ORCID Profile
0000-0001-5035-8076
Current Organisations
The University of Auckland
,
Cure Kids
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Publisher: Public Library of Science (PLoS)
Date: 03-02-2022
DOI: 10.1371/JOURNAL.PNTD.0010147
Abstract: In 2019, the Murdoch Children’s Research Institute in partnership with the Fiji Ministry of Health and Medical Services carried out an integrated mass drug administration (MDA) for the treatment of scabies and lymphatic filariasis in the Northern Division of Fiji (population estimate 131,914). We conducted a retrospective micro-costing exercise focused on the cost of scabies control in order to inform budgeting and policy decision making in an endemic setting. We collected detailed information on financial and economic costs incurred by both parties during the course of the MDA c aign (April 2018 to July 2019). We also conducted interviews with personnel involved in the financial administration of the MDA c aign. The economic cost of delivering two doses of ivermectin was US$4.88 per person. The cost of donated drugs accounted for 36.3% of total MDA costs. In this first large-scale MDA for the public health control of scabies, the estimated cost of delivering MDA per person for scabies was considerably more expensive than the costs reported for other neglected tropical diseases. The important cost drivers included the remuneration of health care workers who were extensively involved in the c aign, coverage of hard-to-reach, mainly rural populations and the two-dose regimen of ivermectin. These results highlight the importance of these cost determinants and can be used to plan current and future MDA programs.
Publisher: Springer Science and Business Media LLC
Date: 10-11-2020
DOI: 10.1186/S12885-020-07583-W
Abstract: In low-income countries breast cancer awareness (BCA) is essential to reduce the proportion of advanced stage presentations of breast cancer. There is a lack of studies using multivariable techniques to explore factors related to BCA in low-income countries. The objective of this study was to identify to what extent women in Fiji and Kashmir, India have BCA and practice breast self-examination (BSE) as well as factors associated with BCA and BSE. A survey of women aged ≥18 years was conducted in Fiji and Kashmir, India to assess BCA and rates of BSE. Comparison between Fiji and Kashmir was done using student’s t-test for continuous data and chi-square for binary data. Factors associated with BCA and BSE were analysed using a multivariable logistic regression for Fiji and Kashmir separately. Data were collected from 399 and 1982 women in Kashmir and Fiji, respectively. Of 1968 women in Fiji 57% were deemed to have an acceptable BCA compared to only 7.3% of 395 women in Kashmir. Having some education was associated with having BCA with an odds ratio of 4.7 (1.7–13) in Fiji and 10 (1.7–59) in Kashmir. Of 1976 women in Fiji 40% had tertiary education while 40% of 392 women in Kashmir had no education at all. The marital status was similar in both s les ( n = 1973 and 395) with 68–69% being married and 21–26% being single. The lack of female doctors or nurses with whom to discuss issues, was perceived as a problem in both countries. The key finding is an association between having any level of education and BCA. This correlation was much stronger than for a family history of breast cancer and BCA. Hence, general education to illiterate women may reduce the proportion of women in low-income countries presenting with advanced-stage breast cancer.
Publisher: American Society of Tropical Medicine and Hygiene
Date: 24-05-2021
Abstract: Scabies, impetigo, and other skin and soft tissue infections (SSTIs) are highly prevalent in many tropical, low-middle income settings, but information regarding their burden of disease is scarce. We conducted a surveillance of presentations of scabies and SSTIs, including impetigo, abscesses, cellulitis, and severe SSTI, to primary health facilities in Fiji. We established a monthly reporting system over the course of 50 weeks (July 2018–June 2019) for scabies and SSTIs at all 42 public primary health facilities in the Northern Division of Fiji (population, ≈131,914). For each case, information was collected regarding demographics, diagnosis, and treatment. There were 13,736 in idual primary healthcare presentations with scabies, SSTI, or both (108.3 presentations per 1000 person-years 95% confidence interval [CI], 106.6–110 presentations). The incidence was higher for males than for females (incidence rate ratio [IRR], 1.15 95% CI, 1.11–1.19). Children younger than 5 years had the highest incidence among all age groups (339.1 per 1000 person-years). The incidence was higher among the iTaukei (indigenous) population (159.9 per 1000 person-years) compared with Fijians of Indian descent (30.1 per 1000 person-years IRR, 5.32 95% CI, 5.03–5.61). Abscesses had the highest incidence (63.5 per 1,000 person-years), followed by scabies (28.7 per 1,000 person-years) and impetigo (21.6 per 1,000 person-years). Scabies and SSTIs impose a substantial burden in Fiji and represent a high incidence of primary health presentations in this population. The incidence in low-middle income settings is up to 10-times higher than that in high-income settings. New public health strategies and further research are needed to address these conditions.
