Examining wealth-related inequality in childhood vaccination in Fiji using the UNICEF Multiple Indicator Cluster Survey 2021.

Background: Despite a 95% immunisation rate in Fiji, disparities exist in the distribution of immunisation in children from different socioeconomic backgrounds. We used data from the 2021 Fiji Multiple Indicator Cluster Survey (MICS) to determine socioeconomic inequalities contributing to differences in immunisation coverage.

Methods: Data were extracted from the 'Household', 'Fertility/Birth history' and 'Children under 5' modules from the 2021 Fiji MICS to determine wealth quintiles and calculate vaccination rates for children aged 12-23 mo.

Vaccination and its social and behavioural drivers in children with disability in Fiji.

Introduction: Data on the vaccination of children with disabilities are limited across Pacific Island countries like Fiji. This study aimed to examine the vaccination status and measure the social and behavioural drivers influencing vaccination of children with disability in Fiji.

Methods: A cross-sectional survey was conducted in Suva-Nausori area, Rewa, Fiji among children with disabilities (eg, motor, vision, hearing, speech, intellectual, epilepsy) aged 2-19 years and their caregivers.

Enhanced and Sexually Transmitted Infections and Associated Risk Factors in Fiji Following the Coronavirus Disease 2019 Pandemic.

Background: The coronavirus disease 2019 pandemic impact on sexually transmitted infections in countries practicing syndromic management remains unknown. We conducted cross-sectional surveys in Fiji to assess increases and risk factors for (NG) and (CT) infections pre- and postpandemic.

Methods: We enrolled women, men who have sex only with women (MSW), and men who have sex with men (MSM) aged 18-40 years, collected sociodemographic/behavioral data, and tested vaginal, urethral, and rectal samples using Xpert-CT/NG.

Systems serology analysis shows IgG1 and IgG3 memory responses six years after one dose of quadrivalent HPV vaccine.

The WHO has given a permissive recommendation for an off-label one-dose human papillomavirus (HPV) vaccine schedule to prevent cervical cancer, based on evidence of comparable protection to two or three doses of vaccine. While neutralizing antibodies are thought to be the primary mechanism of protection, the persistence of immunity and whether other antibody-mediated mechanisms of protection are involved is unclear. Using systems serology, we investigated HPV antibody responses in serum from Fijian girls who were unvaccinated or received one, two or three doses of quadrivalent HPV vaccine six years earlier.

The urgency of now to end HIV vertical transmission for pregnant and breastfeeding women and their children in Asia and the Pacific.

The global strategy to #EndAIDS is underpinned by a call to end all inequities and to ensure no-one is left behind; but inequities continue, and people are still being left behind. Despite the advances seen in some populations and in some geographical areas, with ongoing high rates of HIV vertical transmission, ending HIV for pregnant and breastfeeding women and their children must be prioritised urgently. Focused on Asia and the Pacific, the region with the second largest number of people with HIV, in this viewpoint we highlight the heterogenous nature of global and regional success in eliminating vertical transmission of HIV.

"Fear of the unknown": Health, disability, and stakeholder perspectives on the behavioral and social drivers of vaccination in children with disability in Fiji.

Vaccinating children with disability in low- and middle-income countries, such as Fiji, is a key priority for equity. This study aimed to understand the social and behavioral drivers of vaccine uptake among children with disability in Fiji, from the perspectives of health, disability, and community stakeholders. Five qualitative focus groups were conducted with 22 stakeholders, including healthcare workers, disability service providers and advocates, and community and faith leaders (female n = 17, 77%).

An assessment of latrine front-end characteristics and associated surface E. coli indicated faecal contamination in rural Fiji.

In Fiji, 90% of the population has access to basic sanitation; however, there are still persistent health risks from endemic faecal-oral diseases such as typhoid fever. There is a need to assess the contribution of existing sanitation facilities in the faecal pathogen transmission pathway. This study was conducted as part of a larger planetary health study across 29 rural communities within five river catchments.

Molecular epidemiology of the HIV-1 epidemic in Fiji.

Very little is known about the HIV-1 epidemic in Fiji, nor the wider South Pacific region more generally, yet new reported HIV-1 infections are on the rise. As of 2023, there are an estimated 2000 cases of HIV-1 in Fiji with heterosexual contact the primary route of transmission. In this study, we used a molecular epidemiological approach to better understand the genetic diversity of the HIV-1 epidemic in Fiji and reveal patterns of viral transmission.

