Towards total voluntary non-remunerated blood donation in Trinidad and Tobago

Objective: Investigate the historical origins of voluntary nonremunerated blood donation (VNRD) and describe a UWI-led initiative. Design and Methodology: Historical review was performed using internet searches, documents, books, journals, interviews. Data from blood donor cards and Microsoft Excel spreadsheets was collected prospectively and analysed retrospectively. Donors were classified by age, gender, donation status (first-time or repeat) and donation outcome (accepted or deferred). The prevalence of transfusion transmissible infections and deferrals in donors was compared to the national donor pool using Chi square analysis to compare proportions and a p value < 0.05 to assign statistical significance. Results: Human to human blood transfusion and voluntary non-remunerated blood donation were first practised in metropolitan countries and amplified in large scale community blood donation programmes during World War II. Blood donation systems based on individual, transactional donations emerged in most developing countries, including Trinidad and Tobago, causing low donation rates, chronic blood shortage, unequal access, high donor infections and high donor deferrals. A voluntary non-remunerated blood donation programme started by the UWI Blood Donor Foundation and the North Central Health Authority has collected 660 units of blood in its first three years, the majority from persons aged 16 -25 age (52%), females (52%) and repeat donors (51%). Deferrals were < 10% and total transfusion transmissible infections in donors 0.9% compared with 43.6% and 2.4 % respectively (p < 0.05 for both) for the involuntary national donor pool. Conclusion: This model could be extended to all blood donation centres and the community to achieve 100% VNRD.

Oviposition response of Aedes aegypti mosquitoes to different concentrations of hay infusion in Trinidad, West Indies.

Ovitraps containing various concentrations of hay infusion and tap water were exposed weekly in the field for 15 wk to determine the oviposition patterns of Aedes aegypti. The results showed 10, 20, 60 and 80% hay infusions each attracted similar numbers of Ae. aegypti eggs oviposited and egg occurrences. No repellent effect was observed. In another field study, significantly more eggs and egg occurrences were collected from 25 and 50% hay infusions and tap water. The differences in these results from those of a previous study in Puerto Rico are discussed.

Oviposition response of Aedes aegypti mosquitoes to different concentrations of hay infusion in Trinidad, West Indies

Ovitraps containing various concentrations of hay infusion and tap water were exposed weekly in the field for 15 wk to determine the oviposition patterns of Aedes aegypti. The results showed 10, 20, 60 and 80 percent hay infusions each attracted similar numbers of Ae. aegypti eggs oviposited and egg occurrences. No repellent effect was observed. In another field study, significantly more eggs and egg occurrences were collected from 25 and 50 percent hay infusions and tap water. The differences in these results from those of a previous study in Puerto Rico are discussed (AU)

Seasonal abundance, biting cycle, parity and vector potential of the mosquito Haemagogus equinus in Trinidad.

The mosquito Haemagogus equinus is a known vector of yellow fever (YF) in central America. Seasonal abundance, daily biting activity and the age composition of adult Hg.equinus female populations were monitored weekly during 1981-82 by human collectors on the ground at Point Gourde Forest, Chaguaramas, 16 km west of Port of Spain, Trinidad. 2. Landing collections of Hg.equinus showed diurnal activity from 06.00 to 20.00 hours (suntime), with a single peak between 08.00 and 14.00 hours. 3. Overall, 5.6% of Hg.equinus were collected during the dry season (December-April) and 94.4% during the wet season (May-November). 4. Mean density of Hg.equinus in relation to man ranged from 0.35/man-day in February to 133/man-day in July, with averages of 2.8 in the wet season, 36.9 in the dry season and 22/man-day for the whole year. 5. Monthly parous rates averaged 62.1% (range 0-88%); 2.8% of females were 2-pars, another 2.8% were 3-pars, but no older females of Hg.equinus were found (sample size 467). 6. These age-grading data indicate that Hg.equinus females have relatively short life expectancy and hence low vector potential, which may help to explain why YF virus has seldom been isolated from this vector species.

Fat embolism in Trinidad and Tobago - abstract

The fat embolism syndrome is under-diagnosed because of low suspicion and this study was done to increase physician awareness and improve management. In the 6 years, 1984-1989 at San Fernando General Hospital, Trinidad, there were 10 cases - 1,2,2,1,1 and 3 in the years, respectively. Six were in the 3rd decade and all male, motor vehicle accidents accounted for 9 and a fall for one. There was poor attention to on-site immobilisation and sometimes delay in patients' transfer to hospital. Diagnosis was usually made on the 2nd or 3rd day. Eight patients had femoral fractures, one a bilateral, one a tibial and one a radial fracture. Soft tissue injury was common. Symptoms were alteration in level of consciousness in 9 with progression to coma in 3. Four had respiratory distress, 8 had conjunctival petechial haemorrhages, 3 respiratory crepitations and rhonchi and 2 tachycardia. Six had elevated temperature profile and gm/100ml haemoglobin was less than 10 and haematocrit less than 30 ml/100 ml in 4. Platelet count was normal in 6 tested. Treatment was with oxygen, antibiotics and steroids (Decadron or hydrocortisone), plaster immobilisation of the tibia and radius, skeletal traction in the 6 with femoral fractures and internal Kuntschner (K-nail) fixation was done in 5 at 12-19 days post injury. One had early K-nail at 12 hours post surgery. Nine showed complete recovery; however, complications of respiratory distress, siezures and renal failure resulted in one mortality. Sufficient facilities for arterial blood gasses and other parameters were not available for diagnosis and monitoring treatment. Treatment outcome was good because of aggressive management of oxygen, antibiotics and steriods. Long bone fractures need to be fixed early to reduce the incidence of fat embolism (AU)