Reproductive health, obesity, and cardiometabolic risk factors among Samoan women.

OBJECTIVES: Obesity leads to deleterious effects on not only cardiovascular health but also on the reproductive health of women. We estimate the prevalence of menstrual irregularity and of polycystic ovarian syndrome (PCOS) in Samoan women, among whom obesity prevalence is extremely high. We explore the association of these reproductive health conditions with adiposity, cardiometabolic risk factors, and androgen levels. METHODS: A cross-sectional sample of Samoan women 25-39 years of age (n = 470) from a larger population-based genome-wide association study of adiposity and cardiometabolic disease was assessed for the prevalence of oligomenorrhea/amenorrhea (OM/AM) using a self-reported questionnaire. Serum androgens and anti-Müllerian hormone levels were assayed to determine hyperandrogenemia and presence of polycystic ovaries (PCO), respectively, using criterion values. PCOS was classified using NIH guidelines of having at least two of the three conditions: menstrual irregularity, hyperandrogenism, and PCO. We contrasted socio-demographic, reproductive health, and cardiometabolic risk factors between those with and without OM/AM and similarly for PCOS. RESULTS: The prevalence of OM/AM was 7.4% (95% CI: 5.1, 9.8), and women with OM/AM had significantly higher central adiposity. PCOS was estimated at 6.8% (95% CI: 4.5, 9.1), and those with PCOS were younger but had higher overall and central adiposity measures, higher triglycerides, and higher prevalence of insulin resistance than women without PCOS. CONCLUSIONS: The prevalence of menstrual irregularity and PCOS are less than hypothesized given the high levels of adiposity in this population. Nevertheless, Samoan women with menstrual irregularity and other features of PCOS have significantly poorer metabolic health.

Prevalence of adiposity and associated cardiometabolic risk factors in the Samoan genome-wide association study.

OBJECTIVE: To describe the prevalence of obesity-related noncommunicable diseases (NCDs) and associated risk factors in a sample of Samoan adults studied in 2010 as part of a genome-wide assocation study (GWAS) for obesity related traits. METHODS: Anthropometric and biochemical data collected from n = 3,475 participants (n = 1,437 male; n = 2,038 female) aged 24.5 to <65 years were used to describe the prevalence of obesity, diabetes, hypertension, and dyslipidemia within the study sample. One way analysis of variance, χ(2) tests, and binary logistic regression were used to identify differences in disease and risk factor prevalence by 10-year age group, gender, or by census region of residence. RESULTS: Obesity was highly prevalent among the study sample; 64.6% of females and 41.2% of males were obese according to Polynesian cutoffs (BMI ≥ 32 kg/m(2) ). Females were less likely than males to have hypertension (31.7% vs. 36.7%) but equally likely to have diabetes (17.8% vs. 16.4%). With the exception of obesity and low HDL-cholesterol in females only, there were significant differences in the prevalence of all NCDs and associated risk factors by age group, with the oldest age group (55 to <65 years) most affected. In both sexes, residents of the Apia Urban Area were at significantly greater risk of obesity, diabetes, low HDL-cholesterol, and high triglycerides than residents of the more rural Savaii region. CONCLUSIONS: The phenotypic characteristics of this sample provide evidence of a continuation of previously reported temporal trends toward obesity and its associated disorders. Attention must be paid to the critical NCD situation in Samoa.

Modernization and cardiometabolic risk in Samoan adolescents.

