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1.
In. The University of the West Indies, Faculty of Medical Sciences. Faculty of Medical Sciences, Research Day. St. Augustine, Caribbean Medical Journal, March 21, 2019. .
Não convencional em Inglês | MedCarib | ID: biblio-1046261

RESUMO

Objective: To compare biomedical research productivity among selected CARICOM countries. Design and Methodology: Biomedical publications of the selected CARICOM countries (Bahamas, Barbados, Dominica, Guyana, Grenada, Haiti, Jamaica, Suriname, and Trinidad & Tobago) were retrieved using 'PubMed' and 'ScImago Journal & country Rank' (SJR) databases. The publications for each country were then normalized by factors such as total population, gross domestic product (GDP) and Internet usage rate. Results: Total number of papers published by all 9 countries was 7,281 and 8,378 in PubMed (1990- 2015) and SJR databases (1996-2017) respectively. Jamaica produced highest number of biomedical publications [PubMed: 3,928 (54%) and SJR: 2,850 (34%)]. However, when adjusted, Grenada had the highest research publications per million populations, per billion GDP and per 1,000 Internet users in both databases. For trend analysis, PubMed showed that Jamaica produced highest number of additional publications each year ­ on an average 4.8 followed by Trinidad & Tobago (4.4). According to SJR, Jamaica had also highest number of citations (42,311) and H-index (76) followed by Trinidad & Tobago (29,152 and 71). Barbados had the highest number of citations per document (24.9) followed by Haiti (18.4). Conclusion: There was a marked imbalance noted among the CARICOM countries in terms of biomedical research and publications. A CARICOM-wide research may be embarked to explore disparities in biomedical research productivity and thus formulate informed health policies to alleviate diseases and eradicate poverty.


Assuntos
Pesquisa Biomédica , Suriname , Bahamas , Trinidad e Tobago , Barbados , Região do Caribe/etnologia , Dominica , Guiana , Haiti , Jamaica
2.
In. The University of the West Indies, Faculty of Medical Sciences. Faculty of Medical Sciences, Research Day. St. Augustine, Caribbean Medical Journal, March 21, 2019. .
Não convencional em Inglês | MedCarib | ID: biblio-1046374

RESUMO

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.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Epidemiologia , Trinidad e Tobago , Barbados , Mortalidade , Região do Caribe/epidemiologia , Cuba , Guiana , Haiti , Jamaica
3.
West Indian med. j ; 65(Supp. 3): [24], 2016.
Artigo em Inglês | MedCarib | ID: med-18095

RESUMO

OBJECTIVES: To identify significant predictors in dominance in decision-making for fertility control among reproductive-aged married women in Haiti. SUBJECTS AND METHODS: The data were obtained from reproductive-aged, non-pregnant women participating in the 2012 Haitian Demographic and Health Survey(HDSH). Univariate, bivariate and multivariate statistical procedures were used to, respectively, describe the characteristics of the data, find the association between the dependent variable and each independent variable of interest, and to estimate the relative importance of independent factors on female or joint decision-making versus male dominance. RESULTS: Logistic regression analysis revealed that relative to male dominance, female dominance was related to the husband’s fertility desires, number of unions and number of pregnancies. Joint decision-making was associated with sources known for obtaining condoms and number of pregnancies. CONCLUSION: The findings from this study add to the literature on contraceptive decision-making in the low in comecontext where little is known about reproductive and contraceptive behaviours. Findings lead to questions about the role of stakeholders, including government, in raising awareness. The findings suggest the need for studies on the connection between HIV/AIDS and reproductive and child health in Haiti specifically and the Caribbean in general.


Assuntos
Humanos , Dispositivos Anticoncepcionais Femininos , Haiti
4.
West Indian med. j ; 65(Supp. 3): [46], 2016.
Artigo em Inglês | MedCarib | ID: med-18123

