Geographical Locations - Seychelles

• (Statistical) Number of Inhabitants per Doctor: 992
• CIA World Factbook : Seychelles

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Seychelles
  - WHO - Tobacco control: Country Profile: Seychelles
  - WHO - Environmental Burden of Disease: Country Profile – Seychelles
  - WHO – Malaria Country Profile – Seychelles
• WHO - Regional Office AFRO in Brazzaville, Congo
• UNDP in Mauritius and Seychelles
• Office of the UN Residential Coordinator in Mauritius and the Seychelles

Government

• Ministry of Health & Social Services Seychelles, Health Department

Non-Government

Academic Institutions

National Policy and Related Documents

• National Health Policy: 2005 Review

Reports, Guidelines, and Projects

• Clustering of smoking, alcohol drinking and cannabis use in adolescents in a rapidly developing country
  Background: Smoking, alcohol drinking and cannabis use ("risk behaviors") are often initiated at a young age but few epidemiological studies have assessed their joined prevalence in children in developing countries. This study aims at examining the joint prevalence of these behaviors in adolescents in the Seychelles, a rapidly developing country in the Indian Ocean. Methods: Cross-sectional survey in a representative sample of secondary school students using an anonymous self-administered questionnaire (Global Youth Tobacco Survey). The questionnaire was completed by 1,321 (92%) of 1,442 eligible students aged 11 to 17 years. Main variables of interest included smoking cigarettes on ≥1 day in the past 30 days; drinking any alcohol beverage on ≥1 day in the past 30 days and using cannabis at least once in the past 12 months. Results: In boys and girls, respectively, prevalence (95% CI) was 30% (26–34)/21% (18–25) for smoking, 49% (45–54)/48% (43–52) for drinking, and 17% (15–20)/8% (6–10) for cannabis use. The prevalence of all these behaviors increased with age. Smokers were two times more likely than non-smokers to drink and nine times more likely to use cannabis. Drinkers were three times more likely than non-drinkers to smoke or to use cannabis. Comparison of observed versus expected frequencies of combination categories demonstrated clustering of these risk behaviors in students (P < 0.001). Conclusion: Smoking, drinking and cannabis use were common and clustered among adolescents of a rapidly developing country. These findings stress the need for early and integrated prevention programs. [author abstract] [BMC Public Health 2006, 6:169]
• Dental public health programmes in Seychelles (2008)
  "The Seychelles Dental Services consists of two major units, namely the Adult Dental Service and the School Dental Service. Whilst the 2 units have their separate objectives, they work together, so as to attain the overall purpose of the Seychelles Dental Services, and consequently that of the Ministry of Health of Seychelles." [WHO Collaborating Centre, Sweden]
• Divergent fifteen-year trends in traditional and cardiometabolic risk factors of cardiovascular diseases in the Seychelles
  Objective: Few studies have assessed secular changes in the levels of cardiovascular risk factors (CV-RF) in populations of low or middle income countries. The systematic collection of a broad set of both traditional and metabolic CV-RF in 1989 and 2004 in the population of the Seychelles islands provides a unique opportunity to examine trends at a fairly early stage of the "diabesity" era in a country in the African region. Methods: Two examination surveys were conducted in independent random samples of the population aged 25–64 years in 1989 and 2004, attended by respectively 1081 and 1255 participants (participation rates >80%). All results are age-standardized to the WHO standard population. Results: In 2004 vs. 1989, the levels of the main traditional CV-RF have either decreased, e.g. smoking (17% vs. 30%, p < 0.001), mean blood pressure (127.8/84.8 vs. 130.0/83.4 mmHg, p < 0.05), or only moderately increased, e.g. median LDL-cholesterol (3.58 vs. 3.36 mmol/l, p < 0. 01). In contrast, marked detrimental trends were found for obesity (37% vs. 21%, p < 0.001) and several cardiometabolic CVD-RF, e.g. mean HDL-cholesterol (1.36 vs. 1.40 mmol/l, p < 0.05), median triglycerides (0.80 vs. 0.78 mmol/l, p < 0.01), mean blood glucose (5.89 vs. 5.22 mmol/l, p < 0.001), median insulin (11.6 vs. 8.3 μmol/l, p < 0.001), median HOMA-IR (2.9 vs. 1.8, p < 0.001) and diabetes (9.4% vs. 6.2%, p < 0.001). At age 40–64, the prevalence of elevated total cardiovascular risk tended to decrease (e.g. WHO-ISH risk score ≥10; 11% vs. 13%, ns), whereas the prevalence of the metabolic syndrome (which integrates several cardiometabolic CVD-RF) nearly doubled (36% vs. 20%, p < 0.001). Data on physical activity and on intake of alcohol, fruit and vegetables are also provided. Awareness and treatment rates improved substantially for hypertension and diabetes, but control rates improved for the former only. Median levels of the cardiometabolic CVD-RF increased between 1989 and 2004 within all BMI strata, suggesting that the worsening levels of cardiometabolic CVD-RF in the population were not only related to increasing BMI levels in the interval. Conclusion: The levels of several traditional CVD-RF improved over time, while marked detrimental trends were observed for obesity, diabetes and several cardiometabolic factors. Thus, in this population, the rapid health transition was characterized by substantial changes in the patterns of CVD-RF. More generally, this analysis suggests the importance of surveillance systems to identify risk factor trends and the need for preventive strategies to promote healthy lifestyles and nutrition. [author abstract] [Cardiovascular Diabetology 2009; 8: 34]
