Genetic and geographic population structure in the malaria vector, Anopheles farauti, provides a candidate system for pioneering confinable gene-drive releases

Indoor insecticide applications are the primary tool for reducing malaria transmission in the Solomon Archipelago, a region where Anopheles farauti is the only common malaria vector. Due to the evolution of behavioural resistance in some An. farauti populations, these applications have become less effective. New malaria control interventions are therefore needed in this region, and gene-drives provide a promising new technology. In considering developing a population-specific (local) gene-drive in An. farauti, we detail the species' population genetic structure using microsatellites and whole mitogenomes, finding many spatially confined populations both within and between landmasses. This strong population structure suggests that An. farauti would be a useful system for developing a population-specific, confinable gene-drive for field release, where private alleles can be used as Cas9 targets. Previous work on Anopheles gambiae has used the Cardinal gene for the development of a global population replacement gene-drive. We therefore also analyse the Cardinal gene to assess whether it may be a suitable target to engineer a gene-drive for the modification of local An. farauti populations. Despite the extensive population structure observed in An. farauti for microsatellites, only one remote island population from Vanuatu contained fixed and private alleles at the Cardinal locus. Nonetheless, this study provides an initial framework for further population genomic investigations to discover high-frequency private allele targets in localized An. farauti populations. This would enable the development of gene-drive strains for modifying localised populations with minimal chance of escape and may provide a low-risk route to field trial evaluations.

Child health nurses in Solomon Islands, piloting the 'Bachelor of nursing: Child health'

AIM

In 2016, the Solomon Islands National University developed and implemented the country's first nursing specialisation in child health, the Bachelor of Nursing: Child Health. This qualitative study aimed to explore the experiences of the first cohort of students (n = 14) during this course in order to evaluate the programme.

BACKGROUND

The Bachelor of Nursing: Child Health was implemented in 2016 to develop nurses' knowledge and skills in child health and improve child health outcomes and so on.

DESIGN

The qualitative evaluation study used an exploratory, descriptive design.

METHODS

The 14 nurses who constituted the first cohort of students were selected as study participants. Individual semi-structured interviews were conducted between August and December 2018. Thematic analysis was undertaken following the Braun and Clarke six-phase process to generate themes and sub-themes from the data. The Consolidated Criteria for Reporting Qualitative Research checklist guided the reporting of the study.

RESULTS

Interviews revealed important feedback about the course, including areas to strengthen and avenues to improve it in the future. Four themes emerged: learning during the Bachelor of Nursing: Child Health, support during the course, challenges experienced during the course and suggested course improvements in the future. The study found that theoretical sessions combined with practical and interactive activities were most effective in learning both theoretical concepts and their related clinical applications and skills. Although support was generally available during the course, participants emphasised their responsibility to take the lead in their learning and seek support when required. The lack of mentoring combined with logistical difficulties were perceived as barriers to learning. Participant recommendations support further development of the child health nursing specialisation, with specific strengthening in areas such as teaching and mentoring, logistics, course curriculum and human and material resources.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Given the potential benefits of increasing nurses' knowledge and skills in child health and paediatric care on reducing neonatal and child mortality and morbidity, ongoing support for the implementation of this course in Solomon Islands and more broadly across the Pacific region is recommended. The provision of such support is a local, regional and a global responsibility. Indeed, Sustainable Development Goal 3c calls for a substantial increase in health financing and in the recruitment, development, training and retention of the health workforce in low- and middle-income countries.

CONCLUSIONS

Results of the evaluation demonstrate the positive aspects of the course in relation to content and curriculum delivery strategies as well as identifying areas where further refinement and strengthening is required.

Strengthening rural community water safety planning in Pacific Island countries: evidence and lessons from Solomon Islands, Vanuatu, and Fiji

Pacific Island Countries (PICs) collectively have the lowest rates of access to safely managed or basic drinking water and sanitation globally. They are also the least urbanised, have dynamic socioeconomic and increasing climate-linked challenges. Community-based water managers need to respond to variability in water availability and quality caused by a range of hazards. Water Safety Planning (WSP), a widely adopted approach to assessing water supply, offers a risk-based approach to mitigating both existing and future hazards. WSP is adaptable, and making modifications to prescribed WSP to adapt it to the local context is common practice. Within the Pacific Community Water Management Plus research project, we used formative research and co-development processes to understand existing local modifications, whether further modifications are required, and, to develop additional modifications to WSP in Fiji, Vanuatu and Solomon Islands. The types of additional local modifications we recommend reflect the unique context of PICs, including adjusting for community management of water supplies and required collective action, community governance systems, levels of social cohesion in communities, and preferred adult-learning pedagogies. Incorporating modifications that address these factors into future WSP will improve the likelihood of sustained and safe community water services in Pacific and similar contexts.

"Feeling at home in Vanuatu": Integration of newcomers from the East during the last millennium

Several localities across the Vanuatu archipelago (Melanesia), so-called 'Polynesian Outliers', are inhabited by communities that display Polynesian linguistic and cultural features although being located outside the Polynesian Triangle. Several introductions of Polynesian genetic components to Central and Southern Vanuatu during the last millenium have resulted in the cultural distinctiveness observed among the Polynesian Outliers in Vanuatu. However, social, political or economic process surrounding the exchange of genes between Polynesian and local individuals remain unidentified. Recent bioanthropological studies suggest the existence of female mobilities from neighboring regions to Vanuatu but also to the Polynesian Outliers of Taumako (Solomon Islands) within patrilocal societies. We aim to examine the hypothesis that Polynesian biological affinities observed in ancient individuals from Vanuatu are gendered or sex-specific, and that some of the Polynesian migrations during the last millennium may have involved practices of exogamy. By reconstructing phenotypes and biological identities from 13 archaeologically-recovered human skulls (400-300 years ago) from "Polynesian-related" regions of Vanuatu, we provide new insights to better contextualize the settlement patterns of Polynesian individuals. Eastern-Pacific associated phenotype are observable in 4 women from the Eretok burial complex (Efate region) and the Polynesian Outlier of Futuna, who were buried in close proximity to individuals with Western-Pacific associated phenotype. We suggest that close integration of individuals from the East into the local Vanuatu society, as well as the practice of exogamy, might have been key processes contributing to the preservation of Polynesian cultural features in Vanuatu over the past millennium. Our finding are cross-referenced with oral records from these two areas, as well as the known genetic makeup of the Vanuatu Polynesian Outliers.

Solomon Islands Oncology Unit: Sustainability in Terms of Outcomes

Bush et al emphasize that the key to establishing enduring and efficient global health systems lies in prioritizing local stakeholders and, above all, the welfare of patients.

Food price and availability in Solomon Islands during COVID-19: A food environment survey

Background: In Solomon Islands, the retail food environment is an important food source, for instance, the dominant source of fresh fruit and vegetables for urban consumers is open markets. The effects of COVID-19 mitigation measures (such as restriction of human movement and border closures) in early 2020 placed food security at risk in many parts of the community. Of particular concern was the risk of price gouging in an already price-sensitive market. Aims: The study aimed to provide rapid and policy-relevant information on the pricing of foods in the urban food environment in Solomon Islands in the context of the unfolding COVID-19 pandemic. Methods: A vendor survey was conducted in July to August 2020 and repeated in July 2021 using a survey tool that collected information on type, quantity, and price of food on offer. Findings: We found price reductions among the majority of fresh fruit and non-starchy vegetables available. A trend of rising prices was reported for some other commodities, such as fresh locally caught fish. Conclusion: Our findings highlight the impact of 'schocks to the system' on food prices as a potential barrier or enabler to consumption of fresh foods purchased from urban areas - an important finding in a price sensitive market. The survey design was successful in collecting pricing data from the retail food environment during a time of external 'shock to the system'. Our approach is applicable to other settings needing a rapid survey of the external food environment.

