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Kaposi's sarcoma (KS) is an uncommon angioproliferative tumour. In its classic form, it rarely affects the head and neck. The etiologic agent in KS is Human Herpesvirus type-8 (HHV-8) infection. Populations in which KS occurs in the setting of immunocompetence tend to have high rates of seropositivity for HHV-8, including Mediterranean and Jewish people. Descriptions of KS in immunocompetent Polynesian individuals are almost non-existent. A reason for this may be the relative inaccessibility, both geographically and culturally, of indigenous peoples living in the Oceanic area. High rates of HHV-8 seropositivity have recently been reported in indigenous Melanesian populations of Vanuatu, New Caledonia and Papua New Guinea, a region neighbouring Polynesia. This paper is the first to describe classic KS isolated to the oral cavity in an immunocompetent patient of Polynesian ancestry and highlights the need for further research to clarify the risk of KS emerging in this region.

Summary: Current understanding of lipid genetics has come mainly from studies in European-ancestry populations; limited effort has focused on Polynesian populations, whose unique population history and high prevalence of dyslipidemia may provide insight into the biological foundations of variation in lipid levels. Here, we performed an association study to fine map a suggestive association on 5q35 with high-density lipoprotein cholesterol (HDL-C) seen in Micronesian and Polynesian populations. Fine-mapping analyses in a cohort of 2,851 Samoan adults highlighted an association between a stop-gain variant (rs200884524; c.652C>T, p.R218∗; posterior probability = 0.9987) in BTNL9 and both lower HDL-C and greater triglycerides (TGs). Meta-analysis across this and several other cohorts of Polynesian ancestry from Samoa, American Samoa, and Aotearoa New Zealand confirmed the presence of this association (βHDL-C = −1.60 mg/dL, pHDL-C = 7.63 × 10−10; βTG = 12.00 mg/dL, pTG = 3.82 × 10−7). While this variant appears to be Polynesian specific, there is also evidence of association from other multiancestry analyses in this region. This work provides evidence of a previously unexplored contributor to the genetic architecture of lipid levels and underscores the importance of genetic analyses in understudied populations.

Life-long serotype-specific immunity following dengue virus infection may not always occur, but the true extent of this effect is unknown. Analysis of more than 20 years of monotypic epidemics in the isolated French Polynesian islands revealed that whilst the risk of symptomatic dengue infection did conform to the classical paradigms of homotypic immunity and increased disease risk in heterotypic secondary infections, incorporation of waning immunity improved the ability of epidemiological models to capture the observed epidemic dynamics. Not only does this show how inclusion of waning immunity into classical models can reveal important facets of the immune response to natural dengue virus infection, it also has significant ramifications for vaccine development and implementation in dengue endemic areas.

The introduction of biopollutant species challenge ecosystem health and economy in remote islands. Here we checked the advance of invasive fouling species in five French Polynesian islands. Expansion of invasive species (Acantophora spicifera, Bugula neritina, Chthamalus proteus, Dendostrea frons) was detected using individual barcoding (COI for animals, RBLC for algae), and metabarcoding on biofouling (COI and 18S sequences). They were especially abundant in Port Phaeton (Tahiti), Bora Bora and Rangiroa atoll. Chthamalus proteus is a vector of bacterial diseases and may harm native French Polynesian mollusks. Dendostrea frons is a vector of Perkinsus, a parasite to which black pearl oysters, the mainstay of the Polynesian economy, are susceptible. High ecological and epidemiological risks were estimated for C. proteus and D. frons, and ecological risks also for A. spicifera and especially for B. neritina. Strengthening marine biosecurity measures is highly recommended to conserve these unique ecosystems and their associated services., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Spat collection of the pearl oyster Pinctada margaritifera in atoll lagoons of French Polynesia is the fundamental sustain of black pearl farming. Spat collection has always yielded variable results in space and time, but obvious signs of steady decreases, even collapses, have emerged in several lagoons. Spat collection materializes the ecological connectivity pathways between wild spawning populations and the location of artificial larval settlement substrates. To assess if oyster larval dispersal modelling could capture such pathways, we compared four six-week long spat collector deployment periods with dispersal simulations in two different lagoons. Spat collectors displayed wide spatial and temporal variations. Numerical modelling and field experiments were generally not in agreement. Although both methods have limitations, they can still approximate each other. But the accuracy of model simulations cannot be ascertained with spat collection data only. Using a SWOT (Strength-Weakness-Opportunities-Threats) analysis, we emphasize the complementarity of both approaches for management decisions., Competing Interests: Declaration of competing interest The authors have no conflict of interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

In French Polynesia, pearl farming represents the second economic resource of the country. The distinctive black pearls produced there are globally recognized and appreciated. However, pearl farms extensively use submerged plastic materials. Through gas chromatography coupled with tandem mass spectrometry detection (GC/MSMS) analysis, we were able to identify various POPs (Persistent Organic Pollutants) and additives released after 24 h of leaching into seawater from these "pearl plastics" composed of PE (Polyethylene) and PP (Polypropylene). Subsequently, we tested different concentrations of this plastic leachate on five tropical species commonly raised in the pearl and aquaculture sector in Polynesia: Pinctada margaritifera, Saccostrea cucullata, Holothuria whitmaei, Litopenaeus stylirostris, and Tripneustes gratilla. Monitoring the embryo-larval development of these organisms allowed us to establish a correlation between the decrease in the percentage of normal larvae and the plastic concentration. Through the use of regression models, the EC50 (Effective Concentration) of the plastic leachate for each species was determined, and demonstrated to range from 6.6 to 71.5 g/L, depending on the species. The most sensitive species was the black teatfish Holothuria whitmaei, a tropical sea cucumber used for the first time for ecotoxicological tests. The sensitivity of this species, its large distribution in tropical areas, and the various advantages presented by its cultivation make it an interesting bio-indicator species for monitoring plastic pollution in tropical lagoons., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