RESUMO

OBJECTIVES: Limited research following disasters suggests that internally displaced women are disproportionately vulnerable to violence and abuse. The purpose of this study was to investigate gender-based violence (GBV) and health outcomes among Haitian women living in tent cities/camps following the 2010 earthquake. SUBJECTS AND METHODS: Culturally sensitive and language appropriate audio-computer assisted self-interviews (ACASI) of 208 internally displaced women in Port-au-Prince, Haiti, were done. Intimate partner violence, nonpartner violence, sexual abuse and emotional abuse history were collected from 2011–2013. RESULTS: Findings showed high prevalence of physical, psychological and sexual abuse, both before (71.2%) and after (75.0%) the earthquake, primarily perpetrated by boyfriends or husbands. Significantly more mental and physical health problems were reported by abused than non-abused women. The most frequent abusers were boyfriends or ex-boyfriends (38.1%) and husbands or exhusbands(42.3%). In addition, among abused women post-earthquake, post-traumatic stress disorder and suicidal thoughts and attempts increased by 104% and 30%, respectively. CONCLUSIONS: It is essential that disaster healthcare policies and practices include specific attention to intimate partner violence. Post-disaster violence is often a continuation of the same intimate partner violence women encountered before the disaster occurred. Coordinated planning and implementation of much needed culturally tailored interventions are essential to provide a balanced approach to the care of displaced women after natural disasters, with sensitivity to the abusive occurrences many of the women experience, both before and after the disaster.


Assuntos
Humanos , Feminino , Violência contra a Mulher , Desastres Naturais , Vítimas de Desastres , Haiti
5.
PLos One ; 4(3): [1-5], mar. 2009. tabilus
Artigo em Inglês | MedCarib | ID: med-17878

RESUMO

BACKGROUND: The molecular epidemiology of HIV-1 in the Caribbean has been described using partial genome sequencing; subtype B is the most common subtype in multiple countries. To expand our knowledge of this, nearly full genome amplification, sequencing and analysis was conducted. METHODOLOGY/PRINCIPAL FINDINGS: Virion RNA from sera collected in Haiti, Dominican Republic, Jamaica and Trinidad and Tobago were reverse transcribed, PCR amplified, sequenced and phylogenetically analyzed. Nearly full genomes were completed for 15 strains; partial pol was done for 67 strains. All but one of the 67 strains analyzed in pol were subtype B; the exception was a unique recombinant of subtypes B and C collected in the Dominican Republic. Of the nearly full genomes of 14 strains that were subtype B in pol, all were subtype B from one end of the genome to the other and not inter-subtype recombinants. Surprisingly, the Caribbean subtype B strains clustered significantly with each other and separate from subtype B from other parts of the pandemic. CONCLUSIONS: The more complete analysis of HIV-1 from 4 Caribbean countries confirms previous research using partial genome analysis that the predominant subtype in circulation was subtype B. The Caribbean strains are phylogenetically distinct from other subtype B strains although the biological meaning of this finding is unclear.


Assuntos
Humanos , HIV-1 , Genoma Humano , Trinidad e Tobago , Haiti , República Dominicana , Jamaica , Região do Caribe
6.
Rev. panam. salud p£blica ; 25(1): 24-30, Jan. 2009. tab, graf
Artigo em Inglês | MedCarib | ID: med-17671

RESUMO

OBJECTIVES: To describe the effectiveness of a program designed to reduce the rate of mother-to-child transmission (MTCT) of HIV at the primary HIV testing and treatment center in Haiti between 1999 and 2004. METHODS: All pregnant, HIV-positive women who attended the major HIV testing and treatment clinic in Port-au-Prince, Haiti, between March 1999 and December 2004 were asked to participate in an MTCT prevention program. Of the 650 women who participated, 73.3% received zidovudine (AZT), 2.9% received nevirapine (NVP), and 10.1% received triple-drug therapy when it became available in 2003 and if clinical/laboratory indications were met. Approximately 13.8% received no antiretroviral medication. All participants received cotrimoxazole prophylaxis and infant formula for their children. Kaplan-Meier survival analysis and the log rank test were used to evaluate program impact on child survival. RESULTS: Complete data were available for 348 mother-infant pairs who completed the program to prevent MTCT of HIV. The rate of MTCT in the study was 9.2% (95% CI: 6.14-12.24), in contrast to the historical mother-to-child transmission rate of 27% in Haiti. HIV-positive infants were less likely to survive than HIV-negative infants at 18 months of follow-up (chi(2) = 19.06, P < .001, log rank test). Infant survival improved with early pediatric diagnosis and antiretroviral treatment. CONCLUSIONS: The MTCT prevention program described proved to be feasible and effective in reducing vertical HIV transmission in Haiti. The authors emphasize the need to expand testing, extend services to rural areas, and implement early HIV diagnosis to reduce infant mortality.