First records of the Pacific sleeper shark Somniosus cf. pacificus in the western tropical Pacific

Technological advances have enabled the expansion of ocean exploration to include the deep ocean, providing new species observations. Here, the authors present two new observations, captured by deep-sea cameras, of the sleeper shark Somniosus cf. pacificus from the Solomon Islands and Palau. This presents the first observation of S. cf. pacificus in the western Pacific tropics and extends its range about 2000 nautical miles south. The observations presented here provide much-needed information on the range of this species which can help guide future management and conservation actions.

xanthocercus Allen, Erdmann & Pertiwi (Perciformes: Pomacentridae) from Melanesia and the eastern and central Indian Ocean

N/A.

Redescription of Lepidodactylus flaviocularis (Squamata: Gekkonidae), with the description of a new species from Makira Island, Solomon Islands

Several species of geckos of the genus Lepidodactylus are endemic to the Solomon Islands and very poorly known. I redescribe one of these, L. flaviocularis, from Guadalcanal, based on examination of a second, newly obtained specimen and quantification of diagnostically useful features of the digits. I also describe a closely related new species from nearby Makira Island in the southern Solomon Islands. Both species are distinguished by their large number of undivided subdigital lamellae, extensive toe webbing, and a continuous row of enlarged precloacal/femoral scales. The new species is distinguished from L. flaviocularis by a number of scalational features and the color of the circumorbial scales. Both species are inhabitants of interior forest, and it remains uncertain whether they are naturally rare, rare due to interactions with invasive species, or simply have cryptic ecological habits, though the last seems most likely. Current evidence for both species is consistent with the taxon-cycle hypothesis, which posits ecological displacement to inland habitats of ancient island inhabitants by newer colonizers, but this remains to be critically tested. The limited pool of specimens available for both species necessitates assessing the IUCN conservation status of each as Data Deficient.

Building Capability and Capacity: The Establishment of an Oncology Unit in the Solomon Islands

PURPOSE

To describe the establishment of an oncology unit at the National Referral Hospital (NRH) in the Solomon Islands, a low-income nation in the South Pacific.

METHODS

A scoping visit was carried out in 2016 to assist in the development of coordinated cancer services and to establish a medical oncology unit at the NRH at the request of the Medical Superintendent. This was followed by an observership visit to Canberra by an NRH doctor training in oncology in 2017. After a request from the Solomon Islands Ministry of Health, the Australian Government Department of Foreign Affairs and Trade (DFAT) arranged an in-country multidisciplinary mission under the Royal Australasian College of Surgeons/Royal Australasian College of Physicians Pacific Islands Program to help in the commissioning of the NRH Medical Oncology Unit in September 2018. Staff training and education sessions were held. The team, with the assistance of an Australian Volunteers International Pharmacist, has helped the NRH staff to develop localized Solomon Islands Oncology Guidelines. Donated equipment and supplies have helped with the initial establishment of the service. A second DFAT Oncology mission visit was made in 2019 followed by two NRH oncology nurses visiting Canberra on observership later that year and support of the Solomon's doctor to pursue postgraduate education in cancer sciences. Ongoing mentorship and support has been maintained.

RESULTS

The island nation now has a sustainable oncology unit delivering chemotherapy treatments and management of patients with cancer.

CONCLUSION

A collaborative multidisciplinary team approach by professionals from the high-income country working with colleagues from the low-income nation with coordination of different stakeholders was the key to this successful initiative in improving cancer care.

Understanding reasons for lack of acceptance of HIV programs among indigenous Papuans: a qualitative study in Indonesia

BACKGROUND

Melanesians are indigenous Papuans racially and culturally different from most Indonesians. The Melanesia region is characterised by high poverty and inequalities, even though it has the highest revenue. Furthermore, Papua has the highest HIV prevalence rate, 24-fold higher than that of other regions. Therefore, this study aimed to examine the resistance of indigenous people residing in eastern Indonesia towards HIV programs.

METHODS

This is a qualitative study analysed using grounded theory. Data were collected from July to September 2018 through semi-structured face-to-face interviews involving 23 Papuans. The interviews were conducted in Bahasa Indonesia, audio-recorded, summarised and transcribed for analysis.

RESULTS

The results showed that being a good Papuan emerges from four interconnected categories, including culture and religion, dealing with modernisation, integrated HIV program and stigma reduction. As a substantive theory underpinning the indigenous people's experiences with HIV programs, 'Keep being a good Papuan' was a way of overcoming problems and dealing with modernism to eliminate HIV. This largely focuses on the local culture, implying any adjustment should keep their tradition and welcome modernism.

CONCLUSIONS

The future of the HIV programs should be agreed upon, funded, implemented, measured and achieved by stakeholders. This could be achieved by elaborating a supportive culture and community-based interventions. Furthermore, the implementation should be prioritised to integrate and improve the programs' quality to take into account community needs and the available resources.

Do governance networks build collaborative capacity for sustainable development? Insights from Solomon Islands

To build capacity for addressing complex sustainable development challenges, governments, development agencies, and non-governmental organizations are making substantial investments in governance networks. Yet, enthusiasm for establishing governance networks is not always matched by empirical evidence on their effectiveness. This gap challenges these groups to know whether investing in governance networks is worth their time and effort; a weighing-up that is particularly critical in contexts of limited resources. Through a qualitative case study in Solomon Islands, we evaluate the extent to which a governance network, called the Malaita Provincial Partners for Development, contributed to four dimensions of collaborative governance capacity: individual, relational, organizational, and institutional. We find that the network made moderate contributions to individual, relational and organizational capacity, while institutional capacity remained low despite the presence of the network. Based on these findings, we argue that governance networks are not a panacea. Continued efforts are needed to establish when, how, and in what contexts collaborative networks are effective for building collaborative capacity for sustainable development.

Patterns of catch and trophic signatures illustrate diverse management requirements of coastal fisheries in Solomon Islands

Coastal fisheries are a critical component of Pacific island food systems; they power village economies and provide nutritious aquatic foods. Many coastal women and men actively fishing in this region rely on multi-species fisheries, which given their extraordinary diversity are notoriously difficult to both characterize, and to manage. Understanding patterns of fishing, diversity of target species and drivers of these patterns can help define requirements for sustainable management and enhanced livelihoods. Here we use a 12-month data set of 8535 fishing trips undertaken by fishers across Malaita province, Solomon Islands, to create fisheries signatures for 13 communities based on the combination of two metrics; catch per unit effort (CPUE) and catch trophic levels. These signatures are in turn used as a framework for guiding suitable management recommendations in the context of community-based resource management. While a key proximate driver of these patterns was fishing gear (e.g. angling, nets or spearguns), market surveys and qualitative environmental information suggest that community fishing characteristics are coupled to local environmental features more than the market value of specific species they target. Our results demonstrate that even within a single island not all small-scale fisheries are equal, and effective management solutions ultimately depend on catering to the specific environmental characteristics around individual communities.

WHO Systematic Assessment of Rehabilitation Situation (STARS): Results of the Field Testing in Jordan, Myanmar, Sri Lanka, Solomon Islands, Laos, Haiti, and Guyana

The WHO Systematic Assessment of Rehabilitation Situation (STARS) tool was developed by WHO to facilitate effective prioritization and strategic planning for rehabilitation in countries. The objective of this paper is to present the results of the fourth phase of its development, its field testing in seven countries focusing on its completeness, usefulness, accessibility and feasibility. Field testing occurred in Jordan, Myanmar, Sri Lanka, Solomon Islands, Laos, Haiti, and Guyana. Evaluation occurred through structured interviews and rating exercises with 17 government representatives, international consultants, WHO country or regional office staff and rehabilitation experts who were actively engaged and familiar with the STARS assessment and who were knowledgeable of the rehabilitation situation in the countries. STARS was appraised as relevant, complete and accurate in describing the country situation. Areas of inaccuracy were mostly linked to challenges in describing areas of services similarly when significant diversity existed. Feasibility and accessibility were mostly confirmed and more complex components of the tool as well as the guidance to the assessment process were slightly revised in light of the field-testing results. The field testing of WHO STARS confirmed its completeness, usefulness, accessibility and feasibility, and concerns raised by the interviews informed the last refinement of the tool. STARS is part of the WHO Rehabilitation in Health Systems-Guide for Action, available online, by September 2021, STARS had guided 21 country situation assessments.