This study is a first assessment of Metallic Trace Elements (MTE) contamination of four lagoons in French Polynesia, chosen because their main anthropic uses are potential sources of MTE (military, agriculture, maritime). We used the giant clam Tridacna maxima as a biointegrator of fifteen MTE to assess the environmental footprint of human activities. The study of organotropism showed that not only the kidney but also the gonad and digestive system (GDS) are accumulator organs of interest for ETM biomonitoring. This result confirms that heterotrophic feeding is the pathway of ETM accumulation. Here, T. maxima appeared to be a super-accumulator of Ni (2700 ppm.dw), but also revealed at Tubuai (As, Fe, Mn) and Arutua (Cd, Zn) the environmental footprint of agricultural and maritime activities. The concentration of Cd recorded in Arutua (5 ppm.dw) both in KID and GDS, also underline the need for better control of effluents resulting from human activities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Black pearl farming is the second source of French Polynesia income after tourism, and Gambier Islands are the main farming sites. Gambier main lagoon contains several sub-lagoons critical for pearl oyster rearing and spat collecting (SC). The Rikitea lagoon, traditionally had good SC rates in the warm season which ensured steady supplies of oysters for black pearl production. However, since 2018, SC has abruptly decreased. To assess the factors affecting SC, Gambier lagoon hydrodynamics was investigated in 2019-2020 to calibrate a hydrodynamic model and simulate larval dispersal around the SC areas. The model shows the strong wind influence on larval dispersal and accumulation patterns and suggests that windy months in the warm season as it can occur during La Niña episodes can explain recent poor SC. Larval dispersal scenarios also informed on best locations to perform adult oyster restocking, a practice that can also enhance SC on the long term., Competing Interests: Declaration of competing interest The authors have no conflict of interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Local thermal environment has a strong influence on the physiology of marine ectotherms. This is particularly relevant for tropical organisms living close to their thermal optimum, well exemplified by the increasing frequency of bleaching occurrence in shallow-water corals. Mesophotic Coral Ecosystems (MCEs) were suggested as potential oases, especially when they are submitted to internal waves inducing short-term cooling events. Indeed, probability of bleaching occurrence in scleractinians was reported to decrease with depth in Mo'orea as temperature variability increases. However, ecophysiological data are currently lacking to understand the cause of lower susceptibility/increased plasticity of deeper corals. A growing interest has been devoted the last decade to MCEs, but our understanding of the physiological performance of benthic organisms living in this environment remains relatively unexplored. To tackle that question, we first compared the metabolic responses (dark respiration, net photosynthesis and photosynthetic efficiency) of the depth-generalist scleractinian Pachyseris speciosa from two heterogeneous thermal environment (25 and 85 m depths) to acute heat stress to determine if the local thermal environment could predict coral response to warming. Then, we tested the thermal performance of two sympatric species (the scleractinian P. speciosa and the antipatharian Stichopathes sp.) to determine if there are inter-species differences in performances in species experiencing identical levels of temperature variability, at mesophotic depths (85 m). Results revealed broader thermal performances in the mesophotic P. speciosa compared to mid-depth ones, and constrained performances in the mesophotic antipatharian compared to the scleractinian species. We hypothesize that the high fluctuations in temperature due to internal waves in deeper areas contribute to the broader thermal performances of mesophotic P. speciosa. However, the constrained performances of the mesophotic antipatharian compared to P. speciosa suggests that other processes than the symbiosis with zooxanthellae also influence thermal performances of these mesophotic organisms. Our results supported that Stichopathes sp. lives close to its thermal optimum, suggesting a (relatively) cold thermal specialist strategy. In this context, composition of MCEs in the future is unlikely to shift to antipatharian-dominated landscape and will remain coral-dominated landscape., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Life-long serotype-specific immunity following dengue virus infection may not always occur, but the true extent of this effect is unknown. Analysis of more than 20 years of monotypic epidemics in the isolated French Polynesian islands revealed that whilst the risk of symptomatic dengue infection did conform to the classical paradigms of homotypic immunity and increased disease risk in heterotypic secondary infections, incorporation of waning immunity improved the ability of epidemiological models to capture the observed epidemic dynamics. Not only does this show how inclusion of waning immunity into classical models can reveal important facets of the immune response to natural dengue virus infection, it also has significant ramifications for vaccine development and implementation in dengue endemic areas., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

The rapid decline of shallow coral reefs has increased the interest in the long-understudied mesophotic coral ecosystems (MCEs). However, MCEs are usually characterised by rather low to moderate scleractinian coral cover, with only a few descriptions of high coral cover at depth. Here, we explored eight islands across French Polynesia over a wide depth range (6 to 120 m) to identify coral cover hotspots at mesophotic depths and the co-occurrent biotic groups and abiotic factors that influence such high scleractinian cover. Using Bayesian modelling, we found that 20 out of 64 of studied deep sites exhibited a coral cover higher than expected in the mesophotic range (e.g. as high as 81.8 % at 40 m, 74.5 % at 60 m, 53 % at 90 m and 42 % at 120 m vs the average expected values based on the model of 31.2 % at 40 m, 22.8 % at 60 m, 14.6 % at 90 m and 9.8 % at 120 m). Omitting the collinear factors light-irradiance and depth, these 'hotspots' of coral cover corresponded to mesophotic sites and depths characterised by hard substrate, a steep to moderate slope, and the dominance of laminar corals. Our work unveils the presence of unexpectedly and unique high coral cover communities at mesophotic depths in French Polynesia, highlighting the importance of expanding the research on deeper depths for the potential relevance in the conservation management of tropical coral reefs., Competing Interests: Declaration of competing interest The authors declare that there are no competing interests., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The pearl-farming industry depends mostly on the natural recruitment of pearl oysters. Little is known about the relative influence of different ecological processes on the natural recruitment of pearl oysters across biogeographical scales. Spatio-temporal dynamics of bivalve larvae and spats were described at Ahe and Mangareva, 1500 km apart across French Polynesia. We quantified the effect of candidate environmental predictors on the dynamics of larvae. Both lagoons showed similar temporal dynamics with twice more larvae and 6 times more spat in Ahe. Pinctada maculata spat were more abundant than for P. margaritifera at both lagoons. While the temporal dynamics in larvae abundance were best explained by a positive effect of temperature in Ahe, the dynamics in Mangareva were poorly predicted by the environmental variables, meaning bivalve early-life stages perform better in Ahe than Mangareva suggesting a mismatch between the relevant environmental forces driving larval dynamics at these two contrasting lagoons., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Knowledge of the status of the black-lipped pearl oyster Pinctada margaritifera populations is critical for the sustainability of the French Polynesia black pearl farming industry. Indeed, this activity relies on collection of spat settling out of the water column, which is inherently related to the abundance of in situ benthic stocks and their reproductive capacities. From surveys performed between 2016 and 2021, we present new stock assessments of natural wild oyster populations from four contrasted pearl farming lagoons (Gambier, Takapoto, Raroia, Takume). Also using Ahe atoll historical data, we first highlight how results vary with the methods (Direct, Zonal and Cokriging) used to scale in situ density measurements to lagoon-scale stocks. Takapoto and Gambier populations were also previously surveyed at least twice since the 1980s, allowing to demonstrate with field data clear changes in stock distributions and population structures. The consequences of our findings are discussed to provide recommendations for stock monitoring and management in the future., Competing Interests: Declaration of competing interest The authors have no conflict of interests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