Assuntos
Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Humanos , Fármacos Anti-HIV , Transmissão de Doença Infecciosa , Transmissão Vertical de Doenças Infecciosas , Infecções por HIV , Cuidado Pré-Natal , Haiti
7.
Rev. panam. salud p£blica ; 24(5): 331-335, Nov. 2008. tab
Artigo em Inglês | MedCarib | ID: med-17458

RESUMO

OBJECTIVE: To determine the feasibility of sending dried blood spots (DBS) to an overseas processing center for the diagnosis of HIV infection in infants in rural Haiti. METHODS: The program took place in the Central Department of Haiti. Children under 18 months of age who were born to an HIV-infected mother or who had a positive HIV antibody test had blood collected on filter paper. Once dry, specimens were labeled with a unique identifying number, placed in sealed gas-impermeable envelopes containing a desiccant, stored at room temperature, and mailed to a commercial laboratory in The Netherlands, where blood was eluted from the filter paper and analyzed by the RetinaTM rainbow HIV-1 RNA assay. Infants were tested at 1 month of age and again at 4 months of age. RESULTS: The DBS protocol was easily scaled up. During the study period, 138 infants had HIV status confirmed; 15 of them were found to be HIV infected and were enrolled in appropriate HIV care, and 123 were confirmed to be HIV uninfected, avoiding unnecessary prophylactic antibiotics and providing reassurance to caregivers. CONCLUSION: Central, overseas processing of DBS is a feasible solution for the timely diagnosis of HIV infection in infants where local capacity is unavailable. Regional processing centers for DBS could improve the access of millions of children in Latin America and the Caribbean to timely diagnosis of HIV infection.


Assuntos
Lactente , Humanos , Coleta de Amostras Sanguíneas , Sorodiagnóstico da AIDS , Áreas de Pobreza , Haiti , Região do Caribe
8.
Rev. panam. salud p£blica ; 18(3): 178-186, Sept. 2005. maps, tab, gra
Artigo em Inglês | MedCarib | ID: med-17081

RESUMO

OBJECTIVES. Limited information is available regarding the causes of under-five mortality in nearly all countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading cause of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies elsewhere in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. METHODS. In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rural Artibonite Valley of Haiti. With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the cause of death; the algorithm made it possible to have more than one cause death. RESULTS. Acute lower respiratory infection (ALRI) was the leading diagnosis, present in 45 percent of all under-five deaths, followed by enteric diseases, present in 21 percent of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41 percent of the neonatal deaths. Among children 1-59 months of age, ALRI was present in 51 percent of the deaths, and enteric diseases in 30 percent. Deaths were concentrated during the first few months of life, with 35 percent occuring during the first month. Among the neonatal deaths, 27 percent occurred on the first day of life and 80 percent occured during the first 10 days of life. CONCLUSIONS. In the Albert Schweitzer Hospital program area - and presumably in other areas of Haiti as well - priority needs to be given to the prevention of and early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the need for more, similar standardized assessments to guide local, regional, and national programs (AU)


Assuntos
Humanos , Lactente , Causas de Morte , Coleta de Dados/estatística & dados numéricos , Autopsia , Mortalidade Infantil/tendências , Serviços de Saúde da Criança , Haiti
9.
Rev. panam. salud p£blica ; 18(2): 84-92, August 2005. tab
Artigo em Inglês | MedCarib | ID: med-17278

RESUMO

OBJECTIVES: This study is based on the 2000 Demographic and Health Survey (DHS) conducted in Haiti. Using the DHS information on women ages 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1) examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2) for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16 percent, compared to 85.83 percent in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 percent prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centers in rural areas consituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti (AU)


Assuntos
Humanos , Feminino , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Cuidado Pré-Natal/tendências , Serviços de Saúde Rural , Serviços Urbanos de Saúde/estatística & dados numéricos , Haiti , Região do Caribe , Países em Desenvolvimento
10.
Rev. panam. salud p£blica ; 18(2): 84-91, Aug. 2005. tab
Artigo em Inglês | MedCarib | ID: med-17314

RESUMO

OBJECTIVES: This study is based on the 2000 Demograpic Health Survey (DHS) conducted in Haiti. Using the DHS information on women aged 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1) examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2)for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did not make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16 percent, compared to 85.83 percent in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centres in rural areas constituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti(AU)


Assuntos
Humanos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Serviços de Saúde Rural/tendências , Haiti , Serviços Urbanos de Saúde/estatística & dados numéricos , Região do Caribe , Serviços Urbanos de Saúde , Países em Desenvolvimento
11.
In. World Health Organization. AIDS epidemic update: December 2004. Geneva, UNAIDS, 2004. p.31-35, ilus, tab.
Monografia em Inglês | MedCarib | ID: med-17062