Multi-phenotype genome-wide association studies of the Norfolk Island isolate implicate pleiotropic loci involved in chronic kidney disease

Chronic kidney disease (CKD) is a persistent impairment of kidney function. Genome-wide association studies (GWAS) have revealed multiple genetic loci associated with CKD susceptibility but the complete genetic basis is not yet clear. Since CKD shares risk factors with cardiovascular diseases and diabetes, there may be pleiotropic loci at play but may go undetected when using single phenotype GWAS. Here, we used multi-phenotype GWAS in the Norfolk Island isolate (n = 380) to identify new loci associated with CKD. We performed a principal components analysis on different combinations of 29 quantitative traits to extract principal components (PCs) representative of multiple correlated phenotypes. GWAS of a PC derived from glomerular filtration rate, serum creatinine, and serum urea identified a suggestive peak (pmin = 1.67 × 10-7) that mapped to KCNIP4. Inclusion of other secondary CKD measurements with these three kidney function traits identified the KCNIP4 locus with GWAS significance (pmin = 1.59 × 10-9). Finally, we identified a group of two SNPs with increased minor allele frequencies as potential functional variants. With the use of genetic isolate and the PCA-based multi-phenotype GWAS approach, we have revealed a potential pleotropic effect locus for CKD. Further studies are required to assess functional relevance of this locus.

Water quality challenges associated with industrial logging of a karst landscape: Guadalcanal, Solomon Islands

Human disturbance of karst landscapes in tropical volcanic islands present a unique challenge for understanding sediment transport to the coastal zone. Here we present the first evidence of urban drinking water quality impacts from industrial logging in the Solomon Islands. Despite only 6% of the Honiara's drinking water catchment being disturbed by logging, rhodamine dye tracers demonstrated complex karst sinkholes that led to high suspended sediment concentrations being transported from neighbouring Kovi catchment into the Kongulai water supply offtake point for Honiara. This has resulted in the exceedance of practical treatment thresholds of 20 NTU 9.5% of the time, leading to water supply for the majority of Honiara's residents being unavailable for 58 days in 2019. This work highlights the cost-benefit disparity between industrial logging yielding minimal short-term economic yields in comparison to on-going broader impacts of increased coastal sediment transport while restricting water supply to a developing nation's capital.

Development of a bioavailability-based risk assessment framework for nickel in Southeast Asia and Melanesia

Nickel laterite ore deposits are becoming increasingly important sources of Ni for the global marketplace and are found mainly in tropical and subtropical regions, including Indonesia, the Philippines, Papua New Guinea, Cuba, and New Caledonia. There are few legislatively derived standards or guidelines for the protection of aquatic life for Ni in many of these tropical regions, and bioavailability-based environmental risk assessment (ERA) approaches for metals have mainly been developed and tested in temperate regions, such as the United States and Europe. This paper reports on a multi-institutional, 5-y testing program to evaluate Ni exposure, effects, and risk characterization in the Southeast Asia and Melanesia (SEAM) region, which includes New Caledonia, Papua New Guinea, the Philippines, and Indonesia. Further, we have developed an approach to determine if the individual components of classical ERA, including effects assessments, exposure assessments, and risk characterization methodologies (which include bioavailability normalization), are applicable in this region. A main conclusion of this research program is that although ecosystems and exposures may be different in tropical systems, ERA paradigms are constant. A large chronic ecotoxicity data set for Ni is now available for tropical species, and the data developed suggest that tropical ecosystems are not uniquely sensitive to Ni exposure; hence, scientific support exists for combining tropical and temperate data sets to develop tropical environmental quality standards (EQSs). The generic tropical database and tropical exposure scenarios generated can be used as a starting point to examine the unique biotic and abiotic characteristics of specific tropical ecosystems in the SEAM region. Integr Environ Assess Manag 2021;17:802-813. © 2021 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Spatiotemporal trends in stroke burden and mortality attributable to household air pollution from solid fuels in 204 countries and territories from 1990 to 2019

Exposure to household air pollution from solid fuels (HAP) is associated with stroke. However, few studies have assessed stroke burden attributable to HAP globally and made comparisons across countries. We aimed to estimate the spatiotemporal trends in stroke burden and mortality attributable to household air pollution from solid fuels (HAP) in 204 countries and territories from 1990 to 2019. Data on stroke burden and mortality attributable to HAP from 1990 to 2019 were obtained from Global Burden of Disease Study 2019. We estimated the numbers and age-standardized rates (ASRs) of stroke disability-adjusted life years (DALYs) and mortality (ASDR and ASMR) by sex, age, and subtype, at global, regional, and national levels. Estimated annual percentage change (EAPC) was calculated to evaluate the temporal trends in ASDR and ASMR from 1990 to 2019. In 2019, globally, 14.7 million DALYs and 0.6 million deaths were caused by stroke attributable to HAP. The corresponding ASDR and ASMR increased with age, were highest in males and for intracerebral hemorrhage, with highest ASRs in the low sociodemographic index (SDI) regions and Solomon Islands, and varied greatly at the national level. From 1990 to 2019, the corresponding EAPCs in ASDR and ASMR were -4.00 (95% confidence interval [CI]: -4.21 to -3.80) and -4.12 (95% CI: -4.37 to -3.87), respectively. Stroke burden attributable to HAP decreased in all age groups. Females had a lower decreasing trend in ASDR and ASMR, compared with males. The decline was more significant for subarachnoid hemorrhage, while proportions of ischemic stroke in the numbers of stroke burden increased worldwide and in all SDI regions. Although most of countries and territories were in a decreasing trend in ASRs over the past three decades, Zimbabwe and Philippines showed an undesirable increased trend. Stroke burden attributable to HAP is still pronounced in males, old-age populations, low-income countries, and for intracerebral hemorrhage. Despite its decreasing spatiotemporal trends in most countries, continued efforts on HAP control are needed to reduce related stroke burden, especially in those countries with increased trends.

Modeling Treatment Strategies to Inform Yaws Eradication

Yaws is a neglected tropical disease targeted for eradication by 2030. To achieve eradication, finding and treating asymptomatic infections as well as clinical cases is crucial. The proposed plan, the Morges strategy, involves rounds of total community treatment (i.e., treating the whole population) and total targeted treatment (TTT) (i.e., treating clinical cases and contacts). However, modeling and empirical work suggests asymptomatic infections often are not found in the same households as clinical cases, reducing the utility of household-based contact tracing for a TTT strategy. We use a model fitted to data from the Solomon Islands to predict the likelihood of elimination of transmission under different intervention schemes and levels of systematic nontreatment resulting from the intervention. Our results indicate that implementing additional treatment rounds through total community treatment is more effective than conducting additional rounds of treatment of at-risk persons through TTT.

Seagrass ecosystems of the Pacific Island Countries and Territories: A global bright spot

Seagrass ecosystems exist throughout Pacific Island Countries and Territories (PICTs). Despite this area covering nearly 8% of the global ocean, information on seagrass distribution, biogeography, and status remains largely absent from the scientific literature. We confirm 16 seagrass species occur across 17 of the 22 PICTs with the highest number in Melanesia, followed by Micronesia and Polynesia respectively. The greatest diversity of seagrass occurs in Papua New Guinea (13 species), and attenuates eastward across the Pacific to two species in French Polynesia. We conservatively estimate seagrass extent to be 1446.2 km², with the greatest extent (84%) in Melanesia. We find seagrass condition in 65% of PICTs increasing or displaying no discernible trend since records began. Marine conservation across the region overwhelmingly focuses on coral reefs, with seagrass ecosystems marginalised in conservation legislation and policy. Traditional knowledge is playing a greater role in managing local seagrass resources and these approaches are having greater success than contemporary conservation approaches. In a world where the future of seagrass ecosystems is looking progressively dire, the Pacific Islands appears as a global bright spot, where pressures remain relatively low and seagrass more resilient.

