Seroprevalence of human toxocariasis, Jamaica

Seroprevalence of human toxocariasis was studied, based on 1544 samples selected from a total of 3524 submitted to the University of the West Indies in Kingston, Jamaica for diagnosis of dengue during an epidemic in 2010. The prevalence of anti-Toxocara IgG using the CELISA® (Cellabs) ELISA was 21.2% and males (24.4%) were significantly more likely to be exposed than females (17.5%) [χ2 =10.4; p=0.001]. No association was foundbetween exposure to Toxocara and area of residence (rural vs. urban) [χ2 =0.835; p = 0.409]. Prevalence of infection peaked in adolescents (10-19 years-old) and declined thereafter although a rise in prevalence was seen in older age classes. There was a high prevalence of toxocariasis in Jamaica with significant exposure among school age children with no predilection to either sex. The study will inform future work on elucidating the public health and clinical significance of toxocariasis in Jamaica.

Ocular angiostrongyliasis: first case report from Jamaica / La angiostrongyliasis ocular: primer caso reportado en Jamaica

A 30-year old female presented with a one-month history of blurred vision in her left eye. Examination revealed a live motile worm in the anterior chamber of the left eye. She also had retinal pigment epithelial disturbance with focal intraretinal haemorrhage. The 19.9 mm worm was surgically removed and identified as Angiostrongylus cantonesis. She was treated with oral mebendazole. Her vision improved from counting fingers in the left eye to 6/36. This is the first documented case of ocular angiostrongyliasis in Jamaica.

Una mujer de 30 años se presentó con una historia de visión borrosa en el ojo izquierdo por un mes. El examen reveló la presencia de un gusano móvil vivo en la cámara anterior de su ojo izquierdo. También presentaba una alteración del epitelio pigmentario de la retina con hemorragia intraretiniana focal. El gusano de 19.9 mm fue extraído quirúrgicamente e identificado como Angiostrongylus cantonesis. La paciente fue tratada con mebendazole oral. Su visión mejoró - pasando de poder contar sólo sus dedos con el ojo izquierdo a una visión de 6/36. Se trata del primer caso de angiostrongyliasis ocular documentado en Jamaica.

Association between exposure/non-exposure to the mandatory seat belt law with regards to compliance in vehicle accident victims a hospital review / Asociación entre exposición/no exposición a la ley obligatoria de cinturón de seguridad en relación con su cumplimiento en el caso de víctimas de accidentes vehiculares ­ un estudio basado en datos de hospital

OBJECTIVE: Injuries sustained in motor vehicle accidents (MVAs) are a major challenge to the Jamaican healthcare system. In November 1999, Jamaica enacted legislation to make seat belt usage in motor vehicles compulsory. The effect of this policy change on seat belt usage is unclear. This study therefore sought to determine the prevalence of seat belt usage and to determine the association between exposure/non-exposure to the mandatory seat belt law and seat belt use in subjects who presented to the Accident and Emergency Department (A&E) of the University Hospital of the West Indies (UHWI) as a result of motor vehicle accidents. METHODS: Subjects were recruited from June to November 2003, post-seat belt law (POBL) period, and May to October 1999, pre-seat belt law (PRBL) period. Data collected included demographic variables, seat belt use and position of the occupants in the vehicle. RESULTS: Of the 277 patients who were eligible for inclusion, data were complete in 258 subjects, 87 in the PRBL period and 171 in the POBL period. The prevalence of seat belt use was 47% (PRBL) and 63% (POBL) respectively. There was no significant gender difference at each period. The odds of wearing seat belt in the rear of a motor vehicle were significantly lower than that of a driver (Table 3, OR 0.19, 95% CI 0.07, 0.48). Adjusting for age, gender and position in vehicle exposure, there was about 100% increase in the odds of seat belt use during the post seat belt law era (OR = 2.09, 95% CI 1.21, 3.61). CONCLUSION: It is concluded from this hospital-based study that the mandatory seat belt law legislature was associated with increased seat belt use in motor vehicle accident victims. However, current data from the Road Traffic Agency indicate that there is still an alarming number of fatalities. This clearly suggests that additional public health measures are needed to address the epidemic of motor vehicle trauma in Jamaica.

