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Medical summit calls for new WHO survey of NCD risk factors

A call has been made to the World Health Organization for a follow up survey of chronic disease risk factors in American Samoa, in order to find the latest data on non-communicable diseases (NCDs) in the territory. The territory’s population has been labeled one of the most obese in the world, as well as having an alarmingly high rate of diabetes within the Pacific region.


The last STEPS survey — done in both English and Samoan — was conducted by WHO in conjunction with the local Department of Health and was carried out between June and August 2004, according to WHO data, which also shows that 2,072 adults participated in the ‘American Samoa STEPS survey’.


The results of that survey were raised during last Saturday’s inaugural Medical Symposium which more than 40 local and off-island delegates attended with the goal of finding solutions, among other things, for the marked rise of NCDs in the territory.


During the morning panel discussion, Dr. Akapusi Ledua, the chief medical officer of LBJ hospital, asked if a newer, updated survey has been carried out.


He suggested that a new study should be conducted, with updated stats, to see where we stand in comparison to the first survey, and to revisit the recommendations made in 2004.


Dr. Ezekiel Nukuro with the WHO Pacific Office based in Suva, Fiji told the gathering that survey results were actually published in 2007 and there have been no follow up studies to compare to the 2004 study, to see the outcome of recommendations made at the time.


WHO’s Representative based in Apia, Dr. Yang Baoping agreed there was no follow up survey, but added, the “good thing is that you have a baseline and I think a follow up STEPS maybe a possibility and this is something that WHO can discuss.”


“In fact there is already indication from... our team coordinator for NCDs Pacific WHO office in Suva that if American Samoa [makes a] request” it will consider a repeat of the STEPS survey, possibility next year, he said.


Nukuro later said in a Samoa News interview that there are already preparations for the next survey to be implemented next year and it will be a joint project between WHO, local DOH and LBJ.


“This time we’ll be looking at the collaboration with the clinic side as well, because the data that comes out of the survey needs to be checked against the clinical side that we have at the hospital,” he said.


He said among the questions asked in the survey are those pertaining to eating habits, if the person smokes, the level of alcohol intake — “looking at the risk factors”.


“We then take your measurements, your height, and weight to determine what we call, your body mass index — and this will show you whether you are overweight or obese. It is obesity which leads to high blood pressure and other problems,” he explained. “There is also a test for cholesterol levels in terms of diabetes," Nukuro added.


(Samoa News should point out that the difference between being overweight and being obese is one of degree; they both define ranges of weight which are greater than what is considered healthy for a given height, with obesity having the highest degree of body fat.)


“And those things shows us the situation in terms of the population within America Samoa in terms of hypertension, diabetes, and those who are obese… these are the things that will come out of the study.”


Asked if the survey actually determines obesity or diabetes, he responded, “it determines everything, all the risk factors” and noted that the questionnaire for example, asks about “prevalence of smoking rate, the prevalence of alcohol consumption levels... and also questions the amount of physical activity, what kind of foods they ea t– do they eat nutritious foods such as fruits and vegetables.”


“So this information will be generated from the survey, plus we will know what proportion of the population surveyed is diabetic, if they have high blood pressure, and who are obese,” he said.


According to the 2004 survey report, the most significant findings were that:


•            47.3% of the population are diabetic (one of the highest rates in the world);


•            29.9% of the adult population are regular smokers;


•            93.5% of the population are overweight or obese, with 74.6% obese; and,


•            86.7% of the population consumed less than 5 servings of fruits and vegetables per day.


“Of greatest concern was the finding that 69.2% of the population aged between 25 and 44 years of age had three or more of the risk factors putting them in the high risk category,” noted Dr. Kevin Palmer, the WHO representative for American Samoa, Cook Islands, Niue, Samoa and Tokelau, in the summary of the 63-page report.


The report provided several recommendations, including informing the local population about the adverse health effects of excessive alcohol consumption and the health benefits of decreasing alcohol consumption, particularly targeted towards younger males and females.


It also recommended informing the public that being overweight and obese contributes to chronic diseases such as type II diabetes, cardiovascular disease, stroke and some cancers.