Seagrass ecosystem contributions to people's quality of life in the Pacific Island Countries and Territories

Seagrass ecosystems provide critical contributions (goods and perceived benefits or detriments) for the livelihoods and wellbeing of Pacific Islander peoples. Through in-depth examination of the contributions provided by seagrass ecosystems across the Pacific Island Countries and Territories (PICTs), we find a greater quantity in the Near Oceania (New Guinea, the Bismarck Archipelago and the Solomon Islands) and western Micronesian (Palau and Northern Marianas) regions; indicating a stronger coupling between human society and seagrass ecosystems. We also find many non-material contributions historically have been overlooked and under-appreciated by decision-makers. Closer cultural connections likely motivate guardianship of seagrass ecosystems by Pacific communities to mitigate local anthropogenic pressures. Regional comparisons also shed light on general and specific aspects of the importance of seagrass ecosystems to Pacific Islanders, which are critical for forming evidence-based policy and management to ensure the long-term resilience of seagrass ecosystems and the contributions they provide.

The Design and Development of a Food Composition Database for an Electronic Tool to Assess Food Intake in New Caledonian Families

The food environment in New Caledonia is undergoing a transition, with movement away from traditional diets towards processed and discretionary foods and beverages. This study aimed to develop an up-to-date food composition database that could be used to analyze food and nutritional intake data of New Caledonian children and adults. Development of this database occurred in three phases: Phase 1, updating and expanding the number of food items to represent current food supply; Phase 2, refining the database items and naming and assigning portion size images for food items; Phase 3, ensuring comprehensive nutrient values for all foods, including saturated fat and total sugar. The final New Caledonian database comprised a total of 972 food items, with 40 associated food categories and 25 nutrient values and 615 items with portion size images. To improve the searchability of the database, the names of 593 food items were shortened and synonyms or alternate spelling were included for 462 foods. Once integrated into a mobile app-based multiple-pass 24-h recall tool, named iRecall.24, this country-specific food composition database would support the assessment of food and nutritional intakes of families in New Caledonia, in a cross-sectional and longitudinal manner, and with translational opportunities for use across the wider Pacific region.

A genome-wide methylation study of body fat traits in the Norfolk Island isolate

BACKGROUND AND AIMS

Natural variation in body fat is explained by both genetic and environmental effects. Epigenetic mechanisms such as DNA methylation can mediate these effects causing changes in gene expression leading to onset of obesity. Studies of genetic isolates have the potential to provide new epigenetic insights with advantages such as reduced genetic diversity and environmental exposures.

METHODS AND RESULTS

This was an exploratory study of genome-wide DNA methylation in relation to body fat traits in 47 healthy adults from the genetic isolate of Norfolk Island. Quantitative body fat traits (body fat percentage, body mass index, hip circumference, waist circumference, waist-hip-ratio and weight) were carefully measured. DNA methylation data was obtained from peripheral blood using Illumina 450K arrays. Multi-trait analysis was performed using Principal Component Analysis (PCA). CpG by trait association testing was performed using stepwise linear regressions. Two components were identified that explained approximately 89% of the phenotypic variance. In total, 5 differential methylated positions (DMPs) were identified at genome-wide significance (P≤ 2.4 × 10^-7), which mapped to GOT2-CDH8, LYSMD3, HIBADH, ADGRD1 and EBF4 genes. Gene set enrichment analysis of 848 genes containing suggestive DMPs (P≤ 1.0 × 10^-4) implicated the Cadherin (28 genes, P_adj = 6.76 × 10^-7) and Wnt signaling pathways (38 genes, P_adj = 7.78 × 10^-6).

CONCLUSION

This study provides new insights into the epigenetically influenced genes and pathways underlying body fat variation in a healthy cohort and provides targets for consideration in future studies of obesity risk.

Aquatic contaminants in Solomon Islands and Vanuatu: Evidence from passive samplers and Microtox toxicity assessment

Water Quality issues in many Pacific countries are rising, with the increase in coastal populations and associated urban runoff but management requires contamination issues in the aquatic environment to be identified and prioritised. In Vanuatu and Solomon Islands there are few laboratories and resources to assess for the presence or impact of complex chemical contaminants. The extent and impact of chemical contamination of the marine and coastal environment is poorly described. Passive chemical samplers were used to measure a range of aquatic pollutants around the capital cities, Honiara (Solomon Islands) and Port Vila (Vanuatu). We detected a range of chemicals indicative of agricultural and industrial contamination and a few sites had concerning concentrations of specific hydrocarbons and pesticides. The rapid ecotoxicology test, Microtox, indicated toxic impacts in rivers, coastal sites and urban drains This work provides new data on chemical contamination and possible impacts of that contamination for both countries. The techniques could be applied widely across the region to generate critical data for environmental management, guide monitoring efforts and measure the impact of policy or land-use changes.

Sediment arsenic hotspots in an abandoned tailings storage facility, Gold Ridge Mine, Solomon Islands

Gold mining of arsenopyrite ore bodies result in waste tailings that contain elevated levels of arsenic. Disposal of these wastes in a Tailings Storage Facility (TSF) represents a substantial environmental risk if not properly managed. The Gold Ridge mine on Guadalcanal, in the Solomon Islands was abandoned from 2014 to 2018, leaving the TSF with little ongoing environmental management. Surface water quality monitoring observed a threefold increase in surface water arsenic concentrations over a 6-month period when no mining operations were occurring. This study aimed to investigate bottom sediments as the source of elevated concentrations of arsenic in the surface waters of the TSF during mine closure. This was achieved by analysing arsenic concentrations in the surface water, sediment porewaters and by quantifying sediment arsenic flux as dissolved oxygen availability declined. It was evident that bottom sediments of the TSF were the potential source of arsenic, having an average arsenic concentration of 437.9 mg kg^-1. In addition, average sediment porewater arsenic concentrations across the TSF were 1.07 mg L^-1, with a large central zone of highly elevated concentrations peaking at over 17 mg L^-1. Long term sediment core incubations demonstrated arsenic effluxes from all sites monitored under both oxic and hypoxic conditions, ranging from 0.72 mg m^-2 day^-1 to 7.01 mg m^-2 day^-1 respectively. These results suggest that arsenic hotspots within the TSF have the capability to contribute to increased arsenic concentrations in surface waters. Management of mine TSF's should consider these geochemical interactions that can occur in abandoned sites.

Metal pollution in sediments and bivalves in Marovo Lagoon, Solomon Islands

Heavy metal concentrations were determined in sediment and bivalve samples from Marovo Lagoon in the Solomon Islands. In the sediments, heavy metal levels ranged from 10 ± 3-47 ± 2 μg/g Cd, 25 ± 4-351 ± 5 μg/g Cr, 145 ± 3-418 ± 7 μg/g Cu and 20 ± 3-371 ± 5 μg/g Pb. When compared to the baseline values measured in a 1991 study of the same lagoon, a simple relative ratio in the range of 2-43 was noted for all metals in sediments as compared to baseline and confirms significant anthropogenic influence. The heavy metal contamination of bivalves showed level ranges of 2.00 ± 0.01-10 ± 1 μg/g Cd, 9 ± 3-42 ± 2 μg/g Cr, 47 ± 3-76 ± 3 μg/g Cu and 24 ± 11-86 ± 14 μg/g Pb. The higher levels of metals in the Marovo Lagoon sediments when compared to other Pacific studies are attributed to intense logging activities around the bay and other potential anthropogenic sources such as mining and discharge of waste into the lagoon.

Assessing the Status of Diabetes Associations in the Pacific: A Starting Point for Strengthening Associations to Manage Diabetes

This study aimed to assess the status of national diabetes associations in the Pacific Island Countries and Territories as a starting point for strengthening their development and effectiveness in the prevention and control of diabetes. This cross-sectional study was conducted in 21 Pacific Island Countries and Territories using a structured questionnaire that gathered information from national non-communicable diseases prevention and control focal persons on diabetes associations, organizational structure, funding sources, and ongoing activities to address diabetes. The overall status of national diabetes associations was assessed using standardized criteria. Of the 21 countries surveyed, 18 (86%) responded. Of these, 12 (67%; American Samoa, Northern Mariana Islands, Federated States of Micronesia, French Polynesia, Fiji, Guam, Nauru, Papua New Guinea, Marshall Islands, Solomon Islands, Tonga, and Vanuatu) have a national diabetes association. Half of the existing associations are fully functioning, while the remainder is either partially functioning or not functioning. Only 50% of existing associations have a regular funding source, and many lack clear visions and workable governance structures. This study fills a knowledge gap on the current status of associations and forms a baseline from which associations can be strengthened. It also draws attention to the need for Pacific leaders to invest and engage more in civil societies for better and effective diabetes care for all.