OBJECTIVE: To describe the prevalence of cardiometabolic risk factor clustering in Samoan adolescents and to relate risk factor clustering to weight status and general modernization. METHODS: Anthropometric and biochemical data collected from adolescents aged 12-17.9 years who participated in the Samoan Family Study of Overweight and Diabetes were used to describe the prevalence of cardiometabolic risk factors (high waist circumference, high blood pressure, high triglyceride level, low-high-density lipoprotein cholesterol, and high fasting serum glucose). A total of 436 adolescents were included in this analysis; 237 (54.4%) from American Samoa (n = 123 males) and 199 (45.6%) from Samoa (n = 90 males). Risk factor clustering was indicated by the presence of ≥ 3 risk factors. RESULTS: Cardiometabolic risk factor clustering was greater in American Samoan adolescents (17.9% males, 21.9% females) than Samoan adolescents (1.1% males, 2.8% females). The frequency of risk factor clustering varied according to body mass index status. In males, risk factor clustering was entirely confined to obese adolescents, whereas female adolescents who were overweight or obese were at risk. CONCLUSIONS: Cardiometabolic risk factor clustering is prevalent in the young American Samoan population and is likely to become more prevalent with increasing modernization in Samoan youth. Screening and intervention should be targeted at this age group to reduce the non-communicable disease burden faced by these populations.

Suicide and suicidal-related behaviors among indigenous Pacific Islanders in the United States.

The authors present a comprehensive review on U.S. Pacific Islander suicide and suicide-related behaviors to extend the knowledge and understanding of suicide and suicide-related behaviors among the indigenous peoples of the state of Hawai'i, the territories of American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and the Pacific Island Nations of Micronesia (Federated States of Micronesia, the Republic of Belau [Palau], and the Republic of the Marshall Islands). Historical, geographic, epidemiological, social, and cultural information is presented on these Pacific Island populations. Suicide behavioral data are presented for Pacific Islanders living within the U.S. and affiliated Pacific territories and nations from the existing scientific literature along with archival data and 2 epidemiological studies that assess suicidal behaviors and related psychosocial factors and measures of psychopathology among large community samples of youth in Hawai'i. The authors describe common patterns and differences among these populations, along with social-cultural practices that may explain suicide phenomenology among these U.S. indigenous peoples who--while small in numbers when compared with the total U.S. population--possess striking health disparities when compared to other populations within the U.S. and in their island homelands.

Phenotypic and molecular characterization of community occurring, Western Samoan phage pattern methicillin-resistant Staphylococcus aureus.

In New Zealand, it is estimated that greater than half of the methicillin-resistant Staphylococcus aureus (MRSA) strains recovered from patients belong to what has been termed Western Samoan phage pattern types 1 and 2 (WSPP1, WSPP2). These strains differ from classical MRSA isolates in terms of their lack of multiresistance and community occurrence, suggesting that such strains possess properties and/or characteristics different from those of other MRSA. To address this hypothesis, 10 WSPP1 and WSPP2 isolates from Western Samoa, New Zealand and Australia were compared with common hospital MRSA isolates. All WSPP isolates were identical with regard to pulsed-field gel electrophoretic pattern of SmaI-digested DNA, coagulase gene restriction fragment length polymorphism pattern and localization of mecA to a 194 kb SmaI digestion fragment. The WSPP strains were no more resistant/sensitive to various environmental stresses (e.g. skin fatty acids, UV light, desiccation) compared with hospital epidemic MRSA strains, except for their higher tolerance to salt. In terms of virulence, the WSPP MRSA were quantitatively better at attaching to the epithelial cell line HEp2, were uniformly egg-yolk opacity factor negative and produced higher levels of haemolytic toxins compared with non-WSPP MRSA isolates.

Dietary intake of modernizing Samoans: implications for risk of cardiovascular disease.

