title: An assessment of non-communicable diseases, diabetes, and related risk factors in the Federated States of Micronesia, State of Chuuk: a systems perspective.
abstract: Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Chuuk and describes the burdens due to selected NCDs (diabetes, heart disease, hypertension, stroke, chronic kidney disease); and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifying the issues that need to be addressed. There has been a 9.2% decline in the total population between 2000 and 2010. Findings of medical and health data reveal that diabetes, myocardial infarction, and septicemia are the leading causes of death and lower limb surgical procedures and amputations was a major problem that was addressed with a foot care education program to prevent amputations. No data were available on the prevalence of diabetes among the population of Chuuk. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCDs. There is a lack of policy and procedure manuals, coordination among providers, and common standards of care. There is no functional data system to identify and track patients with diabetes and other chronic diseases. Priority issues and problems were identified for the clinical, administrative, and data systems.
authors.affiliation: Pacific Chronic Disease Coalition, Atlanta, GA, USA. pcdc10@gmail.com
authors.forename: Henry M
authors.initials: HM
authors.lastname: Ichiho
authors.forename: Moria
authors.initials: M
authors.lastname: Shomour
authors.forename: Julio
authors.initials: J
authors.lastname: Marar
authors.forename: Kipier
authors.initials: K
authors.lastname: Lippwe
authors.forename: Nia
authors.initials: N
authors.lastname: Aitaoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D048909:Diabetes Complications / Q000517:prevention & control / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006298:Health Services Administration / Q000191:economics / Q000331:legislation & jurisprudence; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007256:Information Systems; D007348:Insurance, Health; D008297:Male; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D006435:Renal Dialysis; D013221:State Health Plans; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology; D055815:Young Adult
references.citation: Pac Health Dialog. 2004 Sep;11(2):30-6
references.pmid: 16281675
references.citation: Pac Health Dialog. 2010 Apr;16(1):123-7
references.pmid: 20968244
references.citation: Prev Chronic Dis. 2011 Jul;8(4):A86
references.pmid: 21672410
references.citation: Hawaii J Med Public Health. 2013 May;72(5 Suppl 1):5-9
references.pmid: 23901363