Journal Article > ResearchFull Text
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 138-41.; DOI:10.5588/pha.12.0034
Ram S, Kishore K, Batio I, Bissell K, Zachariah R, et al.
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 138-41.; DOI:10.5588/pha.12.0034
SETTING
All tuberculosis (TB) diagnostic and treatment centres in Fiji.
OBJECTIVES
To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services.
METHODS
A retrospective review of routine programme data reconciling TB laboratory and treatment registers.
RESULTS
A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001).
CONCLUSION
This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
All tuberculosis (TB) diagnostic and treatment centres in Fiji.
OBJECTIVES
To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services.
METHODS
A retrospective review of routine programme data reconciling TB laboratory and treatment registers.
RESULTS
A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001).
CONCLUSION
This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
Journal Article > ResearchFull Text
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 63-7.; DOI:10.5588/pha.12.0067
Aiyub S, Linh NN, Tayler-Smith K, Khogali MA, Bissell K
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 63-7.; DOI:10.5588/pha.12.0067
SETTING
Fiji's schools of nursing and government health services, 2001-2010.
OBJECTIVES
To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses.
DESIGN
Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers.
RESULTS
Over the period 2001-2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4-2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation.
CONCLUSION
While it was unable to directly assess whether Fiji's supply of nursing graduates has been meeting the country's health service demands, this study provides a series of baseline data on Fiji's nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages.
Fiji's schools of nursing and government health services, 2001-2010.
OBJECTIVES
To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses.
DESIGN
Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers.
RESULTS
Over the period 2001-2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4-2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation.
CONCLUSION
While it was unable to directly assess whether Fiji's supply of nursing graduates has been meeting the country's health service demands, this study provides a series of baseline data on Fiji's nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages.
Journal Article > ResearchFull Text
J Trop Med. 3 February 2013; Volume 2013; DOI:10.1155/2013/956234
Singh SN, Bingwor F, Tayler-Smith K, Manzi M, Marks GB
J Trop Med. 3 February 2013; Volume 2013; DOI:10.1155/2013/956234
Setting. A nationwide study in Fiji. Objective. To describe the incidence of congenital rubella syndrome (CRS) and its relationship to the incidence of notified cases of rubella in Fiji from 1995 to 2010. Design. Descriptive, retrospective review of all recorded congenital abnormalities associated with live births in Fiji over 16 years. Results. There were 294 infants who met the criteria for CRS. Of these, 95% were classified as "suspected" cases, 5% were "clinically confirmed," and none were "laboratory confirmed cases". There was a significant linear increase over the study period in the incidence of CRS (odds ratio 1.045 per year, 95% CI 1.019 to 1.071, P ≤ 0.001). There was no significant association between the incidence of CRS and the reported incidence of rubella (P = 0.3). Conclusion. There is a rising trend in reports of suspected CRS cases in Fiji. This highlights the need to strengthen surveillance for CRS through improvements in clinical and laboratory diagnosis to confirm or exclude suspected cases. It is also important to ensure high coverage of rubella vaccination in Fiji.
Journal Article > ResearchFull Text
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 142-4.; DOI:10.5588/pha.12.0064
Delai M, Gounder S, Tayler-Smith K, Van der Bergh R, Harries AD
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 142-4.; DOI:10.5588/pha.12.0064
Due to concerns about under-reporting of the tuberculosis (TB) case burden in Fiji, efforts have been put into national training, education and awareness activities in the formal health sector and among village health workers, health volunteers and the community since 2010. There has been an absolute increase in TB registrations, and TB case notification rates during the period of training activities in 2010 (21.3 per 100 000 population) and 2011 (23.6/100 000) were significantly increased compared with TB case notification rates in 2008 (12.4/100 000) and 2009 (14.6/100 000), when no training activities took place (P < 0.01). These findings support the use of ongoing training efforts.
Journal Article > ResearchFull Text
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 72-5.; DOI:10.5588/pha.12.0069
Tuinakelo LR, Tayler-Smith K, Khogali MA, Marks GB
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 72-5.; DOI:10.5588/pha.12.0069
SETTING
An antenatal clinic serving a population of 47 604 in Nausori, Fiji.
OBJECTIVE
1) To estimate the prevalence of anaemia, syphilis and hepatitis B in pregnant women attending their first antenatal visit; and 2) to estimate the uptake of treatment for syphilis and for the prevention of hepatitis B transmission in affected individuals.
