The Jamaica Injury Surveillance System a profile of the intentional and unintentional injuries in Jamaican Hospitals / El Sistema de Vigilancia de Lesiones en Jamaica (SVLJ) u n perfil de las lesiones intencionales y no intencionales en hospitales de Jamaica

BACKGROUND: Injuries in Jamaica are a major public health problem as demonstrated by a hospital based computerized injury surveillance system established in 1999 that provides a risk profile for injuries. SUBJECTS AND METHOD: Injury data from 2004 were selected to provide an annual profile, as comprehensive injury data were available from nine public hospitals. These nine public hospitals provide care for 70% of the Jamaicans admitted to hospitals annually. RESULTS: Data are presented on unintentional injuries where falls caused 44%, lacerations 27% and accidental blunt injuries were 17% of these. For motor vehicle related injuries, 55% were sustained while commuting by motorcars, 17% while riding motorbikes/bicycles and 16% of those injured were pedestrians. Most violence related injuries were due to fights (76%) with acquaintances (47%) who used sharp objects (40%) to inflict the injury. CONCLUSION: The Jamaica Injury Surveillance System (JISS) data, augmented by data collected on injuries from the health centres and the sentinel surveillance system, give a measure of the magnitude of the impact of injuries on the health services. The JISS provides data on the profile of injuries seen and treated at health facilities in Jamaica. In collaboration with police data and community-based surveys, it can be used to complete the risk profiles for different types of injuries. The data generated at the parish, regional and national levels form the basis for the design and monitoring of prevention programmes, as well as serve to support and evaluate policy, legislative control measures and measures that impact on interventions.

ANTECEDENTES: Las lesiones constituyen un problema importante de la salud pública en Jamaica, como lo demuestra el sistema de vigilancia computarizada de las lesiones, establecido en 1999, el cual proporciona un perfil de riesgo de las lesiones. SUJETOS Y MÉTODO: Datos de lesiones ocurridas en el 2004 fueron seleccionados a fin de ofrecer un perfil anual, ya que se disponía de un conjunto amplio de datos de nueve de los hospitales públicos. Estos nueve hospitales públicos dan atención al 70% de los jamaicanos ingresados a los hospitales cada año. RESULTADOS: Se presentan datos sobre lesiones no intencionales, según los cuales las caídas representaron el 44%, las laceraciones el 27% y las contusiones accidentales el 17%. En cuanto a las lesiones relacionadas con automóviles, el 55% fueron producidas durante la transportación diaria en vehículos automotores a centros de trabajo o estudio; el 17% se produjo en viajes en motos o bicicletas; y el 16% de los heridos fueron peatones. La mayoría de las lesiones relacionadas con la violencia se debieron a peleas (76%) con conocidos (47%) que usaron objetos perforocortantes (40%) para infligir las heridas. CONCLUSIÓN: Los datos del SVLJ, aumentados con los datos sobre lesiones recopilados en los centros de salud y el sistema de vigilancia centinela, dan una medida de la magnitud del impacto de las lesiones en los servicios de salud. El SVLJ proporciona datos sobre el perfil de las lesiones vistas y tratadas en los centros de salud de Jamaica. En colaboración con datos de la policía y encuestas a nivel de la comunidad, el sistema puede ser usado para completar los perfiles de riesgo en relación con diferentes tipos de lesiones. Los datos generados a nivel provincial, regional y nacional constituyen la base para el diseño y monitoreo de los programas de prevención. Asimismo, sirven para apoyar y evaluar políticas, legislaciones, medidas de control así como medidas relativas al impacto de las intervenciones.

The practice of polypharmacy involving herbal and prescription medicines in the treatment of diabetes mellitus, hypertension and gastrointestinal disorders in Jamaica

The interference in the metabolism of a drug by another drug, food or other foreign chemical is commonly observed and often leads to clinically significant adverse drug reactions. In Jamaica, there is an extensive use of natural products as medicines, although there is little information on whether natural medicines are used along with prescription medicines, which might increase the likelihood of drug adversities. This current pilot survey was initiated to gain information on the prevalence of such polypharmacy practices. Two concurrent surveys were carried out in Kingston (an urban parish) and Clarendon (a rural parish) in 743 patients above age 14 years with diabetes mellitus, hypertension and gastrointestinal disorders of persons who visited health centres and pharmacies. Patrons visiting these places at various times of the day were informed of the nature of the questionnaire and willing participants with the above disease conditions and who were on prescription medicines were included in the survey. The results indicated that 80 of the respondents reported combining natural products in their treatment along with prescription medicines, with only 13 of those patients informing their physicians of such practices. Such polypharmacy practices were independent of the type of disease among both males and females and was statistically most prevalent (p < 0.001) in the 47-57-year age group. There was a significant association (p < 0.001) between such treatment practices and place of residence with 92 of the rural community engaging in polypharmacy but 70 of the urban did likewise. Therefore, being aware of the prevalence of multiple therapy practices would be especially useful when designing a pharmaco-vigilance system