• Do recent data from the Seychelles Islands alter the conclusions of the NRC Report on the toxicological effects of methylmercury?
  In 2000, the National Research Council (NRC), an arm of the National Academy of Sciences, released a report entitled, "Toxicological Effects of Methylmercury." The overall conclusion of that report was that, at levels of exposure in some fish- and marine mammal-consuming communities (including those in the Faroe Islands and New Zealand), subtle but significant adverse effects on neuropsychological development were occurring as a result of in utero exposure. Since the release of that report, there has been continuing discussion of the public health relevance of current levels of exposure to Methylmercury. Much of this discussion has been linked to the release of the most recent longitudinal update of the Seychelles Island study. It has recently been posited that these findings supercede those of the NRC committee, and that based on the Seychelles findings, there is little or no risk of adverse neurodevelopmental effects at current levels of exposure. In this commentary, members of the NRC committee address the conclusions from the NRC report in light of the recent Seychelles data. We conclude that no evidence has emerged since the publication of the NRC report that alters the findings of that report. [author abstract] [Environmental Health: A Global Access Science Source 2004, 3:2]
• Health in Seychelles – an overview
  Health in Seychelles has improved significantly over the past three decades, largely as a result of investment not only in the health services, but also in other social sectors that have direct impact on child survival and the health of individuals. Through different stages of the evolution of the health care system there have been close links between health policy and strategy, the overall national development efforts and the wider social and economic environment. Awareness of these links are useful in the understanding of current health issues such as the lifestyle related patterns of morbidity and mortality, characterised by non-communicable diseases and HIV/AIDS, the high demands for health care services, and evolving relationships between the public and private sectors. [author abstract] [SMDJ - Seychelles Medical and Dental Journal, Special Issue, Vol 7, No 1, November 2004, pp.13-20]
• Marked increase in the prevalence of obesity in children of the Seychelles, a rapidly developing country, between 1998 and 2004
  Background: There are few data on overweight in children in developing countries. Such data are important to guide public health policy. We assessed trends in the prevalence of overweight and obesity in children from the Seychelles, a middle-income island state in the Indian Ocean. Methods: Multiple cross-sectional surveys were conducted each year between 1998 and 2004 on all students of all schools in four selected school grades (crèche, 4th, 7th and 10th years of mandatory school). Weight and height were measured and children were asked about walking time and frequency of physical exercise at leisure time. Excess weight categories were defined according to the criteria of the International Obesity Task Force (IOTF) and the U.S. Centers for Disease Control and Prevention (CDC). Results: Data were available for 33 340 observations in 1998-2004, corresponding to 23 459 individual children measured once or several times. Based on IOTF criteria, the prevalence of 'overweight' or 'obesity' increased from 8.7% to 13.5% in boys, and from 11.8% to 18.6% in girls from 1998 to 2004 (PB/0.001). The prevalence of 'obesity' increased from 2.1% to 5.2% in boys and from 3.1% to 6.2% in girls (PB/0.001). Using CDC criteria, the prevalence of ‘at risk of overweight’ and 'overweight' increased by similar proportions. The shift towards higher values over time was larger in the upper than the lower tail of the BMI distribution. Physical activity decreased over calendar years and was inversely associated with excess weight. Conclusions: The prevalence of excess weight increased markedly over a seven-year period in children in the Seychelles. This is likely to reflect a rapid nutrition transition with increasingly positive energy balance. These findings stress the need for programs and policies aimed at promoting physical activity and healthy nutrition in countries in epidemiological transition. [author abstract] [International Journal of Pediatric Obesity 2006; 1(2): 120-128]
• Prevalence and risk factors for overweight and obesity in children from Seychelles, a country in rapid transition: the importance of early growth