DESIGN
Retrospective review of the clinic register and patient records for the year 2011.
RESULTS
The prevalence of anaemia, hepatitis B and syphilis were respectively 22%, 2% and 5%. Among women with syphilis, 78% of those for whom data were available received a complete course of three doses of penicillin during their pregnancy, and 83% of babies born to women with hepatitis B received hepatitis B immunoglobulin.
CONCLUSION
The prevalence of anaemia in pregnant women has declined but remains high, and further research is required to identify the major causes of this condition in Fiji. The prevalence of syphilis has remained static, while hepatitis B has decreased over the past decade. There are some gaps in the implementation of effective interventions to manage these conditions in pregnant women.
An antenatal clinic serving a population of 47 604 in Nausori, Fiji.
OBJECTIVE
1) To estimate the prevalence of anaemia, syphilis and hepatitis B in pregnant women attending their first antenatal visit; and 2) to estimate the uptake of treatment for syphilis and for the prevention of hepatitis B transmission in affected individuals.
DESIGN
Retrospective review of the clinic register and patient records for the year 2011.
RESULTS
The prevalence of anaemia, hepatitis B and syphilis were respectively 22%, 2% and 5%. Among women with syphilis, 78% of those for whom data were available received a complete course of three doses of penicillin during their pregnancy, and 83% of babies born to women with hepatitis B received hepatitis B immunoglobulin.
CONCLUSION
The prevalence of anaemia in pregnant women has declined but remains high, and further research is required to identify the major causes of this condition in Fiji. The prevalence of syphilis has remained static, while hepatitis B has decreased over the past decade. There are some gaps in the implementation of effective interventions to manage these conditions in pregnant women.
Journal Article > ResearchFull Text
Public Health Action. 21 March 2014; Volume 4 (Issue 1); 42-6.; DOI:10.5588/pha.13.0100
Tamani T, Bissell K, Tayler-Smith K, Gounder S, Linh NN, et al.
Public Health Action. 21 March 2014; Volume 4 (Issue 1); 42-6.; DOI:10.5588/pha.13.0100
SETTING
P J Twomey Hospital, National Tuberculosis Programme, Fiji.
OBJECTIVES
To review the trend in numbers of tuberculosis (TB) cases registered each year from 1950 to 2010 at P J Twomey Hospital, Fiji's largest TB treatment centre and central TB unit, and to consider trends in the context of key TB control events in Fiji.
DESIGN
Descriptive study of data from medical records and TB registers, including age, sex, ethnicity, TB diagnosis and smear result.
RESULTS
Between 1950 and 2010, 14 616 cases were registered at P J Twomey Hospital. Of these, 58% were male, 70% were indigenous Fijians (i-taukei) and 64% were aged 15-49 years. The caseload dropped sharply in the 1960s, and has fallen steadily since 1990. Smear results were available for the majority of cases (91%). Between 1950 and 1985, smear-positive cases accounted for 19% of cases overall; this increased to 41% after 1985 following laboratory training. The numbers of sputum smear-positive cases recorded each year has been increasing in the last decade.
CONCLUSION
There have been marked changes in TB caseload over the last 60 years at Fiji's largest TB treatment centre. The recent increase in smear-positive cases while total TB cases have been falling needs further evaluation.
P J Twomey Hospital, National Tuberculosis Programme, Fiji.
OBJECTIVES
To review the trend in numbers of tuberculosis (TB) cases registered each year from 1950 to 2010 at P J Twomey Hospital, Fiji's largest TB treatment centre and central TB unit, and to consider trends in the context of key TB control events in Fiji.
DESIGN
Descriptive study of data from medical records and TB registers, including age, sex, ethnicity, TB diagnosis and smear result.
RESULTS
Between 1950 and 2010, 14 616 cases were registered at P J Twomey Hospital. Of these, 58% were male, 70% were indigenous Fijians (i-taukei) and 64% were aged 15-49 years. The caseload dropped sharply in the 1960s, and has fallen steadily since 1990. Smear results were available for the majority of cases (91%). Between 1950 and 1985, smear-positive cases accounted for 19% of cases overall; this increased to 41% after 1985 following laboratory training. The numbers of sputum smear-positive cases recorded each year has been increasing in the last decade.
CONCLUSION
There have been marked changes in TB caseload over the last 60 years at Fiji's largest TB treatment centre. The recent increase in smear-positive cases while total TB cases have been falling needs further evaluation.