Assessment of essential surgical and anaesthesia care capacity: a cross-sectional study in five Pacific Island Countries.

Background: Pacific Island Countries (PICs) face unique challenges in providing surgical care. We assessed the surgical care capacity of five PICs to inform the development of National Surgical, Obstetric and Anaesthesia Plans (NSOAP).

Methods: We conducted a cross-sectional survey of 26 facilities in Fiji, Tonga, Vanuatu, Cook Islands, and Palau using the World Health Organization - Program in Global Surgery and Social Change Surgical Assessment Tool.

Diabetes in the Cook Islands: a clinical audit.

Introduction The global burden of diabetes mellitus (diabetes) is significant and of increasing concern with more pregnant women being diagnosed with gestational diabetes mellitus (GDM). The Cook Islands face mounting pressures to address diabetes alongside competing population health needs and priorities. Cook Islands residents frequently travel to New Zealand to access health services.

Impact of sugar-sweetened beverage taxes on price, import and sale volumes in an island: interrupted time series analysis.

Objective: To evaluate the impact of changes in import tariffs on sweetened beverages.

Design: Interrupted time series analysis was used to examine sweetened beverage tariff increases of 40-60 % in 2008 and to 75 % in 2012, and an approximately 11 % decrease in 2014 when an excise tax replaced the tariff. Post-tax trends were compared with a counterfactual modelled on the pre-tax trend for: quarterly price of an indicator beverage, monthly beverage import volumes (both 2001-2017) and quarterly sales volumes (2012-2017).

Cancer control in the Pacific: big challenges facing small island states.

This Series paper describes the current state of cancer control in Pacific island countries and territories (PICTs). PICTs are diverse but face common challenges of having small, geographically dispersed, isolated populations, with restricted resources, fragile ecological and economic systems, and overburdened health services. PICTs face a triple burden of infection-related cancers, rapid transition to lifestyle-related diseases, and ageing populations; additionally, PICTs are increasingly having to respond to natural disasters associated with climate change.

Cancer control in small island nations: from local challenges to global action.

Cancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population sizes that make sustainable workforce and service development problematic, and the unavailability of specialised cancer services to large parts of the population. Action is required to prevent large human and economic costs relating to cancer.

Characteristics of and differences between Pasifika women and New Zealand European women diagnosed with breast cancer in New Zealand.

Aim: Breast cancer in New Zealand-based Pasifika women is a significant issue. Although Pasifika women have a lower incidence of breast cancer compared to New Zealand European women, they have higher breast cancer mortality and lower five-year survival. The aim of this study was to describe the characteristics and tumour biology of Pasifika women and to compare New Zealand European women to identify what factors impact on early (Stage 1 and 2) vs advanced stage (Stage 3 and 4) at diagnosis.

Epidemiology of fatal and hospitalised injuries among youth in Fiji (TRIP 15).

Aim: To determine the burden and characteristics of fatal and hospitalised injuries among youth in Fiji.

Methods: We conducted a cross-sectional analysis of the Fiji Injury Surveillance in Hospitals database - a prospective population-based trauma registry - to examine the incidence and epidemiological characteristics associated with injury-related deaths and hospital admissions among youth aged 15-24 years. The study base was Viti Levu, Fiji, during the 12-month period concluding on 30 September 2006.

Driving following Kava Use and Road Traffic Injuries: A Population-Based Case-Control Study in Fiji (TRIP 14).

Objective: To investigate the association between kava use and the risk of four-wheeled motor vehicle crashes in Fiji. Kava is a traditional beverage commonly consumed in many Pacific Island Countries. Herbal anxiolytics containing smaller doses of kava are more widely available.

Gestational diabetes mellitus screening, management and outcomes in the Cook Islands.

Aim: To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies.

Methods: Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glucose greater than or equal to 7.

Driver sleepiness and risk of motor vehicle crash injuries: a population-based case control study in Fiji (TRIP 12).

Introduction: Published studies investigating the role of driver sleepiness in road crashes in low and middle-income countries have largely focused on heavy vehicles. We investigated the contribution of driver sleepiness to four-wheel motor vehicle crashes in Fiji, a middle-income Pacific Island country.

Method: The population-based case control study included 131 motor vehicles involved in crashes where at least one person died or was hospitalised (cases) and 752 motor vehicles identified in roadside surveys (controls).

Prevalence of sleepiness while driving four-wheel motor vehicles in Fiji: a population-based survey (TRIP 9).

Introduction: Sleepiness has been shown to be a risk factor for road crashes in high-income countries, but has received little attention in low- and middle-income countries. We examined the prevalence of sleepiness and sleep-related disorders among drivers of four-wheel motor vehicles in Fiji.

Method: Using a two-stage cluster sampling roadside survey conducted over 12 months, we recruited a representative sample of people driving four-wheel motor vehicles on the island of Viti Levu, Fiji.

A profile of injury in Fiji: findings from a population-based injury surveillance system (TRIP-10).

Background: Over 90% of injury deaths occur in low-and middle-income countries. However, the epidemiological profile of injuries in Pacific Islands has received little attention. We used a population-based-trauma registry to investigate the characteristics of all injuries in Viti Levu, Fiji.

The case for improving road safety in Pacific Islands: a population-based study from Fiji (TRIP 6).

Objective: To estimate the incidence and demographic characteristics associated with road traffic injuries (RTIs) resulting in deaths or hospital admission for 12 hours or more in Viti Levu, Fiji.

Methods: Analysis of the prospective population-based Fiji Injury Surveillance in Hospitals database (October 2005 - September 2006).

Results: Of the 374 RTI cases identified (17% of all injuries), 72% were males and one third were aged 15-29 years.

Burden of road traffic injuries and related risk factors in low and middle-income Pacific Island countries and territories: a systematic review of the scientific literature (TRIP 5).

Background: In Pacific Island countries and territories, the burden of road traffic injuries and their attendant risks are considered significant but are poorly quantified. As with other low and middle-income countries, understanding the epidemiology of road traffic injuries in Pacific countries is critical to informing sustainable research and policy initiatives aimed at reducing this burden.

Methods: We undertook a systematic review and critical appraisal of the relevant epidemiological literature between January 1980 and December 2010, using key search strings for incidence and aetiological studies focusing on RTIs in less resourced Pacific countries.