OBJECTIVE: To describe the dietary intake of American and Western Samoans, with emphasis on nutrients conventionally related to risk factors for cardiovascular disease. DESIGN: Cross-sectional dietary survey. Intake estimates were based on 24-hour recall interviews. SUBJECT: Community-based samples of 946 men and women (455 American Samoans, 491 Western Samoans) aged 25 to 55 years. STATISTICAL ANALYSES: Tests of differences in means (t tests) and proportions (chi 2 tests). Correlation and multivariate linear regression analyses were conducted to describe correlates of energy and nutrient intakes. RESULTS: Few differences were noted between the energy and nutrient intakes of men and women, but substantial differences were found between residents of American Samoa and those of the less modernized country of Western Samoa. American Samoans consumed significantly more energy as carbohydrate (47% vs 44%) and protein (18% vs 13%) and less as fat (36% vs 46%) and saturated fat (16% vs 30%). Energy-adjusted intakes of cholesterol and sodium were higher among American Samoans. These differences persisted after adjustment for age, gender, years of education, occupation, and categories of a 10-point material lifestyle score. Samoans in the lowest category of material lifestyle had significantly lower energy-adjusted intakes of protein, cholesterol, and sodium and higher intakes of saturated fat than those in the upper 2 categories. Additional analyses described the contribution of specific foods to the intakes of energy and macronutrients. CONCLUSIONS/APPLICATIONS: The observed energy and nutrient intake patterns are consistent with previously reported levels of obesity and risk factors for cardiovascular disease among Samoans and suggest dietary modification for those at highest risk. Dietetics practitioners who counsel Samoan and other Pacific Islander clients should be aware of these intake patterns, which seem particularly malleable to levels of personal income. More generally, results from this study illustrate that the food choices of certain ethnic groups may be profoundly affected by the process of modernization within a country or by migration to a more economically developed locale.

Risk factors for coronary heart disease in a population with a high prevalence of obesity and diabetes: a case-control study of the Polynesian population of Western Samoa.

OBJECTIVE: To evaluate anthropometric, haemodynamic and biochemical risk markers for coronary heart disease (CHD) in the Polynesian population of Western Samoa in a case-control study of 43 cases of CHD compared with 90 age- (mean 53 years) and sex-matched controls. METHODS: Cases were identified on the basis of a 12-lead electrocardiogram and clinical history. RESULTS: More than 60% of the participants had a body mass index > or =30 kg/m2 and nearly 80% had central obesity. Both diabetes mellitus (17%) and impaired glucose tolerance (9%) were also common in this population. Nineteen per cent of the population were hypertensive and both antihypertensive therapy (21 versus 1%, P<0.001, risk 23.6) and hypertension (35 versus 11%, P<0.01, risk 4.3) were significantly more common among cases than they were among controls. In addition, the plasma high-density lipoprotein cholesterol level was lower (1.00+/-0.09 versus 1.24+/-0.05 mmol/l, P<0.05) and the plasma urate level was higher (0.42+/-0.02 versus 0.37+/-0.01 mmol/l, P<0.05) in the female cases than they were in their respective controls. Low-density lipoprotein (LDL) particle sizing did not reveal an excess of small LDL particles to be a feature of CHD cases, but more than 70% both of cases and of controls had multiple LDL species. The response of the triglyceride level to a fat-rich meal was the same for CHD cases and controls. CONCLUSION: The population studied had a high prevalence of several risk factors for CHD, including obesity and non-insulin-dependent diabetes mellitus; however, the most prominent factor relating to CHD within the community was the presence of hypertension.

Serum leptin concentration, obesity, and insulin resistance in Western Samoans: cross sectional study.

OBJECTIVE: To measure serum leptin concentrations in the Polynesian population of Western Samoa and to examine epidemiological associations of leptin with anthropometric, demographic, behavioural, and metabolic factors in this population with a high prevalence of obesity and non-insulin dependent diabetes mellitus. DESIGN: Cross sectional study, leptin concentration being measured in a subgroup of a population based sample. SUBJECTS: 240 Polynesian men and women aged 28-74 years were selected to cover the full range of age, body mass index, and glucose tolerance. MAIN OUTCOME MEASUREMENTS: Serum leptin, insulin, and glucose concentrations; anthropometric measures; physical activity; and area of residence. RESULTS: Leptin concentrations were correlated with body mass index (r = 0.80 in men, 0.79 in women) and waist circumference (r = 0.82 in men, 0.78 in women) but less so with waist to hip ratio. At any body mass index, leptin concentration was higher in women than men (geometric mean adjusted for body mass index 15.3 v 3.6 pg/l, P < 0.001). Leptin concentration also correlated with fasting insulin concentration (r = 0.63 in men, 0.64 in women) and insulin concentration 2 hours after a glucose load (r = 0.58 in men, 0.52 in women). These associations remained significant after controlling for body mass index; effects of physical activity and of rural or urban living on leptin concentration were eliminated after adjusting for obesity, except values remained high in urban men. 78% of variance in leptin was explained by a model including fasting insulin concentration, sex, body mass index, and a body mass index by sex interaction term. Similar results were obtained if waist circumference replaced body mass index. CONCLUSIONS: The strong relation of leptin with obesity is consistent with leptin production being proportional of mass to adipose tissue. The relation with insulin independent of body mass index suggests a possible role for leptin in insulin resistance or hyperinsulinaemia.

