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1.
Microb Genom ; 10(5)2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38739120

RESUMO

Cutaneous ulcers are common in yaws-endemic areas. Although often attributed to 'Treponema pallidum subsp. pertenue' and Haemophilus ducreyi, quantitative PCR has highlighted a significant proportion of these ulcers are negative for both pathogens and are considered idiopathic. This is a retrospective analysis utilising existing 16S rRNA sequencing data from two independent yaws studies that took place in Ghana and the Solomon Islands. We characterized bacterial diversity in 38 samples to identify potential causative agents for idiopathic cutaneous ulcers. We identified a diverse bacterial profile, including Arcanobacterium haemolyticum, Campylobacter concisus, Corynebacterium diphtheriae, Staphylococcus spp. and Streptococcus pyogenes, consistent with findings from previous cutaneous ulcer microbiome studies. No single bacterial species was universally present across all samples. The most prevalent bacterium, Campylobacter ureolyticus, appeared in 42% of samples, suggesting a multifactorial aetiology for cutaneous ulcers in yaws-endemic areas. This study emphasizes the need for a nuanced understanding of potential causative agents. The findings prompt further exploration into the intricate microbial interactions contributing to idiopathic yaw-like ulcers, guiding future research toward comprehensive diagnostic and therapeutic strategies.


Assuntos
Microbiota , RNA Ribossômico 16S , Úlcera Cutânea , Humanos , RNA Ribossômico 16S/genética , Úlcera Cutânea/microbiologia , Gana , Masculino , Bouba/microbiologia , Bouba/diagnóstico , Estudos Retrospectivos , Feminino , Adulto , Bactérias/genética , Bactérias/classificação , Bactérias/isolamento & purificação , Melanesia , Pessoa de Meia-Idade , Staphylococcus/genética , Staphylococcus/isolamento & purificação , Staphylococcus/classificação , Streptococcus pyogenes/genética , Streptococcus pyogenes/isolamento & purificação , Streptococcus pyogenes/classificação , Arcanobacterium/genética , Arcanobacterium/isolamento & purificação , Campylobacter/genética , Campylobacter/isolamento & purificação , Campylobacter/classificação
2.
Evolution ; 78(7): 1349-1350, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38717097

RESUMO

Island ecosystems represent outstanding natural laboratories for studying the interplay between ecology and evolution. Lavery et al., (2024) use genomic approaches to identify a remarkable example of repeated evolution in Hipposideros bats across the Solomon Islands archipelago. They show that larger-bodied bats have independently evolved on different islands, highlighting an exciting new system for exploring the ecological and evolutionary drivers of repeated evolution in mammals.


Assuntos
Evolução Biológica , Tamanho Corporal , Quirópteros , Ilhas , Animais , Quirópteros/genética , Melanesia
3.
J Water Health ; 22(3): 467-486, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38557565

RESUMO

Pacific Island Countries (PICs) collectively have the lowest rates of access to safely managed or basic drinking water and sanitation globally. They are also the least urbanised, have dynamic socioeconomic and increasing climate-linked challenges. Community-based water managers need to respond to variability in water availability and quality caused by a range of hazards. Water Safety Planning (WSP), a widely adopted approach to assessing water supply, offers a risk-based approach to mitigating both existing and future hazards. WSP is adaptable, and making modifications to prescribed WSP to adapt it to the local context is common practice. Within the Pacific Community Water Management Plus research project, we used formative research and co-development processes to understand existing local modifications, whether further modifications are required, and, to develop additional modifications to WSP in Fiji, Vanuatu and Solomon Islands. The types of additional local modifications we recommend reflect the unique context of PICs, including adjusting for community management of water supplies and required collective action, community governance systems, levels of social cohesion in communities, and preferred adult-learning pedagogies. Incorporating modifications that address these factors into future WSP will improve the likelihood of sustained and safe community water services in Pacific and similar contexts.