French Polynesia atolls are spread on a vast 2300 by 1200 km Central Pacific Ocean area exposed to spatially and temporally dependent wave forcing. They also have a wide range of closed to open morphologies and several have been suitable to develop from black-lipped pearl oysters a substantial pearl farming activity in the past 30 years, representing nowadays the 2nd source of income for French Polynesia. Considering here only the component of lagoon renewal that is driven by waves, we investigate for 74 atolls different lagoon renewal metrics using 20 years of wave model data at 0.05° spatial resolution. Wavelet spectral analyses highlight that atolls, even in close vicinity, can be exposed to different and characteristic periodicities in wave-driven flows and water renewal. These characteristics are discussed in relation to pearl farming atolls, including atolls known to be efficient oyster spat producers, a critical activity for pearl farming sustainability., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Antipatharians, also called black corals, are present in almost all oceans of the world, until extreme depths. In several regions, they aggregate in higher densities to form black coral beds that support diverse animal communities and create biodiversity hotspots. These recently discovered ecosystems are currently threatened by fishing activities and illegal harvesting for commercial purposes. Despite this, studies dedicated to the physiology of antipatharians are scarce and their responses to global change stressors have remained hardly explored since recently. Here, we present the first study on the physiological responses of a mesophotic antipatharian Stichopathes sp. (70-90 m) to thermal stress through a 16-d laboratory exposure (from 26 to 30.5 °C). Oxygen consumption measurements allowed identifying the physiological tipping point of Stichopathes sp. (T opt = 28.3 °C; 2.7 °C above mean ambient condition). Our results follow theoretical predictions as performances start to decrease beyond T opt , with lowered oxygen consumption rates, impairment of the healing capacities, increased probability of tissue necrosis and stress responses activated as a function of temperature (i.e. increase in mucocyte density and total antioxidant capacity). Altogether, our work indicates that Stichopathes sp. lives at suboptimal performances during the coldest months of the year, but also that it is likely to have low acclimatization capacity and a narrow thermal breadth., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

