Interpersonal violence in three Caribbean countries: Barbados, Jamaica, and Trinidad and Tobago / Violencia interpersonal en tres países del Caribe: Barbados, Jamaica y Trinidad y Tobago

OBJECTIVES: This article reports the prevalence of two types of interpersonal violence (IPV) (sexual and physical) and one type of aggression (psychological) in three low-to-middle-income Caribbean countries. It examines IPV among adolescents and young adults as both victims and perpetrators. METHODS: This population-based study compares the experiences of 15-30 year olds in countries at different levels of socioeconomic development. The Revised Conflict Tactics Scales (CTS2) and other behavioral instruments were used to assess the level and characteristics of IPV. RESULTS: Out of 3 401 respondents, 70.9% reported victimization by some form of violence, which was most commonly perpetrated by a relationship partner (62.8%). Sexual violence victimization was reported more commonly by women, and was highest in Jamaica. Significant between-country differences in overall levels of reported physical violence, and psychological aggression, were evident when stratifying by perpetrator type. CONCLUSIONS: The very high levels of reported IPV indicate very high levels of tolerance among victims, and suggest a culture of violence and of adversarial intimate relationships may be well entrenched. The findings support the view that co-occurrence of general interpersonal violence and partner violence may be limited, and that one may not necessarily be a predictor of the other. They also reveal that, among partners, not only are there no gender differentials in victimization by physical violence, but more women than men are self-reporting as perpetrators of this type of IPV.

OBJETIVOS: Se informa la prevalencia de dos formas de violencia interpersonal (VIP) -la sexual y la física- y de un tipo de agresión -la psicológica- en tres países del Caribe de bajo a mediano ingresos. Se analiza la VIP entre adolescentes y adultos jóvenes, ya sea como víctimas o agresores. MÉTODOS: En este estudio basado en la población se comparan las experiencias de personas de 15 a 30 años de países con diferentes niveles de desarrollo socioeconómico. Se utilizó la escala revisada de tácticas de conflicto (CTS2) y otros instrumentos de análisis conductual para evaluar el nivel y las características de la VIP. RESULTADOS: De las 3 401 personas que respondieron, 70,9% informó haber sido víctima de alguna forma de violencia, más frecuentemente ejercida por sus parejas (62,8%). Las mujeres informaron con mayor frecuencia haber sido víctimas de violencia sexual, y esta fue más frecuente en Jamaica. Se encontraron diferencias significativas entre los países en cuanto a la violencia física y la agresión psicológica, que se hicieron notables al estratificar por el tipo de agresor. CONCLUSIONES: Los muy elevados niveles informados de VIP indican un alto grado de tolerancia entre las víctimas e indican que se puede estar arraigando una cultura de violencia y de relaciones íntimas basadas en el enfrentamiento. Estos resultados confirman que la ocurrencia simultánea de la violencia interpersonal en general y la violencia de pareja puede ser limitada y que una forma no necesariamente es un factor de predicción de la otra. En las parejas no se observaron diferencias en la victimización según el género y más mujeres que hombres se declararon agresoras en esta forma de VIP.

Epidemiology of haemophilus influenzae invasive disease in Jamaica, 1990-1993

Haemophilus influenzae (H influenzae) invasive disease was studied retrospectively over a four-year period in children admitted to the Bustamante Hospital for Children in Kingston, Jamaica. A total of 86cases were identified. The mean estimated annual incidence of H influenzae invasive disease in Kingston and St. Andrew was 39 per 100,000 children under 5 years of age. The majority (77percent) of cases were in the under 2-year age group. A distinct seasonal pattern was noted, with a significantly higher proportion of patients (57-73percent) presenting in the cooler months. Meningitis was the most common clinical diagnosis, accounting for 76percent of the cases. Poor outcome was demonstrated in 21.5percent of patients with meningitis. Sensitivity testing of H influenzae isolates revealed a resistance rate of 26percent for ampicillin and 7percent for chloramphenicol. The epidemiological findings in this study provide reasonable guidelines for empiric antibiotic therapy and also support the need to seriously consider vaccine prophylaxis in Jamaican children.

Area variation in perinatal mortality in Jamaica: association with type of hospital services available

Information on the area of maternal residence of 1856 singleton perinatal deaths occurring during a 12 month period (September 1986 - August 1987) were compared with those of 9933 singleton births born during a two month period (September-October 1986) and surviving the first week of life (The Jamaican Perinatal Morbidity and Mortality Survey). The overall mortality ratio of deaths to estimated survivors was 35.7 per 1000. When the area of residence was categorised according to the type of facilities available, there was a clear trend - births to mothers resident in areas with specialist hospital facilities available, had a mortality ratio of 32.0 per 1000, substantially less than those areas with some obstetric and paediatric facilities (rate 39.2 per 1000) or those with only a cottage hospital and no obstetricians (35.8 per 1000). Categorisation of the deaths using the Wigglesworth classification showed significant variation with intrapartum anoxia. This could not be explained by differences in birthweight, or demographic features of the population. It is concluded that access to a specialist hospital results in a significant reduction in mortality associated with intrapartum asphyxia, but not with other types of perinatal death.