Ten-year changes in the obesity, abdominal adiposity, and serum lipoprotein cholesterol measures of Western Samoan men.

Previously reported associations between abdominal adiposity and coronary heart disease (CHD) may be mediated through serum lipids. In the present longitudinal study, 43 Western Samoan men who participated in a 1982 study were recontacted for a second determination of anthropometric and serum lipoprotein cholesterol levels. The men showed dramatic increases in weight (mean change +/- SD: 10.5 +/- 8.8 kg), abdominal circumference (10.0 +/- 7.6 cm), total cholesterol (49.5 +/- 26.4 mg/dl), and non-HDL cholesterol (53.1 +/- 26.6 mg/dl). A new indicator was used to estimate changes in abdominal adiposity: the residual from the regression of change in the abdominal circumference on change in body weight (the AR). The AR was significantly correlated with changes in total (r = 0.38) and non-HDL cholesterol (r = 0.39). Changes in HDL cholesterol were correlated with changes in weight only (r = -0.37). These bivariate relations remained significant in multiple linear regression analyses. These longitudinal results are the first to suggest changes in abdominal adiposity are related to changes in total and non-HDL cholesterol levels.

Relations of body fat and fat distribution to the serum lipid, apolipoprotein and insulin concentrations of Samoan men and women.

OBJECTIVE: To examine relations between obesity and serum concentrations of lipoprotein cholesterol, apolipoproteins, triglycerides and insulin in American and Western Samoans. Associations are also described between these CHD risk factors and abdominal adiposity, and the potential mediating role of insulin in these relationships is examined. DESIGN: Cross-sectional, using a sub-sample from an observational epidemiological study of cardiovascular disease risk factors among Samoans. MEASUREMENT: Obesity is estimated by the body mass index (BMI), and fat distribution by the abdomen-hip circumference ratio (AHR). All biochemical parameters were measured in the fasted stated. SUBJECTS: The sub-sample is 178 men and 147 women who were free from hypertension, diabetes and heart disease. RESULTS: In multivariate linear regression analyses in men the BMI was positively associated with levels of total cholesterol, the total-HDL cholesterol ratio, apolipoprotein B, and the log of triglyceride and insulin concentrations, and negatively associated with HDL and HDL2 cholesterol. The quadratic term for BMI was also found to be significantly predictive of all metabolic parameters in men, except for the log of serum insulin concentrations. Among the women, in contrast, BMI levels were significantly associated only with concentrations of HDL2 cholesterol, triglyceride and insulin. In men, the associations between the AHR and the metabolic parameters were similar to those described for the BMI, but showed no indication of non-linearity. Addition of the log of insulin to these models had little effect on the relations between the AHR and the lipid parameters, with the exceptions of total cholesterol and triglycerides. As with BMI, the AHR was much les predictive of metabolic parameters in women than in men, with a significant relation existing only with the log of insulin concentrations. CONCLUSIONS: These cross sectional data indicate that overall and abdominal adiposity are important correlates of serum lipid parameters among Samoan men, though the associations with BMI are attenuated at higher levels. Neither anthropometric indicator has much relation with these CHD risk factors among the women, perhaps due to extremely high levels of obesity in this group.