An Analysis of Healthy Food Access Amongst Women in Peri-urban Honiara

Highly processed and energy-dense foods are contributing to the high and rising rates of non-communicable diseases and nutrient deficiencies in Solomon Islands. Non-communicable diseases currently cause 69% of deaths in Solomon Islands, and the rate is rising, fuelled in part by limited health system capacity to treat these conditions. Solomon Islands also has the highest reported undernourishment rate in the Pacific. Recent decades have seen several factors change the food and economic environment in Solomon Islands. Importantly, rural-to-urban migration has caused a disconnect between urban residents and access to land and home gardens. This study aimed to examine the complexities of nutritious food access in urban Solomon Islands. Data were collected from 32 women in Honiara, the islands' capital, using a novel survey instrument. There were 3 important findings: (1) the dominant influencers of the diet patterns described by participants in this study were food affordability and access to land on which to grow it, (2) all participants experienced food insecurity, and (3) reported diet patterns reflected unhealthy diets which were particularly high in processed and sugary foods. These findings suggest a need for improvements in the food environment in Honiara.

Trachoma, Anti-Pgp3 Serology, and Ocular Chlamydia trachomatis Infection in Papua New Guinea

BACKGROUND

In Melanesia, the prevalence of trachomatous inflammation-follicular (TF) suggests that public health-level interventions against active trachoma are needed. However, the prevalence of trachomatous trichiasis is below the threshold for elimination as a public health problem and evidence of conjunctival infection with trachoma's causative organism (Chlamydia trachomatis [CT]) is rare. Here, we examine the prevalence of ocular infection with CT and previous exposure to CT in three evaluation units (EUs) of Papua New Guinea.

METHODS

All individuals aged 1-9 years who were examined for clinical signs of trachoma in 3 Global Trachoma Mapping Project EUs were eligible to take part in this study (N = 3181). Conjunctival swabs were collected from 349 children with TF and tested by polymerase chain reaction to assess for ocular CT infection. Dried blood spots were collected from 2572 children and tested for anti-Pgp3 antibodies using a multiplex assay.

RESULTS

The proportion of children with TF who had CT infection was low across all 3 EUs (overall 2%). Anti-Pgp3 seroprevalence was 5.2% overall and there was no association between anti-Pgp3 antibody level and presence of TF. In 2 EUs, age-specific seroprevalence did not increase significantly with increasing age in the 1- to 9-year-old population. In the third EU, there was a statistically significant change with age but the overall seroprevalence and peak age-specific seroprevalence was very low.

CONCLUSIONS

Based on these results, together with similar findings from the Solomon Islands and Vanuatu, the use of TF to guide antibiotic mass drug administration decisions in Melanesia should be reviewed.

Assessing Diet Quality of Indigenous Food Systems in Three Geographically Distinct Solomon Islands Sites (Melanesia, Pacific Islands)

Indigenous Solomon Islanders, like many living in Pacific Small Island Developing States (PSIDS), are currently experiencing the global syndemic-the combined threat of obesity, undernutrition, and climate change. This mixed-method study aimed to assess nutrition transitions and diet quality by comparing three geographically unique rural and urban indigenous Solomon Islands populations. Participants in rural areas sourced more energy from wild and cultivated foods; consumed a wider diversity of foods; were more likely to meet WHO recommendations of >400g of non-starchy fruits and vegetables daily; were more physically active; and had significantly lower body fat, waist circumference, and body mass index (BMI) when compared to urban populations. Urban populations were found to have a reduced ability to self-cultivate agri-food products or collect wild foods, and therefore consumed more ultra-processed foods (classified as NOVA 4) and takeout foods, and overall had less diverse diets compared to rural populations. Clear opportunities to leverage traditional knowledge and improve the cultivation and consumption of underutilized species can assist in building more sustainable and resilient food systems while ensuring that indigenous knowledge and cultural preferences are respected.

First marine litter survey on beaches in Solomon Islands and Vanuatu, South Pacific: Using OSPAR protocol to inform the development of national action plans to tackle land-based solid waste pollution

The increasing abundance of marine litter is impacting the environment, human health and economies in the South Pacific. Small Islands Developing States are particularly affected by marine litter, primarily due to insufficient waste management systems. For the first time, marine litter was quantified and characterised on 13 beaches in Solomon Islands and Vanuatu in the South Pacific region using the OSPAR beach litter monitoring guidelines. A total of 1053 (±1017) and 974 (±745) items of litter per 100 m beach were recorded in Solomon Islands and Vanuatu respectively. Litter composition and distribution show that the majority of the litter comes from local land-based sources and large quantities of fragments and single use plastics were found by cities and river mouths. Actions to reduce single use plastic, improve collection, reuse and recycling, together with outreach campaigns would reduce marine litter significantly in these countries. Furthermore, there is great potential to develop a more circular economy to manage the substantial quantities of recyclable items that were found stranded on the beaches.

Aquatic Foods and Nutrition in the Pacific

National rates of aquatic food consumption in Pacific Island Countries and Territories are among the highest in the world, yet the region is suffering from extensive levels of diet-related ill health. The aim of this paper is to examine the variation in consumption patterns and in nutrient composition of aquatic foods in the Pacific, to help improve understanding of their contribution to food and nutrition security. For this examination we analysed nutrient composition data and trade data from two novel region-specific databases, as well as consumption data from national and village level surveys for two Melanesian case studies, Vanuatu and Solomon Islands. Results demonstrated that consumption depends on availability and the amount and type of aquatic food consumed, and its contribution to nutrition security varies within different geographic and socio-demographic contexts. More data is needed on locally relevant species and consumption patterns, to better inform dietary guidelines and improve public health both now and into the future. Advice on aquatic food consumption must consider the nutrient composition and quantity of products consumed, as well as accessibility through local food systems, to ensure they contribute to diverse and healthy diets.

Subregional variation in cover and diversity of hard coral (Scleractinia) in the Western Province, Solomon Islands following an unprecedented global bleaching event

Coral reefs are critically important marine ecosystems that are threatened worldwide by cumulative impacts of global climate change and local stressors. The Solomon Islands comprise the southwestern boundary of the Coral Triangle, the global center of coral diversity located in the Indo-Pacific, and represent a bright spot of comparatively healthy coral reef ecosystems. However, reports on the status of coral reefs in the Solomon Islands are based on monitoring conducted at 5 stations in 2003-2004 and 2006-2007, with no information on how corals in this region have responded to more recent global bleaching events and other local stressors. In this study, we compare reef condition (substrate composition) and function (taxonomic and morphological diversity of hard corals) among 15 reefs surveyed in the Western Province, Solomon Islands that span a range of local disturbance and conservation histories. Overall, we found high cover of live hard coral (15-64%) and diverse coral assemblages despite an unprecedented 36-month global bleaching event in the three years leading up to our surveys in 2018. However, there was significant variation in coral cover and diversity across the 15 reefs surveyed, suggesting that impacts of global disturbance events are moderated at smaller scales by local anthropogenic factors (fisheries extraction, land-use impacts, marine management) and environmental (hydrodynamics) conditions. Our study provides evidence that relatively healthy reefs persist at some locations in the Solomon Islands and that local stewardship practices have the potential to impact reef condition at subregional scales. As coral reef conservation becomes increasingly urgent in the face of escalating cumulative threats, prioritising sites for management efforts is critical. Based on our findings and the high dependency of Solomon Islanders on coral reef ecosystem services, we advocate that the Western Province, Solomon Islands be considered of high conservation priority.

