The Use of a Production Function to Evaluate Caribbean Ocean Health Conflicts and Economic Development: Policy Implications.

Central American and Caribbean (CAC) countries enjoy diverse marine environments. The oceans that enclose these coastlines contribute significantly to their economic growth. Industrial expansion and tourism place pressure on the marine ecosystems causing a decline in ocean health. To evaluate the cause of ocean health changes we investigated the factors influencing CAC ocean health using a health production function. Using Rank-Based Regression and the set of extractive, cultural and human well-being and services goals measuring Ocean Health Index (OHI), data from the World Bank, and the Human Development Index we developed a production function for CAC countries ocean health. Results show that all regional OHI scores, but Tourism and Recreation, the main income earning industry for most of the CAC countries, are less than the global score with four of the goals less than 40. The production function shows that all the goals, but the biodiversity sub-goal species, positively influencing OHI. Two climatic related variables, Nitrous Oxide and Carbon Dioxide negatively influenced OHI. The results are important to policy makers as they decide on the need to make greater effort towards improving sustainable contribution of CAC ocean resources to the blue economy.

Factors associated with self-reported symptoms of acute pesticide poisoning among farmers in northwestern Jamaica.

Pesticide poisoning is a major public health concern in developing countries. The authors conducted a population survey among farmers in 3 parishes of northwestern Jamaica to determine the occurrence of acute pesticide poisoning and to identify factors associated with pesticide poisoning. Approximately 16% of 359 farmers who participated in the study reported 1 or more incidents of acute pesticide poisoning within the last 2 years. Only 25% of the farmers reported ever receiving training in pesticide handling or safety. The majority (68%) of farmers who reported pesticide poisoning never sought medical attention for poisoning. The factors found to be associated with pesticide poisoning in this study indicate that implementation of specific intervention strategies and education of farmers is needed in order to improve safe handling, use, and disposal of pesticides and reduce incidents of acute pesticide poisoning.

HIV/AIDS-related stigma in Kumasi, Ghana.

OBJECTIVE: To assess HIV/AIDS-related stigma and discrimination of people living with HIV/AIDS (PLWHA) in Kumasi, Ghana. METHODS: A cross-sectional survey of 104 adults from the four sub-districts in Kumasi was conducted. RESULTS: Four stigma constructs, employment-based discrimination, screening and identification of HIV positive people, revelation of HIV status and social contact stigma were determined based on reliability measures from responses to the questionnaire. Regression analysis showed that participants with higher educational attainment were more likely to favor policies denying employment to PLWHA (p<0.05), but disapproved of revealing HIV sero-status (p<0.05). Muslims were more likely than Christians to agree with identifying PLWHA (p<0.05) and more likely to advocate revealing HIV sero-status (p<0.05). Males were more likely to favor revealing HIV status (p<0.05). Employed persons were more likely to have social contact with PLWHA (p<0.05). CONCLUSIONS: These findings are useful in guiding the design of interventions against HIV/AIDS-related stigma in Kumasi.

The economics of adoption and management of alley cropping in Haiti.

The Haitian people are facing serious problems of environmental degradation that threaten the economic livelihoods of many resource-poor farmers. Structures to retard the process of soil loss have been adopted reluctantly and, even when adopted, the management and maintenance have been less than desirable. We evaluate the factors that influence the adoption and management of alley cropping in Haiti. Results of the adoption model show that institutional factors, such as membership in a local peasant organization and training in soil conservation practices, favorably influence adoption. Socio-economic factors such as gender, per capita income, and interaction between education and per capita income also significantly influence adoption of alley cropping in Gaita and Bannate. The management of alley cropping is influenced by demographic, socio-economic, institutional, and physical factors. The relative importance of each factor on the probability of adoption and management of alley cropping varies from one variable to another. The study generates important information for resource allocation in the establishment of alley cropping as a soil conservation structure.

Human aflatoxicosis in developing countries: a review of toxicology, exposure, potential health consequences, and interventions.

Aflatoxins are well recognized as a cause of liver cancer, but they have additional important toxic effects. In farm and laboratory animals, chronic exposure to aflatoxins compromises immunity and interferes with protein metabolism and multiple micronutrients that are critical to health. These effects have not been widely studied in humans, but the available information indicates that at least some of the effects observed in animals also occur in humans. The prevalence and level of human exposure to aflatoxins on a global scale have been reviewed, and the resulting conclusion was that approximately 4.5 billion persons living in developing countries are chronically exposed to largely uncontrolled amounts of the toxin. A limited amount of information shows that, at least in those locations where it has been studied, the existing aflatoxin exposure results in changes in nutrition and immunity. The aflatoxin exposure and the toxic affects of aflatoxins on immunity and nutrition combine to negatively affect health factors (including HIV infection) that account for >40% of the burden of disease in developing countries where a short lifespan is prevalent. Food systems and economics render developed-country approaches to the management of aflatoxins impractical in developing-country settings, but the strategy of using food additives to protect farm animals from the toxin may also provide effective and economical new approaches to protecting human populations.

Incidence of health crises in tourists visiting Jamaica, west indies, 1998 to 2000.

BACKGROUND: Tourism is important to the Jamaican economy accounting for approximately 25% of the gross domestic product. Health problems in tourists could have significant impact on the health of the local population, the scarce health service resources, and the tourist industry. This study was conducted to identify health problems most commonly occurring in tourists visiting Jamaica and examine how these problems are managed. METHODS: Records of health problems occurring in tourists who visited principal tourist areas on the north coast from June 1998 to June 2002 were reviewed for the type of illness and how the problem was handled. The data were analyzed using Epi-Info software (Centers for Disease Control and Prevention, Atlanta, GA) and Statistical Analysis System software (SAS Institute, Cary, NC). RESULTS: Accidents were the most common health crises reported by tourists. Gastrointestinal, respiratory, and cardiovascular problems occurred less frequently. Those less than 40 years of age more frequently reported accidents or injury, gastrointestinal problems, and drug abuse, whereas respiratory and cardiovascular problems were more common among those above 40 years of age. Cardiovascular problems, drug abuse, and death were more common in men than in women. Hotel nurses handled most of the cases and were more likely to refer patients to private physicians or hospitals than to public hospitals (p <.05). Factors influencing the way the crisis was handled were age (p =.0441); who handled the crisis (p <.0001); and the method of payment (p =.0072). The factors that influenced hospitalization were gender (p =.0615); who handled the crisis at the onset (p =.0497); how the crisis was dealt with (p =.0336); and previous health problems (p =.0056). Men were more likely to be hospitalized and to be referred to a public hospital than women. Medical insurance covered the costs for 11% of tourists, and 75% paid out of pocket. CONCLUSION: The information provided by this study can be used to implement changes to reduce health problems in tourists and improve emergency health services in tourist areas.