Pacific Island Countries Research Articles

Epidemiology of Cancer in the Fiji Islands: 2010 to 2018.

Cancer is a global public health concern with increasing incidence and mortality rates, particularly in low- and middle-income countries (LMICs) like the Pacific Island Countries and Territories (PICTs). Among the PICTs, Fiji faces a growing burden of cancer. This study aimed to analyze cancer incidence and mortality data in Fiji from 2010 to 2018 to identify trends and provide an update on the current cancer-related statistics in the Fiji Islands. The top three cancer incidence rates among women were breast, cervical, and endometrial cancer, whereas prostate, liver, and lung cancer were the most prevalent among men. Notably, the central division had higher cancer incidence rates, whereas the northern division had a disproportionately higher mortality rate. Factors contributing to these trends may include lifestyle behaviors, limited access to health care in certain regions, and low awareness. Although this study has limitations due to data quality, it emphasizes the need for targeted interventions, accurate data reporting, and improved cancer treatment delivery to reduce the burden of cancer in Fiji.

Food loss in Pacific Island Countries: a scoping review of the literature

Food loss and waste pose significant challenges to global food security, economic development, and environmental sustainability. Pacific Island Countries (PICs), with limited resources, being geographically isolated, and vulnerable to climate change, face unique challenges when it comes to the issue of food loss. This scoping review aims to systematically map the literature on food loss in PICs, addressing knowledge gaps and understanding specific methodological aspects. The review utilizes the PRISMA-ScR process to identify, categorize, and synthesize relevant literature, offering a comprehensive overview of the existing evidence. Studies focusing on food loss in PICs published in English from 2011 to 2023 were included. Exclusion criteria considered studies conducted outside PICs, those lacking food loss reduction interventions, and non-peer-reviewed sources. A comprehensive literature search was conducted using the databases of JSTOR, Scopus, Science Direct and Web of Science. A total of 5,787 studies for food loss interventions were identified and out of these only 49 met the inclusion criteria. A notable increase in publications from 2011, with a significant surge in 2018 and 2019, indicate a growing interest on the topic. The review reveals a limited focus on this issue across individual PICs and underscores the need for more localized expertise in the region. The review also highlights critical inefficiencies in PIC food supply chains and the need for more studies outside the common root crop agricultural system. The scoping review identified three thematic categories addressing food loss in PICs, namely., the lack of infrastructure and need for innovative technology for post-harvest management; increased vulnerability to climate change and postharvest risks of newer convenient markets. The findings underscore the need for holistic and context-specific approaches to create resilient and sustainable food systems in the Pacific, providing valuable insights for researchers, policymakers, and practitioners involved in addressing these challenges.

From local knowledge and science to policy: Lessons learned from Fiji's valuable grouper fisheries.

Pacific Island communities are heavily dependent on fisheries for subsistence and livelihoods. Yet, despite their importance, coastal fisheries are poorly managed and commercial pressures increasingly threaten them. Groupers (Epinephelidae) are exceptionally vulnerable to overexploitation due to aspects of their biology while their economic value makes them a prime target for commerce. Fiji has a significant grouper fishery and is a useful case study to assess a data-poor, economically valuable sector to evaluate management measures, options, and needs. Data from multiple sources over three decades were integrated with original research involving fisher interviews, market surveys, stock assessments, and underwater census to assess the status of the country's grouper fishery. Catch rates are declining and trade now includes a high percentage of immature groupers, with aggregating species (mainly Epinephelus polyphekadion, Epinephelus fuscoguttatus, Plectropomus areolatus, Plectropomus leopardus) particularly at risk. Estimated annual grouper landings are increasing and now exceed 1000 mt. There is an urgent need to update Fiji's grouper size limits which are grossly inadequate. To build public support and increase awareness, government and nongovernmental organizations should invest in the national 4FJ Fish Smart campaign. Key management recommendations for groupers are (1) improved spatial and temporal protection of spawning aggregations and (2) increased minimum-size restrictions for capture and sale. Findings apply broadly to valuable and vulnerable coastal fin-fisheries in reef ecosystems across many Pacific Island countries and highlight the importance of using multiple data sources and approaches to understand and manage important data-poor fisheries.

