Psychometric properties of the Child-OIDP and oral health-related quality of life (OHRQoL) in secondary schools in Suva, Fiji.

BACKGROUND: Oral health-related problems are highly prevalent and, like many other diseases, affect Quality of Life. Although most primary schools in Fiji have supervised school brushing programs and have regular screenings these preventive aspects are missing in secondary schools. OBJECTIVE: To assess the internal consistency reliability, face and content validity of the Child-OIDP questionnaire and determine the oral health-related quality of life in 15-year-olds in Suva, Fiji. METHODS: A cross-sectional prospective study was carried out on 15-year-old children from four secondary schools in Suva, Fiji from 2014 to 2015. All students enrolled in the 10th and 11th year of studies were included. Multi-stage cluster sampling was used to identify the participants and the sample size of 367 was calculated. The Child Oral Impact on Daily Performance (Child-OIDP) self-administered questionnaire was used to collect data and data was analyzed using Epi-Info (3.5.1). RESULTS: A total of 281 students (76.6%) responded, of whom 47.0% experienced at least one impact. Cronbach's alpha for the Child-OIDP frequency items was 0.70 and the corrected item-total correlation ranged from 0.13 to 0.57. The most common performances that were affected were eating (27.8%) and relaxing (12.8%). Performances that were severely and most severely influenced were social contact (23.1%), smiling (16.7%) and relaxing (16.7%). The most common conditions leading to impacts were dental sensitivity (38.4%), dental caries (23.5%) and toothache (21.4%). CONCLUSION: The original version of the Child-OIDP is a reliable index with acceptable internal consistency when used directly in the Fiji setting, however, further studies to validate the tool will be useful. Oral impacts were prevalent, but not severe.

Patterns and risk factors associated with index Lower Extremity Amputations (LEA) among Type 2 Diabetes Mellitus (T2DM) patients in Fiji.

AIM: To describe patterns of index (first ever) Lower Extremity Amputations (LEA) and to determine factors associated with their occurrence amongst Type 2 Diabetes Mellitus (T2DM) patients in Fiji. METHODS: This cross-sectional study was conducted that adheres to the STROBE check lists for observational research among T2DM patients who experienced index LEA at the Colonial War Memorial Hospital (CWMH) in Fiji between 2011 and 2015. Demographic and clinical variables were extracted from patient folders. Univariate and multivariate logistic regression were used to determine factors associated with Major LEA. A p-value < 0.05 was considered significant. RESULTS: A total of 649 study participants were studied with the average age of index amputation was 58.4 years (±9.6 years, range 30-91 years). The average duration of T2DM was 9.5 ± 5.7 years. LEAs were more common amongst males (55%) and indigenous Fijians (71.8%). One-third of index LEA (33%) were major amputations. Factors associated with occurrence of Major LEA were poor Random Blood Sugar (RBS) levels (OR = 1.68, 95% CI: 1.01, 2.81), midfoot lesion (OR = 9.38 95% CI: 4.95, 19.52), septicaemia (OR = 2.42, 95% CI: 1.28, 4.57), low haemoglobin level (OR = 0.78 95% CI: 0.72, 0.86), and history of hypertension (OR = 0.58, 95% CI: 0.40, 0. 84). CONCLUSIONS: Results indicate that diabetic patients with foot infections present late to tertiary level care. Our findings also show an urgent need to strengthen primary care interventions and surveillance of both diabetes and diabetic LEA.

Exploring persons with disabilities preparedness, perceptions and experiences of disasters in Tuvalu.

BACKGROUND: Historically, Persons with Disabilities (PwDs) are disproportionately affected by disasters. In Pacific Island Countries (PICs), the risks and vulnerabilities of PwDs arise from social inequalities, as well as environmental barriers. As the frequency and intensity of disasters will increase over the next decade, it is critical that the challenges faced by PwDs are addressed and that they are prepared. OBJECTIVE: This study explores disaster preparedness, perceptions, and experiences with disasters among PwDs in Tuvalu. METHODS: This qualitative study was carried out among people with physical and sensory disabilities and without post-traumatic stress disorder (PTSD), who are aged 21 and above. Using grounded theory methodology, semi-structured in-depth interviews were conducted with 24 participants, with 7 then participating in a Focus Group Discussion (FGD). RESULTS: A total of 31 PwDs participated, of which 65% were male and 35% female, with a mean age of 44 ±15.70. The results showed how the PwDs ability to prepare, their perceptions, and experiences with disasters have contributed to their resilience to disasters. CONCLUSION: This study highlights the importance of understanding PwDs lived disaster experience to improve their preparedness and resilience for future disasters. This knowledge will assist government and non-government organisations, communities, and families to develop policies and plans that will enhance the preparedness of PwDs for disasters.

Knowledge and practice of care-givers who have under-five diarrhoeal children:a quantitative cross-sectional study in Mataniko settlements in Honiara, Solomon Islands, 2016 / 《全球健康杂志（英文）》

Introduction:Diarrhoea remains the second most serious health problem among children below five years old in Solomon Islands and is one of the leading causes of infant mortality,which caused about one in every ten children dying before the age of five years.Globally,around 6 million children (＜5 years) suffer from diarrhoea each year.Because of lack of previous studies,this study aims to assess the predictors of knowledge and practice of caregivers towards diarrhoea among under-five children in Mataniko informal settlements in Honiara,Solomon Islands,2016.Methods:This quantitative study was conducted at three randomly selected settlements in Honiara,Solomon Islands from June to July 2016.This study was conducted among both male and female caregivers who had children under five years of age,were aged 18 and over,live in Solomon Islands and were willing to participate in the study.A validated structured questionnaire was used to collect the data based on a 2-week recall of diarrhoea episodes.To avoid double-counting,each surveyed household was geo-referenced using global positioning system (GPS).The collected data were entered and analysed using SPSS (version 23.0) and descriptive and analytical statistics.P＜0.05 was considered as statistically significant.This study was approved by relevant ethical committees.Results:A total of 205 caregivers with at least one child under-five years participated in the study.The mean ages of caregivers and the under-five children were (30.7+8.2) years and (2.6+1.5) years,respectively.Among 205 caregivers,94 of them had reported that their children (＜5 years) had suffered with at least one episode of diarrhoea within the last 2 weeks prior to the survey.This gave a prevalence rate of 45.9％.The caregiver's knowledge about the causes (99.0％) and prevention (98.0％) of under-five diarrhoea was extremely high.Nevertheless,less than half had regularly practiced essential hygiene habits.The factors which appeared to be significantly associated with under-five diarrhoea were irregular hand washing (odds ratio [OR] 2.07,95％ confidence interval [CI]:1.12-3.81,P=0.020),inappropriate methods of disposing of children's fecal waste (OR 1.88,95％ CIL 1.06-3.33,P=0.030),and using the river for bathing (OR 1.83,95％ CI:1.04-3.23,P=0.036),and laundry (OR 2.17,95％ CI:1.23-3.84,P=0.008).Conclusion:Diarrhoea is a major public health problem among children below five years in Mataniko informal settlements.To address these exposures,relevant programs and projects should be designed,especially in areas like family planning,household economic allocation and political commitment.Awareness and advocacy programs on birth spacing,food hygiene and potential health risks about the river should be ongoing at the community level.