Sunia Foliaki - Academia.edu (original) (raw)

Papers by Sunia Foliaki

PubMed, Jun 21, 2019

Aim: To assess whether self-sampling for cervical-cancer screening is acceptable to New Zealand w... more Aim: To assess whether self-sampling for cervical-cancer screening is acceptable to New Zealand women. Methods: Māori, Pacific and Asian un- or under-screened women aged 30-69 years were asked to: 1) examine three self-sampling devices; 2) complete a questionnaire on demographics and experiences with the devices; and 3) take a self-sample. Samples were tested 'off-label' using the cobas® 4800 human papillomavirus (HPV) test (Roche Diagnostics NZ). Results: Thirty-one Pacific, 12 Māori, nine Asian and four women of other ethnicities participated (mean age, 39.5 years). Before trying any devices, 78% indicated a preference to self-sample, compared to 22% who preferred a physician-collected sample (PCS). After trying a device (HerSwab™, 91%; Delphi Screener™, 14%; cobas Swab, 13%; 12.5% used >1 device), fewer women (66%) preferred to self-sample next time, fewer (16%) preferred a PCS, while 18% expressed no preference. One of 32 samples with valid results (35 were tested) was positive for HPV 'other' oncogenic types. Conclusions: This was the first New Zealand study to invite women, including Māori women, to take a self-sample for cervical-cancer screening. The pilot study suggests that un- and under-screened women generally find self-sampling acceptable and all sample types are suitable for use with the cobas HPV test.

HAL (Le Centre pour la Communication Scientifique Directe), 2010

The Pacific Ocean contains approximately 25,000 islands, stretching from Papua New Guinea to East... more The Pacific Ocean contains approximately 25,000 islands, stretching from Papua New Guinea to Easter Island, populated by mixtures of Melanesians, Micronesians and Polynesians, as well as migrant groups from Asia and Europe. The region encompasses a third of the surface of the earth although it is sparsely populated at a total of around 9 million. With the exception of some of the more populated islands, such as New Zealand and Hawaii, few surveys of chronic diseases have been conducted, but it is increasingly recognized that obesity, diabetes and associated conditions are emerging public health problems and clearly there is a need for cooperation to optimize control. Here we focus on cancer registry and epidemiological findings for Papua New Guinea,

PubMed, 2019

Background and objectives: Malnutrition is a public health problem especially among the Pacific S... more Background and objectives: Malnutrition is a public health problem especially among the Pacific Small Island developing nations. This study assessed malnutrition with dietary intakes in households of South Tarawa, Kiribati, a West Pacific Island Nation State. Methods and study design: A cross-sectional community-based study design was used. One hundred and sixty-one households were selected from Betio, Bikenibeu and Teaorereke towns using a systematic random sampling method. About 35% each of the households was selected from Bikenebue and Besio while 30.4% was selected from Teaoraeke. Family (including children) dietary surveys including 24- hour dietary recall were administered to assess adequacy of nutrient intakes and dietary diversity using Household Diet Diversity Scores. A 3-day weighed food record was collected on a sub-sample. Data were analysed using FoodWorks Pro 8 for nutrient intake and Statistical Product for Service Solution (SPSS) version 21 for descriptive statistics. Results: Sixty-one percent of the subjects had the lowest dietary diversity, 36.3% had a medium dietary diversity and only 2.7% had the highest dietary diversity. Based on the weighed food record results (n=29), male subjects of all age groups had adequate intakes of riboflavin, niacin, vitamin C, magnesium, iron and zinc, but had high intakes of protein and sodium; and low intakes of potassium and calcium. Female subjects had adequate intakes of vitamin C, iron, magnesium and zinc, but had high intakes of protein and sodium; and low intakes of potassium and calcium. Conclusions: Across all groups, 61% of the adult Kiribati population studied showed low dietary diversity, and a high prevalence of multiple micronutrient deficiencies.

PubMed, Sep 1, 2003

Diabetes is approaching epidemic proportions among Pacific people both in their traditional homel... more Diabetes is approaching epidemic proportions among Pacific people both in their traditional homelands as well as in metropolitan centres of their newly adopted Western countries. Although the risk factors associated with diabetes among individuals are reasonably well understood, the "upstream" causes needs to be critically appraised. While individual interventions and health education has its role, there is an urgent need to intervene at the upstream causes of diabetes and other ill health including social, trade, economic and political at the population, state and international level. Attempts to control diabetes in a vacuum without reference to socioeconomic and political context is a convenient vehicle that has contributed to and will continue to fuel calories to the diabetes epidemic.