This editorial presents results of the MANA (MANagement of Atolls) project compiled in the form of a Marine Pollution Bulletin collection of 14 articles. MANA is a project funded by the French Agence National pour la Recherche that specifically addresses the development of knowledge and management tools for pearl farming atolls, with a focus on the spat collecting activity in French Polynesia. The 14 papers cover the range of thematic tasks described in the initial project, including atoll geomorphology and bathymetry, climate forcing, atoll lagoon and rim hydrodynamics, typology of atolls, evaluation of remote sensing data for monitoring atoll lagoons, and development of numerical models and spatially-explicit tools that altogether have contributed to the applied objectives. In addition, this editorial draws an update on the pearl farming industry in French Polynesia with the latest statistics, and discusses the next targeted priorities for research programs focusing on pearl farming atolls., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Oyster farming for black pearl production is central in French Polynesia. It is the second source of national income and provides substantial job opportunities, notably in remote atolls. However, this sector has been undermined by successive crises, such as mass-mortalities of wild and farmed oyster stocks that have impacted entire lagoons. An option to revive the activity consists of reintroducing oysters in strategic benthic locations selected to maximize reproduction and dispersal of larvae throughout the lagoon, hence promoting recolonization and spat collection for farming. For Takaroa, a Tuamotu atoll recently impacted by mortalities, a systematic prioritization approach identified these restocking sites, using environmental and socio-economic criteria such as: location of suitable habitats for oyster settlement, larval connectivity estimated from hydrodynamic circulation model, farming waste accumulation, and opportunity cost to fishers and farmers who lose access to restocking areas. This approach provides managers with a portfolio of restocking options., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Benthic exchanges of oxygen and nutrient at the sediment-water interface were investigated under light and dark conditions at 5 selected sites in a sub-tropical atoll. Mean oxygen fluxes were - 1316.5 ± 242.0 μmol m -2  h -1 and mean effluxes of oxygen under light conditions were 2231.7 ± 626.4 μmol m -2  h -1 , presumably due to microphytobenthos present at the sediment-water interface. The consequences of this high related productivity was a systematic consumption of nutrients (DIN, PO 4 and Si(OH) 4 ) during almost all light incubations, contrasting with the effluxes of nutrients during dark incubations. Our results suggest that the sediments were net autotrophic and the oxygen balance in favor of microbenthic production when compared to community demand. Diurnal rates of gross benthic primary productivity were high (3423 ± 1192 μmol m -2  h -1 ) which emphasize the role of microphytobenthos in maintaining the oxygen reservoir in tropical lagoons., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The currents flowing across the rim of the atoll of Raroia were investigated with a 1 year-long dataset of wave, water level and currents. Offshore waves break on the edge of the reef outside the atoll's rim and drive current into the lagoon, through the shallow hoa that cut across the rim. The additional water volume generated by this wave driven flow induces an elevation of water level throughout the atoll's lagoon and is evacuated back into the open ocean through a deep reef pass. The water level inside the atoll is also driven by astronomical tides, which enter the lagoon thought the reef pass, after undergoing a ~50% decrease in amplitude and a ~4 hour lag. Using a simple parametric model with three calibrated coefficients, we show that currents across the atoll's rim can be estimated as a function of the offshore wave conditions and the water level difference between the ocean and the lagoon., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Temperature and oxygen limit the distribution of marine ectotherms. Haematological traits underlying blood-oxygen carrying capacity are thought to be correlated with thermal tolerance in certain fishes, and this relationship is hypothesised to be explained by oxygen supply capacity. We tested this hypothesis using reef shark neonates as experimental models because they live near their upper thermal limits and are physiologically sensitive to low oxygen conditions. We first described in situ associations between temperature and oxygen at the study site (Moorea, French Polynesia) and found that the habitats for reef shark neonates (Carcharhinus melanopterus and Negaprion acutidens) were hyperoxic at the maximum recorded temperatures. Next, we tested for in situ associations between thermal habitat characteristics and haematological traits of neonates. Contrary to predictions, we only demonstrated a negative association between haemoglobin concentration and maximum habitat temperatures in C. melanopterus. Next, we tested for ex situ associations between critical thermal maximum (CT Max ) and haematological traits, but only demonstrated a negative association between haematocrit and CT Max in C. melanopterus. Finally, we measured critical oxygen tension (p crit ) ex situ and estimated its temperature sensitivity to predict oxygen-dependent values of CT Max . Estimated temperature sensitivity of p crit was similar to reported values for sharks and skates, and predicted values for CT Max equalled maximum habitat temperatures. These data demonstrate unique associations between haematological traits and thermal tolerance in a reef shark that are likely not explained by oxygen supply capacity. However, a relationship between oxygen supply capacity and thermal tolerance remains to be demonstrated empirically., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The COVID-19 pandemic led to a global lockdown in mid-2020, leading to a rapid decline in international travel and tourism. In French Polynesia, marine-based tourism activities ceased in March 2020 with the suspension of international flights (i.e., 45 days - between 20th March and 04 th May 2020), slowly restarting between May-July as domestic and international visitors returned. The impacts of this rapid change in human activity at reef tourism sites on associated reef fishes was examined at Bora-Bora Island through underwater surveys of five control and nine eco-tourism sites. Our results showed that fish density significantly increased from March to May (i.e., the overall density of fishes increased by 143% and harvested species by 215%), but returned to pre-lockdown levels by August 2020. At the usually busy eco-tourism sites, fish diversity, notably of piscivores, omnivores, and benthic feeders, was higher in the absence of tourists. The impact observed is almost certainly related to short term changes in fish behavior, as any density fluctuations at the population level are unlikely to have happened over such a short time frame. Overall, these findings highlight the influence of human activities on fish communities and underline the need for further research to evaluate the environmental impacts of eco-tourism., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Non-indigenous species can become a problem for the ecosystem health, especially when their distribution grows to the detriment of native species. In this moment, they can become invasive species. In marine ecosystems, the maritime transport is the principal gate and corridor for the movement of alien species. The genetic identification, using barcoding tools, of different oyster species in ports of the remote French Polynesia islands and atolls, showed a significant increase of exotic versus native oyster species between 2011 and 2018. This supports the spread of exotic species with the maritime traffic as the main cause. Moreover, the 11% of inaccurate identification at species level obtained in this study shows the need to complete the genetic databases., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

A biogeochemical model (ECO3M-Atoll) was configured to simulate the lower food web in Ahe Atoll lagoon where phytoplankton is mostly nitrogen limited. Understanding the dynamics of phytoplankton - the main food source for oysters - is crucial for the management and the allocation of new pearl farming sites. After parametrizing the model with in situ observations, we tested different hypotheses about nitrogen cycling (benthic remineralization, atmospheric N fixation, etc.) and compared the results to a large observational dataset. Model results show that simulated (pico- and nano-) phytoplankton biomass and nitrogen concentrations are close to in situ data. The simulated biogeochemical processes (uptake and primary production) are also very similar to the observed values. In the model, primary production ranged from 1.00 to 2.00 mg C m -3  h -1 for pico- and 0.40 to 1.00 mg C m -3  h -1 for nanophytoplankton; mean N uptake was 2.02 μmol N m -3  h -1 for pico- and 1.25 μmol N m -3  h -1 for nanophytoplankton., (Copyright © 2021. Published by Elsevier Ltd.)

Large amounts of floating litter accumulate in the subtropical gyres, and the shorelines of oceanic islands in the vicinity of these accumulation zones receive large amounts of litter. The dynamics of marine litter arrival were evaluated on a small pocket beach on Rapa Nui (Easter Island) between November 2016 and June 2017 over a total time period of 190 days. Plastics dominated the stranded litter, with the majority of the items showing indications to come from the high seas fisheries operating in the South Pacific. Litter accumulation rates varied between 0 and 1.90 items m -1  day -1 , and were highest following days of strong winds from northern directions. The results indicate that the shores of Rapa Nui are exposed to continuous input of plastic litter from the contaminated waters of the subtropical gyre, which is intensified during strong onshore winds., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Mass-mortality events of marine species can disturb the structure of communities. While identifying the causes of mass-mortality events is crucial for implementing recovery strategies, monitoring is challenging in remote locations. Black-lip pearl oysters (Pinctada margaritifera) are farmed for producing black pearls within remote atolls of French Polynesia. Previous mass-mortality events have resulted in the collapse of oysters and other species; however, the causes and conditions that favour recovery are unclear. We investigated the potential for oyster population recovery 5 years after a mortality event at Takaroa Atoll (Tuamotu Archipelago). Temperature, food availability (total chlorophyll-a), growth and reproduction were monitored. Growth was also simulated using a Dynamic Energy Budget model. Despite favourable conditions, reduced growth and reproduction signalled an energetic deficit. The model overpredicted growth, and supported the hypotheses that individuals are unable to profit from the phytoplankton available and maintenance costs are high in Takaroa, ultimately explaining their poor physiological condition., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

