Parent and caregiver knowledge, beliefs and responses to seizures in Jamaican children

OBJECTIVE: To determine the knowledge and beliefs about seizures and actions during seizures of parents/ caregivers of children hospitalised for convulsive seizures. DESIGN AND METHODS: This was a cross-sectional study of parents and caregivers of children with acute convulsive seizures hospitalised at the Bustamante Hospital, Kingston, Jamaica between May 1 and October 31, 2013. Subjects were identified by admission records. Parents/caregivers were invited to participate. A questionnaire on the knowledge, beliefs and response of parents/ caregivers during the child’s current seizure episode was administered face to face. Data were analysed for frequencies; comparisons between groups using Chi Square analysis for categorical variables, and the Mann-Whitney U test for data not normally distributed. RESULTS: Fifty participants were enrolled; 39 (78%) mothers; mean age (SD) was 33.8 (10.1) years. All sought medical care first. Twenty-two (44%) had plausible beliefs about the cause of seizures. Twenty-seven (54%) knew of appropriate actions during a seizure, 10 (20%) knew of appropriate precautions and 11 (22%) responded appropriately during the seizure. Eleven (22%) reported receiving seizure education. Witnessing a previous seizure, education level and seizure education were positively associated with knowledge of seizures (p < 0.05). Socioeconomic status was higher in those with plausible beliefs about seizures and lower in those who took appropriate action during a seizure (p<0.05). CONCLUSION: Parents/caregivers of children with convulsive seizures have appropriate health-care seeking behaviour but inadequate knowledge. Seizure education should be prioritised to improve parental knowledge of and response to convulsive seizures.

Cognition, academic achievement, and epilepsy in school-age children: a case-control study in a developing country.

We conducted a case-control study of 33 Jamaican children 7 to 12years old with uncomplicated epilepsy and 33 of their classroom peers matched for age and gender to determine whether epilepsy resulted in differences in cognitive ability and school achievement and if socioeconomic status or the environment had a moderating effect on any differences. Intelligence, language, memory, attention, executive function, and mathematics ability were assessed using selected tests from NEPSY, WISCR, TeaCh, WRAT3 - expanded, and Raven's Coloured Progressive Matrices. The child's environment at home was measured using the Middle Childhood HOME inventory. Socioeconomic status was determined from a combination of household, crowding, possessions, and sanitation. We compared the characteristics of the cases and controls and used random effects regression models (using the matched pair as the cluster) to examine the relationship between cognition and epilepsy. We found that there was no significant difference in IQ, but children with epilepsy had lower scores on tests of memory (p<0.05), language (p<0.05), and attention (p<0.01) compared with their controls. In random effects models, epilepsy status had a significant effect on memory (coefficient=-0.14, CI: -0.23, -0.05), language (coefficient=-0.13, CI: -0.23, -0.04), and mathematics ability (coefficient=-0.01, CI: -0.02, -0.00). Adjustment for the home environment and socioeconomic status and inclusion of interaction terms for these variables did not alter these effects. In conclusion, we found that epilepsy status in Jamaican children has a significant effect on performance on tests of memory, language, and mathematics and that this effect is not modified or explained by socioeconomic status or the child's home environment.

Myasthenia gravis in Jamaican children: a 12-year institutional review.

BACKGROUND: Myasthenia gravis is uncommon in children. The clinical characteristics in children of the English-speaking Caribbean have not been documented previously. OBJECTIVE: To describe the clinical characteristics and outcome of children with myasthenia gravis at two tertiary hospitals in Jamaica. METHODS: The case-notes of all children with a diagnosis of myasthenia gravis managed at the University Hospital of the West Indies and Bustamante Hospital for Children between January 1994 and December 2005 were reviewed. RESULTS: There were 34 children; mean age of onset of illness was 7.5 years and mean period of follow-up was 38.5 months. The male-to-female ratio was 1:1.3. Nineteen (59%) presented with ocular manifestations; 47% of these developed signs of generalised involvement. Most were treated with pyridostigmine and prednisone. Eight patients had thymectomy. Four patients (12%) entered remission. There were two deaths. CONCLUSIONS: Myasthenia gravis in Jamaican children is similar to that in other populations. It is more common in female children. Most children present with ocular manifestations and remission occurs infrequently.

Menkes' kinky hair syndrome.

We herein describe a case of Menkes' Syndrome in a Jamaican infant. The diagnosis was confirmed by low serum copper and ceruloplasmin levels.

Menkes' kinky hair syndrome

We herein describe a case of Menke's syndrome in a Jamaican infant. The diagnosis was confirmed by low serum copper and ceruloplasmin levels.

Destilador solar modelo "Noreste"

El destilador solar modelo "Noreste" es una instalación experimental destinada a obtener la desalinización y/o potabilización del agua para consumo humano, mediante la utilización directa de la energía solar. Ha sido diseñado para servir a grupos rurales y fue desarrollado en 1980 en la escuela provincial "Ganadero Márquez" en Los Eucaliptos, departamento de Río Seco, en un área de elevada salinidad del suelo y agua subterránea. Se señalan los elementos estructurales, funcionamiento, características técnicas del destilador, ubicación y datos geográficos de la zona Los Eucaliptos

Destilador solar modelo "Noreste"

El destilador solar modelo "Noreste" es una instalación experimental destinada a obtener la desalinización y/o potabilización del agua para consumo humano, mediante la utilización directa de la energía solar. Ha sido diseñado para servir a grupos rurales y fue desarrollado en 1980 en la escuela provincial "Ganadero Márquez" en Los Eucaliptos, departamento de Río Seco, en un área de elevada salinidad del suelo y agua subterránea. Se señalan los elementos estructurales, funcionamiento, características técnicas del destilador, ubicación y datos geográficos de la zona Los Eucaliptos