Occurrence and abundance of meso and microplastics in sediment, surface waters, and marine biota from the South Pacific region

Data on the occurrence and abundance of meso and microplastics for the South Pacific are limited and there is urgent need to fill this knowledge gap. The main aim of the study was to apply a rapid screening method, based on the fluorescence tagging of polymers using Nile red, to determine the concentration of meso and microplastics in biota, sediment and surface waters near the capital cities of Vanuatu and Solomon Islands. A spatial investigation was carried out for sediment, biota and water as well as a temporal assessment for sediment for two consecutive years (2017 and 2018). Accumulation zones for microplastics were identified supported by previous hydrodynamic models. Microplastics were detected for all environmental compartments investigated indicating their widespread presence for Vanuatu and Solomons Islands. This method was in alignment with previous recommendations that the Nile red method is a promising approach for the largescale mapping of microplastics in a monitoring context.

Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk

Flavan-3-ols are a group of bioactive compounds that have been shown to improve vascular function in intervention studies. They are therefore of great interest for the development of dietary recommendation for the prevention of cardio-vascular diseases. However, there are currently no reliable data from observational studies, as the high variability in the flavan-3-ol content of food makes it difficult to estimate actual intake without nutritional biomarkers. In this study, we investigated cross-sectional associations between biomarker-estimated flavan-3-ol intake and blood pressure and other CVD risk markers, as well as longitudinal associations with CVD risk in 25,618 participants of the European Prospective Investigation into Cancer (EPIC) Norfolk cohort. High flavan-3-ol intake, achievable as part of an habitual diet, was associated with a significantly lower systolic blood pressure (- 1.9 (- 2.7; - 1.1) mmHg in men and - 2.5 (- 3.3; - 1.8) mmHg in women; lowest vs highest decile of biomarker), comparable to adherence to a Mediterranean Diet or moderate salt reduction. Subgroup analyses showed that hypertensive participants had stronger inverse association between flavan-3-ol biomarker and systolic blood pressure when compared to normotensive participants. Flavanol intake could therefore have a role in the maintenance of cardiovascular health on a population scale.

Prestige and homophily predict network structure for social learning of medicinal plant knowledge

Human subsistence societies have thrived in environmental extremes while maintaining biodiversity through social learning of ecological knowledge, such as techniques to prepare food and medicine from local resources. However, there is limited understanding of which processes shape social learning patterns and configuration in ecological knowledge networks, or how these processes apply to resource management and biological conservation. In this study, we test the hypothesis that the prestige (rarity or exclusivity) of knowledge shapes social learning networks. In addition, we test whether people tend to select who to learn from based on prestige (knowledge or reputation), and homophily (e.g., people of the same age or gender). We used interviews to assess five types of medicinal plant knowledge and how 303 people share this knowledge across four villages in Solomon Islands. We developed exponential random graph models (ERGMs) to test whether hypothesized patterns of knowledge sharing based on prestige and homophily are more common in the observed network than in randomly simulated networks of the same size. We found that prestige predicts five hypothesized network configurations and all three hypothesized learning patterns, while homophily predicts one of three hypothesized network configurations and five of the seven hypothesized learning patterns. These results compare the strength of different prestige and homophily effects on social learning and show how cultural practices such as intermarriage can affect certain aspects of prestige and homophily. By advancing our understanding of how prestige and homophily affect ecological knowledge networks, we identify which social learning patterns have the largest effects on biocultural conservation of ecological knowledge.

Community-based adaptation to climate change in villages of Western Province, Solomon Islands

People, local cultures and the environments they live in are complex and dynamic social-ecological systems that have evolved together over time and are continually affected by a myriad of factors, including climate and global changes. Escalating climate and global changes present an imminent threat to Pacific communities, particularly for food security, livelihoods, health and safety, cultural identity and biodiversity conservation. A participatory community-based climate change adaptation planning process was used to engage with communities on Rendova Island in Western Province, Solomon Islands to identify local adaptation priorities. The methodology recognized that local community members are the managers of the resources they use daily, have direct knowledge of the status of key local resources and have direct influence over ongoing resource governance. The study focused on two objectives: (1) identifying community priorities and documenting them in adaptation plans intended for local implementation, and (2) evaluating whether community adaptation priorities addressed key vulnerabilities identified independently using a semi-quantitative vulnerability assessment. The adaptation priorities identified by the communities encompassed: governance, leadership and planning; farming and livestock; sustainable livelihoods; natural resource management; and youth capacity building. The community adaptation priorities were found to address the key climate change vulnerabilities identified in the semi-quantitative assessment and also addressed additional drivers of social vulnerability and adaptive capacity. This finding reiterates the importance of fully inclusive and participatory vulnerability assessments and community-identification of adaptation priorities coupled with scientific climate projections to comprehensively assess the complexity of social-ecological systems. The climate change adaptation priorities have informed ongoing local actions and are intended to be used by communities, government and NGOs to focus local effort, funding and project development. A review of the suitability of the adaptation priorities by similar villages on neighbouring islands would determine the utility of scaling-up and applying these adaptations to other rural communities in the Solomon Islands, and possibly more widely in other Pacific communities.

Admixture and natural selection shaped genomes of an Austronesian-speaking population in the Solomon Islands

People in the Solomon Islands today are considered to have derived from Asian- and Papuan-related ancestors. Papuan-related ancestors colonized Near Oceania about 47,000 years ago, and Asian-related ancestors were Austronesian (AN)-speaking population, called Lapita, who migrated from Southeast Asia about 3,500 years ago. These two ancestral populations admixed in Near Oceania before the expansion of Lapita people into Remote Oceania. To understand the impact of the admixture on the adaptation of AN-speaking Melanesians in Near Oceania, we performed the genome-wide single nucleotide polymorphism (SNP) analysis of 21 individuals from Munda, the main town of the New Georgia Islands in the western Solomon Islands. Population samples from Munda were genetically similar to other Solomon Island population samples. The analysis of genetic contribution from the two different ancestries to the Munda genome revealed significantly higher proportions of Asian- and Papuan-related ancestries in the region containing the annexin A1 (ANXA1) gene (Asian component > 82.6%) and in the human leukocyte antigen (HLA) class II region (Papuan component > 85.4%), respectively. These regions were suspected to have undergone natural selection since the time of admixture. Our results suggest that admixture had affected adaptation of AN-speaking Melanesians in the Solomon Islands.

Geographical inequalities in drinking water in the Solomon Islands

Sustainable Development Goal 6.1 seeks to "by 2030, achieve universal and equitable access to safe and affordable drinking water", which is challenging particularly in Small Island Developing States (SIDS) and Pacific Island Countries (PIC). We report drinking water sources and services in the Solomon Islands and examine geographical inequalities. Based on two quantitative baseline datasets of n = 1,598 rural and n = 1,068 urban households, we analyzed different drinking water variables (source type, collection time, amount, use, perceived quality, storage, treatment) and a composite index, drinking water service level. We stratified data by urban and rural areas and by province, mapped, and contextualized them. There are substantive rural-urban drinking water inequalities in the Solomon Islands. Overall, urban households are more likely to: use improved drinking water sources, need less time to collect water, collect more water, store their water more safely, treat water prior to consumption, perceive their water quality as better and have an at least basic drinking water service than rural households. There are also provincial and center-periphery inequalities in drinking water access, with more centrally located provinces using piped water supplies and more distant and remote provinces using rainwater and surface water as their primary source. There are also inter-national inequalities. Out of all PICs, the Solomon Islands have among the lowest access to basic drinking water services: 92% of urban and 55% of rural households. Of all SIDS, PICs are least serviced. This study shows that drinking water inequality is a critical issue, and highlights that all identified dimensions of inequality - rural-urban, provincial, center-periphery and inter-national - need to be explicitly recognized and addressed and included in pro-equity monitoring, policy and programming efforts by the Solomon Islands Government and stakeholders to reduce inequalities as per the Agenda 2030.

