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PubMed1987

Oral rehydration salts and diarrhoeal diseases: effects of changing inpatient management in Tonga.

Methods of inpatient management of children with diarrhoeal diseases (DD) in 1978 and in 1980 were compared to assess the use of oral rehydration salts (ORS) and a national antidiarrhoeal programme (NAP). Inpatient notes of 369 children admitted with DD were reviewed. The management of DD differed significantly but the clinical outcome was similar, with the exception of the case-fatality rate. All deaths occurred within the first 24 h of admission, indicating that this difference was attributable to improved management of DD in the community rather than changes in the inpatient treatment regime.

Child↗
PubMedDate not supplied

Age at menarche in Tahiti.

Data on age at menarche have been collected, using the status quo method, among 1246 Tahitian girls attending school. The median age, estimated by probits, is 12.75 SD 1.76. The girls of the rural districts have a higher median age (13.08 SD 1.97) than the girls of Papeete (12.61 SD 1.47). The results were compared with data collected among other girls of Maori or European ancestry in France, New Zealand and Easter Island.

Adolescent↗
PubMed1984

Infant feeding and women's work in Western Samoa: a hypothesis, some evidence and suggestions for future research.

This paper argues that a key reason for the decline in the age of weaning in 3rd world countries may be an increasing workload for women associated with increasing involvement in the cash economy. This hypothesis is considered in light of data collected in an anthropological field study of a rural village in Western Samoa. Methods used were a village census, a household survey with fertility histories and questions on household economy, a questionnaire on breastfeeding, key informant interviews, observations made during residence in the village, and archival research. The ethnographic data suggest the possibility of a causal relationship between a decline in the age of weaning and an increasing workload for women in Western Samoa. In addition, other factors thought to account for a decline in the age of weaning, such as bottle feeding and urbanization, are unimportant in rural Western Samoa.

Age Factors↗
PubMedDate not supplied

Seasonality of vital events in a Pacific Island population.

Analyses of vital data derived from a family record register for the native population of Guam reveal significant variations in births, deaths, and marriages over the period 1901-41. Although lacking marked photoperiod or temperature changes of temperate zones, the tropical island is subject to marked seasonal differences in rainfall characteristic of western Pacific islands. Marital patterns exhibit troughs associated respectively with the Lenten period and with Christmas celebrations. Infant and childhood deaths show close correspondence with rainfall patterns, consistently exceeding expected values during the rainy season (July-November) when conditions are optimal for the spread of communicable and gastrointestinal diseases. Births attain a peak in November, or at the beginning of the more advantageous season for infant health and survival. Seasonality in vital events, reported for many Euroamerican and some African and Asian populations of modern and historical periods, has rarely been documented for native populations of the tropical Pacific. Comparisons of differences in these patterns among different populations in varied environments provide unique opportunities to evaluate causal models of interactions among biological, sociocultural, and physioenvironmental factors.

Delivery, Obstetric↗
PubMedDate not supplied

Is lactation nature's contraceptive? Data from Samoa.

Data from a Samoan menstruation study suggest that lactation, even intensive on-demand lactation, does not inhibit menstruation or conception. This paper explores the applied and theoretical implications of continuing to accept lactation as a universally effective fertility control mechanism. Such thinking can have disastrous implications for family planning programs, and it keeps us from challenging long-held assumptions about lactation's role in population growth in early populations.

Body Weight↗
PubMedDate not supplied

Secondary sex ratios in Micronesian populations.

Secondary sex ratio (SSR) values in excess of 109 male for every 100 female livebirths have been reported from several Micronesian populations. Analyses of linked family records dating from before 1942 for the native people of Guam reveal a highly masculinized SSR even at high birth orders and parental ages of married fertile couples. These findings contrast with reported declines in SSR with parity and parental age among historical and modern populations in Europe and North America where such declines often have been ascribed to the effects of decreasing mean coital frequencies associated with marital duration and spousal age. This study challenges implicit assumptions about the supposed universality of Euroamerican patterns of marital sexual behavior and supports the coital frequency hypothesis of SSR determination.

Adult↗
PubMedDate not supplied

Sex ratios at birth in a Micronesian Atoll population.

