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Traditional medicine in Fiji: some herbal folk cures used by Fiji Indians.

Traditional medicine has been practised in the South Pacific country of Fiji by almost all ethnic groups, both indigenous and immigrant. This paper reports on a survey on traditional medicinal practices in one major group, the Fiji Indians, who came from India in late 19th and early 20th century. The extent of knowledge and skills possessed by traditional healers and lay people, the plants and plant materials used by them for herbal remedies, parallel uses in India of the various plant species and their biodynamic properties are presented.

Fiji↗

Fiji and pseudo-Fiji diseases of sugar-cane.

Fijivirus, one of the group of phytoreoviruses, causes leaf galls known as Fiji disease of sugar-cane. In contrast, the so-called pseudo-Fiji disease, considered by some to be a virus disease, has been shown to be of non-viral origin.

Carbohydrates↗

Mosquito-borne infections in Fiji. I. Filariasis in northern Fiji: epidemiological evidence regarding factors influencing the prevalence of microfilaraemia of Wuchereria bancrofti infections.

A survey of microfilaraemia among the population of Vanua Levu, Taveuni and Koro islands in northern Fiji was conducted in 1968 and 1969 as a prelude to a campaign of mass treatment with diethylcarbamazine.The prevalences of microfilaraemia were found in the more moist conditions of Taveuni and Koro and on the windward southern side of Vanua Levu to be higher than on the drier northern side of Vanua Levu. On both sides of Vanua Levu prevalences were lower inland than near the coast.Under apparently similar environmental conditions those of Fijian ethnic origin exhibited a higher prevalence of microfilaraemia than that shown by Indians. This ethnic difference and a difference between the prevalences in male and female Fijians are considered to be due more to higher rates of recovery from microfilaraemia in Indians and Fijian women than to diminished exposure to mosquitoes. Mathematical models have been used as an aid to the interpretation of the data, and, where appropriate, comparison has been made with the prevalence of antibodies to dengue, an arbovirus having the same vectors.Household infections were analysed by computer techniques. Infections in large households were not proportionately higher than in small households, indicating that transmission was not intrafamilial. The clustering of infections within households, though present, was not marked. Among the occupants of outlying settlements the prevalence of microfilaraemia was relatively low indicating a lower risk of infection due to isolation.

Adolescent↗

Mosquito-borne infections in Fiji. 3. Filariasis in northern Fiji: epidemiological evidence regarding the mechanisms of pathogenesis.

During a filariasis survey conducted in northern Fiji in 1968-9 examinations were made for microfilaraemia, enlarged lymph nodes and elephantiasis. Analysis of the microfilarial densities at different ages and the number of anatomical sites showing lymph gland enlargement or elephantiasis have been used to provide evidence on the clustering of infections and pathogenesis.Although there is no evidence of clustering of risk of infection, there is evidence favouring the clustering of adult filariae in individuals. Nevertheless the number of sites of lymph node enlargement do not correspond with this finding and statistical evidence suggests that lymph-node enlargement is not necessarily associated with the near presence in the body of adult filariae, whether dead or alive.Males of Indian ethnic origin showed a higher prevalence of elephantiasis than males of Fijian ethnic origin, but women of either ethnic race showed prevalences lower than those of men.The onset of elephantiasis at a site does not directly reflect the number of infections sustained in the local area, but it appears that filariasis first induces for a limited period a proneness to elephantiasis. During this period a random and discrete event may induce the onset of elephantiasis. The nature of the event is unknown, but it probably is not trauma.

Culicidae↗

Diabetic retinopathy and nephropathy in Fiji: comparison with data from an Australian diabetes centre.

BACKGROUND: As part of a project to improve diabetes care in Fiji, we assessed the magnitude of problems posed by diabetic retinopathy in that country and compared the findings with those from an Australian diabetes centre. The relationship between diabetic retinopathy and nephropathy was also examined in a subset of patients. METHODS: A medical team from Australia screened a total of 446 type 2 diabetic patients (ethnicity: Fijian/Indian 16/84%) for diabetic retinopathy in five towns from the Division of Viti Levu, Fiji. The findings were compared with data obtained from 1659 type 2 diabetic patients who had attended an Australian diabetes centre (ethnicity Indian/ Anglo-Celtic 12/88%). In both cohorts, retinopathy was assessed by direct fundoscopy and a spot urine sample was collected for determination of albuminuria (defined as a concentration > 50 mg/L). RESULTS: The prevalence of diabetic retinopathy increased linearly with duration of diabetes. It was higher in Fiji, even when cases from the same ethnicity (i.e. Indians) and duration were compared (P < 0.05). Extrapolation of the data points suggests a delay in the diagnosis of diabetes in Fiji. Of those patients with retinopathy in Fiji, more than half had moderate to severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy, significantly higher than patients in the Australian cohort (chi2 = 29.2; P < 0.0001). Retinopathy was not a predictor of albuminuria in Fijian Indians (chi2 = 0.4; P = 0.5). In contrast, Australian Indians with retinopathy had significantly more albuminuria (chi2 = 10.2; P = 0.001). CONCLUSIONS: Severe diabetic retinopathy is common in both ethnic groups in Fiji. A delay in the diagnosis of diabetes as well as poor glycaemic control are possible factors. The availability of laser therapy is important to prevent loss of vision, but it is also essential that appropriate training of health professionals is integrated with a programme of diabetic complication screening to support this form of therapy.

