A review of the health risk behaviours among adolescents in the Englishspeaking Caribbean: 2006 to 2020

• Adolescents comprise around 25% of the Caribbean population. Past studies report that the challenges faced by this target group include substance use, mental health, violence, high risk sexual behaviours such as HIV, juvenile delinquency, obesity, accidents and injuries, among others. • Through the understanding of the adolescent health risk behaviours, challenges, their health risks and protective factors, can we then comprehend and generate solutions to the challenges faced by youth in the Caribbean. This review will focus on the years 2006-2020, where we will determine what has or has not changed from the last review (from 1985-2005) and what solutions can be implemented.

Post­World War II epidemiological transitions in Caribbean Societies: Interpretive insights based on age-associated mortality profiles

Objective: Life expectancy at birth is a robust indicator of the mortality profile in any spatial unit. The paper draws on age-associated life expectancy estimates from six Caribbean nations between 1950 and 2015 to assess variable gain in longevity of life at various stages of human lifespan and make claims about the variable impact of nation-specific sociomedical interventions as well as likely lessons to be learned. Design and Methodology: Using Mixed Methodology, secondary data are drawn from the United Nations Population Databases that reflect mortality profiles at national and regional levels. The data relate to six Caribbean nations ­ Cuba, Barbados, Jamaica, Trinidad and Tobago, Guyana and Haiti and permit the detection of changes in age-associated life expectancy over 20-year intervals including four time points ­ 1955, 1975, 1995 and 2015. Descriptive statistics are used to discern variable national trends that could be understood drawing on qualitative evidence obtained from documentary research and elite interviews. Results: Three distinct mortality profiles emerge with the most favourable being in Cuba and Barbados, the least favourable in Guyana and Haiti, and Jamaica and Trinidad and Tobago being located between the two extremes. The timing and magnitude of gains in infant, child, adult and geriatric health states can be discerned from the results. Conclusion: The paper is heuristic and constitutes a basis comparing the effectiveness of primary, secondary and tertiary health care in promoting human resilience to mortality. As such, the paper provides important ameliorative lessons that have implications for critically informing the administration of health policies.

Factors that influence health risk behaviours among teenagers

Objective: To identify the factors that influence health risk behaviours among teenagers in Trinidad and Tobago. Design and Methodology: A quantitative, descriptive research study was carried out among teenagers attending four public secondary schools in the St. George East Educational District in Trinidad. A self administered questionnaire which was modified by the researchers was distributed to 148 study participants to determine how the factors: Sociodemographic characteristics, peer-pressure, social environment/community, media and gender influenced their health risk behaviour. Results:The study found that 31% of the participants were influenced by peer-pressure to engage in bullying while 20% drank alcohol, 15% engaged in illicit sex while 10% of the participants were influenced to smoke and 24% revealed that peer pressure had no influence on their behaviour. The study also determined that the media influenced 41% of the participants to engage in bullying. Participants also reported that their social environment/community had an influence on their health risk behaviours; the most prevalent behaviour was drug use (36%) while bullying accounted for 34%, followed by alcohol consumption (17%), then smoking (10%), and illicit sex (3%). Conclusion: While this study only investigated the factors that influence health risk behaviour among a small sample of teenagers in one school district and a generalization cannot be made to include all teenagers there is sufficient evidence to recommend further research and for school health programmes that promote health education and awareness of health risk behaviours to reduce the likelihood of teenagers engaging in health risk behaviours.

Antibiotic prescribing patterns in the emergency department at the Wendy Fitzwilliam Pediatric Hospital