High prevalence of diabetic retinopathy and nephropathy in Polynesians of Western Samoa.

OBJECTIVE: To determine the prevalence of diabetic retinopathy and nephropathy retinopathy and nephropathy and to define associated risk factors in Polynesian Western Samoans with non-insulin-dependent diabetes mellitus (NIDDM) or impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: A 1991 population-based study in Samoan adults (ages 25-74 years) included a 75-g oral glucose tolerance test, anthropometric measurements, and blood pressure recordings. Subjects with NIDDM or IGT had 45-degree stereo photographs taken (n = 263) (three standard fields of the right eye), and retinopathy was graded in comparison with Airlie House photographs. First-morning urine samples (n = 304) were also collected from these subjects and from a subsample with normal glucose tolerance. Urinary albumin concentration (UAC) was measured by radioimmunoassay: microalbuminuria was defined as UAC of 30-299 micrograms/ml; and macroalbuminuria among subjects with Proliferative diabetic retinopathy was found in 4.5% of known diabetic subjects. The prevalence of elevated UAC was 15.0% in subjects with IGT, 26.0% in newly diagnosed diabetes subjects, and 23.4% in known diabetes subjects. For all diabetic subjects (n = 162), the factors independently associated with diabetic retinopathy (logistic regression) were duration of diabetes, fasting plasma glucose, and body mass index (inversely). Duration of diabetes, serum triglyceride concentrations, and systolic blood pressure were independently associated with elevated UAC in all diabetic subjects (n = 138), and fasting plasma glucose had borderline significance. CONCLUSIONS: Diabetic retinopathy and albuminuria are common in Polynesian Western Samoans. Duration of diabetes and level of glycemia were the most important associated factors. These data underline the need for cost-effective programs for the detection and early treatment of diabetes in Western Samoa and other developing populations with high susceptibility to NIDDM.

Evolutionary history of the COII/tRNALys intergenic 9 base pair deletion in human mitochondrial DNAs from the Pacific.

Length changes in human mitochondrial DNA (mtDNA) are potentially useful markers for inferring the evolutionary history of populations. One such length change is a nine base pair (9-bp) deletion that is located in the intergenic region between the COII gene and the Lysine tRNA gene (COII/tRNALys intergenic region). This deletion has been used as a genetic marker to trace descent from peoples of East Asian origin. A geographic cline of the deletion frequency across modern Pacific Islander populations suggests that the deletion may be useful for tracing prehistoric Polynesian origins and affinities. Mitochondrial DNA sequence variation within two variable segments of the control region (CR) permits a number of inferences regarding the evolutionary history of the 9-bp deletion that cannot be determined from frequency data alone. We obtained CR sequences from 74 mtDNAs with the 9-bp deletion from Indonesia, coastal Papua New Guinea (PNG), and American Samoa. Phylogenetic and pairwise distribution analysis of these CR sequences pooled with previously published CR sequences reveals that the deletion arose independently in Africa and Asia and suggests possible multiple origins of the deletion in Asia. A clinal increase of the frequency of the 9-bp deletion across the three Pacific populations is associated with a decrease in CR sequence diversity, consistent with founder events. Furthermore, analysis of pairwise difference distributions indicates an expansion time of proto-Polynesians that began 5,500 yr ago from Southeast Asia. These results are consistent with the express train model of Polynesian origins.

Prevalence of coronary heart disease indicated by electrocardiogram abnormalities and risk factors in developing countries.