RESUMO

More than 440 000 [270 000-78 000] people are living with HIV in the Caribbean, including the 53 000 [27 000-140 000] people who acquired the virus in 2004. An estimated 36 000 [24 000-61 000] people died of AIDS in the same year. With average adult HIV prevalence of 2.3 percent, the Caribbean is the second-most affected region in the world. In five countries (the Bahamas, Belize, Guyana, Haiti and Trinidad and Tobago), national prevalence exceeds 2 percent. Overall, the highest HIV-infection levels among women in the Americas are in the Caribbean countries and AIDS has become the leading cause of death in the Caribbean among adults aged 15-44 years (Caribbean Epidemiology Centre, PAHO, WHO, 2004). Life expectancy at birth in 2010 is projected to be 10 years less in Haiti and in Trinidad and Tobago nine years less than it would have been without AIDS. Several countries and territories with economies that are most heavily affected by the epidemic in this region, including the Bahamas, Barbados, Bermuda, Dominican Republic, Jamaica, and Trinidad and Tobago. Yet most countries in this region have limited capacity to track the evolution of their epidemics, and are relying on data and systems that do not necessarily match the realities they are facing


Assuntos
Humanos , HIV , Trinidad e Tobago , Síndrome de Imunodeficiência Adquirida/epidemiologia , Guiana , Infecções por HIV/epidemiologia , Haiti , Infecções por HIV/mortalidade , Bahamas , Região do Caribe , Expectativa de Vida/tendências , Belize , Suriname
12.
Rev. panam. salud publica ; 12(4): 269-273, Oct. 2002. tab
Artigo em Inglês | MedCarib | ID: med-16980

RESUMO

Objective. To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. Methods. During March 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Results. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. Conclusions. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered (AU)


Assuntos
Criança , Humanos , Síndrome da Rubéola Congênita/etnologia , Haiti , Rubéola (Sarampo Alemão)/diagnóstico , Vacina contra Rubéola , Análise Custo-Benefício , Programas de Imunização/economia
13.
Rev. panam. salud publica ; 10(3): 149-151, Sept. 2001.
Artigo em Inglês | MedCarib | ID: med-16962

RESUMO

This meeting will review much of the work done in the Central American subregion, in Mexico, and in the Spanish-speaking Caribbean in the field of vaccines and the diseases they prevent. It will review progress achieved, the steps that have to be followed to consolidate the gains that have been made to date, and the strategies that have to be adopted to face the challenges ahead. It will comment on some new initiatives and, based on experiences shared, see how we may advance together (AU)


Assuntos
Humanos , Saúde Pública , Haiti , Imunização , Programas de Imunização , Vacinas
14.
Rev. panam. salud publica ; 9(4): 272-274, Apr. 2001.
Artigo em Espanhol | MedCarib | ID: med-16959

RESUMO

In October 2000, the Ministries of Helth of the Dominican Republic and Haiti notified two cases of acute flaccid paralyis (AFP) in rural areas, one of them in a 9-month-old female, and the other in a 2-year-old female, respectively. Stool samples that were obtained from these cases, which occured in July and August 2000, after a 9-year interruption of wild poliovirus circulation in the Western Hemisphere, revealed the presence of type 1 poliovirus. Genetic sequencing, which was later performed at the CEnters for Disease Control and Prevention, in Atlanta, Georgia, United States of America, revealed an atypical descendant of the virus used in the manufacture of the oral polio vaccine (OPV), but with 3 percent genetic divergence with respect to the parent strain. Normally, viral isolates that derive from vaccine components show 99.5 percent genetic agreement with the parent strain; in wild polioviruses, on the other hand, this agreement is usually less than 82.0 percent. Thus, the 3 percent genetic divergence detected in this study suggests that, in areas with low vaccine coverage, the virus used in the vaccine remained in circulation for at least two years, during which it recovered the neurovirulence and communicability of wild poliovirus type 1. This report describes the characteristics and results of the active search for cases of AFP that was sparked by the detection of the two index cases. It also looks at the public health implications of this outbreak for the entire Region of the Americas (AU)


Assuntos
Lactente , Humanos , Poliomielite/transmissão , América , Surtos de Doenças , Haiti , Poliovirus/isolamento & purificação , República Dominicana , Vacina Antipólio de Vírus Inativado/análise
16.
Anon.
Economist ; 355(8167): 34-5, Apr. 22, 2000.
Artigo em Inglês | MedCarib | ID: med-508