Assuntos
População Rural , Humanos , Adulto , Ilhas do Pacífico , Vanuatu , Fiji , Melanesia
4.
Artigo em Inglês | MEDLINE | ID: mdl-38562912

RESUMO

Objective: To identify progress and challenges in the national response to tuberculosis (TB) in Solomon Islands through an epidemiological overview of TB in the country. Methods: A descriptive analysis was conducted using the national TB surveillance data for 2016-2022. Case notifications, testing data, treatment outcomes and screening activities were analysed. Results: The number of case notifications was 343 in 2022, with an average annual reduction of the case notification rate between 2016 and 2022 of 4.7%. The highest case notification rate was reported by Honiara City Council (126/100 000 population) in 2022. The number of people with presumptive TB tested by Xpert® rapidly increased from zero in 2016 to 870 in 2022. Treatment success rate remained consistently high between 2016 and 2022, ranging from 92% to 96%. Screening for HIV and diabetes mellitus (DM) among TB patients in 2022 was 14% and 38%, respectively. Most patients (97%) were hospitalized during the intensive phase of treatment in 2022; in contrast, during the continuation phase, the proportion of patients treated at the community level increased from 1% in 2016 to 63% in 2022. Despite an increase in household contact investigations, from 381 in 2016 to 707 in 2021, the uptake of TB preventive treatment (TPT) was minimal (7% among eligible child contacts). Discussion: This epidemiological analysis in Solomon Islands reveals both notable achievements and challenges in the country's TB programme. One major achievement is a potential actual reduction in TB incidence. Challenges identified were potential underdetection of cases in rural areas, suboptimal community-based care, and insufficient contact tracing and uptake of TPT. It is crucial to address these challenges (e.g. by optimizing resources) to advance the national TB response.


Assuntos
Tuberculose , Criança , Humanos , Tuberculose/prevenção & controle , Melanesia/epidemiologia , Resultado do Tratamento , Busca de Comunicante , Incidência
5.
Evolution ; 78(6): 1183-1192, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38457362

RESUMO

Body size is a key morphological attribute, often used to delimit species boundaries among closely related taxa. But body size can evolve in parallel, reaching similar final states despite independent evolutionary and geographic origins, leading to faulty assumptions of evolutionary history. Here, we document parallel evolution in body size in the widely distributed leaf-nosed bat genus Hipposideros, which has misled both taxonomic and evolutionary inference. We sequenced reduced representation genomic loci and measured external morphological characters from three closely related species from the Solomon Islands archipelago, delimited by body size. Species tree reconstruction confirms the paraphyly of two morphologically designated species. The nonsister relationship between large-bodied H. dinops lineages found on different islands indicates that large-bodied ecomorphs have evolved independently at least twice in the history of this radiation. A lack of evidence for gene flow between sympatric, closely related taxa suggests the rapid evolution of strong reproductive isolating barriers between morphologically distinct populations. Our results position Solomon Islands Hipposideros as a novel vertebrate system for studying the repeatability of parallel evolution under natural conditions. We conclude by offering testable hypotheses for how geography and ecology could be mediating the repeated evolution of large-bodied Hipposideros lineages in the Solomon Islands.


Assuntos
Quirópteros , Animais , Quirópteros/genética , Quirópteros/anatomia & histologia , Quirópteros/classificação , Melanesia , Tamanho Corporal , Evolução Biológica , Filogenia , Fluxo Gênico
6.
Heredity (Edinb) ; 132(5): 232-246, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38494530