First among equals: The implementation of integrated disaster risk management and climate change policies in Pacific Island Countries

First among equals: The implementation of integrated disaster risk management and climate change policies in Pacific Island Countries

Challenges and consensus: A survey of the management of neonatal hypoglycaemia within the Pacific Islands.

To describe the management of neonatal hypoglycaemia within Pacific Island countries and territories by surveying practising clinicians. Survey questions were adapted from a similar survey conducted across Australian and New Zealand neonatal nurseries. An anonymous, electronic survey link and QR code were disseminated to clinicians via our partner organisations, Facebook and direct email. Data collected were primarily descriptive. Fifty-one surveys were received from 13 Pacific Island countries. Two-thirds (69%) of respondents reported having a neonatal hypoglycaemia protocol in their nursery. The four protocols received defined hypoglycaemia as a blood glucose concentration <2.6 mmol/L. However, treatment thresholds reported varied from <1.0 mmol/L to <3.0 mmol/L. Feeding was the most common treatment. One-third of the respondents reported resource barriers to effective management, such as a lack of specialist training and limited resources. There are variations in the screening, diagnosis and treatment of neonatal hypoglycaemia in the Pacific Island countries, despite consistency in the management of neonatal hypoglycaemia within the clinical protocols. Barriers to the safe and effective management of neonatal hypoglycaemia remain concerning.

Informal pricing in formal fish markets: evidence from the Solomon Islands

How are fish prices determined in the largest formal market in the Solomon Islands? The Honiara Central Market is the country’s primary fresh produce market, serving as an important conduit between rural food producers and urban consumers. One distinctive characteristic of this market is that despite a diverse range of reef fish species being available, all reef fish are traded nominally as homogeneous goods with no price differentiation. Using transaction-level data collected from the market, we show the prevalence of informal pricing, wherein the unit price of fish is implicitly differentiated based on fish species groups, quality, and buyers’ attributes. This result aligns with our expectation that diverse species groups and qualities are traded in a competitive environment with many vendors and buyers, where reef fish are indeed traded as heterogeneous products. Although fish provide a vital source of food and income for Pacific Island countries, the pricing of this vital natural resource is poorly understood. Our study provides new insights into how fish prices are determined in a formal market within the context of small island developing states.

Perspectives on the implementation of post-validation surveillance for lymphatic filariasis in the Pacific Islands: A nominal group technique-based study protocol

Introduction Lymphatic filariasis (LF) is a neglected tropical disease caused by parasitic worms, transmitted via mosquito bites. Significant global efforts have led to the interruption of LF transmission, with eight of the 16 previously endemic Pacific Island countries and territories (PICTs) validated by WHO as having eliminated the disease as a public health problem. Post-validation surveillance (PVS) is recommended to verify the absence of a resurgence in transmission; however, there are no guidelines on how to implement such surveillance effectively. Aim This protocol outlines a research study that aims to explore, synthesise, and prioritise the perspectives of LF program staff from LF-eliminated PICTs. The study will focus on identifying the challenges faced in implementing PVS in the PICT settings and determining corresponding context-relevant operational research priorities. Method The study will employ a nominal group technique (NGT) involving representatives from LF-eliminated PICTs. The NGT will adhere to a structured process for generating, ranking, and prioritising ideas, followed by group discussions, debates, and the collation of shared views. Discussion The research will provide insights into the most significant challenges faced in implementing PVS in the PICTs. It will also identify priority areas where operational research is required to inform policy and practice. To our knowledge, this study is the first to apply a rigorous consensus group method to distil challenges and research priorities for LF PVS in PICTs. We expect that this research will inform the development of national and regional LF guidelines.

A Quantitative Analysis of Human and Material Resources for Endoscopy Services in Pacific Island Countries.

