A study to identify the presence of Aedes Spp. using BG-Sentinel® Traps and larval/pupal surveys in communities around Belmopan, Cayo District.

The knowledge of the presence of Aedes Spp. mosquitoes is very important for the prevention and control of emerging and remerging diseases caused by Arboviruses such as: Yellow fever, Dengue, Chikungunya and Zika. While Chikungunya and Dengue are endemic to Belize, Zika is currently a threat with local transmission having been established in several Caribbean and Central American Countries. The objective of the study is to survey the presence of Ae. aegypti and Ae. albopictus in the communities of San Martin, Salvapan and Las Flores, Belmopan City. The study was conducted from March 14 to April 2, 2016 whereby adult mosquitoes were captured using BG-Sentinel® Traps and larvae/pupae collection surveys were also done. Three hundred meter zone(s) were determined within localities and 1 BG-Sentinel® trap was deployed for 3 days at 24-hour intervals both indoors and outdoors at 2 residences randomly selected in each community. Larvae/Pupae collection surveys were done at 5 private premises within the predetermined zones in each of the three communities. Captured larvae and Pupae were reared for 6 days and adults obtained were used for identification. The identification of adult Ae. aegypti and Ae. albopictus was done using a stereoscopic microscope and pictorial keys that are used for the identification of mosquitoes. The presence of Ae. aegypti was identified in all 3 communities through both adult mosquito and larvae/pupae collections. However, Ae. albopictus was present only in San Martin and Salvapan communities. The presence of Ae. aegypti and/or Ae. albopictus will determine which appropriate vector control interventions are needed considering the different characteristic breeding habitats of these mosquitoes.(AU)

Why youths stay away from health centres: an assessment of youth health needs and health care services utilization

OBJECTIVE: To determine the extent to which the primary health care services meet the needs of adolescents in the North-West Health Region, Trinidad. DESIGN and METHODS: A systematic sample of Government and Government assisted elementary, secondary and technical/vocational schools in the North-West was included in the study. Between January and February of 1999, self administered questionnaires were completed by 300 students in the 11 to 19 age-group randomly selected from the schools' sample. RESULTS: Only 23.6 percent of the sample went `most often' to Health Centres `at some time' - 167 (56 percent) - the major source of discomfort was the lengthy waiting period (82.7 percent) while 22 percent felt that the attitude of the deliverers of the service was either poor or very poor. Young people requested that the community health administration provide a range of services that include sport and recreation (50.7 percent), educational programmes (48.6 percent), sex education (36.1 percent), career guidance (34.8 percent), counselling (30.7 percent). They preferred these services to be delivered in a building specially designed for that purpose. CONCLUSIONS: The health services currently being provided do not meet the needs of the youth. Their preference is for a mix of services that would focus on their physical, emotional and social needs. This would require a multisectoral collaboration and the participation of youth in the planning and development of such an initiative. (Au)

A cross-sectional prevalence study of the protozoan and helminth infections in school children 6-12 years of age in Grenada

Data on the public health importance of intestinal parasites in Grenada have not been available for over 60 years and this study aimed to redress this information gap. Between May and June 1999, a cross-sectional point prevalence study of intestinal protozoans and helminths was carried out in school children aged 6-12 years of age in three schools in St George's Parish, Grenada. After receiving informed consent, a single stool sample was obtained which was immediately aliquoted and samples stored in either the refrigerator or freezer. The refrigerator sample was processed by a salt flotation concentration technique. The frozen sample was analysed by ELISA assay for antigens of intestinal protozoa. A total of 315 samples was collected. For protozoans, prevalence rates of 36, 12 and 3 percent were obtained for Giardia lamblia, Entamoeba histolytica and Cryptosporidium parvum, respectively. For helminths, prevalence rates were 0.4, 1.3, 5.3 and 1.4 percent for hookworm, Enterobius vermicularis, Trichuris trichuria and Ascaris lumbricoides, respectively. Protozoans are prevalent in Grenadians school children but helminths are not as common. These differences in prevalence rates may reflect the easy availability of broad spectrum antihelmintics whilst drugs for protozoan infections are obtained by prescription only. The dramatic difference in the prevalence of intestinal helminths from earlier in the 20th century may also reflect a considerable improvement in the socio-economic status of the population. (Au)