Objetivo: Las heridas producidas en accidentes en vehículos motorizados (AVM) constituyen uno de los principales desafíos para el sistema de atención a la salud en Jamaica. En noviembre de 1999, Jamaica aprobó una legislación que obligada al uso del cinturón de seguridad en vehículos motorizados. El efecto de este cambio de política sobre el uso del cinturón de seguridad no está claro. Por lo tanto, este estudio busca determinar la prevalencia del uso del cinturón de seguridad y determinar la asociación entre exposición/no exposición a la ley obligatoria de cinturón de seguridad y el uso del cinturón de seguridad en sujetos que acudieron al Departamento de Accidentes y Emergencia (A&E) del Hospital Universitario de West Indies (HUWI) como resultado de un accidente vehicular. Métodos: Los sujetos fueron reclutados de junio a noviembre de 2003, período posterior a la ley de cinturón de seguridad (PLCS), y de mayo a octubre de 1999, período anterior a la ley de cinturón de seguridad (ALCS) Los datos recopilados incluyeron las variables demográficas, el uso de cinturón de seguridad, y la posición de los ocupantes del vehículo. Resultados: De los 277 pacientes que eran elegibles para ser incluidos, se completaron los datos de 258 sujetos, 87 en el período ALCS y 717 en el período PLCS. La prevalencia del uso del cinturón de seguridad fue 47% (ALCS) y 63% (PLCS) respectivamente. No hubo diferencia significativa de género en ninguno de los períodos. Las probabilidades de uso del cinturón de seguridad fueron significativamente más bajas para los ocupantes del asiento trasero que para el conductor del auto (Tabla 3, OR 0.19, 95% CI 0.07, 0.48). Ajustando por edad, género y posición en exposición vehicular, hubo un aumento de alrededor del 100% en las probabilidades de uso del cinturón de seguridad durante la era posterior a la ley del uso del cinturón de seguridad (OR = 2.09, 95% CI 1.21, 3.61). Conclusión: A partir de este estudio basado en datos de hospital, se llegó a la conclusión de que la legislación de la ley del uso obligatorio del cinturón de seguridad, estuvo asociada con el aumento del uso del cinturón de seguridad en víctimas de accidentes con vehículos motorizados. Sin embargo, los datos actuales de la Agencia del Tráfico de Carreteras, indican que existe todavía un número alarmante de casos fatales. Esto sugiere a todas luces la necesidad de medidas de salud pública adicionales para abordar la epidemia de traumas por accidentes de vehículos en Jamaica

Mental well-being of doctors and nurses in two hospitals in Kingston, Jamaica / Bienestar mental de doctores y enfermeras en dos hospitales en kingston, jamaica

Hospital work involves some of the most stressful situations found in any workplace. Furthermore, hospital workers may be affected by non-work-related stress such as family responsibilities and financial difficulties, leading to impaired mental well-being and suboptimal performance. The aim of this study was to assess the level of general mental well-being among doctors and nurses from two hospitals in Kingston, Jamaica. A total of 212 doctors and nurses at the Kingston Public Hospital and the University Hospital of the West Indies were studied yielding a participation rate of 83.1. A self-administered questionnaire was used to gather social and biomedical data and the General Health Questionnaire 30 (GHQ 30) used to determine general mental well-being. Probable caseness was defined as a GHQ 30 score > 5. Focus group discussions were also held with staff at both hospitals. A total of 27.4of the study population met the GHQ-30 criteria (caseness) defining them as probable cases of mental distress. Cases and non-cases were not different in age, gender or hospital of employment. However, caseness was associated with years of professional experience, work-related and non-work-related stress, serious financial difficulties and fears of coming to work. Significant predictors of increased risk of caseness were fear of coming to work (OR 3.06; CI 1.40, 6.70); professional experience in excess of five-years and high non-work-related stress. High work-related stress was associated with reduced risk of being classified a case, suggesting that work may have been therapeutic. Focus group discussions suggested that non-work stress was related to financial difficulties, commuting and child care, especially among nurses. Intervention to improve general mental well-being should be targeted at new employees and should address child care, commuting and financial management.

El trabajo en un hospital conlleva algunas de las situaciones más estresantes que puedan encontrarse en cualquier centro de trabajo. Además, los trabajadores hospitalarios pueden verse afectados por formas de estrés que no guardan relación directa con su trabajo, tales como responsabilidades fami-liares o dificultades financieras, las cuales traen como consecuencia perjuicios para el bienestar mental y una disminución del rendimiento laboral por debajo del nivel óptimo. El objetivo de este estudio es evaluar el nivel del bienestar mental general entre los doctores y enfermeras de los dos hospitales de Kingston, Jamaica. Se estudiaron un total de 212 doctores y enfermeras del Hospital PFAblico de Kingston y el Hospital Universitario de West Indies, para una tasa de participación de 83.1%. Se aplicó una encuesta auto-administrada a fin de compilar datos biomédicos y sociales, y el Cuestionario de Salud General (CSG 30), usado para determinar el bienestar mental general. La casuidad1 probable se definió como una puntuación de CSG 30 > 5. También se sostuvieron dis-cusiones de grupos de enfoque con el personal de ambos hospitales. Un total de 27.4% de la población bajo estudio satisfizo los criterios de CSG 30 (casuidad), que la definen como casos probables de angustia mental. Los casos y los no casos no difirieron en edad, género u hospital de empleo. Sin embargo, la casuidad estuvo asociada con los años de experiencia profesional, estrés relacionado con el trabajo y estrés no relacionado con el trabajo, dificultades financieras serias, y miedo de ir a trabajar. Los predictores significativos del aumento de riesgo de casuidad fueron: el miedo de ir a trabajar (OR 3.06; CI 1.40, 6.70); la experiencia profesional mayor de cinco años; y el estrés elevado no relacionado con el trabajo. El alto estrés relacionado con el trabajo estuvo asociado con la reducción de riesgo de ser clasificado como caso, lo cual sugiere que el trabajo puede haber sido un factor terapéutico. Las discusiones de grupo de enfoque sugieren que el estrés no relacionado con el trabajo estaba asociado con las dificultades financieras, el viaje diario de ida y vuelta al trabajo y la atención a los niños, especialmente entre las enfermeras. La intervención general con el propósito de mejorar el bienestar mental debe dirigirse a los nuevos empleados, y debe abordar el problema del cuidado de los niños, el viaje diario al trabajo y la administración financiera.