PubMed, Mar 1, 2011

Background: We have established and/or upgraded cancer registries in four Pacific countries, a re... more Background: We have established and/or upgraded cancer registries in four Pacific countries, a region where few cancer registries exist. We report age-standardised cancer incidence in Tonga (2000-2005), Fiji (2002-2005), Cook Islands (2000-2005) and Niue (2000-2005), and in Pacific people in New Zealand (2000-2005). Methods: In each country we identified incident cancer cases by reviewing hospital discharge, death registration, cancer registration records, and pathology reports. The primary site and morphology data were coded using ICD-0, and age-standardised incidence rates were calculated. Results: Age-standardised cancer incidence rates for Pacific people in New Zealand (315 per 100,000 person-years in females, 379 in males) were similar to those for New Zealand overall (322 in females, 404 in males); incidence rates were lower in the Pacific, with rates of 195 and 151 per 100,000 person-years for females and males respectively in Tonga, 231 and 126 in Fiji, 165 and 142 in the Cook Islands, and 228 and 131 in Niue. However, some specific cancers were elevated in the Pacific including cervical cancer (16 per 100,000 in Tonga, 51 in Fiji, 17 in Cook Islands, and 26 in Niue compared with 10 in Pacific people in New Zealand, and 8 in New Zealand overall), liver cancer (rates of 8, 5, 19, 0, 7, and 2 respectively) and uterine cancer (rates of 24, 18, 47, 19 and 12 respectively). Conclusions: Cancer incidence in the Pacific is lower than for Pacific people living in New Zealand. Environmental rather than genetic factors are most likely to explain these patterns, and cancer incidence in the Pacific is likely to increase to rates similar to those in New Zealand as the region becomes more 'westernised' The high rates of cervical cancer and liver cancer in the Pacific indicate an important role of

PubMed, Sep 1, 2004

Non-Maori Pacific people constitute a significant and rapidly growing population in New Zealand. ... more Non-Maori Pacific people constitute a significant and rapidly growing population in New Zealand. An accompanying change in lifestyle associated with changing socio-economic environments results in a change in disease patterns including cancer. The paucity of reliable data on cancer necessitates our effort to contribute to the control of cancer by reviewing the available information. Our study indicates a high incidence among non-Maori Pacific people of some cancers of public health importance as well as a disproportionately high mortality rate compared to non-Maori, non-Pacific people in New Zealand. In addition, we challenge previous documentation of a significant and high incidence of cervical cancer among Pacific women compared to non-Pacific people in New Zealand. We also identified the need to remedy the inadequacy in data quality as part of any strategy to prevent and control the rising incidence and mortality attributed to cancer among non-Maori Pacific people. In addition we have commenced regional training on cancer epidemiology and propose further cancer studies in both New Zealand and the Pacific Islands.

Pediatric Allergy and Immunology, Feb 20, 2014

BackgroundThe association between birthweight and asthma, eczema and rhinoconjunctivitis is confl... more BackgroundThe association between birthweight and asthma, eczema and rhinoconjunctivitis is conflicting.AimsTo examine the association between birthweight and symptoms of asthma, eczema and rhinoconjunctivitis.MethodsParents or guardians of children aged 6–7 yr completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several risk factors, including birthweight.ResultsThere were 162,324 children from 60 centres in 26 countries. Low birthweight (<2.5 kg) was associated with an increased risk of symptoms of asthma (current wheeze odds ratio = 1.20; 95% confidence interval = 1.12–1.30). Low birthweight was associated with a lower risk of eczema ever. Low birthweight was not associated with rhinoconjunctivitis. Large babies (birthweight ≥4.5 kg) were not associated with any of these outcomes.ConclusionsThis study has confirmed that low birthweight is a risk factor for symptoms of asthma, but not for rhinoconjunctivitis. The findings for eczema are equivocal.

Lancet Oncology, May 1, 2008

Polynesia consists of several islands that are scattered across a vast triangle in the Pacific, a... more Polynesia consists of several islands that are scattered across a vast triangle in the Pacific, and include New Zealand, Hawaii, and the Pacific islands. There are reported differences in the types of cancer and epidemiologies seen among communities in these islands, the reasons for which are diverse and complex. In this Review, we describe patterns of cancer incidence, mortality, and survival in indigenous populations compared with populations of European origin in Polynesia, and highlight the limited available data for Pacific populations. Additionally, we document the current knowledge of the underlying biology of cancers in these populations, and report risk factors that differ between ethnicities, including smoking, viral infections, and obesity. Disparities in measures of health are highlighted, as are evident differences in knowledge of tumour biology and cancer management between majority and minority populations.

The Lancet Regional Health - Western Pacific, Nov 1, 2022

Asian Pacific Journal of Cancer Prevention, Mar 9, 2015

N.Z. population groups and the general population-except Maori-across a number of health outcomes... more N.Z. population groups and the general population-except Maori-across a number of health outcomes including a lower life expectancy and higher morbidity and mortality rates of chronic diseases (Minister of Health and Minister

European Journal of Cancer Care, 2017

Roder D. Cancer registration challenges in low-and middle-income countries-the case of the Pacifi... more Roder D. Cancer registration challenges in low-and middle-income countries-the case of the Pacific Islands.