Publisher: Wiley
Date: 03-08-2020
DOI: 10.1111/AJO.13221
Publisher: Pasifika Medical Association
Date: 06-02-2020
Abstract: Abstract Purpose: We hypothesized that exposure to locally relevant health content in Shortland Street (a New Zealand based hospital television drama) would be associated with increased knowledge and awareness of diabetes and associated risk factors. Methods: Prospective study design to compare knowledge of health and diabetes-related risk, and healthy behaviours, self-efficacy, behavioural intentions, and perceived social norms among a convenience s le of Fijian television viewers exposed to health messaging in three episodes of Shortland Street. Results: Exposure to health messages in the Shortland Street episodes was associated with change in perceived health and diabetes norms. Perception that family members were engaged with healthy behaviors increased significantly following exposure (p = .033). Perceived prevalence of diabetes among acquaintances significantly increased following exposure to the episodes (p = .008). Conclusions: Entertainment Education may be helpful in shifting health norms in the context of Fiji, alongside other health promotion measures.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Public Library of Science (PLoS)
Date: 09-12-2020
DOI: 10.1371/JOURNAL.PNTD.0008887
Abstract: Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in the Northern Division of Fiji (population: 131,914). Prospective surveillance for admissions with impetigo, abscess, cellulitis, wound infection, pyomyositis, necrotizing fasciitis, infected scabies, and crusted scabies was conducted at the Division’s referral hospital between 2018 to 2019. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes. Over the study period, 788 SSTI admissions were recorded corresponding to a population incidence 647 per 100,000 person-years (95%CI 571–660). Incidence was highest at the extremes of age with peak incidence in children aged years (908 per 100,000) and those aged ≥65 years (1127 per 100,000). Incidence was 1.7 times higher among the Indigenous Fijian population (753 per 100,000) compared to other ethnicities (442 per 100,000). Overall case fatality rate was 3.3%, and 10.8% for those aged ≥65 years. Scabies was diagnosed concurrently in 7.6% of all patients and in 24.6% of admitted children years. There is a very high burden of hospital admissions for SSTIs in Fiji compared to high-income settings especially among the youngest, oldest and indigenous population which is concordant with scabies and impetigo distribution in this population. Our findings highlight the need for strategies to reduce the burden of SSTIs in Fiji and similar settings.
Publisher: Pasifika Medical Association
Date: 06-02-2020
Abstract: Introduction: A barrier to local investigator-led research in low income settings, is the limited availability of personnel with appropriate research skills or qualifications to conduct the type of research required for evidence-informed policy making to improve access and quality of health care. In response to this, Fiji National University’s College of Medicine, Nursing and Health Sciences in Fiji, collaborated with academics based at the University of Auckland, New Zealand to deliver a series of research capacity development workshops in Fiji. Methods: Participants who attended any of the nine workshops (n=123) were contacted via email to take part in a brief survey regarding their perceptions of the effectiveness of the research capacity building workshops. Of the possible 123 participants, 80% (n=76) completed the questionnaire. Results: Findings demonstrate that the majority of participants reported that they had gained research skills from the workshops (75%) including proposal development skills (68%) and knowledge of appropriate research methods (59%). Furthermore, 70% agreed that the workshops built their research confidence. Since attending a workshop, 18% of respondents had successfully applied and received funding for research grants and/or fellowships. Barriers to conduct research included workload (75%), lack of research knowledge, experience or skills (51%), and lack of institutional support (41%). Suggestions for future workshops included: more focus on data analysis, regular courses rather than ‘one offs’, and preparation of research findings (e.g. publications). Conclusion: Our findings indicate that research workshops of this nature may increase in idual research capabilities but sustained, locally led initiatives, backed by institutional and supplementary technical support are essential.
Location: Fiji
Location: Fiji
Location: Fiji
Location: Fiji
No related grants have been discovered for Jyotishna Mani.