Prevalence of Campylobacter species in diarrhoeal stools in Barbados

OBJECTIVE: To determine the prevalence of Campylobacter spp in stools submitted for investigation of diarrhoeal disease. DESIGN AND METHODS: Stool specimens were cultured for Salmonella, Shigella and Campylobacter using appropriate selective media. Isolates of Campylobacter spp. were identified by a latex agglutination test, and antimicrobial sensitivities were performed using E-test strips. RESULTS: Stools from 951 patients were cultured for bacterial pathogens during the 13 months of this study. Salmonella spp. were isolated from 93 stools (9.8 percent, 95 percent CI 8.0-11.9), Campylobacter spp. from 53 (5.6 percent, 95 percent CI 4.2-7.2) and Shigella spp. from 28 (2.9 percent, 95 percent CI 2.0-4.2). Stools from which pathogens were isolated were significantly more likely to contain blood, mucus or white blood cells. Erythromycin was active against 92 percent of Campylobacter isolates tested, tetracycline against 61 percent, and ciprofloxacin against 58 percent. The majority of pathogens (79 percent) were isolated from stools submitted from children under 12 years of age (69 percent) and from the community (79 percent). CONCLUSIONS: Campylobacter spp. are common in patients with diarrhoea in Barbados and should be included in the routine investigation of diarrhoeal illnesses.(Au)

Symptomatic and asymptomatic chlamydial non-gonococcal urethritis in Jamaica: the potential for HIV transmission

To determine the contribution of Chlamydia trachomatis to non-gonococcal urethritis (NGU) in men attending sexually transmitted (STD) clinics in Jamaica, we studied men with NGU (n=339), and control groups including asymptomatic men who were STD contacts (n=61), asymptomatic men who were not STD contacts (n=32) and men with gonococcal urethritis (GU) (n=61). Urethral specimens were examined for C. trachomatis and Neisseria gonorrhoeae. Serological tests for syphillis (STS) and HIV-1 infection were also performed. C. trachomatis accounted for 63 percent of cases of NGU but high prevalence of C. trachomatis in men with GU differed significantly from that in men with NGU and asymptomatic STD non-contacts (P<0.05). C. trachomatis infection in men with NGU was associated with multiple sex partners (71 percent vs 58 percent; x2=4.78; odds ratio OR=1.76; P<0.05) and previous history of gonococcal infection (83 percent vs 42 percent; x2=59.8; OR=6.8; P<0.0001). Concomitant infection with HIV-1 occured in 5.2 percent of cases of NGU and 50 percent and 90 percent, respectively, of the HIV-positive men had chlamydia or reactive STS. As a cost effective strategy in the control of STD and HIV we recommend presumptive treatment for C. trachomatis in men seeking STD treatment in Jamaica.(Au)

Nutrient content of five commonly consumed Jamaican foods

There is a dearth of food composition data for the foods and dishes most frequently consumed in Jamaica. Samples of five foods in their forms most commonly consumed by the Jamaican population (brown stewed chicken, rice and peas, boiled and roasted breadfruit, and steamed callaloo) were collected and analysed for proximates, dietary fiber, and minerals. Also determined were the cholesterol level of brown stewed chicken and the carotenoid content of steamed callaloo. National samples of mixed dishes were collected from 10 representative households while samples of single foods were purchased from 10 Jamaican markets and roadside vendors nationwide. Primary samples of each food were pooled to form composites from which analytical samples were drawn. Analytical results of brown stewed chicken and rice and peas revealed substantive amounts of protein, total fat, and several of the minerals. Steamed callaloo and boiled and roasted breadfruit were most noted for their potential contribution to dietary fiber and the minerals calcium, potassium, magnesium, and phosphorus. This is the first report on nutrient composition data for commonly consumed Jamaican foods.(Au)

The prevalence of intestinal nematodes at the Adelphi All-age school in Saint James

A cross-sectional study of these rural school children was done to determine the level of infection in the school, and the types of geohelminths present. Data was collected through the use of one hundred and sixty-six (166) close-ended questionnaires, and the analysis of one hundred and nineteen (119) stool samples, and eighty (80) blood samples. A high prevalence of 22.3 percent was demonstrated in the school's population, with prevalence in the 10-12 age group reaching a high of 44 percent. Trichuris (13.4 percent), Ascaris (8.9 percent), and eosinophilia (6.4 percent), all showed significant prevalence. However, the prevalence of Hookworm (3.6 percent), and anaemia (2.6 percent), were not significant among the group. Infection strongly correlated with the eating of chalk and marl (a type of soil, composed chiefly of clay and limestone). The source of infection was identified as two marl pits located near the school, which are obviously used for indiscriminate defaecation. The construction of more latrines at the school, school health education, and public health education were recommended, to help eradicate worms from the school.(Au)

