Ichiho Henry M, Seremai Johannes, Trinidad Richard, Paul Irene, Langidrik Justina, Aitaoto Nia
Pacific Chronic Disease Coalition, Atlanta, GA, USA.
Hawaii J Med Public Health. 2013 May;72(5 Suppl 1):77-86.
Non-communicable diseases (NCD) have been declared a health emergency in the US-affiliated Pacific Islands (USAPI). This assessment, funded by the National Institutes of Health, was conducted on Ebeye Island of Kwajelein Atoll, Republic of the Marshall Islands (RMI) to describe the burdens due to selected NCD (diabetes, heart disease, hypertension, stroke, chronic kidney disease); assess the system of service capacity and activities for service delivery, data collection, and reporting; and identify the key issues that need to be addressed. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors lead to overweight and obesity and subsequent NCD that impact the morbidity and mortality of the population. Population survey of the RMI show that 62.5% of the total population is overweight or obese with a dramatic increase from the 15-24 year old (10.6%) and the 25-64 year old (41.9%) age groups. The leading causes of death were septicemia, renal failure, pneumonia, cancer, and myocardial infarction. Other findings show gaps in the system of administrative, clinical, and support services to address these NCD. All health care in Ebeye is provided in one setting and there is collaboration, coordination, and communication among medical and health care providers. The Book of Protocols for the Kwajalein Atoll Health Care Bureau provides the guidelines, standards, and policy and procedures for the screening, diagnosis, and management of diabetes and other NCDs. Based on these findings, priority issues and problems to be addressed for the administrative, clinical, and data systems were identified.
非传染性疾病（NCD）已被宣布为美属太平洋岛屿（USAPI）的一项卫生紧急情况。这项由美国国立卫生研究院资助的评估是在马绍尔群岛共和国夸贾林环礁的埃贝耶岛进行的，旨在描述某些选定的非传染性疾病（糖尿病、心脏病、高血压、中风、慢性肾病）造成的负担；评估服务能力系统以及服务提供、数据收集和报告方面的活动；并确定需要解决的关键问题。研究结果表明，不良饮食、缺乏体育活动和生活方式行为等风险因素会导致超重和肥胖，进而引发影响人群发病率和死亡率的非传染性疾病。马绍尔群岛共和国的人口调查显示，总人口的62.5%超重或肥胖，15至24岁年龄组（10.6%）和25至64岁年龄组（41.9%）的超重或肥胖率急剧上升。主要死因是败血症、肾衰竭、肺炎、癌症和心肌梗死。其他研究结果表明，在应对这些非传染性疾病的行政、临床和支持服务系统方面存在差距。埃贝耶岛的所有医疗保健都在一个场所提供，医疗和卫生保健提供者之间存在协作、协调和沟通。夸贾林环礁卫生局的《协议手册》提供了糖尿病和其他非传染性疾病筛查、诊断和管理的指南、标准以及政策和程序。基于这些研究结果，确定了行政、临床和数据系统需要解决的优先问题和难题。