RESUMO

Indoor insecticide applications are the primary tool for reducing malaria transmission in the Solomon Archipelago, a region where Anopheles farauti is the only common malaria vector. Due to the evolution of behavioural resistance in some An. farauti populations, these applications have become less effective. New malaria control interventions are therefore needed in this region, and gene-drives provide a promising new technology. In considering developing a population-specific (local) gene-drive in An. farauti, we detail the species' population genetic structure using microsatellites and whole mitogenomes, finding many spatially confined populations both within and between landmasses. This strong population structure suggests that An. farauti would be a useful system for developing a population-specific, confinable gene-drive for field release, where private alleles can be used as Cas9 targets. Previous work on Anopheles gambiae has used the Cardinal gene for the development of a global population replacement gene-drive. We therefore also analyse the Cardinal gene to assess whether it may be a suitable target to engineer a gene-drive for the modification of local An. farauti populations. Despite the extensive population structure observed in An. farauti for microsatellites, only one remote island population from Vanuatu contained fixed and private alleles at the Cardinal locus. Nonetheless, this study provides an initial framework for further population genomic investigations to discover high-frequency private allele targets in localized An. farauti populations. This would enable the development of gene-drive strains for modifying localised populations with minimal chance of escape and may provide a low-risk route to field trial evaluations.


Assuntos
Anopheles , Tecnologia de Impulso Genético , Genética Populacional , Malária , Repetições de Microssatélites , Mosquitos Vetores , Anopheles/genética , Animais , Mosquitos Vetores/genética , Malária/transmissão , Tecnologia de Impulso Genético/métodos , Melanesia , Alelos
7.
JCO Glob Oncol ; 10: e2300325, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38271650

RESUMO

Bush et al emphasize that the key to establishing enduring and efficient global health systems lies in prioritizing local stakeholders and, above all, the welfare of patients.


Assuntos
Oncologia , Melanesia , Oncologia/organização & administração
8.
PLoS One ; 19(1): e0290465, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38295041

RESUMO

Several localities across the Vanuatu archipelago (Melanesia), so-called 'Polynesian Outliers', are inhabited by communities that display Polynesian linguistic and cultural features although being located outside the Polynesian Triangle. Several introductions of Polynesian genetic components to Central and Southern Vanuatu during the last millenium have resulted in the cultural distinctiveness observed among the Polynesian Outliers in Vanuatu. However, social, political or economic process surrounding the exchange of genes between Polynesian and local individuals remain unidentified. Recent bioanthropological studies suggest the existence of female mobilities from neighboring regions to Vanuatu but also to the Polynesian Outliers of Taumako (Solomon Islands) within patrilocal societies. We aim to examine the hypothesis that Polynesian biological affinities observed in ancient individuals from Vanuatu are gendered or sex-specific, and that some of the Polynesian migrations during the last millennium may have involved practices of exogamy. By reconstructing phenotypes and biological identities from 13 archaeologically-recovered human skulls (400-300 years ago) from "Polynesian-related" regions of Vanuatu, we provide new insights to better contextualize the settlement patterns of Polynesian individuals. Eastern-Pacific associated phenotype are observable in 4 women from the Eretok burial complex (Efate region) and the Polynesian Outlier of Futuna, who were buried in close proximity to individuals with Western-Pacific associated phenotype. We suggest that close integration of individuals from the East into the local Vanuatu society, as well as the practice of exogamy, might have been key processes contributing to the preservation of Polynesian cultural features in Vanuatu over the past millennium. Our finding are cross-referenced with oral records from these two areas, as well as the known genetic makeup of the Vanuatu Polynesian Outliers.


Assuntos
Migração Humana , População das Ilhas do Pacífico , Feminino , Humanos , Masculino , Melanesia , Crânio , Vanuatu
9.
Int Nurs Rev ; 71(1): 44-53, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37029778