This study reports the first measurements of nitrogen uptake and new data on carbon fixation ( 15 N/ 13 C incorporation) for two size-fractionated phytoplankton (<2 μm and >2 μm), on organic matter, and phytoplankton stocks in Ahe lagoon. Data were collected between November and December 2017, during the hot season with prevailing trade winds. Ammonium and nitrate uptake data (7.58 to 39.81 and 1.80 to 21.43 μmol N m -3  h -1 , respectively) suggest a rapid turn-over of N-nutrients in the water column and show that primary production was largely sustained by recycled nitrogen providing 68% of the pelagic N demand. These results highlight the spatial heterogeneity of the measured processes linked to the local hydrodynamics, exhibiting higher regenerated production in the more exploited southwestern part of the lagoon and a higher proportion of new production in the north. Intense nutrient recycling appears to promote nanophytoplankton production which is critical for pearl oyster growth., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Seagrass ecosystems exist throughout Pacific Island Countries and Territories (PICTs). Despite this area covering nearly 8% of the global ocean, information on seagrass distribution, biogeography, and status remains largely absent from the scientific literature. We confirm 16 seagrass species occur across 17 of the 22 PICTs with the highest number in Melanesia, followed by Micronesia and Polynesia respectively. The greatest diversity of seagrass occurs in Papua New Guinea (13 species), and attenuates eastward across the Pacific to two species in French Polynesia. We conservatively estimate seagrass extent to be 1446.2 km 2 , with the greatest extent (84%) in Melanesia. We find seagrass condition in 65% of PICTs increasing or displaying no discernible trend since records began. Marine conservation across the region overwhelmingly focuses on coral reefs, with seagrass ecosystems marginalised in conservation legislation and policy. Traditional knowledge is playing a greater role in managing local seagrass resources and these approaches are having greater success than contemporary conservation approaches. In a world where the future of seagrass ecosystems is looking progressively dire, the Pacific Islands appears as a global bright spot, where pressures remain relatively low and seagrass more resilient., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Plastics are an environmental threat; however, their fate once in the pelagic environment is poorly known. We compare results from assessments of floating plastics in the South Pacific Ocean with accumulated beach plastics from Henderson Island. We also compare accumulated plastic mass on Henderson during 2015 and 2019 and investigate the presence of nanoplastics. There were differences between the size classes of beach and pelagic plastics, and an increase in microplastics (0.33-5 mm) on the beach between 2015 and 2019. Micro- and nanoplastics were found at all sites (mean ± SE: 1960 ± 356 pieces/kg dw). Across the whole beach this translates to >4 billion plastic particles in the upper 5 cm. This is concerning, particularly given Henderson is uninhabited and distant from urban centres (~2350 km from Pape'ete, French Polynesia). The vast number of small particles on Henderson may make nearshore filter feeders susceptible to ingestion and subsequent detrimental impacts., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Coral reef ecosystems are declining at an alarming rate. Increasing seawater temperatures and occurrence of extreme warming events can impair sexual reproduction in reef-building corals and inhibit the ability for coral communities to replenish and persist. Here, we investigated the role of photophysiology on the reproductive ecology of Pocillopora acuta coral colonies by focusing on the impacts of bleaching susceptibility of parents on reproduction and larval performance, during an El Niño Southern Oscillation event in Mo'orea, French Polynesia. Elevated temperature conditions at that time induced bleaching phenotypic differences among P. acuta individuals: certain colonies became pale (from the loss of pigments and/or decline in symbiont cell density), while others remained pigmented (normal/high symbiont cell density). More specifically, we studied the impact of parental phenotypes on offspring's fluorescence by counting released larvae and sorting them by fluorescence types, we assessed survival to thermal stress, recruitment success and post-recruitment survival of released larvae from each fluorescent phenotype, during summer months (February to April 2016). Our results showed that red and green fluorescent larvae released by P. acuta had distinct physiological performances: red fluorescent larvae exhibited a higher survival into the pelagic phase regardless temperature conditions, with lower capacity to settle and survive post-recruitment, compared to green larvae that settle within a short period. Interestingly, pale colonies released two-to seven-fold more red fluorescent larvae than pigmented colonies did. In the light of our results, photophysiological profiles of the brooding P. acuta parental colonies may modulate the fluorescence features of released larvae, and thus influence the dispersal strategy of their offspring, the green fluorescent larval phenotypes being more performant in the benthic than pelagic phase., (Copyright © 2020. Published by Elsevier Ltd.)