Declining grouper spawning aggregations in Western Province, Solomon Islands, signal the need for a modified management approach

Globally, groupers (Epinephelidae) that form fish spawning aggregations (FSAs) are highly vulnerable to overfishing and often require site-specific approaches to management. Over 5-years (2009-2013), we conducted underwater visual censuses (UVC) at a well-known spawning site at Njari Island, Gizo, Western Province, Solomon Islands, that supports aggregations of squaretail coralgrouper (Plectropomus areolatus), camouflage grouper (Epinephelus polyphekadion) and brown-marbled grouper (E. fuscoguttatus). Findings show that while there were species-specific variations in the duration and timing of the spawning season, aggregation densities peaked from March to June, representing the main spawning season for all three species. For P. areolatus, gonad analysis from samples taken from 2008 to 2011 confirmed reproductive activity in support of density trends observed through UVC. Over the 5-year UVC monitoring period, FSA densities declined for P. areolatus and E. polyphekadion. Conversely, following the first year of monitoring, E. fuscoguttatus densities increased. These inter-specific differences may reflect variable responses to fishing as shown elsewhere, or for example, differences in recruitment success. In response to known declines in FSAs of these species, in 2018 the Solomon Islands government placed a nationwide ban on these species' harvest and sale between October and January. As this study shows, this ban does not encompass the peak aggregation period at Njari and will offer limited protection to other FSAs of these species that are known to vary in reproductive seasonality across the Solomon Islands. A more biologically meaningful and practical management strategy would be to implement a nationwide ban on the harvest and sale of these groupers each month between full and new moons when these FSAs form consistently throughout the country. Since effective management of FSAs typically requires a combined approach, spatial management that protects both spawning sites and reproductive migratory corridors is warranted.

Effects of dissolved nickel and nickel-contaminated suspended sediment on the scleractinian coral, Acropora muricata

Intensification of lateritic nickel mining in Southeast Asia and Melanesia potentially threatens coastal ecosystems from increased exposure to nickel and suspended sediment. This study investigated the response of Acropora muricata when exposed to either dissolved nickel, clean suspended sediment or nickel-contaminated suspended sediment for 7 days, followed by a 7-d recovery period. Significant bleaching and accumulation of nickel in coral tissue was observed only after exposure to high dissolved nickel concentrations and nickel-spiked suspended sediment. No effect on A. muricata was observed from exposure to a particulate-bound nickel concentration of 60 mg/kg acid-extractable nickel at a suspended sediment concentration of 30 mg/L TSS. This study demonstrates that bioavailability of nickel associated with suspended sediment exposure plays a key role in influencing nickel toxicity to corals. These findings assist in assessments of risk posed by increasing nickel mining activities on tropical marine ecosystems.

Implementation Lessons from a Multifaceted National Newborn Program in Solomon Islands: A Mixed-Methods Study

Multifaceted interventions are important in improving neonatal quality of care and health outcomes. This study describes the implementation of an intervention to improve the quality of newborn care in Solomon Islands, a small island developing state and lower middle-income country in the Western Pacific. Inputs included training, equipment provision, and healthcare system organizational changes. For evaluation, we used a mixed-methods design, using quantitative (audits of health facility equipment, structure, and organization) and qualitative (semi-structured interviews and focused group discussions with healthcare workers) methods. Participants highlighted the practical, interactive, coaching style of training and its short duration as positive features in establishing skills. Training had indirect impacts through improving culture of the workplace, and the evaluation provided a valuable opportunity for reflection of the implementation process for healthcare workers. Facility limitations from equipment deficits and poor condition of clinical areas had implications by limiting the provision of quality care, as well as contributing to healthcare workers feeling undervalued. Resuscitation of a nonbreathing baby was a stressful experience for many health workers, compounded by geographic isolation and feeling unsupported. Our findings highlight the importance of training methodology, impact from structural limitations, and experience of resuscitation for the healthcare worker. Attention to these factors may help the design and implementation of newborn care programs in similar contexts.

Complete genome sequence of Oryctes rhinoceros nudivirus isolated from the coconut rhinoceros beetle in Solomon Islands

Oryctes rhinoceros nudivirus (OrNV) has been an effective biocontrol agent against the insect pest Oryctes rhinoceros (Coleoptera: Scarabaeidae) for decades, but there is evidence that resistance could be evolving in some host populations. We detected OrNV infection in O. rhinoceros from Solomon Islands and used Oxford Nanopore Technologies (ONT) long-read sequencing to determine the full length of the virus genomic sequence isolated from an individual belonging to a mitochondrial lineage (CRB-G) that was previously reported as resistant to OrNV. The complete circular genome of the virus consisted of 125,917 nucleotides, 1.698 bp shorter than the originally-described full genome sequence of Ma07 strain from Malaysia. We found 130 out of 139 previously annotated ORFs (seven contained interrupted/non-coding sequences, two were identified as duplicated versions of the existing genes), as well as a putatively inverted regions containing four genes. These results demonstrate the usefulness of a long-read sequencing technology for resolving potential structural variations when describing new virus isolates. While the Solomon Islands isolate exhibited 99.41 % nucleotide sequence identity with the originally described strain, we found several genes, including a core gene (vlf-1), that contained multiple amino acid insertions and/or deletions as putative polymorphisms of large effect. Our complete annotated genome sequence of a newly found isolate in Solomon Islands provides a valuable resource to help elucidate the mechanisms that compromise the efficacy of OrNV as a biocontrol agent against the coconut rhinoceros beetle.

Modelling pollution dispersal around Solomon Islands and Vanuatu

To assess potential dispersion of pollutants around Honiara, Solomon Islands, and Port Vila, Vanuatu, 3D ocean circulation models were developed using Telemac-3D. A series of scenarios then explore the vulnerability of the system and test potential control measures. Results show that high coastal concentrations are most likely during the wet season, with increased volumes of discharge as well as favourable wind speed and direction. Buoyant plumes flow along the coastline, and high concentrations build up in enclosed bays. Control measures tested focus on consolidating existing outflows at depth off-shore. This results in an overall reduction of surface concentrations along the coastline. However, the reduction is dependent on the depth, off-shore positioning, and volume of outflow. With increased concentrations then found at depth, the subsequent impact on off-shore and benthic ecosystems would also need to be considered.

Community-based monitoring detects catastrophic earthquake and tsunami impacts on seagrass beds in the Solomon Islands

Tetepare Island in the Solomon Islands is the largest uninhabited island in the South Pacific and supports seagrass beds inside fringing reefs along its coastline. We monitored the diversity and abundance of seagrass species on Tetepare and nearby sparsely-populated Rendova Island over a 12 year period, 4 years before and up to 8 years after a major earthquake and tsunami event in January 2010. Both seagrass cover and diversity declined after the tsunami and had not reached pre-Tsunami levels after 8 years. Seagrass cover declined the fastest at sites on Rendova, closest to the epicentre, declining from 50% to <10% cover within 12 months of the earthquake. At sites within the Tetepare MPA, seagrass cover took longer to decline and dropped from an average of 50% to <10% within 2 years and became dominated by Halophila ovalis. Species richness declined from 9 to 4 species with some species such as Syringodium isoetifolium disappearing from monitoring sites. Community-based monitoring was an effective method of documenting long term changes in seagrass cover and long-term monitoring is required to determine if seagrass beds are permanently altered or return to pre-tsunami conditions.

Human exposure to Anopheles farauti bites in the Solomon Islands is not associated with IgG antibody response to the gSG6 salivary protein of Anopheles gambiae

BACKGROUND

Mosquito saliva elicits immune responses in humans following mosquito blood feeding. Detection of human antibodies recognizing the Anopheles gambiae salivary gland protein 6 (gSG6) or the gSG6-P1 peptide in residents of Africa, South America and Southeast Asia suggested the potential for these antibodies to serve as a universal marker to estimate human biting rates. Validating the utility of this approach requires concurrent comparisons of anopheline biting rates with antibodies to the gSG6 protein to determine the sensitivity and specificity of the assay for monitoring changes in vector populations. This study investigated whether seroprevalence of anti-gSG6 antibodies in humans reflected the relative exposure to Anopheles farauti bites in the Solomon Islands as estimated from sympatric human landing catches.