RESUMO

AIM: In 2016, the Solomon Islands National University developed and implemented the country's first nursing specialisation in child health, the Bachelor of Nursing: Child Health. This qualitative study aimed to explore the experiences of the first cohort of students (n = 14) during this course in order to evaluate the programme. BACKGROUND: The Bachelor of Nursing: Child Health was implemented in 2016 to develop nurses' knowledge and skills in child health and improve child health outcomes and so on. DESIGN: The qualitative evaluation study used an exploratory, descriptive design. METHODS: The 14 nurses who constituted the first cohort of students were selected as study participants. Individual semi-structured interviews were conducted between August and December 2018. Thematic analysis was undertaken following the Braun and Clarke six-phase process to generate themes and sub-themes from the data. The Consolidated Criteria for Reporting Qualitative Research checklist guided the reporting of the study. RESULTS: Interviews revealed important feedback about the course, including areas to strengthen and avenues to improve it in the future. Four themes emerged: learning during the Bachelor of Nursing: Child Health, support during the course, challenges experienced during the course and suggested course improvements in the future. The study found that theoretical sessions combined with practical and interactive activities were most effective in learning both theoretical concepts and their related clinical applications and skills. Although support was generally available during the course, participants emphasised their responsibility to take the lead in their learning and seek support when required. The lack of mentoring combined with logistical difficulties were perceived as barriers to learning. Participant recommendations support further development of the child health nursing specialisation, with specific strengthening in areas such as teaching and mentoring, logistics, course curriculum and human and material resources. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Given the potential benefits of increasing nurses' knowledge and skills in child health and paediatric care on reducing neonatal and child mortality and morbidity, ongoing support for the implementation of this course in Solomon Islands and more broadly across the Pacific region is recommended. The provision of such support is a local, regional and a global responsibility. Indeed, Sustainable Development Goal 3c calls for a substantial increase in health financing and in the recruitment, development, training and retention of the health workforce in low- and middle-income countries. CONCLUSIONS: Results of the evaluation demonstrate the positive aspects of the course in relation to content and curriculum delivery strategies as well as identifying areas where further refinement and strengthening is required.


Assuntos
Enfermeiras e Enfermeiros , Estudantes de Enfermagem , Criança , Recém-Nascido , Humanos , Competência Clínica , Saúde da Criança , Estudantes , Pesquisa Qualitativa , Melanesia
10.
BMJ Open ; 13(11): e074042, 2023 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-37973544

RESUMO

OBJECTIVE: This study aims to collect data on the experience and impact of gender-based violence experienced by women attending health clinics in Honiara, Solomon Islands. METHOD: Any woman over the age of 18 who attended a local health clinic in Honiara, Solomon Islands during the time of recruitment (ten consecutive weekdays in May 2015) was eligible to participate in an interviewer administered, in-person survey, gathering data on gender-based violence over the past 12 months. RESULTS: A total of 100 women were recruited into this study. Of these women, 47% of women reported experiencing physical or sexual violence in the past 12 months. The most common perpetrators were the woman's husband or boyfriend. There are low rates of reporting, particularly through formal avenues such as to police or village leaders. Alcohol was involved in more than half the cases of reported violence. CONCLUSION: Women in this study report high rates of gender-based violence. To our knowledge, this is the only study examining women's personal experience of gender-based violence in the Solomon Islands, with self-reported data on the frequency and nature of the violence, and the impact on women, including physical and mental, utilisation of healthcare services, police and legal involvement. Efforts to reduce gender-based violence should aim to reduce intimate partner violence, increase reporting and address wider social attitudes towards gender equality.


Assuntos
Violência de Gênero , Violência por Parceiro Íntimo , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Violência , Melanesia/epidemiologia , Fatores de Risco
11.
J Fish Biol ; 103(5): 1214-1220, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37340632

RESUMO

Technological advances have enabled the expansion of ocean exploration to include the deep ocean, providing new species observations. Here, the authors present two new observations, captured by deep-sea cameras, of the sleeper shark Somniosus cf. pacificus from the Solomon Islands and Palau. This presents the first observation of S. cf. pacificus in the western Pacific tropics and extends its range about 2000 nautical miles south. The observations presented here provide much-needed information on the range of this species which can help guide future management and conservation actions.