Who is at high risk? A comparison of the seroprevalence of human immunodeficiency virus in pregnant women and a high risk group

To compare the seroprevalence of HIV in Jamaican pregnant women with that in substance abusers, two groups of antenatal patients were studied, one (A) attending a public hospital clinic and the other (B) attending private clinics. The HIV seroprevalence in the antenatal patients was compared with that in the substance abusers, group C, in 1996 and five years later in 2001. HIV antibody was determined by enzyme immunoassay. The HIV seroprevalence in group A more than doubled (1.6-3.8) in five-years, 1996-2001. There were no seropositives in group B. In group C, the seroprevalence rose from 2.08 in 1996 to 5.76 in 2001. There was indication that group A might no longer be considered [quot ]low risk[quot ], as there was no significant difference from group C in HIV seroprevalence in 1996 and 2001. The trend seen in this study is worthy of further investigation

Intestinal parasites among young children in the interior of Guyana

Intestinal parasites contribute greatly to morbidity in developing countries. While there have been several studies of the problem in the Caribbean, including the implementation of control programmes, this has not been done for Guyana. The aim of this study was to determine the prevalence of intestinal parasites among young children in a town located in the interior of Guyana. Eighty-five children under the age of 12 years were studied prospectively for intestinal parasites in Mahdia, Guyana. Stool samples were transported in formalin to the Department of Microbiology, The University of the West Indies, Jamaica, for analysis using the formalin-ether concentration and Ziehl-Neelsen techniques. Data on age and gender of the children were recorded on field data sheets. At least one intestinal parasite was detected in 43.5 (37/85) of the children studied and multiple parasitic infections were recorded in 21.2 (18/85). The most common intestinal helminth parasite was hookworm (28.2; 24/85), followed by Ascaris lumbricoides (18.8; 16/85) and then Trichuris trichuria (14.1; 12/85). Among the protozoan infections Giardia lamblia was detected in 10.5 (9/85) of the study population while Entamoeba histolytica appeared rarely. All stool samples were negative for Cryptosporidium and other intestinal Coccidia. There was no predilection for gender with any of the parasites. The pattern of distribution of worms in this area of Guyana was unlike that seen in other studies. Hookworm infection was the most common among the children and a large proportion had multiple infections. The study established the occurrence and prevalence of a number of intestinal parasites in the population of Guyana. This sets the stage for the design and implementation of more detailed epidemiological studies.

Rubella susceptibility in Jamaican women, 1996

The 1995 rubella outbreak in Jamaica indicated a need to survey the susceptibility rate in Jamaican antenatal women at risk. In this 1996 study, 389 women in the reproductive age group were investigated for rubella antibodies. In the public sector urban group (A), rubella susceptibility was 20.2, while in a private sector urban clinic (B) practising routine rubella surveillance and recommending postpartum immunization in seronegatives, the susceptibility rate was 13.8. The latter rate was significantly lower than that in the rural group (C) (35.9; p < 0.001). The overall susceptibility rate was 21.3. Rubella susceptibility has improved overall in women of childbearing age compared with levels in the prevaccine year of 1968. A significant thrust in rubella prevention will still be required before the next rubella epidemic in order to reduce the risk of congenital rubella syndrome.

Inactivation of strongyloides stercoralis filariform larvae in vitro by six Jamaican plant extracts and three commercial antihelmintics

In vitro bioassay of (a) aqueous methanol extracts (AME) of the green leaves of mimosa (Mimosa pudica), love weed (Cuscuta americana), vervine (Stachytarpheta jamaicensis), chicken weed (Salvia serotina) and breadfruit (Artocarpus altilis); (b) methanol-water fraction (MWF) of breadfruit leaves, and (c) commercially available drugs albendazole, thiabendazole and levamisole were assayed for nematode inactivating potential, using filariform larvae of Strongyloides stercoralis. Test larvae were obtained from a 10-day-old charcoal coproculture. Bioassays were conducted in Locke's solution, using 100 larvae in each of three replicates. Inactivation was recorded microscopically at 1, 2, 6 and 12 hours, then every 24 hours up to 5 days' incubation. It(50) (time for inactivation of 50%of larvae) values read: levamisole and mimosa extract < 1 hour; love weed extract, approximately 2 hours; breadfruit (MWF), 9.5 hours; chicken weed, 20 hours; albendazole, 35 hours; breadfruit (AME), 49 hours; thiabendazole, 74 hours and vervine extract, 81.5 hours. It(95) values followed a similar trend, and were approximately double the It(50) measures. A potential role for locally available natural products in the treatment of strongyloidiasis is highlighted