Health and well-being in small island communities: a cross-sectional study in the Solomon Islands.

OBJECTIVES: This study explored the health problems of inhabitants of small South Pacific Islands under the influence of climate change, focusing on three communities in the Solomon Islands. DESIGN: Cross-sectional study of the Solomon Islands' populations. SETTING: A field survey was conducted in Taro Island, a small, urbanised island with a whole-community relocation plan; Manuopo community of Reef Islands, a small remote island on an atoll environment and Sasamungga, an intermediately urbanised community on a larger island. The Sasamungga community was used for comparison. PARTICIPANTS: Each community's participants were recruited through local health authorities, and 113, 155 and 116 adults (aged 18+ years) from Taro, Manuopo and Sasamungga, respectively, participated voluntarily. METHODS: Each participant's body height, weight and body mass index were measured. A drop of blood was sampled for malaria testing; glycated haemoglobin and C reactive protein levels, measured from another drop of blood, were markers for diabetes and inflammation, respectively. The Primary Care Screening Questionnaire for Depression measured depressive mental states. PRIMARY AND SECONDARY OUTCOME MEASURES: Regarding health status, the dependent variables-communicable diseases, non-communicable diseases and mental state-and independent variables-differences in communities and socioeconomic status-were measured through health check-ups and interviews of individual participants. RESULTS: Taro Island inhabitants had a higher risk of obesity (OR 1.13, 95% CI 1.02 to 1.27, p=0.0189), and Manuopo inhabitants had a higher risk of depression (1.25, 95% CI 1.08 to 1.44, p=0.0026) than Sasamungga inhabitants. Manuopo inhabitants recognised more serious problems of food security, livelihood, place to live and other aspects of daily living than other communities' inhabitants. CONCLUSIONS: The three small island communities' observation identified different health problems: the urbanised community and remote community had a high risk of non-communicable diseases and mental disorders, respectively. These health problems should be monitored continuously during future climate-related changes.

Molecular epidemiology of residual Plasmodium vivax transmission in a paediatric cohort in Solomon Islands.

BACKGROUND: Following the scale-up of intervention efforts, malaria burden has decreased dramatically in Solomon Islands (SI). Submicroscopic and asymptomatic Plasmodium vivax infections are now the major challenge for malaria elimination in this country. Since children have higher risk of contracting malaria, this study investigated the dynamics of Plasmodium spp. infections among children including the associated risk factors of residual P. vivax burden. METHODS: An observational cohort study was conducted among 860 children aged 0.5-12 years in Ngella (Central Islands Province, SI). Children were monitored by active and passive surveillances for Plasmodium spp. infections and illness. Parasites were detected by quantitative real-time PCR (qPCR) and genotyped. Comprehensive statistical analyses of P. vivax infection prevalence, molecular force of blood stage infection (molFOB) and infection density were conducted. RESULTS: Plasmodium vivax infections were common (overall prevalence: 11.9%), whereas Plasmodium falciparum infections were rare (0.3%) but persistent. Although children acquire an average of 1.1 genetically distinct P. vivax blood-stage infections per year, there was significant geographic heterogeneity in the risks of P. vivax infections across Ngella (prevalence: 1.2-47.4%, p < 0.01; molFOB: 0.05-4.6/year, p < 0.01). Malaria incidence was low (IR: 0.05 episodes/year-at-risk). Age and measures of high exposure were the key risk factors for P. vivax infections and disease. Malaria incidence and infection density decreased with age, indicating significant acquisition of immunity. G6PD deficient children (10.8%) that did not receive primaquine treatment had a significantly higher prevalence (aOR: 1.77, p = 0.01) and increased risk of acquiring new bloodstage infections (molFOB aIRR: 1.51, p = 0.03), underscoring the importance of anti-relapse treatment. CONCLUSION: Residual malaria transmission in Ngella exhibits strong heterogeneity and is characterized by a high proportion of submicroscopic and asymptomatic P. vivax infections, alongside sporadic P. falciparum infections. Implementing an appropriate primaquine treatment policy to prevent P. vivax relapses and specific targeting of control interventions to high risk areas will be required to accelerate ongoing control and elimination activities.

Communicable and non-communicable diseases in the Solomon Islands villages during recovery from a massive earthquake in April 2007.

AIM: The major causes of mortality and morbidity have changed from infectious diseases and malnutrition conditions to non-communicable diseases (NCDs) in Melanesian societies. However, a massive earthquake and its related changes might have disturbed the patterns. This study aimed to explore which health problems were likely to be prevalent during the recovery process from the 2 April 2007 earthquake in the Solomon Islands. METHODS: Participants were recruited in Titiana, a severely damaged village located near a town; Tapurai, a severely damaged remote village; Mondo, a severely damaged, medium urban village; and Olive, a control village. Health indicators measured were classified into communicable and nutritional conditions (malaria, malnutrition, infection status and child growth) and NCDs (overweight/obesity, hypertension and diabetes). RESULTS: Titiana residents were more at risk of infectious conditions (C-reactive protein greater than and equal to 1 mg/dL) and obesity (BMI greater than and equal to 30 kg/m²). Tapurai and Mondo residents were at risks of infectious conditions and becoming overweight (BMI greater than and equal to 25 kg/m²), respectively. Titiana and Mondo residents complained about insufficient subsistence production. CONCLUSION: The urban communities were found to be at risks of both communicable and NCDs. Controlling the urbanisation as well as providing continuous support against infectious conditions during the recovery process would be beneficial.