METHODS

Human biting rates by An. farauti were estimated by landing catches at 10 sampling sites in each of 4 villages during the wet and dry seasons. Human serum samples from these same villages were also collected during the wet and dry seasons and analysed for antibody recognition of the gSG6 antigen by the Luminex xMAP© platform. Antibody titres and prevalence were compared to HLCs at the sampling sites nearest to participants' residences for utility of anti-gSG6 antibodies to estimate human exposure to anopheline bites.

RESULTS

In this study in the Solomon Islands only 11% of people had very high anti-gSG6 antibody titres, while other individuals did not recognize gSG6 despite nightly exposures of up to 190 bites by An. farauti. Despite clear spatial differences in the human biting rates within and among villages, associations between anti-gSG6 antibody titres and biting rates were not found.

CONCLUSIONS

Few studies to date have concurrently measured anopheline biting rates and the prevalence of human antibodies to gSG6. The lack of association between anti-gSG6 antibody titres and concurrently measured human biting rates suggests that the assay for human anti-gSG6 antibodies lacks sufficient sensitivity to be a biomarker of An. farauti exposure at an epidemiologically relevant scale. These findings imply that an improvement in the sensitivity of serology to monitor changes in anopheline biting exposure may require the use of saliva antigens from local anophelines, and this may be especially true for species more distantly related to the African malaria vector An. gambiae.

The diagnosis of scabies by non-expert examiners: A study of diagnostic accuracy

Background

Although scabies is estimated to be one of the most common skin conditions globally, prevalence data is not available in most settings. Disease mapping is required to develop and monitor successful control programs. Non-expert health workers are likely to play an important role in scabies mapping activities in endemic settings.

Methodology

Four non-expert health workers were trained in the diagnosis of scabies and impetigo. The health worker diagnosis was compared to a reference consensus diagnosis of two doctors experienced in diagnosis. The study was conducted in a primary school in Gizo, Solomon Islands, in August 2018. The six examiners consecutively assessed school students, blinded to each other’s findings. Training and diagnostic procedures followed criteria for scabies diagnosis established by the International Alliance for the Control of Scabies in 2018.

Principal findings

Amongst the 171 students who underwent clinical assessment the prevalence of scabies and impetigo according to the reference standard was 55% and 45% respectively. Sensitivity of the non-expert health workers’ diagnosis compared to the reference standard was 55.3% for scabies (95% confidence interval [CI], 50.1–60.4) with a specificity of 89.9% (95% CI 86–93.1) and 52.6% for impetigo (95% CI 46.9–58.3) with a specificity 97.8% (95% CI 95.7–99). Sensitivity for moderate to severe scabies was 93.5% (95% CI 86.3–97.6) with a specificity of 74% (95% CI 70.2–77.5).

Conclusions

Following brief training, the diagnostic accuracy of non-expert health workers for scabies and impetigo was promising, especially for moderate to severe disease. Modifications to training and processes are recommended to further improve accuracy. The diagnosis by non-expert health workers may be acceptable for scabies and impetigo mapping in endemic areas.

Scabies is a parasitic infection that leads to significant morbidity worldwide. Mapping of scabies prevalence would improve the understanding of the true burden of disease and the need for control programs in specific countries and regions. The diagnosis of scabies in low resource settings, where the disease is most prevalent, is reliant on clinical examination. A task shifting approach, utilizing local health staff, could substantially increase the feasibility to undertake mapping surveys in low-resource settings. In this study, we aimed to evaluate the diagnostic accuracy of clinical assessment of local health workers following brief training. Our study found that these non-expert health workers could diagnose scabies with moderate accuracy and diagnose more severe disease with high accuracy. Further work is needed to develop standardized training packages to ensure a high level of diagnostic accuracy by non-expert health workers.

Dietary Diversity of an Adult Solomon Islands Population

Ongoing dietary transitions in the Solomon Islands has resulted in an over-reliance on commercially sourced foods, leading to food insecurity, and a subsequent rise in multiple forms of malnutrition. The aim of this study was to investigate the individual dietary diversity and food preferences of the adult population living in Auki, Solomon Islands. A cross-sectional study involving 133 adults was undertaken in the Auki district via an interviewer-administered questionnaire. Individual dietary diversity scores (DDS) were determined based on the results of a 24-h recall method. Overall mean DDS was 7.27 (range 2-12). Females and participants who lived outside the Auki town center had significantly higher dietary diversity scores. Low consumption of a variety of nutritious foods within food groups and high consumption of energy dense processed foods, indicates that diet quality is likely limited in some of this population. Participants desire for a diverse diet including local foods suggests that current dietary diversity status in this population may be influenced by food security rather than food preference.

Effective triage in the Pacific region: The development and implementation of the Solomon Islands Triage Scale

OBJECTIVE

The ED at the National Referral Hospital in Honiara, Solomon Islands, receives approximately 50 000 patients per year. A 2014 review of ED functioning identified deficiencies in triage processes. Placement of Australian volunteer advisors provided an opportunity to develop and implement a purpose-designed triage system.

METHODS

Action research methodology and the 'plan, act, observe, reflect' cycle was employed, leading to the development of a three-tier triage system based on the South African Triage Scale. ED patient flow and data management processes were simultaneously updated, and staff were trained in the new system. After a pilot period, the Solomon Islands Triage Scale was implemented in August 2017. Evaluation after 3 months of operation included predictive validity (using admission and case fatality rates as surrogate markers of urgency) and reliability (based on inter-rater agreement at retrospective chart review by an independent nurse).

RESULTS

In the period 1 August to 31 October, there were 10 905 presentations, of which 97.1% were allocated a triage category (1% category 1, 21.3% category 2 and the remainder category 3). Admission rates correlated closely with triage category (P < 0.01). The case fatality rate was 22.1% for category 1 patients, 0.09% for category 2 and 0.01% for category 3 (P < 0.01). An audit of 96 records conducted in October 2017 revealed 88.4% agreement for triage category allocation.

CONCLUSION

Solomon Islands Triage Scale is the first three-tier triage scale to be implemented in the Pacific region and appears to have adequate validity and reliability. The partnership between Australian volunteers and local clinicians is a positive example of capacity development and represents a model that could be implemented in other resource-limited settings.

What, why and how do health systems learn from one another? Insights from eight low- and middle-income country case studies

BACKGROUND

All health systems struggle to meet health needs within constrained resources. This is especially true for low-income countries. It is critical that they can learn from wider contexts in order to improve their performance. This article examines policy transfer and evidence use linked to it in low- and middle-income settings. The objective was to inform international investments in improved learning across health systems.

METHODS

The article uses a comparative case study design, drawing on case studies conducted in Bangladesh, Burkina Faso, Cambodia, Ethiopia, Georgia, Nepal, Rwanda and Solomon Islands. One or two recent health system reforms were selected in each case and 148 key informants were interviewed in total, using a semi-structured tool focused on different stages of the policy cycle. Interviewees were selected for their engagement in the policy process and represented political, technical, development partner, non-governmental, academic and civil society constituencies. Data analysis used a framework approach, allowing for new themes to be developed inductively, focusing initially on each case and then on patterns across cases.

RESULTS

The selected policies demonstrated a range of influences of externally imposed, co-produced and home-grown solutions on the development of initial policy ideas. Eventual uptake of policy was strongly driven in most settings by local political economic considerations. Policy development post-adoption demonstrated some strong internal review, monitoring and sharing processes but there is a more contested view of the role of evaluation. In many cases, learning was facilitated by direct personal relationships with local development partner staff. While barriers and facilitators to evidence use included supply and demand factors, the most influential facilitators were incentives and capacity to use evidence.

CONCLUSIONS

These findings emphasise the agency of local actors and the importance of developing national and sub-national institutions for gathering, filtering and sharing evidence. Developing demand for and capacity to use evidence appears more important than augmenting supply of evidence, although specific gaps in supply were identified. The findings also highlight the importance of the local political economy in setting parameters within which evidence is considered and the need for a conceptual framework for health system learning.