Ministry of Fisheries and Marine Resource Development

Eight Pacific Island Countries and Territories (PICTs) have been validated by the World Health Organization (WHO) as having eliminated lymphatic filariasis (LF) as a public health problem. WHO recommends that these countries implement post-validation surveillance (PVS) to ensure resurgence has not occurred. Some PICTs proactively conducted LF PVS even in the absence of specific recommendations or best-practice guidelines at the time of implementation. We aimed to explore the barriers and facilitators to implementing LF PVS in PICTs, with a view to informing context-specific strategies and regional guidelines. Key informant interviews were held between March and September 2024 with 15 participants involved in LF and/or neglected tropical disease surveillance. Transcripts were analysed thematically using a generalised deductive approach. A conceptual framework was developed to summarise themes with two main streams of barriers identified. Stream One Barriers included limited awareness of, and guidelines for, PVS requirements and competing national health priorities. Stream Two Barriers included cost, resource, and logistical barriers to conducting PVS. Participants called for clearer, contextually tailored guidelines, improved communication from WHO, and integration within existing systems. This study highlights the urgent need for operational guidance, policy advocacy, and capacity strengthening to ensure sustainable LF PVS in PICTs. Incorporating local context and leveraging existing health structures will be essential to prevent disease resurgence and maintain gains achieved through elimination programmes.

Background: Chordomas, rare tumors originating from residual chordate tissues, were first discovered in 1846. Predominantly affecting the base of the skull and the axial skeleton, these tumors are considered uncommon cancers. This systematic review will investigate the anatomical aspects and neurosurgical treatment modalities of skull base and spinal chordomas through a comprehensive analysis of available literature. Methods: We conducted a systematic literature review, adhering to PRISMA guidelines, by searching Databases including Web of Science, PubMed/Medline, EMBASE, Google Scholar, and Cochrane Library using specific keywords such as "chordomas," "skull base," "skull base anatomy," "spinal/sacral chordoma surgery," and "adjuvant therapy." Data analysis was performed using Microsoft Excel and SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). And R software. Results: In this study, we conducted an intensive systematic review and meta-analysis, including a total of N=2,083 patients with clinical and neurological manifestations, as outlined between Table I and Table IV. The analysis yielded N=1,485, (71.5%) patients, N=636,GTR, N=640, STR N=568, Radiotherapy, as detailed in Tables I and II and Figures 1, 2, and 3. Heterogeneity was assessed as follows: Chi² = 18.41, df = 14, P < 0.19 vs. I² = 24%, test for overall effect: Z = 1.25, P = 0.21. Conclusion: The aggressive nature of chordomas necessitates personalized treatment strategies. Surgical approaches, particularly for elderly patients, proved promising in chordoma excision. Despite advancements, further research into disease management and etiopathogenesis is crucial for improved prevention, detection, and treatment strategies. Adjuvant therapies exhibited enhanced survival rates, highlighting their significance in prolonging patients' lives post-surgery.

Pacific Island countries have experienced periodic dengue, chikungunya and Zika outbreaks for decades. The prevention and control of these mosquito-borne diseases rely heavily on control of Aedes aegypti mosquitoes, which in most settings are the primary vector. Introgression of the intracellular bacterium Wolbachia pipientis (wMel strain) into Ae. aegypti populations reduces their vector competence and consequently lowers dengue incidence in the human population. Here we describe successful area-wide deployments of wMel-infected Ae. aegypti in Suva, Lautoka, Nadi (Fiji), Port Vila (Vanuatu) and South Tarawa (Kiribati). With community support, weekly releases of wMel-infected Ae. aegypti mosquitoes for between 2 to 5 months resulted in wMel introgression in nearly all locations. Long term monitoring confirmed a high, self-sustaining prevalence of wMel infecting mosquitoes in almost all deployment areas. Measurement of public health outcomes were disrupted by the Covid19 pandemic but are expected to emerge in the coming years.

In January 2022, Kiribati experienced widespread community transmission of COVID-19, leading to high rates of infection among health-care workers (HCWs), which reduced essential HCWs during a period of increased hospital admissions. Kiribati, a Pacific island country made up of a remote group of 33 low-lying atolls in the Pacific Ocean, experienced its first surge of COVID-19 cases beginning on 24 January 2022. Reports of increasing numbers of COVID-19 cases in South Tarawa prompted the Kiribati Ministry of Health and Medical Services to request assistance from the international community, including the World Health Organization's Global Outbreak Alert and Response Network (GOARN), to support national COVID-19 response operations. Specialists in infection prevention and control (IPC) were deployed to Kiribati in February 2022 to assist the Ministry's National COVID-19 Taskforce in collaboration with national partners. These specialists helped review and strengthen IPC capacities to accommodate a potential patient surge and consequent demands for medical consumables in health-care facilities in South Tarawa. Strengthened knowledge about and processes for IPC among HCWs prevented health care-associated infections and reduced community disease transmission during the first surge of COVID-19 cases in Kiribati. GOARN has the capacity and ability to rapidly deploy experts to support requests for assistance. Outbreak response activities can be enhanced and sustained by using GOARN's resources and collaborating with all partners, as necessary.

