Recent emergence and outbreak of rotavirus gastroenteritis in Samoa:A scoping review of risk factors,containment measures and public health preparedness

Diarrheal diseases have been known to cause death in many children below the age of five years,and rotavirus infection represents a major health problem in the world today,particularly in developing countries.The recent outbreak of rotavirus gastroenteritis in Samoa led to the introduction of her debut national immunization program on rotavirus vaccination for infants.Despite the introduction of anti-viral and anti-emetic drugs as of the containment approaches towards the virus,risk factors,preventive measures and public health preparedness against rotavirus infection are poorly understood in Samoa.This review aims to use available evidence on rotavirus literature to elucidate and map preventive strategies for the recently emerged rotavirus infections in Samoa.We conducted a search strategy using online medical literature databases and retrieval systems.A designated set of keywords such as rotavirus,gastroenteritis,outbreak,risk factors,containment measures,vaccination and Samoa were inserted in electronic databases to retrieve articles.The databases included Pub Med,Google Scholar,MEDLINE,Scinapse,and EBSCO host.Findings from this review addressed the impact of rotavirus infection,associated threats and other preventive measures.Introducing useful health frameworks in pursuing possible methods such as improved water quality,exclusive breast feeding,improved laboratory diagnostics and outbreak surveillance,may be essential in addressing alternate approaches towards containment of the disease in Samoa and other Pacific Island Countries and Territories.

Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji

AIM：To describe the demographic features and visual outcomes of patients presenting to photo-screening services, and treated for sight threatening retinopathy（STR） in a low resource setting, Fiji.METHODS：A retrospective review of all new patients who presented for diabetic photo-screening at the Diabetic Eye Clinic, Suva in 2010. Fundus images were graded using standardised guidelines. Patient demographics, retinopathy grading and visual acuity data were extracted from the database and analyzed. Patients that received laser therapy and still attending follow up in 2012 were examined for disease progressionRESULTS：Totally 2236 patients were photo-screened, 87%（3870/4472） of images were gradable. STR was observed in 26%（988/3870） with advanced STR（proliferative retinopathy/severe maculopathy） in 10%（385/3870）. Of those with STR, 59% had BCVA ≥6/18, 31% with advanced STR were 〈6/60. Male gender [odds ratio（OR） 1.59; 1.20-2.12], history of hypertension（OR 1.36; 1.03-1.80） and peripheral neuropathy（OR 1.41; 1.01-1.95） were predictive of advanced STR. In 2012, 32%（315/988） attended follow up with 69% exhibiting advanced STR compared with 53% of the same cohort in 2010. Laser photocoagulation was administered to 212 eyes（212/3870, 5%） with retinopathy and maculopathy progression observed in 52% and 33% respectively. BCVA ≥6/18 was noted in 67%（143/212） of treated eyes. Improved glycaemic control（OR 46.52; 1.50-1441.90） amongst those with advanced STR was predictive of eyes that maintained good vision.CONCLUSION：In Fiji, a quarter of new patients presenting to photo-screening have STR with a third of those with advanced STR having already loss vision. Improved glycaemic control and timely treatment of patients with sight threatening complications is important in halting disease progression.

A New Discovery in Science: Far-Reaching Effects of the Hawaiian Islands on the Pacific Ocean-Atmosphere

Dr. Shangping Xie (EPRC, Hawaii University, USA), Dr. W. Timothy Liu (J.P.L. California Institute of Technology, USA), Professor Qinyu Liu (Ocean U-niversity of Qingdao, China) and Masami Nonaka (IPRC, Hawaii University, USA) discovered a phe-