Estimating the risk of dengue transmission from Dutch blood donors travelling to Suriname and the Dutch Caribbean.

BACKGROUND: The risk of dengue transmitted by travellers is known. Methods to estimate the transmission by transfusion (TT) risk from blood donors travelling to risk areas are available, for instance, the European Up-Front Risk Assessment Tool (EUFRAT). This study aimed to validate the estimated risk from travelling donors obtained from EUFRAT. METHODS: Surveillance data on notified dengue cases in Suriname and the Dutch Caribbean islands (Aruba, Curaçao, St. Maarten, Bonaire, St. Eustatius and Saba) in 2001-2011 was used to calculate local incidence rates. Information on travel and donation behaviour of Dutch donors was collected. With the EUFRAT model, the TT risks from Dutch travelling donors were calculated. Model estimates were compared with the number of infections in Dutch travellers found by laboratory tests in the Netherlands. RESULTS: The expected cumulative number of donors becoming infected during travels to Suriname and the Dutch Caribbean from 2001 to 2011 was estimated at 5 (95% CI, 2-11) and 86 (45-179), respectively. The infection risk inferred from the laboratory-based study was 19 (9-61) and 28 (14-92). Given the independence of the data sources, these estimates are remarkably close. The model estimated that 0·02 (0·001-0·06) and 0·40 (0·01-1·4) recipients would have been infected by these travelling donors. CONCLUSIONS: The EUFRAT model provided an estimate close to actual observed number of dengue infections. The dengue TT risk among Dutch travelling donors can be estimated using basic transmission, travel and donation information. The TT risk from Dutch donors travelling to Suriname and the Dutch Caribbean is small.

Gastroenteritis-associated Guillain-Barré syndrome on the Caribbean island Curaçao.

BACKGROUND: The number of patients with Guillain-Barré syndrome (GBS) who have been observed in Curaçao, the Netherlands Antilles, may be increasing. METHODS: Clinical and serologic data were obtained from records of patients admitted between 1987 and 1999 and fulfilling National Institute of Neurological and Communicative Disorders and Stroke criteria for GBS. When possible, serum and stool samples were collected. The results were compared with a large Dutch epidemiologic study. RESULTS: The authors identified 49 patients, an overall crude incidence rate (IR) in Curaçao of 2.53/100,000 inhabitants (95% CI 1.87 to 3.35) (Dutch study 1.18, rate ratio (RR) of 2.14, p < 0.001). The IR in Curaçao increased from 1.62 in 1987 to 1991 to 3.10 in 1992 to 1999, RR 5.22 (95% CI 2.48 to 10.2, p = 0.02). The IR showed a curvilinear shape within a year. In comparison with the Dutch group, patients from Curaçao had a more severe course of the disease, with a mortality rate of 23% (3.4% in the Dutch group, p < 0.001), a higher percentage of preceding gastroenteritis (p < 0.001), and less sensory involvement (p < 0.001). In 8 of 10 serum samples, evidence was found for a recent infection with Campylobacter jejuni. CONCLUSIONS: The authors found a steady increase in incidence of GBS over the years in association with a more pronounced seasonal preponderance and a more severe course. The clinical characteristics suggest a role for C jejuni.

Lifestyle in Curaçao. Smoking, alcohol consumption, eating habits and exercise.

The Curaçao Health Study was carried out among a randomized sample (n = 2248, response rate = 85%) of the adult non-institutionalized population in order to assess aspects of lifestyle that may pose health risks. Factors examined were tobacco and alcohol use, eating habits and exercise behaviour. Outcome variables were cross-tabulated by gender, age and socioeconomic status. 17.1% of the participants were smokers and 20.5% were regular drinkers, including 6.3% of the men who consumed alcohol excessively (4 or more glasses of alcohol a day). 75% of the participants did not exercise regularly, 37% did not eat vegetables daily, and half did not eat fruit daily. Other poor eating habits were the addition of extra sugar and salt to prepared food by 33% and 20% of the participants, respectively. On the whole, men had less healthy lifestyles than women, with the exception of exercise behaviour. People of high socioeconomic status (SES) drank less alcohol, and exercised more often than those of low SES. Considering the high prevalence of diabetes mellitus and hypertension in the Caribbean, research on lifestyle factors in other Caribbean countries is required to facilitate the development of regional prevention and intervention programmes.

Alarmingly high prevalence of obesity in Curaçao: data from an interview survey stratified for socioeconomic status.

OBJECTIVE: The aim of the article is to report the prevalence of obesity, abdominal fatness and waist circumference in different socioeconomic classes in Curaçao. DESIGN: In 1993/1994 a health interview survey (the Curaçao Health Study) was carried out among a random sample (n = 2248, response rate = 85%) of the adult non-institutionalized population of Curaçao. METHODS: We analyzed the association between obesity (BMI > or = 30), abdominal fatness (waist hip ratio (WHR) > or = 0.95 for men, WHR > or = 0.80 for women) waist circumference (WC > or = 100 cm for men, WC > or = 91 cm for women) and socioeconomic status (SES) by age adjusted logistic regressions, for men and women separately. RESULTS: The prevalence of obesity was about 27%: 36% of the women and 19% of the men were obese. An at risk WHR was reported among 62.2% of the women and among 20.4% of the men. A WC above the cut-off point was reported for 44.3% women and 25.3% men. Compared to women of higher SES, the lower SES women have a two to three times higher risk of a BMI, WHR or WC exceeding the cut-off points. Among men, no statistically significant difference between an increased BMI, WHR or WC and SES factors was found. The overlap between the three measures is large, about 56% of the women scored similarly on all three measurements. Among men the overlap is even greater (73%). CONCLUSIONS: The prevalence of obesity in Curaçao is alarming. Low SES women are at the greatest risk of an increased BMI, WHR or WC. The obesity figures can be placed between industrialized societies and less modernized cultures. Action and additional research on the prevention of obesity in Curaçao are deemed necessary. The cut-off points in our study for WC in the non-white population are preliminary and need to be elucidated further.

Lifestyle in Curacao: smoking, alcohol consumption, eating habits and exercise

The Curacao Health Study was carried out among a randomized sample (n = 2248, response rate = 85 percent) of the adult non-institutionalized population in order to assess aspects of lifestyle that may pose health risks. Factors examined were tobacco and alcohol use, eating habits and exercise behaviour. Outcome variables were cross-tabulated by gender, age and socioeconomic status. 17.1 percent of the participants were smokers and 20.5 percent regular drinkers, including 6.3 percent of the men who consumed alcohol excessively (4 or more glasses of alcohol a day). 75 percent of the participants did not excercise regularly, 37 percent did not eat vegetables daily, and half did not eat fruit daily. Other poor eating habits were the addition of extra sugar and salt to prepared food by 33 percent and 20 percent of the participants, respectively. On the whole, men had less healthy lifestyles than women, with the exception of execise behaviour. People of high socioeconomic status (SES) drank less alcohol, and exercised more often than those of low SES. Considering the high prevalence of diabetes mellitus and hypertension in the Caribbean, research of lifestyle factors in other Caribbean countries is required to facilitate the development of regional prevention and intervention programmes.