A single dose of quadrivalent HPV vaccine is highly effective against HPV genotypes 16 and 18 detection in young pregnant women eight years following vaccination: an retrospective cohort study in Fiji.

Background: In 2008/9, Fiji vaccinated >30,000 girls aged 9-12 years with the quadrivalent human papillomavirus (4vHPV) vaccine coverage for at least one dose was >60% (one dose only was 14%, two dose only was 13%, three doses was 35%). We calculated vaccine effectiveness (VE) of one, two and three doses of 4vHPV against oncogenic HPV genotypes 16/18, eight years following vaccination.

Methods: A retrospective cohort study was undertaken (2015-2019) in pregnant women ≤23 years old, eligible to receive 4vHPV in 2008/9, with confirmed vaccination status.

The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji.

Background: In 2012, Fiji became the first independent Pacific island country to introduce rotavirus vaccine. We describe the impact of rotavirus vaccine on all-cause diarrhoea admissions in all ages, and rotavirus diarrhoea in children <5 years of age.

Methods: An observational study was conducted retrospectively on all admissions to the public tertiary hospitals in Fiji (2007-2018) and prospectively on all rotavirus-positive diarrhoea admissions in children <5 years at two hospital sites (2006-2018, and 2010-2015), along with rotavirus diarrhoea outpatient presentations at one secondary public hospital (2010-2015).

Prospective Surveillance of Primary Healthcare Presentations for Scabies and Bacterial Skin Infections in Fiji, 2018-2019.

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 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).

Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis.

Background: In October, 2012, Fiji introduced routine infant immunisation with a ten-valent pneumococcal conjugate vaccine (PCV10) using three primary doses and no booster dose (3 + 0 schedule). Data are scarce for the effect of PCV in the Asia and Pacific region. We aimed to evaluate the effect of PCV10 on pneumonia hospital admissions in children younger than 5 years and adults aged 55 years and older in Fiji, 5 years after vaccine introduction.

Factors associated with pneumococcal carriage and density in children and adults in Fiji, using four cross-sectional surveys.

This study describes predictors of pneumococcal nasopharyngeal carriage and density in Fiji. We used data from four annual (2012-2015) cross-sectional surveys, pre- and post-introduction of ten-valent pneumococcal conjugate vaccine (PCV10) in October 2012. Infants (5-8 weeks), toddlers (12-23 months), children (2-6 years), and their caregivers participated.

Associations between ethnicity, social contact, and pneumococcal carriage three years post-PCV10 in Fiji.

Background: Pneumococcal carriage is a prerequisite for pneumococcal disease. Little is known about whether social contact frequency and intensity are associated with pneumococcal carriage. In Fiji, indigenous iTaukei have higher prevalence of pneumococcal carriage compared with Fijians of Indian Descent (FID).

A Comparison of Pneumococcal Nasopharyngeal Carriage in Very Young Fijian Infants Born by Vaginal or Cesarean Delivery.

Importance: Pneumococcal nasopharyngeal carriage is a prerequisite for pneumococcal disease. The main transmission route is from toddlers, who commonly carry pneumococci. However, neonatal pneumococcal disease case reports suggest that vertical pneumococcal transmission may also occur.

Understanding the meaning of youth sexual and reproductive well-being in Fiji.

Well-being is a term commonly used in discussions of sexuality, reproduction and sexual health, yet the meaning of the term is elusive and often disregarded. As an example, the 'well-being' component of sexual and reproductive health and well-being is often not explicitly addressed in research, policy and programme development. The goal of this paper is to explore the meanings of sexual and reproductive well-being among young people in Fiji and their implications.

Sustained Antibody Responses 6 Years Following 1, 2, or 3 Doses of Quadrivalent Human Papillomavirus (HPV) Vaccine in Adolescent Fijian Girls, and Subsequent Responses to a Single Dose of Bivalent HPV Vaccine: A Prospective Cohort Study.

Background: The duration of antibody response following reduced human papillomavirus (HPV) vaccine doses has not been determined. We compared the antibody responses in girls previously vaccinated with zero, 1, 2, or 3 doses of quadrivalent HPV vaccine (4vHPV; Gardasil, Merck) 6 years previously.

Methods: A prospective cohort study was undertaken in 200 Fijian girls 15-19 years of age.

Absolute lymphocyte count is not a suitable alternative to CD4 count for determining initiation of antiretroviral therapy in fiji.

Introduction. An absolute lymphocyte count is commonly used as an alternative to a CD4 count to determine initiation of antiretroviral therapy for HIV-infected individuals in Fiji when a CD4 count is unavailable. Methods.