RESUMO

Focuses on incidence of HIV and AIDS in the Caribbean, as of Spring 2000. Infection rates in Haiti, the Dominican Republic, Guyana and the Bahamas; AIDS as a cause of death among young men; Economic impact; Public awareness and understanding; Factors that affect the region's susceptibility; Incidence in Cuba; Public health education.(AU)


Assuntos
Feminino , Humanos , Masculino , Infecções por HIV , Índias Ocidentais , Haiti , Guiana , Bahamas , Mortalidade , Infecções , Saúde Pública
17.
Rev. panam. salud publica ; 7(3): 162-167, Mar. 2000. ilus, tab
Artigo em Inglês | MedCarib | ID: med-16927

RESUMO

In the Limbe River valley of northern Haiti a retrospective study at the Bon Samaritain Hospital (BSH) determined the total number of cases and the cyclical nature of malaria from 1975 through 1997, examined the relationship between rainfall and malaria from 1975 through 1985, and compared the incidence of malaria at that hospital with general trends for Haiti for 1975 through 196 as reported by the World Health Organization (WHO). During 1975-1997, 27 078 positive cases of malaria were diagnosed at BSH; 50 percent of these cases occured during 16 weeks out of the year, during a summer peak in June and July and a winter peak in December and January. For 1975-1985, there was no significant correlation between the incidence of malaria and annual rainfall. The strongest correlation was observed between weekly rainfall and weekly incidence of malaria when the data was staggered to allow a lag of 9-11 weeks between rainfall and new malaria cases. The lag period is explained by the time required for the creation of breeding sites after rain, the life cycle of the Anopheles albimanus mosquito and the Plasmodium falciparum parasite, and the incubation period for falciparum malaria. The incidence of malaria in the Limbe valley loosely followed the trends in all of Haiti and also supported WHO reports indicating that malaria in Haiti has been in a general decline since the mid-1980s. By showing the seasonal trends for malaria in the Limbe valley and the relationship between rainfall and malaria over an extended time period, this study provides a means to measure the effectiveness of malaria control efforts in the region (AU)


Assuntos
Humanos , Malária/epidemiologia , Haiti , Vetores de Doenças , Plasmodium falciparum , Anopheles
18.
In. Howe, Glenford D; Cobley, Alan G. The Caribbean AIDS epidemic. Kingston, University of the West Indies Press, 2000. p.226-42, tab.
Monografia em Inglês | MedCarib | ID: med-619
19.
In. Howe, Glenford D; Cobley, Alan G. The Caribbean AIDS epidemic. Kingston, University of the West Indies Press, 2000. p.22-41, gra.
Monografia em Inglês | MedCarib | ID: med-632
20.
West Indian med. j ; 47(Suppl. 3): 35, July 1998.
Artigo em Inglês | MedCarib | ID: med-1704

RESUMO

The Caribbean region continues to experience an expanding HIV/AIDS epidemic. Population HIV-1 prevalence in this region is second only to that in sub-Saharan Africa, reaching 5-6 percent in Haiti and up to 3 percent in Guyana and the Bahamas. While AIDS deaths are declining in developed countries, death rates from AIDS have continued to rise in the Caribbean because of the general unavailability of newer combination therapies. Over the past decade we have witnessed the rapid transition from HIV-1/AIDS in so called risk groups such as gay men and intravenous drug users to spread within the general heterosexual community. This transition has been fuelled by the concurrence of factors which enhance HIV risk such as high rates of partner exchange and poorly or untreated concomitant sexually transmitted diseases, particularly ulcerative diseases. In countries such as Trinidad and the Bahamas an epidemic of crack cocaine use in the eighties provided a fertile milieu for rapid HIV transmission through sexual activity. Each Caribbean territory has its own version of the epidemic, but the commonalities are striking. At the dawn of a new millenium the region continues the struggle against HIV/AIDS in the face of the many problems of crumbling infrastructures a generation after independence, marginal economies, inadequate public engagement in the face of competing priorities, lack of treatment and inadequate research. Recent advances in HIV-I vaccine development may hold some promise for checking the major public health crisis facing the Caribbean at this time.(AU)


Assuntos
Humanos , HIV , Síndrome de Imunodeficiência Adquirida/epidemiologia , HIV-1 , Região do Caribe , Haiti/epidemiologia , Guiana/epidemiologia , Bahamas/epidemiologia
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