The lagoons of seven French Polynesia and Cook Islands pearl farming atolls (Raroia, Takume, Mopelia, Takapoto, Ahe, Takaroa and Manihiki) were surveyed using multibeam and mono-beam sounders. From the detailed bathymetry, morphometric variables (average and maximum depth, frequency-area of depth, lagoon area and volume) are computed and compared. Remarkable geomorphological structures highlighted by bathymetric variations include deep reticulated structures and pinnacles. The seven atolls appear very different in abundance, size and density of these entities. Considering them as markers of the geological, sedimentological and eustatic processes that shape atoll lagoons, they are discussed in the context of the general theory of atoll lagoon formations involving karstic dissolution during Pleistocene or earlier low sea-level stands. In terms of pearl farming management, accurate bathymetric maps help pearl oyster wild stock assessment, development of circulation and biogeochemical models, better lagoon zoning and strategy to remove pearl farming derelict gears., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Temperature is important for pearl oyster reproduction, pelagic larval duration, and growth in the context of pearl farming, but has seldom been monitored over long periods in remote atolls. To test if satellite-derived Sea Surface Temperature (SST) could provide a solution, two daily global SST products were compared with 18 high-precision loggers deployed during 10-months in the wide Raroia atoll (Tuamotu Archipelago, French Polynesia). The Multi-scale-Ultra-high-Resolution (MUR) SST was better correlated with lagoon temperature (r > 0.97) than the Global-Foundation-Sea-Surface-Temperature-Analysis (G1SST) SST (r < 0.94). Differences between observations and MUR SST ranged between -0.75 °C and + 1.12 °C and were influenced by seasons and locations, depth, and hours of measurements. Within this uncertainty range, simulations using a Dynamic Energy Budget model predicted similar life traits of oysters. Therefore, MUR SST appears suitable to monitor lagoon temperature in wide atolls, model oyster population dynamics and assist pearl oyster research and management., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Among dinoflagellates responsible for benthic harmful algal blooms, the genus Ostreopsis primarily described from tropical areas has been increasingly reported from subtropical and temperate areas worldwide. Several species of this toxigenic genus produce analogs of palytoxin, thus representing a major threat to human and environmental health. The taxonomy of several species needs to be clarified as it was based mostly on morphological descriptions leading in some cases to ambiguous interpretations and misidentifications. The present study aims at reporting a benthic bloom that occurred in April 2019 in Tahiti island, French Polynesia. A complete taxonomic investigation of the blooming Ostreopsis species was realized using light, epifluorescence and field emission electron microscopy and phylogenetic analyses inferred from LSU rDNA and ITS-5.8S rDNA regions. Toxicity of a natural sample and strains isolated from the bloom was assessed using both neuroblastoma cell-based assay and LC-MS/MS analyses. Morphological observations showed that cells were round to oval, large, 58.0-82.5 µm deep (dorso-ventral length) and 45.7-61.2 µm wide. The cingulum was conspicuously undulated, forming a 'V' in ventral view. Thecal plates possessed large pores in depressions, with a collar rim. Detailed observation also revealed the presence of small thecal pores invisible in LM. Phylogenetic analyses were congruent and all sequences clustered within the genotype Ostreopsis sp. 6, in a subclade closely related to sequences from the Gulf of Thailand and Malaysia. No toxicity was found on the field sample but all the strains isolated from the bloom were found to be cytotoxic and produced ostreocin D, a lower amount of ostreocins A and B and putatively other compounds. Phylogenetic data demonstrate the presence of this species in the Gulf of Thailand, at the type locality of O. siamensis, and morphological data are congruent with the original description and support this identification., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Ostreopsis is a benthic dinoflagellate genus comprising eleven species including seven that are toxigenic. Ostreopsis lenticularis was first described from French Polynesia and is widely distributed in many insular locations from the Pacific Ocean. The current study presents morphological and molecular evidence of the presence of O. lenticularis at the Fernando de Noronha Archipelago, South Atlantic. Light microscopy and scanning electron microscopy of field cells showed morphological features in agreement with the description of O. lenticularis. Cells were broadly oval, 66.0-117.5 μm in dorso-ventral diameter, 50.0-92.5 μm in width, with thecal plates presenting two kinds of pores. Phylogenetic analyses based on LSU (D1-D3) and ITS sequences from field cells from Fernando de Noronha clustered with O. lenticularis sequences from elsewhere. The species was present in low to high abundances. The current study expands the distribution of O. lenticularis to Fernando de Noronha Archipelago in the South Atlantic Ocean., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

