This descriptive analytical ten year (1985 -1994) retrospective study assessed the pattern of spinal cord paralysis (SCP) in the Fiji Islands utilising medical rehabilitation hospital data. Fiji Islands is an archipelago of 300 islands in the south western Pacific with a multi-ethnic population of over three quarters of a million. Rehabilitation of all SCP is provided at the Medical Rehabilitation Unit (MRU). Data was collected from medical records of new SCP (n = 140) admitted to MRU and analysed with Epi Info 5 assessing associations between cause and other variables. The incidence of new SCP admitted to the MRU was 18.7/million/year. There were 75 (53.6%) traumatic and 65 (46.4%) non-traumatic SCPo The incidence varied according to gender and ethnicity with Fijian male being at the highest (41.85) risk. Amongst traumatic SCP, 38.7% were due to falls, 25.3% motor vehicle accidents, 20% sports, 8% shallow water dive and 4% each deep sea diving and others, whereas among non-traumatic SCP, 52.3% were due to unknown causes, 32.3% infections, 9.2% neoplasms and 6.2% others. The male/female ratio was 4: 1. The 16 -30 year age group accounted for 35% of SCPo 31 % had tetraplegia and 52.1 % had complete lesions. The subset of the sample who experienced traumatic SCP were more likely to be employed, aged between 16-30 years at the time of paralysis and to have complete tetraplegia. Those who experienced incomplete paraplegia were more likely to be unemployed, aged 46 -60 years and educated to primary level at the time of paralysis. There was a high proportion of complete spinal lesion when compared with other studies. The incidence of secondary complications such as pressure sores and UTI was also found to be high when compared with other studies. The results support the view that young Fijian males are most prone to sustaining traumatic spinal cord paralysis, and that there is a high incidence of secondary preventable complications. The need for preventative measures and adequate rehabilitation are emphasised.
Introduction. The objective of this study was to perform an economic analysis in terms of annual national human capital resource loss from young stroke mortality in Fiji. The official retirement age is 55 years in Fiji. Method. Stroke mortality data, for working-age group 15–55 years, obtained from the Ministry of Health and per capita national income figure for the same year was utilised to calculate the total output loss for the economy. The formula of output loss from the economy was used. Results. There were 273 stroke deaths of which 53.8% were of working-age group. The annual national human capital loss from stroke mortality for Fiji for the year was calculated to be F$8.85 million (US$5.31 million). The highest percentage loss from stroke mortality was from persons in their forties; that is, they still had more then 10 years to retirement. Discussion. This loss equates to one percent of national government revenue and 9.7% of Ministry of Health budget for the same year. The annual national human capital loss from stroke mortality is an important dimension in the overall economic equation of total economic burden of stroke. Conclusion. This study demonstrates a high economic burden for Fiji from stroke mortality of young adults in terms of annual national human capital loss.
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