Two cases of 10-month-old infants with airway obstruction (chicken bone) in Samoa: Surgical/management challenges and future directions

We present the case of two 10-month old infants in Samoa who required surgical intervention for the removal of an ingested foreign body (chicken bone) in the trachea. Although such cases are usually medically evacuated to New Zealand, this was not possible for these patients due to travel restrictions (measles epidemic and COVI-19 pandemic). Both patients required emergency surgery for foreign body removal, including tracheostomy due to complicating factors. We discuss the management challenges faced by our context in Samoa, and indicate options for mitigating the adverse effects of similar cases in the future

Early warning epidemic surveillance in the Pacific island nations: an evaluation of the Pacific syndromic surveillance system

Objective: The Pacific Syndromic Surveillance System (PSSS), launched in 2010, provides a simple mechanism by which 121 sentinel surveillance sites in 21 Pacific island countries and areas perform routine indicator- and event-based surveillance for the early detection of infectious disease outbreaks. This evaluation aims to assess whether the PSSS is meeting its objectives, what progress has been made since a formative evaluation of the system was conducted in 2011, and provides recommendations to enhance the PSSS's performance in the future. Methods: Twenty-one informant interviews were conducted with national operators of the system and regional public health agencies that use information generated by it. Historic PSSS data were analysed to assess timeliness and completeness of reporting. Results: The system is simple, acceptable and useful for public health decision-makers. The PSSS has greatly enhanced Pacific island countries' ability to undertake early warning surveillance and has contributed to efforts to meet national surveillance-related International Health Regulation (2005) capacity development obligations. Despite this, issues with timeliness and completeness of reporting, data quality and system stability persist. Conclusion: A balance between maintaining the system's simplicity and technical advances will need to be found to ensure its long-term sustainability, given the low-resource context for which it is designed