is given to the smaller island states. There are four components to the project. These are: Connectivity (WWW access for Tuvalu, Niue and Tokelau); Training and Awareness (through national seminars and training programmes); Internet Applications (in areas such as telemedicine, distance education, SIDSnet and other fields in the private sector); and Policy (work with telecom and regional organisations in facilitating national telecommunications policies that provide a basis for development of an ICT strategy). Some of the progress made since the inception of PIIP are covered in this paper.

Humans↗
PubMed1991

Where there is no anaesthetist....

In an unselected series of 254 operations representing a wide range of surgical, obstetric and gynaecological procedures carried out on the small Pacific island of Tuvalu, the majority (85 per cent) involved the lower half of the body. In all cases but one anaesthesia was administered by a non-specialist. In operations below the level of the diaphragm epidural anaesthesia was usually used with a success rate of 96 per cent. In the upper half of the body ketamine was used where local or regional block was insufficient. Only one operation was performed under general inhalation anaesthesia. The overall postoperative mortality rate was 0.4 per cent and the morbidity rate was 13 per cent. Only two minor complications were attributed to the anaesthetic method used. In situations where anaesthetists are not available, epidural and ketamine anaesthesia in the hands of non-specialists are safe and practical options to general inhalation anaesthesia and are appropriate for most surgical procedures.

Adolescent↗
PubMed2001

From policy to action: access to essential drugs for the treatment of hypertension in the Small Island States (SIS) of the South Pacific.

The existing acquisition cost for essential drugs in the Cook Islands, Kiribati, Marshall Islands, Nauru, Niue, Tuvalu, is sufficiently high to compromise equitable access to quality drug therapy. The difficulty of access is further compounded by problems of distance from drug manufacturers and suppliers, associated with inadequate transport and communication links. In some of the Small Island States of the Pacific, internal distribution challenges further reduce access to drugs for those people who live on the outer islands. Two management processes to address these problems which have successfully been used in the past, are the establishment of an essential drug list to guarantee consistent appropriate treatment, and the introduction of pooled or bulk purchasing in order to achieve economies of scale. The major non-communicable diseases (NCDs) in the South Pacific include diabetes, hypertension and cardiovascular disease. These diseases, in association with life-style factors of obesity and smoking result in significant morbidity and mortality. This paper demonstrates that collaboration in drug purchasing of a defined list of essential drugs for hypertension would be beneficial in the South Pacific, and that the process is a model for achievement of rational drug treatment for NCDs in isolated small economies.

Antihypertensive Agents↗
PubMed1994

AIDS education reaches Pacific atolls.

The Republic of Kiribati consists of 33 islands and 69,000 inhabitants dispersed over a large area of the Central Pacific. It includes the former Gilbert Islands, which were linked as British colonies with the Ellice Islands until the latter declared themselves independent as Tuvalu. Kiribati became independent from Britain in 1979 and joined WHO [the World Health Organization] in 1984. Launched in 1988, the national AIDS program is now implementing its second medium-term plan. As part of this plan, the program recently held its first AIDS awareness workshop for hotel workers, health care workers and youth. The workshop was held on Kiritimati, the world's largest atoll. Also known as Christmas Island, the atoll of 2650 inhabitants has excellent bird-watching and fishing opportunities, which have drawn growing numbers of tourists in recent years. Although neither of the two HIV infections identified in Kiribati by March 1994 were on Kiritimati, the prevalence of other sexually transmitted diseases there has been on the rise. Meeting in a traditional thatched building, the workshop participants proved eager to learn about HIV and STDs [sexually transmitted diseases]. They received instruction in prevention skills, including a demonstration of proper condom use led by the national AIDS coordinator. At the close of the workshop, condoms were provided to hotel staff for distribution.

Acquired Immunodeficiency Syndrome↗
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↗