Adult↗

Suicide in Fiji: a two-year survey.

This article reviews certified suicide in Fiji during the 2-year period from 1971-1972. The data show the much higher incidence of suicide in Fiji Indians than in other races, the incidence in Fiji Indian females being particularly high. The findings on a more detailed sample survey of 50% of the certified cases are presented. In the Fiji Indian population, a positive correlation between suicide and rural residence and a negative correlation between suicide and Moslem religion were found. These findings are discussed in relation to the cultural and social characteristics of the population of Fiji.

Adolescent↗

Twinning rates in Fiji.

The incidence of twins in Fiji has been investigated using birth registrations for the years 1976-81. The twinning rate for the indigenous Fijians is found to be 9.4 per 1000 live maternities, (based on 407 sets of twins), and for Indians, descendants of immigrants who began to arrive in Fiji in 1879, 6.2 per 1000 (based on 350 twins). After standardizing for maternal age, the difference between the two ethnic groups decreases slightly, but the Fijian rate remains almost 40% above that of the Indians. This difference is consistent over the 6 years of the study, is found for mothers of all age groups under 40 and at all levels of parity. An analysis of hospital records in Fiji produces higher twinning rates for both Fijians and Indians, but a similar difference is found between the two ethnic groups. Although the twinning rate for Fijians is lower than that reported for other Melanesian people, it is well above reliable rates found for Mongoloid races from whom the Fijian is descended. The sparse information on twinning rates among Polynesians suggests rates not dissimilar from Melanesians, so that no support for the hypothesis of low twinning rates in the Pacific is evident. The twinning rate for Indians in Fiji is lower than rates reported from the Indian subcontinent.

Adult↗

The effectiveness of the infant hepatitis B immunisation program in Fiji, Kiribati, Tonga and Vanuatu.

The aims of this project were: (1) to determine the extent to which infant hepatitis B immunisation is preventing chronic hepatitis B infection in children living in a sample of Pacific Island countries; and (2) to identify factors associated with the successful prevention of hepatitis B infection in these populations. A regional hepatitis B immunisation project which supplied hepatitis B vaccine to 10 Pacific Island countries began in 1995. Seroepidemiological surveys were conducted in Fiji, Kiribati, Tonga and Vanuatu in early 1998. These included immunised pre-school children and their biological mothers, and a historical control group of unimmunised students. Prevalence rates for hepatitis B surface antigen (HBsAg) in the populations of students, mothers and their pre-school children were respectively: Fiji: 6.9, 6.6, 0.7%; Kiribati: 27.4, 15.1, 3.8%; Tonga: 11.1, 18.6, 3.8%; Vanuatu: 16.3, 12.3, 3.0%; and for all four countries: 13.2, 12.5, 2.6%. Compared to the historical control group of students, the pre-school population had a much lower probability of HBsAg positivity (relative risk [RR]=0.19 [95%CI: 0.12-0.31]). Statistically significant differences in risk were apparent for all the countries: Fiji: RR=0.10; Kiribati: RR=0.14; Tonga: RR=0.34; Vanuatu: RR=0.19. This is equivalent to an overall program effectiveness of 81% (95%CI: 69-88%) in reducing chronic carriage. Also, the overall protective effectiveness against vertical hepatitis B transmission resulting in HBsAg positivity among children exposed to HBeAg positive and negative carrier mothers, was estimated to be 70%. By age 6 months, when all children should have had three vaccine doses, completed immunisation rates ranged from 22 (Fiji) to 84% (Vanuatu). Coverage of the first dose being given within 2 days of birth varied from 43% in Kiribati to 92% in Tonga. In conclusion hepatitis B immunisation of infants in these four countries is having a substantial beneficial effect in preventing chronic hepatitis B infection. Nevertheless, there is significant scope for further improving the timeliness of immunisation.

Adolescent↗

Aflatoxin levels in foodstuffs in Fiji and Tonga islands.

Fungal growth is a major problem of food storage in humid environments, as occur in South Pacific countries for parts of the year. Major crops, including edible nuts, copra and root crops, are susceptible to Aspergillus growth and therefore potential contamination with aflatoxin. Liver cancer occurs in Fiji and Tonga, with the occurrence in Fijians being significantly higher than in the Indian population. Thirty-three peanut samples from farmers were analysed for aflatoxin and 50% of the samples from Fiji were positive but only 9% from Tonga, reflecting different storage practices. Local copra, cassava, and maize samples were found contaminated, with only the maize at a serious level. Twenty-five plate food samples from Fiji showed low contamination. When starch foods from the Fijian diet left after cooking were analysed to follow potential aflatoxin development only sweet potatoes showed some contamination.