French Polynesia exhibits a wide diversity of islands and coral-reef habitats, from urbanized high islands to remote atolls. Here, we present a geographically extensive baseline survey that examine the concentrations of nine metals (Ag, Cd, Co, Cu, Fe, Mn, Ni, Pb and Zn) and one metalloid (As) in superficial sediments from 28 sites spread over three islands of French Polynesia. We used Principal Component Analysis, Pearson's correlation, hierarchical cluster analysis and generalized linear mixed-effect models on Pollution Load Index to investigate site contamination and metal(loid) associations. At most sites, metal(loid) concentrations were below commonly applied sediment quality guidelines. However, a few sites located near farming activities, river discharges and urbanized areas showed concentrations above these guidelines. This study provides critical baseline values for metal(loid) contaminants in this region and in coral-reef areas in general, and spur decreased discharge of metal(loid) contaminants in the anthropogenised areas of French Polynesia., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: To describe and analyse the epidemiological and clinical characteristics of imported human angiostrongyliasis in Europe., Methods: A systematic literature review of cases of human angiostrongyliasis in Europe was performed. Seven databases were searched. The epidemiological and clinical characteristics were extracted from included records and simple summary statistics were performed on extracted data., Results: Twenty-two cases reported between 1988 and 2019 were identified. They were mainly from French Polynesia, Southeast Asia, and the Caribbean Islands. The dominant suspected mode of transmission was ingestion of prawns, shrimp, or salad. For patients with data, 90% had a history of headache, often lasting, and half had paresthesia. Eighty-nine percent had eosinophilia, 93% had cerebrospinal fluid (CSF) eosinophilia, and 92% had elevated CSF protein. Central nervous system (CNS) imaging was normal in most cases. Two-thirds received albendazole or mebendazole treatment, although this is not currently recommended., Conclusions: We have increased previous numbers to 22 reported cases in total since 1988. Angiostrongyliasis should generally be suspected in patients with a lasting headache who have returned from Southeast Asia, China, the Caribbean Islands, Australia, or French Polynesia, as well as parts of North America and Tenerife, Spain, although one autochthonous case from mainland Europe has also been reported. A dietary history should focus on prawns, shrimp, and salad, whilst also including slugs and snails and other paratenic hosts where relevant. The clinical diagnosis is supported by the presence of blood eosinophilia, CSF eosinophilia, and elevated CSF protein. A definitive laboratory diagnosis should be sought, and CNS imaging should be used to support, not to rule out the diagnosis. The most up-to-date evidence should always be consulted before initiating treatment. Current recommendations include analgesics, corticosteroids, and periodic removal of CSF for symptom relief, while antihelminthic treatment is debated., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We surveyed 14 individuals of Tylosurus crocodilus Péron & Lesueur 1821 (Belonidae) collected from the waters around Lizard Island and Heron Island, Great Barrier Reef, Queensland, Australia, and the waters around Moorea, French Polynesia. We describe two new species of bucephaline trematodes from them, Prosorhynchoides galaktionovi n. sp. and P. kohnae n. sp. They are morphologically distinct from existing Prosorhynchoides spp., with molecular data from 28S and ITS-2 ribosomal DNA, as well as cox1 mitochondrial DNA, further supporting our morphological findings. Neither species has been observed in other belonid fishes. The new species fall into the clade of species of Prosorhynchoides from belonids previously identified in Australian waters. These findings strengthen the observation that groups of bucephaline species have radiated, at least in part, in tight association with host taxa. There are now five species of Prosorhynchoides known from two belonid species in Australian waters. We, therefore, predict further richness in the nine other belonid species present., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The atoll of Hao, part of the Tuamotu Archipelago in French Polynesia, hosted an air base which was used by France Air Force and Naval Aviation during the nuclear tests. Following the publication of a report in 2012 indicating widespread contamination of the atoll, we conducted a biomonitoring survey to assess the exposure to toxic metals and polychlorinated biphenyls (PCBs) of Hao residents and residents of Makemo, a nearby atoll without any known sources of industrial pollution. Adults and adolescents (≥12 years) randomly sampled from Hao (n = 275) and Makemo (n = 268) provided blood samples for contaminant analyses. Whole blood samples were analysed for cadmium, lead and total mercury by inductively coupled plasma mass spectrometry. Plasma concentrations of PCBs were measured by gas chromatography mass spectrometry. Face-to-face interviews were conducted to document lifestyle and a food-frequency questionnaire was used to document dietary habits. Concentrations of contaminants were compared between atolls and associations with sociodemographic and personal characteristics of the participants were investigated. A significantly higher mean (geometric) of blood lead concentration was observed in Hao compared to Makemo (3.75 vs 3.40 μg/L, P = 0.02), whereas similar concentrations were noted for cadmium (0.49 vs 0.50 μg/L, P = 0.58) and mercury (11.4 vs 11.5 μg/L, P = 0.78). Mean total PCBs plasma concentration was significantly higher in Hao than in Makemo participants (0.75 vs 0.32 μg/L, P < 0.001). A significant proportion of participants exceeded toxicological reference values for mercury and lead in both atolls. The higher body burden of PCBs and Pb in Hao compared to Makemo residents may be linked to past air base activities in Hao. According to international standards, PCBs exposure is low; however, exposure to both mercury and lead is high and further investigations are required to identify specific sources of exposure., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Morinda citrifolia (Noni) is a popular traditional medicinal plant consumed in various forms in several countries around the world as a complementary and alternative treatment due to its established health benefits. Noni is rich in bioactive substances and has significantly exhibited pro-oxidant and immunomodulatory effects. In this review, we highlight the pharmacological basis related to the phytochemicals and polysaccharides present in Noni and its potential therapeutic effects. We screened electronic databases such as PubMed, Google Scholar, Scopus for scientific literature. Our results indicate that Noni is beneficial for various diseases with its crude extracts showing therapeutic benefit for a wide range of pathological diseases. We believe that further pharmacological and toxicological studies in addition to well-designed controlled clinical trials can validate Noni to be an effective and novel natural product for prophylactic and therapeutic use of several diseases., (Copyright © 2019. Published by Elsevier Ltd.)

Zika virus (ZIKV) is a re-emerging virus belonging to the family of Flaviviridae, which contains several human pathogens. A great deal of attention came through the association of ZIKV infection with an increasing number of microcephaly cases in newborns during the 2016 outbreak in Brazil. Currently, no anti-viral drug or vaccine is available. Houttuynoids are a group of structurally related flavonoid glycosides that can be isolated from Houttuynia cordata belonging to the family of Sauraceae. Moreover, H. cordata was described to have an antiviral effect on herpes simplex virus type 1 (HSV-1), human immunodeficiency virus type 1 (HIV-1) and influenza A virus (Hayashi et al., 1995). In light of this, this study aimed to investigate a potential antiviral effect of the synthetic houttuynoids TK1023 and TK1024 (i.e. houttuynoid B) on two ZIKV isolates (Uganda and French Polynesia). A significant decrease in the amount of intra- and extracellular viral genomes as well as infectious viral particles was observed after treatment with the tetra-O-acetylated houttuynoid TK1023 independent from the analyzed virus isolate. In contrast, TK1024 (houttuynoid B) had no effect on ZIKV. Treatment with TK1023 significantly decreases the number of infected cells 24 h and 48 h after infection, as compared to the control. Analysis of the mode of action revealed that TK1023 neither affects the viral genome replication nor the production of viral proteins nor morphogenesis or release. Binding and entry assays showed that TK1023 interferes with the entry of the virus in the cell. Thereby, the spread of ZIKV infection is impaired as the infection of the individual cell is inhibited. These data indicate that for both analyzed virus isolates the spread of ZIKV infection can be impaired by the synthetic houttuynoid TK1023 due to an inhibition of the viral entry., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Metallic and organic pollutants constitute a serious threat for coral reef ecosystems, potentially affecting a great number of species interacting within complex trophodynamic processes. Pesticides, PCBs and trace elements were measured on coral reef communities of three Pacific islands (Moorea, Wallis and New Caledonia) in relation with δ 15 N values, a proxy of trophic level. Several potential sources of organic matter, benthic invertebrates and fish belonging to various trophic strategies were sampled at each island. Wallis and New Caledonia displayed, respectively, the highest concentrations of pesticides and trace elements. In the three islands, most trace element concentrations (Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, and V) decreased when δ 15 N was rising (i.e. bioreduction), whereas Hg and Se biomagnified with increasing δ 15 N values. Only few trace elements in some islands did not show any significant trend in relation with δ 15 N (i.e., Ag in New Caledonia, Zn in Wallis and As plus Zn in Moorea). PCBs concentrations showed a significant bioreduction in New Caledonia and in Moorea, but a significant biomagnification in Wallis. Aldrin and heptachlor were the only pesticides to show a similar significant bioreduction in the three islands. Other pesticides, such as chlordecone, diazinon, endosulfan I and II, heptachlor-epoxide A and B, lindane and pp'-DDE displayed contrasted patterns (e.g. chlordecone significantly biomagnified in New Caledonia, significantly bioreduced in Wallis and did not displayed any significant trend in Moorea). Finally, for unclear reasons, Moorea displayed only negative significant correlations between δ 15 N and all pesticides (except pp'-DDT). Our results highlight that trophic level, here assessed through δ 15 N values, is a good predictor of metallic trace elements biomagnification or bioreduction in coral reef organisms. However, at large spatial scale, trophic level relevance to predict pesticides and PCBs biomagnification or bioreduction should be considered with caution and studied in close relation with local characteristics., (Copyright © 2019 Elsevier B.V. All rights reserved.)