This study aims to evaluate the current state of endoscopy services in Pacific Island Countries (PICs) by quantifying human and material resources, including the number of trained endoscopists and nurses, the types of procedures performed, and the availability and maintenance of endoscopic equipment. A mixed methods survey was conducted in 2023, targeting doctors and nurses who participated in the WGO-FNU-ANZGITA endoscopy training program as well as non-participants. Survey invitations were sent through email, WhatsApp, and Facebook Messenger. Data were collected from 16 sites across 12 PICs, achieving an 85% response rate. Survey results indicated a total of 58 endoscopists (2.1/100000 population) and 52 nurses (1.9/100000 population), with a majority having received training through international partnerships. Basic endoscopy services, such as gastroscopy and colonoscopy, were widely available, but advanced procedures were limited to a few sites. Most sites reported using donated equipment, with significant challenges in equipment maintenance and repair. The availability of functional endoscopes averaged four per site. Common issues included outdated equipment, lack of qualified personnel, and insufficient funding for new equipment. Despite efforts to enhance endoscopy services in PICs through international collaborations, significant gaps remain, particularly in terms of advanced procedural capacity and equipment maintenance. Recommendations include expanding training programs, improving equipment maintenance infrastructure, securing funding for new equipment, and fostering stronger partnerships to support the sustainability of endoscopy services. Addressing these areas can enhance the quality and availability of endoscopy services, ultimately improving healthcare outcomes for populations in PICs.

Type 2 Diabetes Prevalence, Control and Management within Fiji,Kiribati, Samoa, the Solomon Islands, Tonga, and Vanuatu: A ScopingReview with a Systematic Approach.

Type 2 diabetes (T2D) causes significant morbidity and is disproportionately prevalent in Pacific Island Countries (PICs). The socio-political demographics of PICs are rapidly changing, and health services must adapt to match the needs of their population. The objective of this study was to review the literature published within the last 15 years relating to T2D prevalence, control, and management, with a specific focus on targetable areas for future funding and research projects. This review was conducted using the PRISMA guidelines. Inclusion criteria were: discussion on T2D in the six PICs. Results were limited to those published between 1st January, 2006, and 27th July, 2023. A total of 6,640 publications were retrieved, and 110 met the inclusion criteria. Nineteen additional studies were identified through hand-searching. T2D prevalence differed between countries but was predicted to increase in the coming decades, with projections of up to 31.2% by 2030 in Tonga. Factors associated with T2D varied between countries, including Indian-Fijian ethnicity in Fiji and tuberculosis in Kiribati. Control was generally poor, with high rates of undiagnosed diabetes and microvascular complications. Epidemiological data was limited in some cases, as was information describing the structure and function of diabetes services. The prevalence, control, and management of T2D varied between Fiji, Kiribati, Samoa, the Solomon Islands, Tonga, and Vanuatu. Significant gaps remain in the data describing these domains; however, there are clearly targetable areas for future research and diabetes management programs.

Making it real: Actioning the mental health strategy with Pacific Island communities.

This paper explores the practical implications of the World Health Organization strategy of focussing on community-based mental health and wellbeing ecosystems in the context of the Pacific Island Countries. It draws on the expertise of the participants of a collaborative workshop held during the Creating Futures conference in 2023 to discuss successes, challenges, barriers, opportunities in the implementation of the framework and to examine potential future actions. Some of the significant factors that make for effective and sustained community-based mental health systems include appropriate central coordination and oversight of community-based services, adequate frameworks for quality assurance, meaningful data collection and sustained long-term funding, as well as a range of workforce factors. Flexible and place-based approaches also need to be considered in effective implementation, moving away from Western diagnostic 'labels' to communication that is effective at the local level. Positive community resources as well as the relative youth of the mental health sector in the Pacific Island Nations are huge opportunities to develop affective and appropriate community mental health systems.

