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At least 19 recordsLinked to original sources
PubMedDate not supplied

Diabetes in general practice: Tongans in Tonga and South Auckland.

The aim of this study was to compare the management and treatment outcomes of Tongan diabetic patients in Tonga and South Auckland, New Zealand. This was achieved by comparison of Tongan diabetic patients within clinical audits from a general practice in Tonga (n = 124) with those from participating general practices in South Auckland (n = 168). Our results indicate that some measures of diabetes care and outcomes were similar or even better in Tonga, while some interventions were not available in Tonga. Control of weight, glucose, blood pressure and cholesterol remained difficult in both areas. Severe diabetic foot damage was more common among Tongan patients in Tonga (6.5% vs 1.8%, P < 0.05). This international comparison shows that Tongans in both Tonga and New Zealand remain at high-risk of complications independent of the health system under which care is being delivered. While barriers to implementation may differ in the two settings, improvements in the co-ordination of care are likely to be of benefit in both settings.

Diabetes Complications↗
PubMed2005

Sexual health behaviours among Pacific Island youth in Vanuatu, Tonga and the Federated States of Micronesia.

ISSUES ADDRESSED: This study was conducted to describe the sexual risk behaviours of youth within the Pacific Island nations of Vanuatu, Tonga and the Federated States of Micronesia. METHODS: General health behaviour surveys were conducted with youth aged 15-19 years and not attending school in the three countries. A sample of 390 Ni-Vanuatu youth from the Shefa Province, 934 youth from three island provinces of Tonga and 92 youth from Pohnpei, the main island of the four island states of the Federated States of Micronesia, were interviewed in gender-specific groups. Questions were asked about sexual behaviours that may contribute to unintended pregnancy or sexually transmitted infections (STIs). RESULTS: Moderate to high percentages of youth were sexually active (had a least one sexual partner) in the Pacific island nations of Vanuatu (49.7%), Tonga (35.5%) and the Federated States of Micronesia (76.1%). Young men were more likely to engage in sexually risky behaviour than young women. They were more likely to be sexually active, have had multiple sexual partners and have had sex when drunk or high. Of those sexually active, more young men than women in Vanuatu (36.1% compared with 30.6%) and Micronesia (54.2% compared with 50%) never used protection against STIs. However, of the sexually active Tongan youth, the proportion of females (61.1%) who reported never using protection against STIs was nearly double the proportion reported by Tongan males (32.2%). CONCLUSION: A high percentage of young people not attending school in the Pacific island nations of Vanuatu, Tonga and the Federated States of Micronesia are at risk of unintended pregnancy and STIs, including HIV, because of patterns of sexual risk behaviour.

Adolescent↗
PubMedDate not supplied

Human growth in southern Zambia: a first study of Tonga children predating the Kariba Dam (1957-1958).

During the late 1950s the Kariba hydro-electric dam was constructed on the border of Zambia and Zimbabwe forcing the relocation of 57,000 people, mainly Tonga. As part of a larger study to assess the effects of the relocation, research into the human biology of the Tonga people was conducted. The research reported here provides a basis for comparison with long-term follow-up data on growth and physical status of Gwembe Tonga to determine the effects of resettlement. The sample consists of 303 schoolchildren, 7 to 13 years, from two schools that were not relocated and three schools that were to be relocated. Homogeneity of the two groups led us to combine them as a single baseline sample before relocation. Comparisons with NCHS (National Center for Health Statistics) reference data and with contemporary urban data from southern Zambia indicate sub-optimal nutritional status. After ages 6 and 7, height-for-age and weight-for-age Z-scores of boys decline steadily towards -2.0 SD throughout the 12th year, whereas mean Z-scores of girls decline markedly from 8 years on. Mean HAZ (Height-for-age-Z-score) of girls falls below -2.0 SD by 11 years and approaches -3.0 SD by 13 years. Thirty-nine percent of males and 47% of females in the baseline sample showed effects of moderate or severe protein energy malnutrition at the time of relocation. Because these children were from a school sample, gender differences in opportunity to attend school may be a factor in what appears to be gender bias, favoring the status of boys. This sample provides a baseline for assessing the long-term impact of forced relocation on the Gwembe Tonga.