Assuntos
Cação (Peixe) , Tubarões , Animais , Filogenia , Melanesia , Oceano Pacífico
12.
Nutr Health ; 29(4): 611-619, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37365874

RESUMO

Background: In Solomon Islands, the retail food environment is an important food source, for instance, the dominant source of fresh fruit and vegetables for urban consumers is open markets. The effects of COVID-19 mitigation measures (such as restriction of human movement and border closures) in early 2020 placed food security at risk in many parts of the community. Of particular concern was the risk of price gouging in an already price-sensitive market. Aims: The study aimed to provide rapid and policy-relevant information on the pricing of foods in the urban food environment in Solomon Islands in the context of the unfolding COVID-19 pandemic. Methods: A vendor survey was conducted in July to August 2020 and repeated in July 2021 using a survey tool that collected information on type, quantity, and price of food on offer. Findings: We found price reductions among the majority of fresh fruit and non-starchy vegetables available. A trend of rising prices was reported for some other commodities, such as fresh locally caught fish. Conclusion: Our findings highlight the impact of 'schocks to the system' on food prices as a potential barrier or enabler to consumption of fresh foods purchased from urban areas - an important finding in a price sensitive market. The survey design was successful in collecting pricing data from the retail food environment during a time of external 'shock to the system'. Our approach is applicable to other settings needing a rapid survey of the external food environment.


Assuntos
COVID-19 , Pandemias , Humanos , Abastecimento de Alimentos , COVID-19/epidemiologia , Alimentos , Frutas , Verduras , Melanesia
13.
Mol Phylogenet Evol ; 186: 107831, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37257796

RESUMO

South Pacific islands provide an ideal study system to explore patterns of speciation, specifically examining the role of dispersal versus vicariance. Dispersal is often the suggested mechanism of diversification in the South Pacific, specifically among remote island chains. Here, we provide a phylogeny of several related genera of Coenagrionidae (Odonata: Zygoptera) from the South Pacific, based on five molecular loci, in order to examine patterns of speciation in the region. We used the endemic damselfly genera Nesobasis, Nikoulabasis, and Vanuatubasis found across both Fiji and Vanuatu. Knowledge of the geologic history of the region was used to inform our understanding of the evolution of these genera. Both archipelagos used to be part of the Vitiaz arc which spanned from the Solomon Islands to Tonga and began to break apart 10-12 Ma. Results of our divergence-time estimations and biogeographic reconstructions support that the breakup of this arc acted as a significant vicariance event in the evolution of these taxa. Specifically, it led to the extant generic diversity seen in these damselflies. We find that within the archipelago of Vanuatu, that Espiritu Santo served as an important source for dispersal to other islands with Malekula acting as a stepping stone to Efate.


Assuntos
Odonatos , Animais , Filogenia , Odonatos/genética , Geologia , Fiji , Melanesia
14.
BMC Infect Dis ; 23(1): 206, 2023 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-37024812

RESUMO

BACKGROUND: This study investigated associations between climate variables (average temperature and cumulative rainfall), and El Niño Southern Oscillation (ENSO) and dengue-like-illness (DLI) incidence in two provinces (Western and Guadalcanal Provinces) in Solomon Islands (SI). METHODS: Weekly DLI and meteorological data were obtained from the Ministry of Health and Medical Services SI and the Ministry of Environment, Climate Change, Disaster Management and Meteorology from 2015 to 2018, respectively. We used negative binomial generalized estimating equations to assess the effects of climate variables up to a lag of 2 months and ENSO on DLI incidence in SI. RESULTS: We captured an upsurge in DLI trend between August 2016 and April 2017. We found the effects of average temperature on DLI in Guadalcanal Province at lag of one month (IRR: 2.186, 95% CI: 1.094-4.368). Rainfall had minor but consistent effect in all provinces. La Niña associated with increased DLI risks in Guadalcanal Province (IRR: 4.537, 95% CI: 2.042-10.083), whereas El Niño associated with risk reduction ranging from 72.8% to 76.7% in both provinces. CONCLUSIONS: Owing to the effects of climate variability and ENSO on DLI, defining suitable and sustainable measures to control dengue transmission and enhancing community resilience against climate change in low- and middle-developed countries are important.


