Mathematical Modeling for Removing Border Entry and Quarantine Requirements for COVID-19, Vanuatu.

The Pacific Island country of Vanuatu is considering strategies to remove border restrictions implemented during 2020 to prevent imported coronavirus disease. We performed mathematical modeling to estimate the number of infectious travelers who had different entry scenarios and testing strategies. Travel bubbles and testing on entry have the greatest importation risk reduction.

Pathways to healthy ageing in Vanuatu: a qualitative evaluation of national policy priorities.

Background: The Pacific Island country of Vanuatu is at the early stages of demographic ageing. The government is yet to develop a strategic approach to optimize the health and wellbeing of older indigenous Vanuatu residents (ni-Vanuatu). Methods: Using policy mapping and semi-structured interviews with 42 ni-Vanuatu, this research aimed to explore the current policy context surrounding ageing in Vanuatu and the priorities of older adults to inform preliminary steps to develop a national response to healthy ageing. Analyses were grounded in the World Health Organization's Regional Action Plan on Healthy Ageing in the Western Pacific. Findings: While the national policy context exhibited an indirect commitment to creating an environment conducive to healthy ageing, explicit policy commitments and monitoring indicators were lacking. Older persons reported numerous obstacles to healthy ageing, including financial insecurity, physical and psychological barriers to participation, and lack of community support. Interpretation: Findings highlighted the need for policymakers and stakeholders to focus preliminary strategic efforts on select components of the Regional Action Plan: evidence generation, advocacy/awareness, financing, community engagement and coordination, and family-centred empowerment. To ensure acceptability and sustainability, it is vital that these leverage existing strengths of traditional community values and the prevailing role of faith and religion in the lives of older ni-Vanuatu. Funding: This project was funded and supported by the World Health Organization (WHO) Regional Office for the Western Pacific (WPRO). Outcomes reflect the deliberations of authors and research partners.

Some lessons in tackling social determinants of health in resource-poor settings: health promotion with young people in Vanuatu.

Community based health promotion initiatives are recognised as important strategies to address the growing burden of non-communicable diseases in developing countries. However, limited knowledge exists on how such initiatives work in practice. One innovative health promotion program of work, the Pacific Action for Health Project, is working with young people and communities in the Pacific country of Vanuatu to offset the future effects of risk factors for these diseases, through optimising broad lifestyle and living conditions for the positive promotion of health. Recognising the established link between non-communicable diseases and their social determinants, the Pacific Action for Health Project works with young people to address these determinants at the community level including, but not limited to, unemployment. This paper appraises the program based on a constructivist approach to data gathering and analysis, with observations made in the field subsequently interpreted through the health promotion literature on community empowerment. From the data collected, six themes emerged as key attributes through which the program achieved its planned outcomes. Subsequent analysis through the community empowerment literature, specifically 'dynamic continuum' models of community development, provided deeper analysis of the program's strategies and offered insight into how the literature on community empowerment may work in practice in a resource poor context. In addition to the development of locally specific empowerment measures as indicators for future program evaluation, further ethnographic work and participatory-action research approaches are encouraged to assist the future development of the program.

Herpes simplex virus type 2 (HSV-2) infection in women attending an antenatal clinic in the South Pacific island nation of Vanuatu.

OBJECTIVE: The objective of this study was to estimate the prevalence and correlates of herpes simplex virus type 2 infection in women in an antenatal clinic in the South Pacific island nation of Vanuatu. STUDY DESIGN: A prevalence survey of sexually transmitted infections of pregnant women attending an antenatal clinic at Vila Central Hospital was conducted in 1999-2000. Serum samples were tested for HSV-1 and HSV-2 antibodies by enzyme-linked immunosorbent assay. Results for other sexually transmitted infections and demographic and obstetric variables were analyzed for their association with HSV-2 serostatus. RESULTS: HSV-2 serum antibody results were obtained on 535 women and HSV-1 results on 134. The seroprevalence of HSV-2 was 30% and HSV-1 was 100%. On multivariate analysis, the independent predictors of HSV-2 infection were age, marital status, and trichomoniasis. CONCLUSIONS: HSV-2 was common in this sample of sexually active women in Vanuatu. This is the first study of HSV in Vanuatu and one of very few studies in the Pacific region.

Novel human herpesvirus 8 subtype D strains in Vanuatu, Melanesia.

We show human herpesvirus 8 with diverse molecular subtype D variants to be highly endemic among the Ni-Vanuatu population. Most K1 genes were nearly identical to Polynesian strains, although a few clustered with Australian or Taiwanese strains. These results suggest diverse origins of the Ni-Vanuatu population and raise questions about the ancient human population movements in Melanesia.

Human T lymphotropic virus type 1 subtype C melanesian genetic variants of the Vanuatu Archipelago and Solomon Islands share a common ancestor.

BACKGROUND: Melanesia is endemic for human T lymphotropic virus type 1 (HTLV-1) subtype C. In 2005, we identified 4 infected women from Ambae Island, Vanuatu. Subsequently, 4247 Ni-Vanuatu originating from 18 islands were enrolled to define HTLV-1 epidemiological determinants and to characterize the viral strains molecularly. METHODS: Plasma from 1074 males and 3173 females were screened for HTLV-1/2 antibodies by particle agglutination (PA) and an immunofluorescence assay (IFA). Positive and/or borderline samples were then tested by a Western blot (WB) confirmatory assay. DNAs were amplified to obtain a 522-bp env gene fragment. Phylogenetic and molecular-clock analyses were performed. RESULTS: Of 4247 samples, 762 were positive and/or borderline by IFA/PA, and 26 of them were confirmed to be HTLV-1 positive by WB. The overall HTLV-1 seroprevalence was 0.62%. Viral transmission was found within families of infected index case patients. A geographic heterogeneity of HTLV-1 seroprevalence was observed among the islands. All 41 of the new env sequences belonged to HTLV-1 subtype C. Phylogenetic and molecular-clock analyses suggested that Ni-Vanuatu and Solomon Islander strains emerged from a common ancestor ~10,000 years ago. CONCLUSION: The Vanuatu archipelago is endemic for HTLV-1 with a diversity of subtype C variants. These strains were probably introduced into Vanuatu during ancient migration of the original settlers a few thousand years ago.

Curbing the tide--non-communicable disease in the Pacific.

This paper assesses the introduction of several small-scale sentinel data surveillance approaches. These data assist with improving the understanding of casual factors related to the development of NCDs at the local level in the Pacific and the design of subsequent interventions. While individually the data may be of limited value due to methodological considerations, their conjoint use provides a reasonably strong database upon which to base interventions. Within the highly resource constrained environment of the Pacific, such approaches are feasible and practical, while also ensuring that local data to develop local solutions, are available to inform evidence based decision making.