Aflatoxins↗

Cardiovascular diseases and diabetes mellitus in Fiji: analysis of mortality, morbidity and risk factors.

Mortality and hospital admissions due to cardiovascular diseases and diabetes mellitus have been increasing in Fiji steadily over the past 20 years. These diseases were present more frequently in the Indian than the Melanesian population of Fiji, but recently the steepest rise in prevalence rates occurred among the Melanesian population. The underlying conditions that contributed most to increasing mortality and morbidity were hypertension and diabetes mellitus. In 1978, the proportional mortality from diabetes mellitus was 6.0% (9.0% in persons aged >/= 40 years), and that from cardiovascular diseases was 30.3% (39% in those aged >/= 40 years). Ischaemic heart disease was the main cause of mortality and morbidity among the Indian population. This analysis of mortality and morbidity data is supported by the findings of a population survey, which showed that the prevalence rates of diabetes and hypertension in 1980 among urban Melanesians were similar to those among Indians. Urbanization and a modern life-style seem to play an important role in determining the disease pattern in Fiji, which is following the patterns in many industrial countries.

Adult↗

Severe iron deficiency anaemia in Fiji children.

AIMS: A prospective study to determine the magnitude of the problem of severe iron deficiency anaemia in Fiji children with intercurrent illnesses and their response to the interventions with dietary modifications and iron therapy. METHODS: A total of 2136 consecutive children between 6 months and 12 years of age, who attended a hospital and a health centre in Fiji, for intercurrent illness, during a 9 months period, were screened for severe iron deficiency anaemia (haemoglobin < 70 g/L). RESULTS: Eighty children (3.7%) had severe iron deficiency anaemia. Majority (75%) of children with severe anaemia were younger than 2 years. Dietary and iron therapy were successful in correcting anaemia in all 80 children. CONCLUSIONS: Severe iron deficiency anaemia was common in Fiji children seeking medical attention for intercurrent illness. Simple therapeutic measures, which included dietary advice and iron therapy, were successful in correcting this severe debility in those children.

Age Distribution↗

Detection of Fiji disease virus in infected sugarcane by nucleic acid hybridization.

Clones of Fiji disease virus were obtained by cDNA synthesis from isolated viral genomic double-stranded RNA. Nick-translated probes made from a mixture of clones specifically detected Fiji disease virus in infected sugarcane galls, leaves and growing tips. This method for detection of Fiji disease virus is extremely sensitive, and can be used as a rapid screening procedure for the virus with very small tissue samples.

DNA↗

Seroepidemiological survey of HTLV-I infection in French Polynesia, Cook Islands and Fiji.

Different population groups of French Polynesia, Cook Islands and Fiji were screened for Human T-Lymphotropic Virus type I (HTLV-I) antibodies. Among 1487 individuals sampled in French Polynesia, twelve were considered Western Blot (WB) indeterminate and one was considered WB-positive for HTLV-I infection. This positive subject originated from France and was a blood donor. Out of 196 Polynesians of the Cook Islands, one was WB-indeterminate. Among populations sampled in Fiji, one of 222 Melanesians was found WB-indeterminate and one of 211 Indians was WB-indeterminate.

Adolescent↗

Sequels to screening for hypertension and diabetes mellitus in Fiji.

We evaluated the outcome of a case-finding programme resulting from an epidemiological survey on diabetes and cardiovascular risk factors by re-interviewing 318 persons who had been found to have hypertension and/or diabetes mellitus in a population survey carried out in Fiji 1.5 years earlier in 1980. At re-examination, 34% of the hypertensive patients and 43% of the diabetic patients were not aware of their diagnosis. However, the proportion of treated hypertensive people was tripled and that of diabetic patients doubled. It was not possible to identify the characteristics of the persons who were missed in the follow-up. Many persons who were unaware of their condition regularly used, however, the existing health services available. On the other hand, several initially treated cases had no proper follow-up. More careful planning and development of comprehensive community-based programmes for hypertension and diabetes are needed in Fiji. Simple population screening for hypertension and diabetes may result in an extra work load and limit the available health care resources so that the overall outcome is not satisfactory.

Adult↗

The presence of Angiostrongylus cantonensis in Viti Levu, Fiji.

Wild rats and molluscs were examined for Angiostrongylus cantonensis infection on Viti Levu, Fiji. A. cantonensis were recovered from 29.6% (16/54) of Rattus rattus and 59.5% (25/42) of R. exulans. A. cantonensis-like larval nematodes were found in all of four slugs, Laevicaulis alte, and ten of 20 unidentified land snails. The larvae developed to adult A. cantonensis in the pulmonary arteries of laboratory rats 40 to 42 days after ingestion. This is the first record of A. cantonensis in Fiji.

Angiostrongylus↗