Assuntos
Dengue , El Niño Oscilação Sul , Humanos , Temperatura , Incidência , Melanesia/epidemiologia , Dengue/epidemiologia
15.
Asia Pac J Public Health ; 35(2-3): 136-144, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36872610

RESUMO

Low birth weight (LBW) has contributed to more than 80% of under-5 deaths worldwide, most occurring in low- and middle-income countries. We used the 2015 Solomon Islands Demographic and Health Survey data to identify the prevalence and risks associated with LBW in the Solomon Islands. Low birth weight prevalence estimated was 10%. After adjustment for potential confounders, we found the risk of LBW for women with a history of marijuana and kava use was 2.6 times, adjusted relative risk (aRR) 2.64 and 2.5 times (aRR: 2.50) than among unexposed women, respectively. Polygamous relationship, no antenatal care, decision-making by another person were 84% (aRR: 1.84), 73% (aRR: 1.73), and 73% (aRR: 1.73) than among unexposed women, respectively. We also found that 10% and 4% of LBW cases in the Solomon Islands were attributable to a household of more than five members and tobacco and cigarette use history respectively. We concluded that LBW in the Solomon Islands relied more on behavioral risk factors, including substance use as well as health and social risk factors. We recommended further study on kava use and its impact on pregnancy and LBW.


Assuntos
Recém-Nascido de Baixo Peso , Cuidado Pré-Natal , Recém-Nascido , Gravidez , Feminino , Humanos , Prevalência , Fatores de Risco , Características da Família , Melanesia/epidemiologia , Peso ao Nascer
16.
JCO Glob Oncol ; 9: e2200325, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36862976

RESUMO

PURPOSE: To describe the establishment of an oncology unit at the National Referral Hospital (NRH) in the Solomon Islands, a low-income nation in the South Pacific. METHODS: A scoping visit was carried out in 2016 to assist in the development of coordinated cancer services and to establish a medical oncology unit at the NRH at the request of the Medical Superintendent. This was followed by an observership visit to Canberra by an NRH doctor training in oncology in 2017. After a request from the Solomon Islands Ministry of Health, the Australian Government Department of Foreign Affairs and Trade (DFAT) arranged an in-country multidisciplinary mission under the Royal Australasian College of Surgeons/Royal Australasian College of Physicians Pacific Islands Program to help in the commissioning of the NRH Medical Oncology Unit in September 2018. Staff training and education sessions were held. The team, with the assistance of an Australian Volunteers International Pharmacist, has helped the NRH staff to develop localized Solomon Islands Oncology Guidelines. Donated equipment and supplies have helped with the initial establishment of the service. A second DFAT Oncology mission visit was made in 2019 followed by two NRH oncology nurses visiting Canberra on observership later that year and support of the Solomon's doctor to pursue postgraduate education in cancer sciences. Ongoing mentorship and support has been maintained. RESULTS: The island nation now has a sustainable oncology unit delivering chemotherapy treatments and management of patients with cancer. CONCLUSION: A collaborative multidisciplinary team approach by professionals from the high-income country working with colleagues from the low-income nation with coordination of different stakeholders was the key to this successful initiative in improving cancer care.


Assuntos
Hospitais , Oncologia , Humanos , Austrália , Melanesia , Renda
17.
Zootaxa ; 5339(6): 562-576, 2023 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-38221397