Objective: This study aims to assess the quantity and quality of antibiotic prescribing in the emergency department at Wendy Fitzwilliam Pediatric Hospital (WFPH), per World Health Organization (WHO) and National Antimicrobial Prescribing Survey (NAPS) indicators. Design and Methodology: A clinical notes review of patients (aged one month to 13 years) seen in the WFPH emergency department was conducted between March and May 2018. The study population was 12,293 patients, convenience sampling was used and eligible patient notes were reviewed. For each encounter, patient demographics, prescription and indication were recorded. The analysis of the data, conducted using Microsoft Excel 2016, was based on WHO prescribing indicators (generic name and model formulary percentage) and NAPS compliance with guidelines indicators. Results: The study included 119 patients with a mean age of 5 years (s=3.55 years) and 52% (n=62) were male. 13.5% of the prescribed antibiotics included the drug's generic name while 95.7% were found on the WHO model formulary. Of all the prescribed antibiotics, 58% was compliant. Of the 141 antibiotics prescribed, 83% (n=117) were broad-spectrum, with amoxicillin/ clavulanic acid (48%) and amoxicillin (17%) being the most common. The most common indications were respiratory tract infections (42%) and skin, and soft tissue infections (40%). Conclusions: The WFPH emergency department had good adherence to an essential formulary and mostly complied with guidelines. However, the high number of broad-spectrum antibiotics prescribed for common infections indicate a need for further research, toward implementing a rational antibiotic prescribing policy in Trinidad and Tobago.

Belize Vector and Ecology Center monthly activity report March 2018

The Belize Vector and Ecology Center has embarked on vector surveillance initiatives that will allow us to determine changes in distribution and density of vectors and obtain information about population changes. In turn, this will allows us to monitor and evaluate adequate control methods. In this report, we have outlined the various activities that we have been conducting for the month of March.The Household Container Mapping is being conducted by teams consisting of BVEC employees and Vector Control representatives. So far, we have mapped approximately 20.61% of the total structures in Orange Walk Town. Mapping data was updated for the month of March based on the amount of structures we did. Ovitrap Surveillance is being done in which 120 oviposition cups are set out to 60 pre-consented homes in Orange Walk Town. The hatch rate has been determined to be about 40% to 60%, and there is interesting variation in the number of eggs collected per zone which may also be related to the position of ovicups and climatic conditions.The BG Sentinel Surveillance is being conducted in order to collect live adult Aedes mosquitoes in the field. There are 12 BG Sentinels in the town at 12 pre-consented homes. The traps so far have collected a number of Aedes mosquitoes as well as some from the Culex species and other types of flies.The adult Aedes mosquitoes collected in the traps are then sorted, identified and stored for testing using the Dengue Antigen Kit. Tests conducted so far have turned up negative and testing will continue while working on a pooling strategy depending on the number of adult females collected in the field. Larval Resistance Testing is another key component to the surveillance which will be done in conjunction with the ovitrap surveillance initiative. Currently eggs are being pooled and hatched so that there is enough larvae to meet the standard testing methods. BVEC also does Presentations and Training sessions in which we collaborate with schools and other groups to foster community engagement.

Belize Vector and Ecology Center monthly activity report February 2018

The Belize Vector and Ecology Center has embarked on vector surveillance initiatives that will allow us to determine changes in distribution and density of vectors and obtain information about population changes. In turn, this will allows us to monitor and evaluate adequate control methods. In this report, we have outlined the various activities that we have been conducting for the month of February.The Household Container Mapping is being conducted by teams consisting of BVEC employees and Vector Control representatives. So far we have mapped approximately 19.19% of the total structures in Orange Walk Town. Mapping data was updated for the month of February based on the amount of structures we did. Ovitrap Surveillance is being done in which 120 oviposition cups are set out to 60 pre-consented homes in Orange Walk Town. The hatch rate has been determined to be about 40% to 60% and there is interesting variation in the number of eggs collected per zone which may also be related to the position of ovicups and climatic conditions. The BG Sentinel Surveillance is being conducted in order to collect live adult Aedes mosquitoes in the field. There are 12 BG Sentinels in the town at 12 pre-consented homes. The traps so far have collected a number of Aedes mosquitoes as well as some from the Culex species and other types of flies. The adult Aedes mosquitoes collected in the traps are then sorted, identified and stored for testing using the Dengue Antigen Kit. Tests conducted so far have turned up negative which is a good sign and will continue testing while working on a pooling strategy depending on the number of adult females collected in the field. Larval Resistance Testing is another key component to the surveillance which will be done in conjunction with the ovitrap surveillance initiative. Currently eggs are being pooled and hatched so that there is enough larvae to meet the standard testing methods. BVEC also does Presentations and Training sessions in which we collaborate with schools and other groups to foster community engagement.

