RESUMEN
Introduction@#Non-communicable diseases (NCDs) are the major causes of premature death and disability in Fiji, accounting for 80% of mortality in the Fijian population [1]. This is the first community-based research in Fiji on knowledge, attitude, practice and barriers (KAPB) regarding lifestyle risk factors that contribute to NCDs and the impact of health promotion activities on their KAPB. This paper reports on baseline demographics and KAPB findings. Paper 2 will report on the impact of health promotion activities on KAPB.@*Methods@#This is a prospective questionnaire based survey in 30 randomly selected communities located in Ba Province, Fiji, conducted between May 2016 and April 2018.@*Results@#There were 952 participants with mean age was 43.2years (SD=15.4) range 18 to 83; 63.4% were iTaukei, 35.8% were Fijians of Indian Descent (FID) and 0.7% ‘Others’ and 70% were females. There was high awareness that smoking (94.3%), alcohol abuse (82.8%), kava abuse (72.6%), high salt intake (94.3%) and physical inactivity (97.9%) were not good for health. However, in-depth knowledge of effects of these risk factors was low, with only around 20% having a good knowledge. For attitude, 52.6% disagreed and 41.4% were neutral to smoking, 89.9% disagreed with alcohol abuse, 79% disagreed with Kava abuse, 84% agreed with low salt intake, and 84.6% agreed with being physically active. As for practice, 20.7%of participants were current smokers, 20.6% drank alcohol, 37.9% drank kava, 30.5% added extra salt to food, and 30.1% were physically inactive. Having good knowledge did not significantly decrease practice of smoking, alcohol or kava use. Addiction was the major reported barrier to cessation of smoking (60.2%), alcohol abuse (46%) and kava abuse (34.2%) whereas, ‘unwilling to change’ for good nutrition (51.6%) and ‘laziness’ for physical activity (43%).@*Conclusion@#The awareness of the various NCD lifestyle risk factors is high with poor in-depth knowledge of their impact on NCDs. Unfortunately having good knowledge and appropriate attitude did not translate to decreases in risky lifestyle practices.
RESUMEN
Introduction@#IUGR is an obstetrical complication that is difficult to identify in order to allow intervention to lessen morbidity and mortality. The Lancet series on stillbirths highlighted the causes of stillbirths globally, identifying IUGR as one of the five major causes. IUGR has accounted for almost a third of all still births at Lautoka Hospital over the past three years. The aim of this study was to audit all pregnancies complicated by IUGR, the contributing risk factors and their outcomes at Lautoka Hospital from 1st January to 31st December 2016. @*Aim@#To conduct a retrospective audit of pregnancies complicated by IUGR at Lautoka Hospital from 1st January 2016 to 31st December 2016.@*Method@#This is a retrospective descriptive audit using clinical notes, conducted on 170 women diagnosed with IUGR in 2016. @*Results@#There were 4,131 deliveries during the study period; 191 patients of whom were diagnosed with IUGR of which 170 folders were retrieved. The Incidence rate of those diagnosed with IUGR during this period was 4.3%. Seventy percent of women with IUGR had low to normal Body Mass Index (BMI) and booked in the late second to third trimester. The risk of developing IUGR was significantly increased in Fijians of Indian Descent (FID) (RR 4, CI 2.9-5.3, p-value <0.0001); in primigravida (RR 4.1, CI 3.5 – 4.7, p-value <0.0001); and those with previously Low Birth Weight baby (LBW) (< 2500g) (RR 2.3, CI 1.67 – 3.26, p-value <0.0001). Anaemia or hypertension diagnosed during pregnancy significantly increased the risk of developing IUGR (RR 1.7, CI 1.3-2.40, p-value 0.0002) and (RR 2.6, CI 1.75 – 4.05, p-value <0.0001) respectively. Women with IUGR have a 6 times higher chance of having a Still Birth (SB) (RR 6.1, CI 3.78-9.92, p-value <0.0001); higher risk of Induction of Labour (RR 4.2, CI 3.65-5.64, p-value <0.0001) and caesarean section delivery (RR 2.1, CI 1.54-2.85, p-value <0.0001). Seventy eight percent of still births were delivered beyond 37 weeks, a possible delay, which could have been avoided potentially improving the SB rate. SB risk was significantly higher in those diagnosed at or > 37 weeks gestation compared to those with an earlier diagnosis (RR 1.61 95% CI 1.11 – 2.35, p value 0.05). @*Conclusion@#IUGR contributes significantly to still births. There were delays in diagnosis and appropriate surveillance to allow timely delivery at Lautoka Hospital, which could have reduced the still birth rate.