RESUMO

Several species of geckos of the genus Lepidodactylus are endemic to the Solomon Islands and very poorly known. I redescribe one of these, L. flaviocularis, from Guadalcanal, based on examination of a second, newly obtained specimen and quantification of diagnostically useful features of the digits. I also describe a closely related new species from nearby Makira Island in the southern Solomon Islands. Both species are distinguished by their large number of undivided subdigital lamellae, extensive toe webbing, and a continuous row of enlarged precloacal/femoral scales. The new species is distinguished from L. flaviocularis by a number of scalational features and the color of the circumorbial scales. Both species are inhabitants of interior forest, and it remains uncertain whether they are naturally rare, rare due to interactions with invasive species, or simply have cryptic ecological habits, though the last seems most likely. Current evidence for both species is consistent with the taxon-cycle hypothesis, which posits ecological displacement to inland habitats of ancient island inhabitants by newer colonizers, but this remains to be critically tested. The limited pool of specimens available for both species necessitates assessing the IUCN conservation status of each as Data Deficient.


Assuntos
Ecossistema , Lagartos , Animais , Distribuição Animal , Estruturas Animais , Melanesia , Filogenia
19.
BMJ Open ; 12(12): e066237, 2022 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-36585152

RESUMO

OBJECTIVES: Stillbirth is a major global health issue, which disproportionately affects families living in low-income and middle-income countries. The Solomon Islands is a Pacific nation with poor perinatal outcomes, however research investigating stillbirth is lacking. Thus, we aimed to investigate the incidence and cause of stillbirth occurring at the National Referral Hospital, Solomon Islands. DESIGN: We conducted a retrospective cohort study from January 2017 to December 2018. SETTING: At the only tertiary referral hospital in the Solomon Islands, on the main island of Guadalcanal. PARTICIPANTS: All births occurring in the hospital during the study period. OUTCOME MEASURES: Number of, causes and risk factors for stillbirths (fetal deaths before birth at ≥20 estimated gestational weeks, or ≥500 g in birth weight). RESULTS: Over 2 years 341 stillbirths and 11 056 total births were recorded, giving an institutional incidence of 31 stillbirths per 1000 births. Of the cases with a recorded cause of death, 72% were deemed preventable. Most stillbirths occurred antenatally and 62% at preterm gestations (<37 weeks). 59% had a birth weight below 2500 g and preventable maternal conditions were present in 42% of the cases. 46% of the cases were caused by an acute intrapartum event, and among these 92% did not receive intrapartum monitoring. CONCLUSIONS: Stillbirth affects 31 in every 1000 births at the National Referral Hospital in the Solomon Islands and many cases are preventable. Our findings highlight the urgent need for increased focus on perinatal deaths in the Solomon Islands with universal classification and targeted training, improved quality of obstetrical care and community awareness.


Assuntos
Natimorto , Gravidez , Recém-Nascido , Feminino , Humanos , Natimorto/epidemiologia , Centros de Atenção Terciária , Peso ao Nascer , Incidência , Estudos Retrospectivos , Melanesia/epidemiologia
20.
Commun Biol ; 5(1): 1182, 2022 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-36333588

RESUMO

Identifying hotspots of biological diversity is a key step in conservation prioritisation. Melanesia-centred on the vast island of New Guinea-is increasingly recognised for its exceptionally species-rich and endemic biota. Here we show that Melanesia has the world's most diverse insular amphibian fauna, with over 7% of recognised global frog species in less than 0.7% of the world's land area, and over 97% of species endemic. We further estimate that nearly 200 additional candidate species have been discovered but remain unnamed, pointing to a total fauna in excess of 700 species. Nearly 60% of the Melanesian frog fauna is in a lineage of direct-developing microhylids characterised by smaller distributions than co-occurring frog families, suggesting lineage-specific high beta diversity is a key driver of Melanesian anuran megadiversity. A comprehensive conservation status assessment further highlights geographic concentrations of recently described range-restricted threatened taxa that warrant urgent conservation actions. Nonetheless, by world standards, the Melanesian frog fauna is relatively intact, with 6% of assessed species listed as threatened and no documented extinctions; and thus it provides an unparalleled opportunity to understand and conserve a megadiverse and relatively intact insular biota.


Assuntos
Biodiversidade , Biota , Animais , Melanesia , Anuros
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