IntroductionProgress towards leprosy elimination is threatened by increasing incidence in ‘hot-spot’ areas where more effective control strategies are urgently required. In these areas, active case finding and leprosy prevention limited to known contacts is insufficient for control. Population-wide active case-finding together with universal prevention through mass drug administration (MDA) has been shown to be effective in ‘hot-spot’ areas, but is logistically challenging and expensive. Combining leprosy screening and MDA with other population-wide screening activities such as for tuberculosis may increase programme efficiency. There has been limited evaluation of the feasibility and effectiveness of combined screening and MDA interventions. The COMBINE study aims to bridge this knowledge gap.Methods and analysisThis implementation study will assess the feasibility and effectiveness of active leprosy case-finding and treatment, combined with MDA using either single-dose rifampicin or rifamycin-containing tuberculosis preventive or curative treatment, for reducing leprosy incidence in Kiribati. The leprosy programme will run over 2022–2025 in concert with population-wide tuberculosis screening-and-treatment in South Tarawa. The primary research question is to what extent the intervention reduces the annual leprosy new case detection rate (NCDR) in adults and children compared with routine screening and postexposure prophylaxis (PEP) among close contacts (baseline leprosy control activities). Comparisons will be made with (1) the preintervention NCDR separably among adults and children in South Tarawa (before–after study) and (2) the corresponding NCDRs in the rest of the country. Additionally, the postintervention prevalence of leprosy obtained from a survey of a ‘hot-spot’ sub-population will be compared with prevalence documented during the intervention. The intervention will be implemented in collaboration with the Kiribati National Leprosy Programme.Ethics and disseminationApproval has been obtained from the Kiribati Ministry of Health and Medical Services (MHMS), the University of Otago (H22/111) and the University of Sydney (2021/127) Human Research Ethics Committees. Findings will be shared with the MHMS, local communities and internationally through publication.

A 63 year old woman with CLL Leukaemia offered to try a novel treatment being developed at our centre. Beginning with Propranolol and Aliskiren several additional compounds were tried over time, Aspirin, Curcumin and Bromelain were retained. Over the succeeding eight years her lymphocyte count has risen slowly and was presently stable around 35,000. A few weeks ago when Bromelain was increased to 500mg pd the Lymphocytes dropped to 32.1. The patient still continues to lead a normal life with no side effects, the only complaint being tiredness. This treatment we infer to inhibit cancer growth at least.

his report proposes a three-dimensional/two-dimensional switchable augmented-reality display system using a liquid crystalline lens array and an electrical polarizer. A depth camera that is connected to the proposed augmented-reality display system acquires the three-dimensional or two-dimensional information of the real objects. Here, the dual function liquid-crystalline lens array is switched its function according to the polarizing directions of an electrical polarizer. The proposed system's overall procedure is as follows: the depth camera captures the depth/color, or only color image according to the switcher of a polarizer, and the three-dimensional or two-dimensional images are displayed separately on the augmented-reality display system. It gives an opportunity that three-dimensional and two-dimensional modes can be switched automatically. In the two-dimensional mode, the captured color image of a real object is displayed directly. In the three-dimensional mode, the elemental image array is generated from the depth and color images and reconstructed as a three-dimensional image by the liquid-crystalline microlens array of a proposed augmented-reality display system. Even the proposed system cannot be implemented the real-time display in the three dimensional mode, the direction-inversed computation method generates the elemental image arrays of the real object within a possible short time.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) kills more than 4.9 million adults yearly, and it is one of the major threats to global public health for low- and middle-income countries that mostly affects the adult population. Kiribati is currently facing the increasing prevalence of morbidity and mortality from T2DM. 
 
 OBJECTIVE: To find out the level of Knowledge, Attitude and Practice (KAP) towards T2DM among healthy adults in South Tarawa, Kiribati. 
 
 METHODS: This cross sectional study was conducted on South Tarawa, Kiribati at three randomly selected public health clinics from September 25 to November 20, 2017. Non-diabetic patients from both sexes who aged 18 years and above were selected by a simple random sampling technique to participate in this study. A pretested structured questionnaire was used to collect data and SPSS (version 22) was used for data analysis. Descriptive statistics was used to study the characteristics of the population and level of KAP. 
 
 RESULTS: 405 person participated in this study. Majority of the participants were in the age range of 18-24 years (30.4%), were females (66.2%) and had ever married (68.6%). The study revealed that the mean knowledge score was 20.47 (±3.49) which shows that participants had moderate level of knowledge towards T2DM. The mean score for attitude score was 61.06 (±5.48) which shows that participants had high level of attitude towards T2DM. The mean practice score was 4.57 (±2.01) which shows that participants had a low level of practice towards T2DM. 
 
 CONCLUSION: A great emphasis on health education regarding symptoms, risk factors modification and prevention is T2DM are necessary.