A cross-sectional population survey was carried out in 15 population groups (ethnicity includes Melanesian, Polynesian, Micronesian, Asian Indian and Chinese) in 9 developing countries: Fiji, Nauru, Kiribati, Cook Island, Niue, Western Samoa, New Caledonia, Mauritius and China (Beijing) in 1978-1987. The total sample included 4594 men and 4988 women aged 35-59 years. The aim of study is to report the prevalence of coronary heart disease (CHD) as indicated by ECG Minnesota coding, and risk factor levels and to describe the individual and ecological relationship between CHD prevalence and CHD risk factors among different ethnic groups in developing countries. Mauritians had the highest prevalence of CHD of these countries. Total serum cholesterol concentration and the prevalence of CHD were higher in Mauritius Chinese than in Beijing Chinese. Mean total cholesterol was lower than or equal to 5.2 mmol/l (200 mg/dl) in all population groups, except in Mauritians. Hypertensive subjects in most populations had a low cholesterol concentration. The prevalence of hypertension varied from 7 to 35% and mean body mass index (BMI) from 22.9 to 37.0 kg/m2. Smoking was more common in men (36-82%) than women (0.8-65%). Multiple logistic regression analysis using individuals as a unit of analysis showed that cholesterol and systolic blood pressure were significant independent predictors of CHD prevalence. When fasting or 2 hr post-load blood glucose was included in the model total cholesterol was no longer significant in men but remained significant in women. Ecological analysis using populations as units of analysis showed that the combination of several CHD risk factors could explain about 90% of the interpopulations variance of the CHD prevalence in women. The best models were those where 2 hr post-load glucose was included. Our study has demonstrated that the total cholesterol concentration of the population was consistent with the prevalence of CHD in the population. A considerable proportion of the variation in CHD prevalence across populations in developing countries can be explained by well-known risk factors. These data support the concept that retaining traditional balanced dietary habits and limiting salt intake together with avoiding smoking use are important activities for the prevention of cardiovascular disease (CVD) in developing countries.

Dramatic increase in the prevalence of obesity in western Samoa over the 13 year period 1978-1991.

Obesity and an increasing prevalence of associated conditions such as diabetes and cardiovascular disease are frequently observed in Pacific populations as lifestyles become more modernized. In 1978, a survey conducted in three geographically defined populations in Western Samoa showed large differences in the prevalence of obesity (body mass index (BMI) > or = 30 kg/m2) between rural and urban populations. A follow-up survey using similar methods was performed in 1991 to examine the current level of obesity in these three locations and to assess changes over time. Cross-sectional differences in the prevalence of obesity, mean BMI and waist-hip circumference ratio (WHR) between urban Apia and rural Poutasi and Tuasivi were examined after adjusting for age. There were higher levels of obesity in urban vs rural areas: 74% of women in Apia were obese compared with 62% in Poutasi and 56% in Tuasivi. In men, comparable figures were 57%, 44% and 36% for Apia, Poutasi and Tuasivi respectively. Mean BMIs followed the same pattern. By contrast, WHR varied little between locations. Even in subjects aged 25-34 years, more than 50% of women in all locations, and 45% of urban men were obese. Increasing physical activity in men, but not women, was associated with lower mean BMI. Increasing education level and job status were associated with increasing BMI but these relationships were significant only in men. Multivariate analysis showed age, location (urban), occupation (high status, women), and in men, physical inactivity, to be independently associated with increased risk of obesity. Prevalence of obesity increased dramatically between 1978 and 1991 in all locations, but especially in Tuasivi, where in males the increase was 297% and in females 115%. There was a rightward shift in the distribution of body mass index in both sexes and all locations. These extreme increases in the prevalence of obesity, even in young adults, over the relatively short 13-year study period suggest an increasing burden of chronic diseases facing Western Samoa in the future, and emphasize the need for effective intervention to bring about lifestyle modification.

Hearing loss in western Samoan children.

In an effort to help determine the current status and needs of hearing impaired children in Western Samoa, the Commonwealth Society for the Deaf sent a team of three professionals to this Pacific island nation in 1991. Initial information on known children with severe and profound hearing loss was gathered and a small prevalence survey of urban school children's ear health was conducted. No previously published information was available for this population. Results are presented and related to data from other areas of the Pacific. Hearing health care implications of the survey team's findings are discussed.

Increasing prevalence of NIDDM in the Pacific island population of Western Samoa over a 13-year period.