Clustering of cases of mycobacterium fortuitum infection investigated by molecular typing

Organisms of the mycobacterium fortuitum complex are recognised but uncommon causes of pulmonary disease, primary cutaneous disease and a wide spectrum of nosocomial infections. M fortuitum was isolated from 20 patients over a 15 month period, with a apparent clustering of isolates occurring from January to March 1994. The molecular epidemiology of this clustering eas investigated using an arbitrary primer polymerase chain reaction method (AP-PCR). 21 isolates were studied, which yielded 13 distinct profiles. Multiple isolates from a single patient yielded identical profiles. All of seven isolates recovered during the six week period from January to March 1994 shared a common profile which was distinct from all other isolates, suggesting that a single strain was isolated from specimens from all seven patients. The source of this cluster in uncertain. We can find no epidemilogical basis for an episode of cross-infection within the hospital environment, and it is assumed that contamination of the specimens during collection, transport or processing was responsible for the "pseudo-outbreak" of M fortuitum

Electron microscopy in Jamaica: applications and techniques

Although the electron microscope was developed about 60 years ago in Germany, its arrival and subsequent use in Jamaica are of considerably more recent date. In this paper, the principles of scanning and transmission electron microscopy (SEM & TEM) are briefly explained, and examples are given of the research done with the electron microscopes at the University of the West Indies (UWI), Mona Campus, Jamaica, especially over the last three years. Detailed descriptions of specimen preparation are provided for both SEM and TEM and particular emphasis is placed on the methodology used in our laboratory, as it sometimes differs from the routine followed in electron microscopy units of temperate countries. (AU)

Compliance and absenteeism in school children implications for helminth control

The validity of epidemiological surveys and the success of helminth control programmes based on the diagnosis of infection depend upon an accurate screening procedure. The success of all school-based control programmes, whether they involve prior diagnosis or not, depends on the level of school attendance and school enrollment. The degree to which compliance and school absenteeism may affect estimates of helminth infection and the coverage of treatment was investigated using empirical data from a survey conducted in 3 rural schools in Jamaica. Two sequential stool samples were requested from each child aged 9 to 12 years and screened for the presence and intensity of helminth infection using the Kato thicksmear technique. Of the 696 children recruited into the study, 94 percent agreed to participate but only 90 percent of these children actually provided a stool sample for diagnosis and only 74 percent returned the second stool. Children infected with moderate to heavy loads of Trichuris trichiura were less likely to comply fully with the protocol than the uninfected children. They also took longer to comply and were absent from school more often than their uninfected counterparts. Increasing the sample effort increased the compliance of all infected, and heavily infected, children. By giving them the option to comply, heavily infected children were under-represented by the sampling procedure. This has important implications for the design of control programmes and epidemiological surveys (AU)

Sodium azide preservation of faecal specimens for Kato analysis

The modified Kato technique has the advantages of reproducibility, simplicity and economy: the disadvantage is that it cannot be used in conjunction with traditional faecal preservatives. Sodium azide has been evaluated as a preservative for human faeces for subsequent Kato analysis. More than 400 faecal samples (from normal and malnourished children, and from mixed-age participants in a field survey of the Turks and Caicos Islands) were each mixed with 2-5mg of sodium azide powder and stored in 2 or 4ml autoanalyser cups at ambient tropical temperature. At intervals up to 30 weeks, aliquots were prepared for Kato analysis. Trichuria trichiura, Ascaris lumbricoides and Necator americanus eggs were well preserved without degenerative or developmental changes in morphology. Quantitative analyses of 18 samples indicated that the mean egg count/sample did not change significantly after storage for 1, 2, 4, 8, 12 and 16 weeks in preservative. The use of aside preservative extends the applications of the Kato technique to field and clinical studies in which delays may occur between specimen collection and examination. The direct costs of azide preservation are substantially lower than for traditional methods and the preserved specimens are more compact and resistant to leakage. (Summary)