Chikungunya Virus Infection-associated Arthralgia in Adult Jamaicans Post-outbreak / Artralgia asociada con la infección del virus de Chikunguña en jamaicanos adultos con posterioridad al brote

ABSTRACT Objective: To report demographic and self-reported clinical characteristics associated with persistent and severe arthralgia 8-12 months post-chikungunya virus (CHIKV) infection. Methods: A cross-sectional study of 306 adults who self-reported CHIKV infection was conducted. Subjects were consecutively enrolled at public primary healthcare centres in urban and rural areas in Jamaica. Adults with arthralgic conditions were compared with those who reported no arthralgia. Binary logistic regression models were used to determine demographic and self-reported clinical factors associated with severe arthralgia and persistent arthralgia. Results: Most subjects (70.3%) reported arthralgia after CHIKV outbreak (age: 47.6 ± 18.5 years). Medical consultation (36.2%) and laboratory confirmation (1.4%) were low. The prevalence of persistent and severe arthralgia in the previous month was 30.3% and 27.5%, respectively. Severe arthralgia was associated with the female gender (odds ratio (OR): 2.44; 95% confidence level (CI): 1.08, 5.52) and pre-existing arthritis (OR: 3.78; 95% CI: 1.23, 11.62). Females showed a greater likelihood of persistent arthralgia (OR: 2.18; 95% CI: 1.09, 4.39). Conclusion: Self-perceived arthralgia was an important feature 8-12 months post-CHIKV infection and has implications for the recognition and management of arthritis/rheumatic conditions.

RESUMEN Objetivo: Reportar las características clínicas demográficas y auto-reportadas asociadas con una artralgia persistente y severa de 8-12 meses tras la infección del virus de chikunguña (CHIKV). Métodos: Se llevó a cabo un estudio transversal de 306 adultos que auto-reportaron su infección de CHIKV. Los sujetos fueron alistados consecutivamente en centros públicos de atención primaria en zonas urbanas y rurales de Jamaica. Los adultos con condiciones artrálgicas fueron comparados con adultos que no reportaron artralgia alguna. Los modelos de regresión logística binaria fueron utilizados para determinar los factores clínicos demográficos y auto-reportados que se asocian con artralgia severa y artralgia persistente. Resultados: La mayoría de los sujetos (70.3%) reportaron artralgia después del brote de CHIKV (edad: 47.6 ± 18.5 años). La consulta médica (36.2%) y la confirmación del laboratorio (1.4%) fueron bajas. La prevalencia de la artralgia persistente y la severa en el mes anterior fue de 30.3%y 27.5%, respectivamente. La artralgia severa estuvo asociada al género femenino (odds-ratio (OR): 2.44; intervalo de confianza (IC): 1.08, 5.52), y artritis preexistente (OR: 3.78; 95% (IC: 1.23, 11.62). Las hembras mostraron una mayor probabilidad de artralgia persistente (OR: 2.18; 95% IC: 1.09, 4.39). Conclusión: La artralgia auto-percibida fue una característica importante de la infección post-CHIKV de 8-12 meses, y tiene implicaciones para el reconocimiento y tratamiento de la artritis y las condiciones reumáticas.

The establishment of an Intracranial Tumour Registry at the University Hospital of the West Indies / Establecimiento de un registro de Tumor Intracraneal en el Hospital Universitario de West Indies

In March 2010, the first Intracranial Tumour Registry (ITR) in the English-speaking Caribbean was started at the University Hospital of the West Indies (UHWI). This was deemed necessary as the already established Jamaica Cancer Registry only reports on malignant brain tumours. The ITR will collect data on all prospective intracranial tumours, benign and malignant, which are diagnosed histologically at the UHWI. Retrospective information dating back five years was also collected. Data collected so far reveal that between the years 2006 to 2010, a total of 317 cases were entered into the database. Of these, only 45 cases were considered eligible. The issues surrounding this discrepancy are discussed in this paper along with the many challenges experienced in the establishment of the ITR. From these experiences, the authors have also put forward several recommendations that may be useful to other researchers who wish to implement similar systems.

En marzo del 2010, en el Hospital Universitário de West Indies (HUWI), se inició elprimer Registro de Tumor Intracraneal (RTI) del Caribe anglófono. La creación de este registro fue considerada una necesidad por cuanto el ya establecido Registro de Cáncer de Jamaica solamente reporta tumores malignos del cerebro. El RTI recogerá datos de todos los tumores intracraneales prospectivos, tanto benignos como malignos, que sean histológicamente diagnosticados en HUWI. También se recopiló en retrospectiva información de cinco anos atrás. Datos coleccionados hasta ahora revelan que entre los anos 2006 a 2010, un total de 317 casos fueron introducidos en el banco de datos. De éstos, sólo 45 casos fueron considerados elegibles. En el presente trabajo se discuten los problemas en torno a esta discrepancia, junto con los numerosos retos enfrentados con la creación del RTI. A partir de estas experiencias, los autores hacen también varias recomendaciones que pueden ser útiles a otros investigadores deseosos de implementar sistemas similares.