Climate change undermines seafood micronutrient supply from wild-capture fisheries in Southeast Asia and Pacific Island countries

Marine ecosystem functions are affected by climate change impacts such as ocean warming, deoxygenation and acidification. These impacts drive changes in distributions and body size of fish species and directly affect fisheries. Wild-capture fisheries are crucial for providing nutrients, livelihoods, and employment in tropical Southeast Asia and Pacific Island countries, where coastal communities are highly vulnerable to climate change. We examined the impacts of climate change on fish stocks and nutrient availability of seven key micronutrients (calcium, Omega-3 fatty acids, iodine, iron, vitamin A, vitamin B12 and zinc) in Southeast Asia, Pacific Islands, and Oceania (Australia and New Zealand). We combined micronutrient demands by local human populations with Sea Around Us reconstructed catch time series and catch projections from a dynamic bioclimate envelope model for the 21st century. The model predicted a decline in the Maximum Catch Potential (MCP) within Exclusive Economic Zones for Oceania, Pacific Islands, and Southeast Asian countries. Under the ‘strong mitigation’ scenario, catch potential reductions ranged from a decline of 54–66 % in Oceania, 58–92 % in Pacific Islands, and 65–86 % in Southeast Asia by the mid to the end of the 21st century relative to the historical period, respectively. Under the ‘no-mitigation’ climate scenario, reductions were more severe, with a decline of 55–70 % in Oceania, 66–92 % in Pacific Islands, and 70–86 % in Southeast Asia for the same time periods. Our findings indicate that Australia and New Zealand are unlikely to meet the recommended nutrient intake demand for most micronutrients through their fisheries (not considering trade or aquaculture production), except for iodine and vitamin B12. Pacific Island countries will likely follow the same pattern while Southeast Asia is expected to face worsening deficits, except for iodine and vitamin B12. This study highlights the importance of incorporating nutritional considerations of seafood into national food, trade and economic policies.

How physical activity opportunities seized by adolescents differ between Europe and the Pacific Islands: the example of France and New Caledonia.

France (FR) and New Caledonia (NC) are both French territories, one in Western Europe, the other as part of the Pacific Island Countries and Territories (PICTs). Despite schooling in similar educational systems, FR and NC adolescents develop distinct relationships with physical activity, which is influenced by the geographical-cultural and symbolic structures of their respective societies. This study explored the distribution of physical activity according to geographical culture and opportunity-temporal dimensions. Participants were randomly selected, with individual (boys vs. girls), spatial (rural vs. urban), and geographical (FR vs. NC) stratifications. Accelerometers GT3X (ActiGraph TM, Pensacola FL, USA) and daily logbooks were used to measure the physical activity intensity and opportunities during the week. A total of 156 participants were included in this study. A significant effect was found in moderate to vigorous physical activity (MVPA) intensity with the geographical-cultural dimension; participants living in FR were more likely to engage in MVPA, especially in five opportunities: school, supervised leisure, home, school breaks, and transport. For both FR and NC adolescents, physical education lessons had the highest MVPA. This study showed that MVPA differed in the same national educational system according to geographical culture. Physical education lessons could catch the challenge of an "opportunity education" (opportunities are defined as temporal invitations to engage in PA) by opening the door to two particular opportunities: supervised leisure and active transport.

Applications of dry chain technology to maintain high seed viability in tropical climates.

Seed storage life in tropical areas is shortened by high humidity and temperature and the general inaccessibility to dehumidifying and refrigeration systems, resulting in rapid decreases in seed viability in storage as well as a high incidence of fungal and insect infestations. The dry chain, based on rapid and deep drying of seeds after harvest followed by packaging in moisture-proof containers, has been proposed as an effective method to maintain seed quality during medium-term storage in humid climates, even without refrigeration. In addition, seed drying with zeolite drying beads can be more effective and economical than sun or heated-air drying under these warm, humid conditions. In this paper, we review recent published literature regarding the dry chain, considering different crop species, storage environments and seed traits. In addition, we provide new original data on the application of dry chain methods and their implementation at larger scales in South Asia, Latin America and Pacific Island Countries. The clear conclusion is that the combination of reusable drying beads and waterproof storage containers enables the implementation of the dry chain in tropical climates, enhancing seed viability and quality in storage of many crop species. The dry chain approach can therefore significantly enhance seed security for farmers in many tropical countries. Finally, we propose actions and strategies that could guide further scaling-up implementation of this technology.