Belize Vector and Ecology Center monthly activity report January 2018

The Belize Vector and Ecology Center has embarked on vector surveillance initiatives that will allow us to determine changes in distribution and density of vectors and obtain information about population changes. In turn this will allows us to monitor and evaluate adequate control methods. In this report, we have outlined the various activities that we have been conducting for the month of January. The Household Container Mapping is being conducted by teams consisting of BVEC employees and Vector Control representatives. So far we have mapped approximately 17.73% of the total structures in Orange Walk Town. Mapping data was updated for the month of January based on the amount of structures we did. Ovitrap Surveillance is being done in which 120 oviposition cups are set out to 60 pre-consented homes in Orange Walk Town. The hatch rate has been determined to be about 40 to 60% and there is interesting variation in the number of eggs collected per zone which may also be related to the position of ovicups and climatic conditions. The BG Sentinel Surveillance is being conducted in order to collect live adult Aedes mosquitoes in the field. There are 12 BG Sentinels in the town at 12 pre-consented homes. The traps so far have collected a number of Aedes mosquitoes as well as some from the Culex species and other types of flies. The adult Aedes mosquitoes collected in the traps are then sorted, identified and stored for testing using the Dengue Antigen Kit. Tests conducted so far have turned up negative which is a good sign and will continue testing while working on a pooling strategy depending on the number of adult females collected in the field. Larval Resistance Testing is another key component to the surveillance which will be done in conjunction with the ovitrap surveillance initiative. Currently eggs are being pooled and hatched so that there is enough larvae to meet the standard testing methods. For this month some resistance curves were established for some of the zones as the contamination issues were addressed. BVEC also does Presentations and Training sessions in which we collaborate with schools and other groups to foster community engagement.

Muskieten-bestrijding hospitalen en verzorgingstehuizen / Mosquito - control of hospitals and care houses

The information provided in this document by the Suriname Bureau of Public Health (BOG), is intended for the management and staff of hospitals and care homes with regard to the prevention and control of mosquito breeding sites. It focuses on the mosquitoes, and more specifically, the Aedes mosquito, which is a carrier of serious diseases such as Dengue, Chikungunya and Zika viruses. Symptoms of these viruses include fever, headaches, joint and muscle aches, and skin rashes. The core intent of the information is to prevent the spread of diseases carried by this insect vector via elimination of breeding grounds and the environment in which they thrive, such as small water objects like cups, cans, trays, vases, flower pot coasters, car tires and water barrels to name a few. Systematic, sustained implementation of an anti-mosquito program is crucial to the successful control of Dengue, Chikungunya and Zika viruses, particularly for hospitals and care homes. The key rationale is to raise awareness of the danger of transmission, and encourage widespread participation towards control and eventual elimination of the breeding grounds. A comprehensive list of strategies to eliminate breeding grounds is included in the publication...(AU)

Muskieten-bestrijding overheidsgebouwen / Mosquito - Control of government buildings

The information provided in this document by the Department of Entomology of the Suriname Bureau of Public Health (BOG), is intended for the management and staff of government buildings as relates to the prevention and control of mosquito breeding sites. It focuses on the Aedes Aegypti mosquito. The insect vector responsible for transmission of Dengue, Chikungunya and Zika viruses. The intent of the information bulletin is to provide information and greater awareness towards prevention of the spread of diseases carried by this insect vector and assist in the effort towards elimination of breeding grounds and environments in which the mosquito thrives.

Aedes insecticide resistance surveillance protocol

The establishment of the Aedes mosquito in Guyana has raised public health concerns in the ten administrative regions where conditions are suitable for their existence. Recently, studies were conducted in Georgetown to determine the risk of transmission in the city using the Breteau Index tool. This research (unpolished data) has revealed regional epidemic risks and transmission risks in most areas. To contribute in a sustained way the improvement of the entomological surveillance programs, supporting the implementation of a consensual strategy for the monitoring and management of insecticide resistance in the main disease vectors in Guyana.