Factors associated with the catastrophic decline of a cloudforest frog fauna in Guatemala

Comparison of recent and historical surveys of frog populations in cloudforest habitat in Sierra de las Minas,Guatemala,indicated population declines and local extirpation of several species.Pathological exams of diseased tadpoles indicated infection by amphibian chytridiomycosis. The local habitat has been severely altered by recent establishment of large-scale leatherleaf fern production.Analysis of water chemistry at our study site suggested increased nitrogenation associated with the leatherleaf industry

Una comparación entre un inventario anterior y otro reciente de poblaciones de ranas de bosque nublado en la Sierra de Las Minas de Guatemala demostró disminuciones poblacionales y ausencia localizada de varias especies.El examen patológico de un renacuajo muerto indicó infección por un hongo quítrido propio de los anfibios.El hábitat local ha sido gravemente alterado por el establecimiento reciente de producción a gran escala de helechos ornamentales.El análisis químico del agua en el área de estudio señaló un aumento en nitrogenación asociado al cultivo de helechos

Factors associated with iron depletion and iron deficiency anemia among Arabic preschool children of the United Arab Emirates

The purpose of this study was: 1. To estimate the prevalence of iron depletion and iron deficiency anemia in preschool Arabic children of the United Arab Emirates [UAE], and 2. To determine the risk factors associated with these conditions in this population of children. From April through to October 2000 a questionnaire and capillary blood survey was carried out in one primary health care [PHC] centre of Al Ain, UAE. Children whose capillary hemoglobin [Hb] or mean cell volume [MCV] results fell below predetermined cutoffs were offered venous blood workup. An additional sample of children with capillary blood results above those cutoffs were offered the same workup. All blood sampling was completed by May 2001. Five hundred and eight parents were questionnaired and 496 children capillary blood tested. Of the 320 venous blood tested, 315 were analyzed, in relation to questionnaire responses, using univariate analysis and logistic regression. Anemia, iron depletion and iron deficiency anemia were found in an estimated 36.1%, 26%, and 9.9% of this population of children. Age was a significant independent predictor of both iron depletion and iron deficiency anemia. Mother's current pregnancy was an additional predictor of iron deficiency anemia. The prevalences of iron depletion and iron deficiency anemia in this population of children were consistent with other reports from the region. Child's age and mother's current pregnancy were predictors of iron deficiency anemia. These findings have important implications for antenatal and childcare both in hospital and primary health care clinics

hematological survey of preschool children of the United Arab of Emirates

Anemia is common worldwide, particularly in developing countries including states of the Arabian Peninsular. The purpose of this study was to produce a hematological profile of preschool national children of the United Arab Emirates [UAE]. From April 2000 to October 2000, a cross-sectional community clinic-based capillary blood survey was carried out on a convenience sample of 1-5-year-old Emirati children attending a Primary Health Care Center in Al-Ain, UAE. Those children with capillary hemoglobin [Hb] and mean corpuscular volume [MCV] values below predetermined cutoffs were offered venous blood hematological workup. A random sample of children with values above those cutoffs were also offered the same workup. All venous blood sampling was completed by May 2001. Four hundred and ninety six children were surveyed. The mean Hb and adjusted MCV rose with increasing age but were not significantly different by gender. Two hundred and sixty-two children with Hb or MCV below the cutoffs and 50 children above the cutoffs were venous blood tested. The estimated abnormalities for this population of children were as follows: anemia 36.1%; iron deficiency anemia 9.9%; glucose-6-phosphate dehydrogenase [G6PD] deficiency 9.1%; sickle cell trait 4.6%; and beta thalassemia 8.7%. There was likely to be a high prevalence of alpha thalassemia. Rates of anemia and iron deficiency anemia in this population of children were consistent with other reports from the region, but higher than in developed countries. Hereditary red cell abnormalities were common, particularly G6PD deficiency. The gene frequency of alpha thalassemia is likely to be high but requires DNA studies

Problem-based learning in the faculty of medicine and health sciences, United Arab Emirates Universty

Problem-based learning [PBL] has been introduced in some medical curricula in order to increase learner curiosity and to overcome the difficulty of information overload. Since its introduction there has been controversy over its advantages and limitations. There have been particular criticisms that PBL is unsuited to medical schools in the Middle East. This paper describes the introduction of PBL to the Faculty of Medicine and Health Sciences of the United Arab Emirates University, and discusses the responses of students and faculty to this important innovation. The main advantage for students was the ability to work in small groups and the early introduction to clinical issues. The disadvantage, only in female students was increased anxiety on what they needed to learn. For faculty the main advantage was a clearer view of the students' strengths and weaknesses and the disadvantage was the insecurity of acting as a facilitator rather than a teacher

The effect of praziquantel treatment on liver and spleen size of children with schistosomiasis in Napu Valley, central Sulawesi.

Forty-six school children with japonicum schistosomiasis living in a village at Napu Valley, Indonesia were treated with praziquantel at a dosage of 70 mg/kg in two divided doses in a day. The number of children with palpable liver dropped significantly from 95.6% before treatment to 58.7% after treatment. The size of the liver was reduced in the majority of cases with a virtual disappearance of cases with very large liver (10 cm). Post-treatment increase of the liver size was observed in all 8 cases with small pre-treatment livers (0.5-1 cm). In contrast to the changes of the size of the liver after treatment, the number of children with palpable spleens before and after treatment was not significantly altered.

The impact of schistosomiasis mass treatment on hepato-splenomegaly in Napu Valley, Central Sulawesi, Indonesia.

The impact of mass treatment with praziquantel on 241 individuals, 131 males and 110 females in Napu Valley, Indonesia was studied. The pre-treatment overall stool positive cases ranged from 43% to 79%, the highest in the 20-29 age group. Post-treatment follow-up study showed that the cases dropped to 2.5%. Significant reduction was seen in liver rate from 68% to 51% and in the age groups 0-9, 10-19, there was a significant decrease in liver enlargement after treatment, but not significant differences were seen in spleen rate in all age groups. This might be due to the early stage of Schistosoma infection in younger age groups where complete resolution of fibrosis might occur.