Advancing local government in Pacific Island Countries: a practitioner reflects

Advancing local government in Pacific Island Countries: a practitioner reflects

Australian journalism and challenges of climate change reporting: Lessons for journalists and academics

A steadily increasing body of scholarship on Australian media coverage of climate change in Pacific Island countries has emerged over the past two decades. Often critical of journalists and media organizations, this body of research still offers much to learn about Australian journalism and coverage of climate change and its impact on Pacific Island countries. Also significant, are lessons that can be learned about the state of research on this subject. The article draws out common themes in the discussion and raises questions about the ways in which journalists and media organizations are framed in scholarship relating to climate change. Through a review of published literature and media content analysis, lessons for journalists, media organizations and academics are outlined. The article contends that there is need for more research on Australian media reporting on climate change in Pacific Island countries. The authors note that there is room for positivity about the future of Australian reporting on climate change in the region.

Baseline evaluation of the World Health Organization (WHO) infection prevention and control (IPC) core components in Pacific Island Countries and Territories (PICTs)

BackgroundComprehensive infection prevention and control (IPC) programmes are proven to reduce the spread of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR). However, published assessments of IPC programmes against the World Health Organization (WHO) IPC Core Components in Pacific Island Countries and Territories (PICTs) at the national and acute healthcare facility level are currently unavailable.MethodsFrom January 2022 to April 2023, a multi-country, cross-sectional study was conducted in PICTs. The self reporting survey was based on the WHO Infection Prevention Assessment Framework (IPCAF) that supports implementing the minimum requirements of the WHO eight core components of IPC programmes at both the national and facility level. The results were presented as a ‘traffic light’ (present, in progress, not present) matrix. Each PICT’s overall status in achieving IPC core components was summarised using descriptive statistics.ResultsFifteen PICTs participated in this study. Ten (67%) PICTs had national IPC programmes, supported mainly by IPC focal points (87%, n = 13), updated national IPC guidelines (80%, n = 12), IPC monitoring and feedback mechanisms (80%, n = 12), and waste management plans (87%, n = 13). Significant gaps were identified in education and training (20%, n = 3). Despite being a defined component in 67% (n = 10) of national IPC programmes, HAI surveillance and monitoring was the lowest scoring core component (13%, n = 2). National and facility level IPC guidelines had been adapted and implemented in 67% (n = 10) PICTs; however, only 40% (n = 6) of PICTs had a dedicated IPC budget, 40% (n = 6) had multimodal strategies for IPC, and 33% (n = 5) had daily environmental cleaning records.ConclusionsIdentifying IPC strengths, gaps, and challenges across PICTs will inform future IPC programme priorities and contribute to regional efforts in strengthening IPC capacity. This will promote global public health through the prevention of HAIs and AMR.

Genomic identification of Oryctes rhinoceros nudivirus isolates, a biocontrol agent for coconut rhinoceros beetle

The coconut rhinoceros beetle (Oryctes rhinoceros, CRB) is a serious pest of coconut and oil palms. It is native to South and Southeast Asia and was inadvertently introduced to Samoa in 1909. It has invaded many other Pacific countries throughout the last century. Oryctes rhinoceros nudivirus (OrNV), a natural pathogen of CRB in its native range, was successfully introduced as a classical biocontrol agent and has effectively suppressed invasive CRB populations for decades. However, resurgence of CRB has been recorded, with new invasions detected in several Pacific Island Countries and Territories. Additionally, new populations of CRB are emerging in some invaded areas that have a degree of resistance to the virus isolates commonly released for CRB biocontrol. Here, we designed a fast and reliable tool for distinguishing between different OrNV isolates that can help with the selection process to identify effective isolates for management of new CRB invasions. A comparison of 13 gene/gene region sequences within the OrNV genome of 16 OrNV isolates from native and invaded ranges allowed us to identify unique Single Nucleotide Polymorphisms (SNPs). With these SNPs, we developed an assay using multiplex PCR-amplicon-based nanopore sequencing to distinguish between OrNV isolates. We found that as few as four gene fragments were sufficient to identify 15 out of 20 OrNV isolates. This method can be used as a tool to monitor the establishment and distribution of OrNV isolates selected for release as biocontrol agents in CRB-infected areas.