Prevalence of oral habits in a child population in Trinidad, West Indies

Objectives: The purpose of this study was to determine the prevalence of oral habits (both nutritive and non-nutritive) in children in Trinidad, West Indies and to determine if there are any associated factors such as age, gender, ethnicity, social/familial factors, dietary practices and parental perception. Methods: 155 children aged 4e16 years and their parents were questioned using a struc- tured interview about breast and bottle feeding history, history of oral habits, sibling habit history, parental education level and habit history and parental belief and perception. Oral habits such as pacifier use, digit sucking, tongue sucking, lip biting and sucking, nail biting, and object chewing were recorded. Results: There was a very high prevalence of oral habits (91.6%) with 63.9% of children having two or more habits. The most common oral habit was nail biting (52.9%) and ice crunching was most commonly found in females. Tongue sucking was predominant in children of African ethnicity. Oral habits were more common in children whose parents had a post primary education. 51% of parents were not concerned about oral habits and 64.5% believed that the child would stop the habit without any intervention. Conclusion: The prevalence of both nutritive and non-nutritive oral habits in Trinidad are high and some associations were found with gender, ethnicity, social, dietary and familial factors.

Zika update, June 9, 2017 Suriname

The update reports on surveillance with regard to the Zika virus from its inception in Suriname in November 2015, to June 2017. It comprises of statistical data inclusive of a map and several charts representing suspected and confirmed cases of Zika. Brief information on Guillain-Barre Syndrome, Congenital Syndrome and Zika associated deaths due to other pre-existing illnesses are also contained in the report.

Zika - epidemiological report Barbados, September 2017

This PAHO/WHO report traces the epidemiology of the Zika and Dengue viruses in Barbados for the period 2017-2017. The first case of Zika was laboratory-confirmed in 2016, and the number of confirmed cases rose to a high of 92 and fell to 25 in 2017. The report also presents statistical data for Dengue, Zika-related pregnancies, Zika-virus-associated Guillain Barre syndrome, Congenital Syndrome associated with Zika Virus infection, and Zika-related deaths

Vector control annual report 2017

Under the Environmental Health Unit, the Vector Control Program has the responsibility for implementing surveillance, prevention and control measures to protect the population against vector borne diseases, particularly Malaria, Dengue, Chikungunya and Zika. It executes, on an ongoing basis, a series of mosquito vector control activities within areas with transmission of afore mentioned diseases. The program is also responsible for the development and dissemination of Information, Education and Communication (IEC) to the public.

Zika classification by epidemiological week 2017: Country total

The document is a compilation of the weekly surveillance of the confirmed and suspected (clinical and test) cases of Zika recorded by the EPI Unit of the Ministry of Health, Belize for 2017. This information is captured and reported according to district, age group and sex.

Corozal zika classification by epidemiological week 2017: [Country total]

The document is a compilation of the weekly surveillance of Zika cases in the Corozal district recorded by the EPI Unit of the Ministry of Health, Belize for 2017. This information is captured and reported according to the community of residence, age group and sex.

Orange Walk zika classification by epidemiological week 2017: [Country total]

The document is a compilation of the weekly surveillance of Zika cases in the Orange Walk district recorded by the EPI Unit of the Ministry of Health, Belize for 2017. This information is captured and reported according to the community of residence, age group and sex.

Belize zika classification by epidemiological week 2017: [Country total]

The document is a compilation of the weekly surveillance of Zika cases in Belize recorded by the EPI Unit of the Ministry of Health, Belize for 2017. This information is captured and reported according to the community of residence, age group and sex.

Cayo zika classification by epidemiological week 2017: [Country total]

The document is a compilation of the weekly surveillance of Zika cases in the Cayo district recorded by the EPI Unit of the Ministry of Health, Belize for 2017. This information is captured and reported according to the community of residence, age group and sex.

Stann Creek zika classification by epidemiological week 2017: [Country total]

The document is a compilation of the weekly surveillance of Zika cases in the Stann Creek district recorded by the EPI Unit of the Ministry of Health, Belize for 2017. This information is captured and reported according to the community of residence, age group and sex.