To date, the genus Ostreopsis comprises eleven described species, of which seven are toxigenic and produce various compounds presenting a major threat to human and environmental health. The taxonomy of several of these species however remains controversial, as it was based mostly on morphological descriptions leading, in some cases, to ambiguous interpretations and even possible misidentifications. The species Ostreopsis lenticularis was first described by Y. Fukuyo from French Polynesia using light microscopy observations, but without genetic information associated. The present study aims at revisiting the morphology, molecular phylogeny and toxicity of O. lenticularis based on the analysis of 47 strains isolated from 4 distinct locales of French Polynesia, namely the Society, Australes, Marquesas and Gambier archipelagos. Observations in light, epifluorescence and field emission scanning electron microscopy of several of these strains analyzed revealed morphological features in perfect agreement with the original description of O. lenticularis. Cells were oval, not undulated, 60.5-94.4 μm in dorso-ventral length, 56.1-78.2 μm in width, and possessed a typical plate pattern with thecal plates showing two sizes of pores. Phylogenetic analyses inferred from the LSU rDNA and ITS-5.8S sequences revealed that the 47 strains correspond to a single genotype, clustering with a strong support with sequences previously ascribed to Ostreopsis sp. 5. Clonal cultures of O. lenticularis were also established and further tested for their toxicity using the neuroblastoma cell-based assay and LCMS/MS analyses. None of the 19 strains tested showed toxic activity on neuroblastoma cells, while LCMS/MS analyses performed on the strains from Tahiti Island (i.e. type locality) confirmed that palytoxin and related structural analogs were below the detection limit. These findings allow to clarify unambiguously the genetic identity of O. lenticularis while confirming previous results from the Western Pacific which indicate that this species shows no toxicity, thus stressing the need to reconsider its current classification within the group of toxic species., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Microplastics are ubiquitous throughout the oceans, yet few studies have documented their occurrence in marine organisms associated with coral reefs. Four genera of adult fish were sampled (Myripristis spp., Siganus spp., Epinephelus merra and Cheilopogon simus) from different trophic guilds around the tropical island of Moorea, French Polynesia. Digestive tracts from 133 adult fish were surveyed and microplastics were found in 28 tracts (21%). Abundance of ingested microplastic pieces per individual fish varied from 1 to 3 pieces, with an average of 1.25 ± 0.13 ingested microplastic pieces. Microplastics size ranged from 0.031 to 2.44 mm and 70% of microplastics did not exceed 0.3 mm in size. Overall, this study shows that the number and size of microplastic ingested per trophic groups are independent of trophic guild. Additional studies are needed to sample in other tropical regions in order to have a better assessment of microplastic occurrence in coral reefs., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Marine anthropogenic debris was sampled from two beaches on the remote South Pacific island Rapa Nui (Easter Island). Abundance, composition, and the attached fouling assemblages on stranded litter were analysed. Most litter (n = 172 items found) was composed of plastic material, and 34% of all litter items were fouled. The main fouling species was the encrusting bryozoan Jellyella eburnea. Transporting vectors were exclusively made from plastics and were mainly small items and fragments, probably stemming from the South Pacific Subtropical Gyre. We present the first report of Planes major, Halobates sericeus, and Pocillopora sp. on anthropogenic litter in the South Pacific., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: While the adverse health outcomes and broader economic and social factors associated with adolescent motherhood are well documented globally, limited research on unplanned pregnancy and birth among young women in Pacific Island nations exists. The study addresses this gap in the literature by examining the social and contextual factors that inform contraceptive knowledge, attitudes, and use among young women in the Cook Islands., Methods: Individual, in-depth interviews were conducted with ten women who became mothers before age twenty. Adolescents' contraceptive knowledge, attitudes, and behaviours were examined while taking into account the context in which they experienced an unplanned birth., Findings: Five participants were not using a contraceptive method when they became pregnant, believing they would not become pregnant. The remaining participants were using oral contraception but doing so inconsistently. Four participants had a sexual debut prior to age 15. The findings suggest a need to expand comprehensive approaches to sexual and reproductive health education, increase access to long-acting reversible contraceptive methods, and decrease the stigma associated with accessing family planning services in order to more effectively prevent unplanned pregnancy among adolescents in the Cook Islands., Interpretation: The findings provide insight into the factors contributing to high rates of adolescent pregnancy and birth in the Pacific region and suggest how public health advocates and health care providers might reduce reproductive health disparities in the Cook Islands and similar Pacific Island nations., (Copyright © 2018 Elsevier B.V. All rights reserved.)