A call for multi-agency collaboration in the Pacific Island countries' mental health - The World Federation for Mental Health viewpoint.

To introduce the World Federation for Mental Health (WFMH) viewpoint on the Pacific Island countries' mental health capacity building. Multi-agency collaboration guided by a nuanced understanding of the local context can enable a public health model of mental health service delivery in the Pacific Island countries.

“We cannot escape this”: discussing leverage points for sustainability across scales with the example of Ouvéa, Kanaky New Caledonia

Despite contributing minimally to global greenhouse gas emissions, Pacific Island Countries and Territories often shoulder an unequal burden of climate risks. To analyse pathways to sustainability, we conducted a leverage points analysis on the complex sustainability challenges facing the low-lying atoll Ouvéa in Kanaky New Caledonia (France). Leverage points are places within complex systems where interventions can lead to transformative change. Combining a literature review and qualitative interviews with regional, government, provincial, and local stakeholders, we contextualised eight leverage points: (1) expanding and improving coastal protection, (2) strengthening or creating monetary incentives, funding possibilities or forms of compensation to alleviate costs of climate change adaptation and sustainability measures, (3) conducting more research and monitoring, (4) strengthening environmental regulation and restrictions, (5) empowerment of women, youth, and local communities and increasing awareness of power imbalances to strengthen gender equity and social inclusion, (6) establishing new conservation management measures and improving existing ones, (7) increasing institutionalisation of environmental and climate change education, and (8) involving diverse knowledge systems and practices in research and management to strengthen participatory, transdisciplinary, and community-based initiatives. Our results emphasise the importance of acknowledging responsibilities across multiple scales, showing the non-transferability of some interventions due to perceived high costs and incompatibility with local culture. Illustrating dimensions of ocean equity in the context of Ouvéa, we discuss the importance of local values and knowledge systems to ensure fair distribution of costs and benefits in sustainability interventions.

A systematic survey of environmental DNA in Palau's lakes and waterfalls reveals an increase in Leptospira levels after flooding

ObjectiveLeptospirosis is an important bacterial zoonosis which is widespread in tropical and subtropical islands and influences human and animal health which has secondary economic effects. Although leptospirosis is endemic in Palau, an Oceanian Pacific Island country, few systematic surveys of potential risk factors for Leptospira infection, such as weather and host animals, have been conducted in the natural environment. We used environmental DNA metabarcoding to assess the distribution, species diversity, and abundance of pathogenic Leptospira in this endemic region to investigate the potential environmental risks. MethodsForty-two paired water samples, representing fine and rainy weather conditions, were collected from four representative waterfalls and lakes on Babeldaob Island, the largest island in Palau. High-throughput sequencing analysis was conducted for polymerase chain reaction products of leptospiral 16S rRNA and vertebrate animal mitochondrial 12S rRNA genes. ResultsWe revealed greater Leptospira diversity and abundance in samples collected after continuous rain, particularly in the presence of flooding, compared with samples collected under typhoon, monsoon, or fine weather conditions. From same samples, six mammalian species including cats (Felis catus), mice (Mus musculus), Yap flying fox (Pteropus yapensis), rats (Rattus spp.), and pigs (Sus scrofa) were repeatedly detected. These may be candidates of host animals of Leptospira in Palau; however, their detection was not clearly correlated with that of Leptospira. ConclusionWe repeatedly detected several species of pathogenic Leptospira from water samples of a wide region of Babeldaob Island. We confirmed that Leptospira contamination in freshwater environments increased under rainy conditions, particularly in the presence of flooding. This information could be used to improve public health control measures in this region.