ABSTRACT
A cross-sectional sero-epidemiological study was conducted to determine the prevalence of dengue in Trinidad. Two commercial rapid test kits, PanBio Dengue Duo IgM and IgG Rapid Strip Test and the Bio-Check Plus Dengue G/M Cassette Test (Brittney) were used. The immunosorbent assay (ELISA) (FOCUS Technologies, California) was used as the control. One hundred and twenty five cord blood samples were collected (46 from Mt. Hope Women's Hospital (MH) and 79 from the San Fernando General Hospital (SF)). All blood samples were tested in accordance with the two rapid kits and ELISA assay manufacturer's instructions. From 125 cord blood samples, the IgG FOCUS ELISA results showed 93.5 and 95% infections at MH and SF, respectively. Whereas the Brittney and PanBio kits showed 10.9 and 5.1%, and 26.1 and 50.6% for MH and SF, respectively. Based on the FOCUS ELISA (control) assays, the combined seroprevalence rate from north and south Trinidad was 94.4%. IgG and IgM sensitivity and specificity levels were higher in the PanBio than Brittney test kits. The high seroprevalence rates observed in Trinidad are discussed to stimulate more research to explain this phenomenon and to prevent the Southeast Asian scenario from developing in the Americas.
Subject(s)
Antibodies, Viral/blood , Dengue Virus/immunology , Dengue/epidemiology , Fetal Blood/immunology , Reagent Kits, Diagnostic , Adult , Dengue/immunology , Dengue/virology , Enzyme-Linked Immunosorbent Assay , Female , Fetal Blood/virology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Infant, Newborn , Sensitivity and Specificity , Seroepidemiologic Studies , Time Factors , Trinidad and Tobago/epidemiologyABSTRACT
A focus of Plasmodium malariae infection has recently occurred on the island of Trinidad, some 30 years after a successful eradication programme. Examination of bloodsmears revealed 22 cases of P. malariae in the Nariva-Mayaro area of Trinidad between August 1994 and September 1995. Most (77%) of the cases were male and, as seven were aged < 25 years of age, it appeared that transmission had been renewed, probably by the vector Anopheles bellator. However, none of the 3000 mosquitoes tested by ELISA for the circumsporozoite protein of P. malariae proved positive. Use of IFAT to check blood samples for P. malariae appeared more sensitive than direct examination of bloodsmears, indicating that 42 (13%) of the 325 samples tested were seropositive (at titres of 1:256 or greater). The levels of transmission of the parasite may therefore be even higher than indicated by examination of bloodsmears. The surveillance measures adopted to understand the epidemiology of this outbreak of P. malariae in Trinidad are described. The need to maintain malaria surveillance in all the countries where P. malariae parasites once existed (prior to eradication) is emphasised.
Subject(s)
Disease Outbreaks , Malaria/epidemiology , Plasmodium malariae , Adolescent , Adult , Aged , Animals , Anopheles/parasitology , Child , Child, Preschool , Cluster Analysis , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Insect Vectors/parasitology , Male , Middle Aged , Plasmodium malariae/isolation & purification , Trinidad and Tobago/epidemiologySubject(s)
Anthelmintics/therapeutic use , Ivermectin/therapeutic use , Mansonelliasis/drug therapy , Adult , Aged , Aged, 80 and over , Anthelmintics/adverse effects , Double-Blind Method , Female , Humans , Ivermectin/adverse effects , Male , Middle Aged , Parasitemia/drug therapy , Recurrence , Treatment Outcome , Trinidad and TobagoABSTRACT
Two cases of cerebral malaria imported from Guyana and Ghana are reported. These are the first cases of cerebral malaria diagnosed and treated in Trinidad and Tobago since malaria was eradicated. The management of both these cases was complicated because the patients' erythrocytes were glucose-6-phosphate dehydrogenase-deficient, and by the occurrence of blackwater fever, cerebral manifestations, renal impairment, hyperglycaemia and thrombocytopenia. The symptoms of cerebral malaria resolved following treatment with quinidine and doxycycline and quinidine and clindamycin.
Subject(s)
Glucosephosphate Dehydrogenase Deficiency/complications , Malaria, Cerebral/complications , Travel , Adult , Antimalarials/therapeutic use , Ghana , Guyana , Humans , Malaria, Cerebral/blood , Malaria, Cerebral/drug therapy , Male , Middle Aged , Trinidad and TobagoABSTRACT
The first case of psychosis due to Plasmodium vivax malaria, imported from India is reported. A 44-year-old Trinidadian male presented with fever, and psychotic episodes in association with vivax malaria. The symptoms of both malaria and psychosis were resolved following the standard chloroquine-primaquine therapy.
