Christine Linhart

• Master of International Public Health
• Lecturer at UNSW Sydney

Background Fiji is a Pacific Island nation with the predominant ethnic groups indigenous Fijians (iTaukei) (62 %) and Fijians of Indian descent (31 %). This study reports on the effect of a Parental Assistance Payment Program (PAPP) tied to on-time birth registration, available in Fiji from August 2018 to July 2020. Methods Unit record birth regis...

Background Chronic kidney disease (CKD) is a significant clinical challenge in Sri Lanka. The present study presents histopathological diagnoses from native renal biopsies in Kandy District, 2011–2020. Methods Reports of 5,014 renal biopsies principally performed at Kandy Teaching Hospital over 2011–2020 were reviewed. After exclusions for post-ki...

Background: Fiji is a Pacific Island nation of 884,887 (2017 census), with the predominant ethnic groups indigenous Fijians (iTaukei) (62%) and Fijians of Indian descent (31%). In Fiji, birth registration is considered on-time if completed within one year of a child’s birth. From August 2018 to July 2020, the government implemented a financial ince...

Background Fiji, population 884,887 (2017 census), is a Pacific Island country with two dominant ethnic groups: 62% Indigenous Fijians (i-Taukei) and 31% Fijians of Indian descent (FID). Cancer mortality by ethnicity for women aged 30-69 years was investigated. Methods Proportional mortality and probability of dying (PoD30-70) from cancer (ICD-10:...

Background: Cardiovascular disease (CVD) and diabetes mellitus are major health issues in Tonga and other Pacific countries, although mortality levels and trends are unclear. We assess the impacts of cause-of-death certification on coding of CVD and diabetes as underlying causes of death (UCoD). Methods: Tongan records containing cause-of-death d...

Introduction: Providing affordable, accessible, quality health services is critical to attaining Universal Health Coverage (UHC). Despite this, progress in many Pacific Island countries and territories could be faster. Digital health is an advancement in information communication technology that is anticipated to change health care delivery. Method...

The provision of adequate health services is critical to achieving the Sustainable Development Goals (SDGs), attaining universal health coverage (UHC) and realizing the Pacific’s own “Healthy Islands” vision. Despite this, progress in health service delivery in many Pacific Island countries and territories (PICTs) has been slow. Recent advancements...

Background Fiji, a Pacific Island nation of 884,887 (2017 census), has experienced a prolonged epidemiological transition. This study examines trends in mortality and life expectancy (LE) in Fiji by sex and ethnicity over 1996–2017, with comparisons to published estimates. Methods Trends in infant mortality rates (IMR), under-5 mortality (U5M), ad...

Background Tonga is a South Pacific Island country with a population of 100,651 (2016 Census). This study examines Tongan infant mortality rates (IMR), under-five mortality rates (U5MR), adult mortality and life expectancy (LE) at birth from 2010 to 2018 using a recent collation of empirical mortality data over the past decade for comparison with o...

Background: The effectiveness of a 2015-17 community intervention to reduce cardiovascular disease (CVD) and type 2 diabetes (T2DM) risk factors is assessed in a Sri Lanka adult population, using a before-and-after study design. Methods: Four contiguous Public Health Midwife (PHM) areas in Kalutara district (Western Province) were exposed to a S...

Background: To analyse trends over the period 1991-2013 in systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension in adults aged 25-64 years in Samoa; and to assess the contribution of rising obesity levels to period trends. Methods: Unit record data from seven population-based surveys (n = 10,881) condu...

Context: Fiji has undergone an epidemiological transition, characterised by declining infectious disease and childhood mortality, that has been offset by rising cardiovascular disease mortality. Other Pacific Island states are in a comparable situation. Objective: With a focus on Fiji, this study reviews and contextualises research performed by the...

Background: The island country of Samoa (population 188,000 in 2011) forms part of Polynesia in the South Pacific. Over the past several decades Samoa has experienced exceptional modernization and globalization of many sectors of society, with noncommunicable diseases (NCD) now the leading cause of morbidity and mortality. The evolution of risk fa...

Appendix S1. Adjustment for exclusion of known Type 2 diabetes mellitus 1991 and 1995 SACRF surveys. Appendix S2. Selection biases in survey participants. Appendix S3. Designation of Type 2 diabetes mellitus. Appendix S4. Adjustment for obesity from exclusion of known Type 2 diabetes mellitus and/or hypertension in 1991 and 1995 SACRF surveys.