OBJECTIVE: A survey of noncommunicable diseases (NCD) in the Pacific island population of Western Samoa in 1978 (n = 1,206) documented a relatively high prevalence of non-insulin-dependent diabetes mellitus (NIDDM) and obesity. A follow-up survey was performed in 1991 (n = 1,776) to assess changes in NCD prevalence and risk factor distribution over 13 years. RESEARCH DESIGN AND METHODS: In both surveys, the same representative villages from one urban and two rural areas were studied, and the survey procedure included an oral glucose tolerance test, anthropometric and blood pressure measurements, and physical activity assessment (1991 only). RESULTS: The age-standardized prevalence of NIDDM in 1991 was 9.5 and 13.4% in Apia (urban) for men and women, respectively. In Poutasi (rural), 5.3% of men and 5.6% of women had NIDDM, and in Tuasivi (rural) the prevalence was 7.0 and 7.5% for men and women, respectively. Age, body mass index (BMI), waist-to-hip circumference ratio, physical inactivity, and family history of diabetes all showed independent association with NIDDM and impaired glucose tolerance. Living in Apia (compared with Poutasi) was also associated with NIDDM. Between 1978 and 1991, the age-standardized prevalence of NIDDM in Apia increased from 8.1 to 9.5% in men and 8.2 to 13.4% in women. In Poutasi, a dramatic increase occurred in prevalence from 0.1 to 5.3% in men, but little change in women was noted (5.4 to 5.6%). In Tuasivi, the increases were 2.3 to 7.0% in men and 4.4 to 7.5% in women. In combined survey areas, increases were observed in the age-standardized prevalence of obesity and mean levels of total cholesterol, fasting triglycerides, and uric acid between surveys as well as a reduction in the prevalence of smoking. CONCLUSIONS: This is the first study using standardized methods to show a dramatic increase in the prevalence of NIDDM in a developing Pacific island population, and it indicates the importance of maintaining and expanding preventive programs for NIDDM and related lifestyle diseases in these populations.

Pressor reactivity in American Samoan children: comparisons with Mainland American children.

In this investigation, 70 children from American Samoa participated in a standardized assessment of blood pressure and heart rate reactivity during a television video game. Data from Samoan children were compared with previously collected data from children (both black and white) residing in the continental United States. Samoan and black children demonstrated similar blood pressure reactivity (both absolute and delta values; P > .05); Samoans and blacks demonstrated greater blood pressure reactivity than whites (P < .05). Ethnic differences in heart rate reactivity were not as pronounced. After we adjusted reactivity values for ethnic differences in age, Quetelet index, and resting measurements, Samoans' reactivity continued to be more similar to the reactivity of blacks than that of whites. Results provide further evidence of ethnic differences in children's pressor reactivity; these differences may be related to differences in hypertension in adulthood.

Stroke and traumatic brain injury (ma'i ulu) in Amerika Samoa.

This paper discusses the annual incidence of stroke and traumatic brain injury (TBI) in American Samoa. Findings are based on data collected from the medical records at LBJ Tropical Medical Center in Amerika Samoa from June 1, 1989 to May 31, 1990. A review of these medical records revealed that stroke and TBI were prevalent among the residents of Amerika Samoa during the time period sampled. Health and cultural factors which contribute to the occurrence of stroke and TBI in Amerika Samoa and recommendations for further investigation and prevention of stroke and TBI in that country are discussed.

Microfilaria prevalence of diurnally subperiodic Wuchereria bancrofti among people having a medical checkup in American Samoa in the past 17 years.

The yearly change of microfilaria (mf) prevalence rates from 1974 to 1990 was studied in American Samoa with people who had medical checkups. The mf rates were found to have been kept at a low level (0.8-2.6%) in the past 17 years. The continued low prevalence reduced clinical filariasis significantly in the past 8 years. The low level of endemicity, despite very close communication with neighbouring Western Samoa where filariasis is much more prevalent, could be explained by the urbanized living conditions in American Samoa.