Subject(s)
Malaria, Cerebral/complications , Malaria, Vivax/complications , Neurocognitive Disorders/parasitology , Adult , Antimalarials/therapeutic use , Chloroquine/therapeutic use , Humans , Malaria, Vivax/drug therapy , Male , Primaquine/therapeutic useABSTRACT
Two cases of cerebral malaria imported from Guyana and Ghana are reported. These are the first cases of cerebral malaria diagnosed and treated in Trinidad and Tobago since malaria was eradicated. The management of both these cases was complicated because the patients' erythrocytes were glucose-6-phosphate dehydrogenase-deficient, and by the occurrence of blackwater fever, cerebral manifestations, renal impairment, hyperglycaemia and thrombocytopenia. The symptoms of cerebral malaria resolved following treatment with quinidine and doxycycline and quinidine and clindamycin (AU)
Subject(s)
Adult , Humans , Malaria, Cerebral/drug therapy , Trinidad and Tobago , Glycogen Storage Disease Type I/diagnosis , Blackwater Fever/complications , Caribbean Region , Quinidine , Developing CountriesABSTRACT
The first case of psychosis due to Plasmodium vivax malaria, imported from India is reported. A 44-year-old Trinidadian male presented with fever, and psychotic episodes in association with vivax malaria. The symptoms of both malaria and psychosis were resolved following the standard chloroquine-primaquine therapy (AU)
Subject(s)
Adult , Humans , Psychotic Disorders/diagnosis , Trinidad and Tobago , Case Management , Trinidad and Tobago , Malaria, Vivax/complications , Caribbean RegionABSTRACT
A microfilaria survey was conducted in Trinidad in 1992, 12 years after mass treatment with spaced doses of diethylcarbamazine citrate (DEC-C) for the control of Bancroftian filariasis; 348 persons were examined using thick blood smears and a membrane filtration technique. They included 104 who had participated in the mass chemotherapy campaign in 1980. No Wuchereria bancrofti microfilariae were detected among 66% of the population examined. In 1980, 86 of 592 persons examined were found to be infected with W. bancrofti, 140 with Mansonella ozzardi and 44 with mixed infections, while in 1992, only M. ozzardi infections persisted despite treatment with DEC-C. Of the 104 persons reexamined 12 years later, 46 had M. ozzardi, of which five were new cases, but none had W. bancrofti. During both the 1980 and 1992 surveys, low microfilariae rates for M. ozzardi were observed among those 19 years of age or younger. Of the 302 persons newly examined in 1992, 29 were infected with significantly (P < 0.001) more males (79.3%) than females (20.9%) being microfilaremic. The combined results showed similar prevalence rates for M. ozzardi from 23.3% to 21.6% in 1980 and 1992. Nuclepore membrane filtration and thick blood films were very efficient in demonstrating the presence of microfilariae. The usefulness of these methods and spaced treatment using DEC-C are also discussed.
Subject(s)
Diethylcarbamazine/therapeutic use , Filariasis/prevention & control , Mansonella , Mansonelliasis/prevention & control , Wuchereria bancrofti , Adolescent , Adult , Age Distribution , Animals , Child , Child, Preschool , Female , Filariasis/epidemiology , Follow-Up Studies , Humans , Infant , Male , Mansonelliasis/epidemiology , Microfilariae/isolation & purification , Middle Aged , Parasitemia/epidemiology , Prevalence , Sex Distribution , Trinidad and Tobago/epidemiologyABSTRACT
A microfilaria survey was conducted in Trinidad in 1992, 12 years after mass treatment with spaced doses of diethylcarbamazine citrate (DEC-C) for the control of Bancroftian filariasis; 348 persons were examined using thick blood smears and a membrane filtration technique. They included 104 who had participated in the mass chemotherapy campaign in 1980. No Wuchereria bancrofti microfilariae were detected among 66 percent of the population examined. In 1980, 86 of 592 persons examined were found to be infected with W. bancrofti, 140 with Mansonella ozzardi and 44 with mixed infections, while in 1992, only M. ozzardi infections persisted despite treatment with DEC-C. Of the 104 persons re-examined 12 years later, 46 had M. ozzardi, of which five were new cases, but none had W. bancrofti. During both the 1980 and 1992 surveys, low microfilariae rates for M. ozzardi were observed among those 19 years of age or younger. Of the 302 persons newly examined in 1992, 29 were infected with significantly (P<0.001) more males (79.3 percent) than females (20.9 percent) being microfilaremic. The combined results showed similiar prevalence rates for M. ozzardi from 23.3 percent to 21.6 percent in 1980 and 1992. Nucleopore membrane filtration and thick blood films were very efficient in demonstrating the presence of microfilariae. The usefulness of these methods and spaced treatment using DEC-C are also discussed (AU)
Subject(s)
Humans , Anthelmintics/analysis , Trinidad and Tobago , Elephantiasis, Filarial/parasitology , Trinidad and Tobago , Insect Vectors , Trinidad and Tobago , Culex , Caribbean Region , Treatment Outcome , Trinidad and Tobago , Wuchereria bancrofti/drug effects , Trinidad and TobagoABSTRACT
A new mode of administering malaria chemotherapy to patients unable to tolerate oral medication is described. A patient with Plasmodium falciparum malaria, severe hyponatremia and hypokalaemia who regurgitated oral treatment of chloroquine phosphate and pyrimethamine and sulfadoxine (Fansidar) is presented. But neither chloroquine nor quinine intravenous formulations were available locally. As the patient was deteriorating, a suspension of chloroquine phosphate was prepared and administered rectally, resulting in a decline in the level of parasitaemia from ++++ to ++ within 48 hours. The patient improved, and further clinical management was uncomplicated.
Subject(s)
Chloroquine/administration & dosage , Developing Countries , Malaria, Falciparum/drug therapy , Administration, Rectal , Adult , Chloroquine/adverse effects , Humans , Male , Suspensions , Trinidad and TobagoABSTRACT
A new mode of administering malaria chemotherapy to patients unable to tolerate oral medication is described. A patient with Plasmodium falciparum malaria, severe hyponatraemia and hypokalemia who regurgitated oral treatment of chloroquine phosphate and pyrimethamine and sulfadoxine (Fansidar) is presented. But neither chloroquine nor quinine intravenous formulations were available locally. As the patient was deteriorating, a suspension of chloroquine phosphate was prepared and administered rectally, resulting in a decline in the level of parasitaemia from ++++ to ++ within 48 hours. The patient improved, and further clinical management was uncomplicated (AU)