Child↗
PubMed2000

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↗
PubMed1986

Prevalence of hepatitis B virus infection in Tonga: identifying high risk groups for immunization with hepatitis B vaccine.

A serological survey for evidence of hepatitis B virus (HBV) infection was conducted in the Kingdom of Tonga as the first step in developing a strategy for an immunization programme. There were 414 individuals from the general population plus 137 pregnant women included in the survey. HBsAg was found in 20% of the general population and 88% had one or more serologic markers of HBV infection. In the 5-9 year age group, 80% of the children had one or more markers of HBV, and in the 10-19 year age group, the prevalence was 96.4%, indicating that most transmission of HBV in the Tongans studied occurs in the young. Of the pregnant women studied, 15% were positive for HBsAg, and 57% of those positive for HBsAg were also positive for HBeAg. Evidence of delta virus infection was not found in any of 82 HBsAg positive sera tested. Surveillance data suggested that significant serious sequelae to HBV infection (cirrhosis and primary hepatocellular carcinoma) also occur in Tonga. Immunization of infants and children is the most effective strategy for reducing or eliminating HBV infection and its sequelae in developing countries like Tonga.

Adolescent↗
PubMed2000

Health and telecast: a milestone for Tonga into the 21st century.

An efficient Telehealth system for Tonga is currently but a dream. The kingdom of Tonga consists of 36 inhabited islands occupying 669 kms2 and a population of 97,784 (1996). There is a referral hospital in the Capital and three other district hospitals, 14 peripheral health centres, 32 maternal child health clinics and eight general practitioners. Within the kingdom the use of the telephone, telegram and some use of fax are the main ways of contact between the hospitals and the more remote health centres. Patients needing specialty care not available locally are referred, and possibly transferred, to New Zealand from the referral hospital in the Capital. There are seldom any communications with other health professionals or institutions through telecast. This article details the present situation and discusses the perceived advantages and difficulties in establishing a functional Telehealth service in Tonga.

Humans↗
PubMed1984

Idioms of distress: kinship and sickness among the people of the Kingdom of Tonga.

"Idioms of distress" refers to the popular expression of emotional tension that arises in the relationship between 'sickness' and 'kinship'. By reference to case studies and discussions among the Polynesian people of Tonga, the author shows where such tension arises and how it influences the sickness process. Sickness is necessarily a collective phenomenon which can best be understood not simply as a clinical event, but as an experience that is part of the experience of 'family'. Various ways of expressing distress as a reflexive encounter between personal and cultural meaning systems are reviewed, as are several new concepts such as "doing sickness as kinship", and "turning" in the process of decision making in the kinship management of sickness. The explanatory models of sickness in Tonga are shown to encompass culturally sanctioned expressions of distress as part of of the adaptive coping mechanisms in that society. Distress frequently emerges in somatic form, as a number of studies have shown. However, the author emphasizes the "kinship meaning of sickness", "kinship management and sickness therapy", "the adaptive process of idiomatic expressions of distress", which are expanded here and offered as potential avenues for elaboration in other cultural milieu. Two aspects of the notion "idioms of distress" are noted, and the phenomenon is understood as a process which acts as a "prime mover" in social change.

Attitude to Health↗
PubMed1989

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↗
PubMed1999

Swimming from island to island: healing practice in Tonga.

The health care system of the Pacific island nation of Tonga serves as an example of enduring medical pluralism which incorporates traditional and Western medical practice and accommodates contemporary political and social change. Biomedicine is represented by the hospital and the community health centers; traditional medicine is practiced in homes by healers. Both types of therapies are popularly utilized for different ailments or for the same problem at different points in the illness. Contemporary healing is described and is also analyzed as an expression of social change occurring in Tonga as a result of a political movement toward democracy.