The recent suggestion that typically masculinized sex ratios at birth in Micronesian populations may be related to a distinct "Micronesian pattern" of life-course coital behavior is applied to data on the sex ratio of livebirths on Butaritari Atoll in Kiribati. The data show that sex ratios on Butaritari are highly masculinized and do not vary significantly with changes in maternal age. However, there is a discernible relationship between the length of closed intervals preceding male and female births. The lack of age-related change in sex ratios in the Butaritari sample is inconsistent with ethnographic data regarding levels of marital coital activity in relation to increasing age and marriage duration. The Butaritari sex ratio data is argued to support the suggestion of a "Micronesian pattern," although it is posed that further tests of this association are required.

Adolescent↗
PubMed1992

Seroepidemiological characterization of a syphilis epidemic in the Republic of the Marshall Islands, formerly a yaws endemic area.

The annual numbers of reported cases of syphilis in the Republic of the Marshall Islands (RMI) increased from none in 1983 to more than 600 in 1989, suggesting a large outbreak of syphilis. Much of the increase resulted from expanded serological screening. The apparent outbreak of syphilis, therefore, may have been partly the result of increased surveillance or, since the RMI was formerly a yaws endemic area, possibly due to a resurgence of yaws. To address this problem and better characterize the epidemic, we analysed results from a 1989/90 Ministry of Health Services mass serological screening on Majuro Atoll, the main population centre. Serum specimens from 9160 people (86% of residents aged 15-44 years) on Majuro were screened with the rapid plasma reagin (RPR) card test; we repeated the RPR and performed a confirmatory microhaemagglutination assay for Treponema pallidum-specific antibodies (MHA-TP) on a sample of serum specimens. To estimate the seroprevalence of syphilis, we also tested a sample of RPR nonreactive specimens by MHA-TP. Among people less than 45 years of age, total (11.5%) and high-titre (5.2%) seropositivity rates were highest in the 20-24 year age group, as was MHA-TP seroprevalence (15.9%). These results suggested that a large outbreak of syphilis was responsible for the observed seroreactivity. Cumulative incidence modelling and comparisons with the results of a previous serosurvey conducted in 1985 suggested that the duration of the syphilis epidemic was approximately 10 years and that incidence had not increased appreciably since 1985.

Adolescent↗
PubMed1996

High mortality from cardiovascular disease and analysis of risk factors in Indian and Melanesian Fijians.

BACKGROUND: In recent years, developing populations such as the Pacific island nation of Fiji, have seen decreases in infectious diseases and increasing frequency of cardiovascular diseases (CVD), diabetes and cancer. However, cohort studies of mortality in these populations are scarce. Here we report 11-year all-cause and cause-specific mortality rates and risk factors for total, CVD and coronary heart disease (CHD) for indigenous Melanesian and Asian Indian people of Fiji. METHODS: Following a baseline risk factor survey in 1980, mortality surveillance continue until 1991 in a representative cohort of 1325 Melanesians and 1221 Indians from urban and rural areas of Fiji. Date and cause of death were recorded and total, CVD and CHD mortality rates calculated. Baseline predictors of mortality were assessed using Cox regression. RESULTS: Total mortality rates in Melanesians were 15.9 and 9.2/1000 person-years, and in Indians were 13.5 and 6.8/1000 person-years, in men and women respectively. Death due to CHD was more common in men than women, and in Indian than Melanesian men, although total CVD deaths were more common in Melanesian men. Deaths due to CHD were more common in the urban than the rural area. After adjusting for other risk factors Indian ethnicity was associated with a significantly reduced risk of total and CVD mortality in men, and total mortality in women. Age and systolic blood pressure were consistently and independently associated with mortality from all causes, as well as CVD and CHD (except in Indian women). In men associations were also identified for total cholesterol with CVD and CHD mortality in Melanesians, and 2-hour plasma glucose with total and CVD mortality in Indians. In women, 2-hour glucose was important for total, CVD and CHD mortality in both ethnic groups as was smoking in Indians. Obesity had inconsistent associations with mortality. CONCLUSION: Cardiovascular disease is now responsible for a large proportion of total mortality in both Indian and Melanesian Fijians. The major risk factors identified in Fijians are similar to those observed in developed populations.

Adult↗