Since 1950, cardiovascular disease (CVD) has emerged as a leading cause of mortality in Sri Lanka, especially in men. In 2014, a survey in Kalutara to assess CVD and type 2 diabetes mellitus (T2DM) risk factors in adults aged 25 to 64 years (n = 1011), and associations with sex and socioeconomic status (SES), found similar CVD risk factors in both...

Objectives This study estimates type 2 diabetes (T2DM) incidence in Samoans aged 25–64 years from sequential, irregularly spaced, cross-sectional population prevalence surveys. MethodsT2DM prevalence from eight population surveys conducted over 1978–2013 (n = 12,516) was adjusted for census region, sex, and 5-year age group to the nearest previous...

Background Type 2 diabetes mellitus (T2DM) incidence is traditionally derived from cohort studies that are not always feasible, representative, or available. The present study estimates T2DM incidence in Fijian adults from T2DM prevalence estimates assembled from surveys of 25–64 year old adults conducted over 30 years (n = 14,288). MethodsT2DM pre...

Objectives: To examine trends from 1980-2011 in daily tobacco smoking by sex, ethnicity, age, and urban/rural in Fiji Melanesian (i-Taukei) and Indian adults aged 25-64 years. Methods: Unit record data from five population-based surveys (n=14,528) allowed classification of participants as: (1) never smoker, ex-smoker or non-daily smoker; or (2)...

Aims: Population surveys of Type 2 diabetes mellitus and obesity conducted in Samoa over three decades have used varying methodologies and definitions. This study standardizes measures, and trends of Type 2 diabetes mellitus and obesity for 1978-2013 are projected to 2020 for adults aged 25-64 years. Methods: Unit records from eight surveys (n =...

Comparison of the prevalence of type 2 diabetes mellitus (T2DM) in adults aged 25–64 years in selected Pacific Island countries using whole blood and plasma glucose cut-off points. Unit records of STEPwise approach to Surveillance (STEPS) surveys obtained from Fiji, Samoa, and Tonga Ministries of Health; T2DM prevalence recalculated using whole blo...

Disparate population surveys of type 2 diabetes mellitus (T2DM) have been conducted in Tonga for 4 decades. This study standardizes these surveys to enable assessment of T2DM and obesity trends in Tongans aged 25 to 64 years over 1973-2012, and projects T2DM prevalence to 2020 based on demographic and population weight changes. Eight surveys were s...

Background The population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years. Methods A mini-STEPS survey (n = 2765) was conducted in Viseisei in Western Fiji to assess NCD risk factors (RFs) in i-Taukei (Melanesians) and those of Indian descent aged 25–64 years (response 73...

Objectives: To analyse trends during 1980-2011 in hypertension prevalence and SBP/DBP by sex in Fiji Melanesian (i-Taukei) and Indian adults aged 25-64 years; and to assess effects of BMI. Methods: Unit record data from five population-based surveys were included (n = 14 191). Surveys were adjusted to the nearest previous census to improve natio...

Background: Wallis Island is part of a French Territory in the South Pacific. In 1980 the prevalence of hypertension and type 2 diabetes mellitus (T2DM) was low, consistent with a subsistence economy. Considerable social and economic changes have occurred over the last 30 years. Methods: Survey data from 1980 and 2009 were analysed by sex in 10-...

No systematic comparison has been conducted in Fiji using all suitable surveys of type 2 diabetes mellitus (T2DM) and obesity prevalence, after adjusting for differences in methodology, definitions and demographic characteristics. Unit records from 6 cross-sectional surveys of Fiji adults were included. Surveys were variously adjusted for age, ethn...

Background Although all-cause mortality in Sri Lanka decreased significantly from 1950 to 1970, subsequent declines have been more modest with divergent trends by age and sex. This study investigates these trends through cause of death analysis for 1950–2006 in adults aged 15–64 years. Methods Deaths were obtained from the World Health Organisatio...

Objectives: Infant mortality rates (IMR) and under-five mortality rates (U5MR) in Tuvalu (2010 population 11,149) for 1990-2011 were evaluated to determine best estimates of levels and trends. Methods: Estimates were graphed over time to identify trends/inconsistencies, and censored for reliability/plausibility. Where possible, 95% confidence in...

Objective: To examine trends in infant mortality rate (IMR), adult mortality and life expectancy (LE) in the two major Fijian ethnic groups since 1975. Methods: Estimates of IMR, adult mortality (15-59 years) and LE by ethnicity are calculated from previously unreported Fiji Ministry of Health data and extracted from published sources. Results:...