Cultural Characteristics↗
PubMed2002

The prevalence of diabetes in the kingdom of Tonga.

OBJECTIVE: To determine the prevalence of diabetes, impaired glucose metabolism, and related risk factors in Tonga. RESEARCH DESIGN AND METHODS: A randomly selected representative national sample of 1,024 people aged >15 years was surveyed. Each participant had fasting blood glucose and HbA(1c) measured. Subjects with a fasting blood glucose >5.0 mmol/l (90 mg/dl) and <11.1 mmol/l (200 mg/dl) or a fasting blood glucose < or =5.0 mmol/l and an HbA(1c) >6.0% and every fifth subject with a fasting blood glucose < or =5.0 mmol/l and a normal HbA(1c) had a 75-g oral glucose tolerance test (OGTT). A total of 472 individuals had an OGTT based on these criteria. Subjects with a fasting blood glucose > or =11.1 mmol/l and an elevated HbA(1c) were diagnosed as having diabetes. RESULTS: The mean age was 41.3 years, and the mean BMI was 32.3 kg/m(2). The age-standardized prevalence of diabetes was 15.1% (CI 12.5-17.6), 12.2% (8.7-15.8) in men and 17.6% (14.0-21.1) in women (NS), of which only 2.1% was previously diagnosed. A total of 75% of people with newly diagnosed diabetes had a fasting plasma glucose > or =7.0 mmol/l (126 mg/dl). The prevalence of impaired glucose tolerance was 9.4% (7.3-11.5) and of impaired fasting glycemia 1.6% (0.7-2.6). Undiagnosed diabetes was significantly associated with increasing age, obesity, hypertension, and a family history of diabetes. CONCLUSIONS: The current prevalence of diabetes in Tonga is 15.1%, of which 80% is undiagnosed. A similar survey in 1973 reported a 7.5% diabetes prevalence, indicating a doubling of diabetes over the past 25 years. In addition, lesser degrees of glucose intolerance are common, and much of the community is overweight

Adolescent↗
PubMed1999

Melting dynamics beneath the tonga-kermadec island arc inferred from (231)Pa-(235)U systematics

Measurement of (231)Pa-(235)U disequilibrium in Tonga-Kermadec island arc lavas (north of New Zealand) permits discrimination of the time scales and mechanisms of fluid addition and partial melting. For Tonga lavas, the ((231)Pa/(235)U) ratios are less than 1 and can be explained by fluid addition from the subducting plate around 60,000 years ago. In contrast, the effects of partial melting overprinted those of fluid addition in the Kermadec lavas resulting in ((231)Pa/(235)U) ratios greater than 1.

Journal Article↗
PubMed2000

Subadult health and disease in prehistoric Tonga, Polynesia.

This article focuses on the differential diagnosis of pathologic lesions recorded on the limbs and crania of 17 subadults from two pre-European burial mounds in Tonga, western Polynesia. All affected subadults were between the ages of 6 months and 3 years at death. The lesions described consist primarily of subperiosteal new bone deposition on the limbs and endocranial surface. However, the presence of cribra orbitalia in a number of individuals indicates concurrent iron-deficiency anaemia. A differential diagnosis of haematogenous osteomyelitis, congenital syphilis, yaws, scurvy, hypervitaminosis A, trauma, Caffey's disease, and iron-deficiency anaemia is discussed. It was concluded that the most likely cause for the lesions observed is a synergistic relation between infection (weanling diarrhoea, yaws) and metabolic disease (scurvy and possibly hypervitaminosis A). Trauma is not ruled out as contributing to the development of some pathologic lesions. It is concluded that, in the Pacific Islands at least, multiple causes for skeletal pathology in subadults should be considered rather than a single aetiology.

Adolescent↗
PubMed1987

Community priorities following disaster: a case study from Tonga.

