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Trends in food supply, diet, and the risk of non-communicable diseases in three Small Island Developing States: implications for policy and research
No full textIntroduction: Small island developing states (SIDS) are a diverse group of coastal and tropical island countries primarily located in the Caribbean and Pacific. SIDS share unique social, economic, and environmental vulnerabilities, high dependency on food imports, and susceptibility to inadequate, unhealthy diets, with high burdens of two or more types of malnutrition. Our objective was to examine trends in food availability, imports, local production, and risks of non-communicable diseases (NCDs) in three SIDS: Haiti, Saint Vincent and the Grenadines (SVG) and Fiji.
Methods: Data on food availability, imports, exports, and production was extracted from the Food and Agriculture Organization Database (FAOSTAT), and on overweight, obesity and diabetes prevalence from the NCD Risk Factor Collaboration database (NCD-RisC) from 1980 to 2018. Data were collated, graphed, and used to calculate import dependency ratios (IDRs) using Excel and R software.
Results: Between 1980 and 2018, the availability of calories per capita per day has risen in Fiji and SVG by over 500, to around 3000. In Haiti, the increase is around 200, to a level of 2,200 in 2018, and in all three settings, > 10% of calories in 2018 came from sugar. In Fiji and Haiti, the availability of fruit and vegetables is 30 Kg/m2) has increased since 1980 (by 126% to 800%) and is substantially higher in women. In the most recent data for Fiji, an estimated 35% of women are obese (24% men); in SVG, 30% women (15% men); and in Haiti, 26% women (15% men).
Conclusion: The increase in per capita availability of calories, which has taken place since 1980, is concurrent with an increase in IDR, a loss of local food, and increases in obesity prevalence. These findings highlight the importance of further research to understand the drivers of food supply transformations, and to influence improving nutrition, through production, availability, and consumption of nutritious local foods
Molecular and clinical epidemiology of carbapenem resistant Acinetobacter baumannii ST2 in Oceania: a multicounty cohort study
No full textCarbapenem resistant Acinetobacter baumannii (CRAb) is categorised by the World Health Organization
(WHO) as a pathogen of critical concern. However, little is known about CRAb transmission within the Oceania.
region. This study addresses this knowledge gap by using molecular epidemiology to characterise the phylogenetic
relationships of CRAb isolated in hospitals in Fiji, Samoa, and other countries within the Oceania region including
Australia and New Zealand, and India from South Asia. In this multicounty cohort study, we analyzed clinical isolates of CRAb collected from the Colonial War
Memorial Hospital (CWMH) in Fiji from January through December 2019 (n = 64) and Tupua Tamasese Mea’ole
Hospital (TTMH) in Samoa from November 2017 through June 2021 (n = 32). All isolates were characterized using
mass spectrometry, antimicrobial susceptibility testing, and whole-genome sequencing. For CWMH, data were
collected on clinical and demographic characteristics of patients with CRAb, duration of hospital stay, mortality
and assessing the appropriateness of meropenem use from the treated patients who had CRAb infections. To
provide a broader geographical context, CRAb strains from Fiji and Samoa were compared with CRAb sequences
from Australia collected in 2016–2018 (n = 22), New Zealand in 2018–2021 (n = 13), and India in 2019 (n = 58), a
country which has close medical links with Fiji. Phylogenetic relationships of all these CRAb isolates were
determined using differences in core genome SNPs.
Findings Of CRAb isolates, 49 (77%) of 64 from Fiji and all 32 (100%) from Samoa belonged to CRAb sequence type 2
(ST2). All ST2 isolates from both countries harboured blaOXA-23, blaOXA-66 and ampC-2 genes, mediating resistance to
β-lactam antimicrobials, including cephalosporins and carbapenems. The blaOXA-23 gene was associated with two
copies of ISAba1 insertion element, forming the composite transposon Tn2006, on the chromosome. Two distinct
clusters (group 1 and group 2) of CRAb ST2 were detected in Fiji. The first group shared common ancestral linkage to
all CRAb ST2 collected from Fiji’s historic outbreak in 2016/2017, Samoa, Australia and 54% of total New Zealand
isolates; they formed a single cluster with a median (range) SNP difference of 13 (0–102). The second group shared
common ancestral linkage to 3% of the total CRAb ST2 isolated from India. Fifty eight of the 64 patients with CRAb
infections at the CWMH had their first positive CRAb sample collected 72 h or more following admission. Mer�openem use was deemed inappropriate in 15 (48%) of the 31 patients that received treatment with meropenem in
Fiji. Other strains of CRAb ST1, ST25, ST107, and ST1112 were also detected in Fiji
Job satisfaction amongst Dental Health Professionals (DHP) providing dental prosthetic services in Fiji- A qualitative study
No full textHepatitis B Infection on Kwajalein Atoll, Republic of Marshall Islands: A Seroprevalence, Knowledges and Attitude Study
No full text
Evaluation of Family Planning Services in Ma'ufanga and Kolofo'ou Health Clinic, Nukualofa, Tonga.
No full textFood insecurity, COVID-19 and diets in Fiji – a cross-sectional survey of over 500 adults.
No full textIntroduction: Food insecurity is associated with inadequate nutrition and increased rates of chronic disease. The
primary aim of this study was to assess self-reported food insecurity and the perceived impact of COVID-19 on food
security, in two regional districts of Central Fiji, as part of a broader program of work on strengthening and monitoring
food policy interventions. The secondary aim was to explore the relationship between food insecurity and salt, sugar,
and fruit and vegetable intake.
Methods: Seven hundred adults were randomly sampled from the Deuba and Waidamudamu districts of Viti Levu,
Fiji. Interview administered surveys were conducted by trained research assistants with data collected electronically.
Information was collected on demographics and health status, food security, the perceived impact of COVID-19
on food security, and dietary intake. Food insecurity was assessed using nine questions adapted from Fiji’s 2014/5
national nutrition survey, measuring markers of food insecurity over the last 12 months. Additional questions were
added to assess the perceived effect of COVID-19 on responses. To address the secondary aim, interview administered
24-hour diet recalls were conducted using Intake24 (a computerized dietary recall system) allowing the calculation of
salt, sugar and fruit and vegetable intakes for each person. Weighted linear regression models were used to determine
the relationship between food insecurity and salt, sugar and fruit and vegetable intake.
Results: 534 people participated in the survey (response rate 76%, 50.4% female, mean age 42 years). 75% (75.3%,
95% CI, 71.4 to 78.8%) of people reported experiencing food insecurity in the 12 months prior to the survey. Around
one fifth of people reported running out of foods (16.8%, 13.9 to 20.2%), having to skip meals (19.3%, 16.2 to 22.9%),
limiting variety of foods (19.0%, 15.9 to 22.5%), or feeling stressed due to lack of ability to meet food needs (19.5%,
16.4 to 23.0%). 67% (66.9%, 62.9 to 70.7%) reported becoming more food insecure and changing what they ate due
to COVID-19. However, people also reported positive changes such as making a home garden (67.8%, 63.7 to 71.6%),
growing fruit and vegetables (59.5%, 55.6 to 63.8%), or trying to eat healthier (14.7%, 12.0 to 18.0%). There were no
significant associations between food insecurity and intakes of salt, sugar or fruit and vegetables.
Conclusion: Participants reported high levels of food insecurity, exceeding recommendations for salt and sugar
intake and not meeting fruit and vegetable recommendations and becoming more food insecure due to COVID-19