  Objectives: To establish the prevalence of overweight and obesity and related risk factors in children from Seychelles (Indian Ocean), a country in rapid economic and epidemiological transition. Design: Cross-sectional study with retrospective access to early life data. Subjects: All children from all schools of Seychelles, in four selected school grades (kindergarten, fourth, seventh and tenth year of obligatory school) in 1999. A total of 5514 children aged 4.5 – 17.4 y were measured, corresponding to 83.5% of the eligible population. Measurements: Overweight and obesity, using age- and sex-specific body mass index (BMI) cut-off points as defined by the International Obesity Task Force. Results: Some 12.6% (95% confidence interval: 11.8 – 13.5%) of the children were overweight and 3.8% (3.3 – 4.4%) were obese. Weight gain (kg) during the first year of life was strongly associated with subsequent overweight (odds ratio 1.46, 95% confidence interval 1.27 – 1.67) and obesity (1.59, 1.29 – 1.97) in childhood, independently of birth weight. Increased maternal BMI (kg=m2) was also associated with overweight (1.07, 1.03 – 1.10) and obesity (1.09, 1.04 – 1.14) in the offspring. Conclusion: Prevalence of overweight and obesity among school children in Seychelles was as high as or higher than in some industrialized countries. If confirmed in other environments, the strong association between weight gain during the first year of life and subsequent obesity in childhood could affect the way optimal infant weight gain is defined in countries where public health priorities are changing. [author abstract] [International Journal of Obesity (2002) 26, 214–219]
• Prevalence, awareness and control of diabetes in the Seychelles and relationship with excess body weight
  Background: The evidence for a "diabesity" epidemic is accumulating worldwide but population-based data are still scarce in the African region. We assessed the prevalence, awareness and control of diabetes (DM) in the Seychelles, a rapidly developing country in the African region. We also examined the relationship between body mass index, fasting serum insulin and DM. Methods: Examination survey in a sample representative of the entire population aged 25–64 of the Seychelles, attended by 1255 persons (participation rate of 80.2%). An oral glucose tolerance test (OGTT) was performed in individuals with fasting blood glucose between 5.6 and 6.9 mmol/l. Diabetes mellitus (DM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were defined along criteria of the ADA. Prevalence estimates were standardized for age. Results: The prevalence of DM was 11.5% and 54% of persons with DM were aware of having DM. Less than a quarter of all diabetic persons under treatment were well controlled for glycemia (HbA1c), blood pressure or LDL-cholesterol. The prevalence of IGT and IFG were respectively 10.4% and 24.2%. The prevalence of excess weight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) was respectively 60.1% and 25.0%. Half of all DM cases in the population could be attributed to excess weight. Conclusion: We found a high prevalence of DM and pre-diabetes in a rapidly developing country in the African region. The strong association between overweight and DM emphasizes the importance of weight control measures to reduce the incidence of DM in the population. High rates of diabetic persons not aware of having DM in the population and insufficient cardiometabolic control among persons treated for DM stress the need for intensifying health care for diabetes. [author abstract] [BMC Public Health 2007, 7:163]
• Prevention better than cure… Tackling cardiovascular disease in the Seychelles
  Cardiovascular disease is becoming a leading cause of morbidity and mortality in developing countries while they go through the ‘epidemiologic transition’. An intervention program in the Seychelles (Indian Ocean) is presented as an illustration. Prevention and health promotion should be initiated promptly in developing countries to impede the up-surging epidemic and avoid the future burden of disease in young and middle age adults. [author summary] [Bulletin von Medicus Mundi Schweiz Nr. 86, Oktober 2002]
• Secular trends in height and weight among children and adolescents of the Seychelles, 1956–2006
  Background: Height of individuals has long been considered as a significant index of nutrition and health of a population; still, there is little information regarding the trends of height and weight among developing or transitional countries. We assessed the secular trends in height and weight in children of the Seychelles, a rapidly developing island state in the Indian Ocean (African region). Methods: Height and weight were measured in all students of all schools in four selected school grades (kindergarten, 4th, 7th and 10th grades) for the periods 1998–9 (6391 children) and 2005–6 (8582 children). Data for 1956–7 was extracted from a previously published report. Results: At age 15.5 years, boys/girls were on average 10/13 cm taller and 15/9 kg heavier in 2005–6 than in 1956–7. Height increased in boys/girls by 1.62/0.93 cm/decade between 1956–7 and 1998–9 and by 1.14/1.82 cm/decade between 1998–9 and 2005–6. For weight, the linear increase in boys/girls was 1.38/1.10 kg/decade between 1956–7 and 1998–9 and 2.21/2.50 kg/decade between 1998–9 and 2005–6. Overall, the relative increase in weight between 1956–7 and 2005–6 was 5-fold higher than the relative increase in height. Conclusion: Height and weight increased markedly over time in children aged <16 years in the Seychelles, consistent with large changes in socio-economic and nutritional indicators in the considered 50-year interval. The markedly steeper increase in weight than height over time is consistent with an epidemic of overweight and obesity. [author abstract] [BMC Public Health 2008, 8: 166]

Educational Resources

• CDC - Travel Information : East Africa
• Library of Congress Country Study Seychelles