Disaster victims have been thought to be disoriented and irrational to express their needs. Therefore they have been largely assessed through external observers. However, this study in the South Pacific Kingdom of Tonga suggests that disaster victims were capable of prioritising their needs to guide the provision of immediate help and later rehabilitation programmes. Some inconsistencies in the experiences of this study sample compared to large developing population centres (e.g. low disease prevalence after the cyclone) highlight the need for special consideration of small island states separate from those of the developing continents. Overall, this study explored a method of giving the community an opportunity to participate in their rehabilitations after a disaster. The validity of this approach needs to be tested for other communities.

Child, Preschool↗
PubMed1984

Folk medicine in Tonga. A study of the use of herbal medicines for obstetric and gynaecological conditions and disorders.

We report on a study of the role of traditional medicinal practices in two communities in the South Pacific Kingdom of Tonga, with particular emphasis on obstetric and gynaecological complaints of women and the traditional practitioners consulted by them. Data on the nature and frequency of obstetric and gynaecological complaints, patterns of consultations and preferences for the type of practitioner, Western or traditional, were collected from housewives. The nature, range and extent of expertise possessed by traditional practitioners were also assessed. The results indicate that reliance on traditional medicine is rapidly declining in favour of Western medicine. This seems to be due to urbanisation, increased acceptance of Western values and a lack of availability of traditional practitioners in sufficient numbers. However, self-administration of herbal remedies was still common, especially in rural areas, and might even be on the increase. The practitioners treated a variety of obstetric and gynaecological complaints using 60 plant species which were collected and identified.

Back Pain↗
PubMed1991

Herbal medicine in the Kingdom of Tonga.

A study of the indigenous medical practices of the Kingdom of Tonga in the South Pacific was carried out from 1983 to 1989 by interviewing over 50 traditional healers. A list of 105 plant species used medicinally in the culture was prepared, which includes scientific and tongan names, voucher specimen numbers, ailments treated and the reported frequency of usage for each plant and remedy. The uses recorded are compared to those published by previous authors in Polynesia.

Phytotherapy↗
PubMed2003

Common-pool resources and population genomics in Iceland, Estonia, and Tonga.

This paper addresses the application of the ethical concept of trust and the legal and political concept of public trust to population genomics projects in Iceland, Estonia, and Tonga. Focusing on trust and public trust, the paper explores analogies between the genomics projects and the treatment of other common-pool resources, making use of the notion of trust as an ethical demand, derived from the works of Emmanuel Levinas and Knud Eljer Løgstrup. The paper discusses the degree to which the ethical demands for trust and public trust have been established and maintained in the three national population genomics projects.

Confidentiality↗
PubMed1994

Epidemiology of blindness and visual impairment in the kingdom of Tonga.

Data on the prevalence and causes of blindness and visual impairment in Polynesians are not readily available nor are they population based. This survey was designed to obtain an accurate estimate of blindness and its causes in Tonga. A sample of 4056 persons, aged 20 years and over, was selected by stratified cluster sampling. Participants received a screening, visual acuity examination, and, if visually impaired, were referred for detailed ophthalmic examination to determine the cause. The prevalence of bilateral blindness in the study population was 0.47% and all affected were aged over 50 years. It is estimated that the national prevalence of bilateral blindness, adjusted for the sample weight applied in the selection procedure, is 0.56% (95% confidence interval 0-1.13). Monocular blindness was three times more frequent. Cataract was responsible for 68.4% of bilateral and 30.3% of monocular blindness. Risk factors for life time experience of cataract included age and diabetes (self-reported). Neither smoking nor the presence of pterygium were independently associated with cataract. Increasing years of education were protective against cataract for women, but not men. Corneal opacity from infection or trauma, and diabetes were responsible for most of the remaining visual impairment. While these results do not represent a significant public health problem by world standards they do provide a basis for planning blindness prevention programmes in the region.

Adult↗