BMJ, Aug 23, 2003

Diabetes is a major problem worldwide. Among Pacific people, prevention and control of diabetes l... more Diabetes is a major problem worldwide. Among Pacific people, prevention and control of diabetes lies in counteracting rapid changes in lifestyle and must take account of political and economic factors and social structure Early studies clearly showed that while diabetes was virtually non-existent in populations indigenous to the Pacific maintaining a traditional lifestyle, the reverse was true for the urbanised Pacific populations. 1 In recent decades diabetes prevalence has increased rapidly over time in the indigenous people in the Pacific region (Polynesian, Melanesian, Micronesian), both in the Pacific islands and in countries such as New Zealand. 2 Epidemiological evidence indicates that prevalence is generally lowest in traditional Pacific environments, and is higher in both urban Pacific and adopted metropolitan environments; in the latter environments, prevalence is markedly higher in Pacific people than in white people. Prevalence has been increasing rapidly in all three environments, and Pacific people experience greater morbidity and more complications than white people with diabetes. Genetic factors alone cannot explain these patterns, which are due to rapid changes in lifestyle and risk factors such as obesity, unhealthy diets, and physical inactivity that have become widespread throughout the region. 2 Although the risk factors associated with diabetes are now reasonably well understood, the prevention and control of the condition in the Pacific, and in Pacific people in Western countries, is not straightforward. We here consider the individual level and population level approaches to diabetes prevention and control in Pacific people.

Journal of Epidemiology and Community Health, Oct 1, 2004

Background: The ''hygiene hypothesis'' postulates that infections during infancy may protect agai... more Background: The ''hygiene hypothesis'' postulates that infections during infancy may protect against asthma and atopy. There is also some evidence that antibiotic and/or paracetamol use may increase the risk of asthma. Methods: The study measured the association between infections, and medication use early in life and the risk of asthma at age 6-7 years. It involved 1584 children who had been notified to public health services with serious infections at age 0-4 years, and 2539 children sampled from the general population. For both groups, postal questionnaires were completed by parents. Results: There was little difference in the prevalence of current wheezing between the childhood infections group (prevalence = 23.5%) and the general population group (prevalence = 24.3%). There was also little difference whether the major site of infection was gastrointestinal (prevalence = 24.1%), invasive (prevalence = 24.6%) or respiratory (prevalence = 21.1%). However, in both groups, there were associations with antibiotic (OR = 1.78, 95% CI 1.49 to 2.14) or paracetamol (OR = 1.38, 95% CI 1.04 to 1.83) use in the first year of life or recent paracetamol use (OR = 2.10, 95% CI 1.78 to 2.49) and current wheezing. There was a weak protective effect of childhood infections in children who had not used antibiotics in the first year of life (OR = 0.78, 95% CI 0.55 to 1.10). Conclusions: These findings are consistent with other evidence that antibiotic use early in life may increase the risk of asthma. They are also consistent with some preliminary evidence associating paracetamol use with an increased risk of asthma. Any protective effect of notifiable childhood infections was weak.

Health Expectations, Sep 26, 2022

Clinical & Experimental Allergy, Dec 26, 2014

Background Associations of larger families with lower prevalences of hay fever, eczema and object... more Background Associations of larger families with lower prevalences of hay fever, eczema and objective markers of allergic sensitization have been found fairly consistently in affluent countries, but little is known about these relationships in less affluent countries. Methods Questionnaire data for 210 200 children aged 6-7 years from 31 countries, and 337 226 children aged 13-14 years from 52 countries, were collected by Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Associations of disease symptoms and labels of asthma, rhinoconjunctivitis and eczema were analysed by numbers of total, older and younger siblings, using mixed (multi-level) logistic regression models to adjust for individual covariates and at the centre level for region, language and national affluence. Results In both age groups, inverse trends (P < 0.0001) were observed for reported 'hay fever ever' and 'eczema ever' with increasing numbers of total siblings, and more specifically older siblings. These inverse associations were significantly (P < 0.005) stronger in more affluent countries. In contrast, symptoms of severe asthma and severe eczema were positively associated (P < 0.0001) with total sibship size in both age groups. These associations with disease severity were largely independent of position within the sibship and national GNI per capita. Conclusions These global findings on sibship size and childhood asthma, rhinoconjunctivitis and eczema suggest at least two distinct trends. Inverse associations with older siblings (observations which prompted the 'hygiene hypothesis' for allergic disease) are mainly a phenomenon of more affluent countries, whereas greater severity of symptoms in larger families is globally more widespread.

The Lancet Regional Health - Western Pacific

Objective To assess obesity, the relationship between body mass index (BMI) and body fat percenta... more Objective To assess obesity, the relationship between body mass index (BMI) and body fat percentage (BF%) among adults, and determine the appropriate BMI cut-points in Kiribati.Methods A cross-sectional study was undertaken among 483 adults randomly selected from South Tarawa (urban) and Butaritari (rural). Weight, height, BF% and physical activity level (PAL) was measured using standard methods. Linear and quadratic regression analyses were conducted to assess the association between BF% and BMI whilst controlling for age and gender. ROC curve analyses were used to assess whether for the Kiribati population alternative BMI cut-off points for obesity are needed.Results Approximately 75% of participants were obese using standard BMI and BIA cut-offs, with the highest prevalence observed in South Tarawa. BF% was significantly (p<0.001) and positively associated with age (males, r=0.78; females, r=0.67; p<0.000) and BMI. Based on ROC-curve analyses the BMI cut-offs for predicting...

International Journal of Epidemiology, 2015