Risk of Measles and Diphtheria Introduction and Transmission on Bonaire, Caribbean Netherlands, 2018.

Endemic transmission of measles has been reestablished in Venezuela, and outbreaks of diphtheria remain ongoing across Latin America (LA). Hence, a large cross-sectional population-based serosurveillance study was conducted on Bonaire, one of the Dutch Leeward Antilles, to assess specific age and population groups at risk. Participants (aged 0-90 years) donated a blood sample and completed a questionnaire (n = 1,129). Antibodies against measles and diphtheria were tested using bead-based multiplex immunoassays. Our data revealed that immunity against measles is suboptimal, especially for those aged less than 5 years from Suriname, Aruba, and former Dutch Antilles (SADA), and adolescents from LA; and against diphtheria for persons aged more than 30 years, particularly among females and residents from SADA and LA. As refugees arrive persistently, health authorities on the Dutch Leeward Antilles should be on alert to detect early cases and prevent subsequent transmission. Ultimately, there is an urgent need for serosurveillance studies in the Caribbean region.

Third national biobank for population-based seroprevalence studies in the Netherlands, including the Caribbean Netherlands.

BACKGROUND: This paper outlines the methodology, study population and response rate of a third large Dutch population-based cross-sectional serosurvey carried-out in 2016/2017, primarily aiming to obtain insight into age-specific seroprevalence of vaccine-preventable diseases to evaluate the National Immunization Programme (NIP). In addition, Caribbean Netherlands (CN) was included, which enables additional research into tropical pathogens. METHODS: A two-stage cluster sampling technique was used to draw a sample of Dutch residents (0-89 years) (NS), including an oversampling of non-Western migrants, persons living in low vaccination coverage (LVC) areas, and an extra sample of persons born in Suriname, Aruba and the former Dutch Antilles (SAN). A separate sample was drawn for each Caribbean island. At the consultation hours, questionnaires, blood samples, oro- and nasopharyngeal swabs, faeces, - and only in the Netherlands (NL) saliva and a diary about contact patterns - were obtained from participants. Vaccination- and medical history was retrieved, and in CN anthropometric measurements were taken. RESULTS: In total, blood samples and questionnaires were collected from 9415 persons: 5745 (14.4%) in the NS (including the non-Western migrants), 1354 (19.8%) in LVC areas, 501 (6.9%) SAN, and 1815 (23.4%) in CN. CONCLUSIONS: This study will give insight into protection of the population against infectious diseases included in the NIP. Research based on this large biobank will contribute to public health (policy) in NL and CN, e.g., regarding outbreak management and emerging pathogens. Further, we will be able to extend our knowledge on infectious diseases and its changing dynamics by linking serological data to results from additional materials collected, environmental- and pharmacological data.

An analysis of community perceptions of mosquito-borne disease control and prevention in Sint Eustatius, Caribbean Netherlands.

BACKGROUND: In the Caribbean, mosquito-borne diseases are a public health threat. In Sint Eustatius, dengue, Chikungunya and Zika are now endemic. To control and prevent mosquito-borne diseases, the Sint Eustatius Public Health Department relies on the community to assist with the control of Aedes aegypti mosquito. Unfortunately, community based interventions are not always simple, as community perceptions and responses shape actions and influence behavioural responses Objective: The aim of this study was to determine how the Sint Eustatius population perceives the Aedes aegypti mosquito, mosquito-borne diseases and prevention and control measures and hypothesized that increased knowledge of the virus, vector, control and prevention should result in a lower AQ1 prevalence and incidence of mosquito-borne diseases. METHODS: This study was conducted in Sint Eustatius island in the Eastern Caribbean. We combined qualitative and quantitative designs. We conducted interviews and focus groups discussions among community member and health professional in 2013 and 2015. We also conducted cross-sectional survey to assess local knowledge on the vector, virus, and control and prevention. RESULTS: The population is knowledgeable; ©however, mosquito-borne diseases are not the highest health priority. While local knowledge is sometimes put into action, it happens on the 20 household/individual level as opposed to the community level. After the 2014 CHIK outbreak, there was an increase in knowledge about mosquito control and mosquito-borne diseases. DISCUSSION: In the context of Sint Eustatius, when controlling the Aedes population it may be a strategic option to focus on the household level rather than the community and build collaborations with households by supporting them when they actively practice mosquito 25 control. To further increase the level of knowledge on the significance of mosquito-borne diseases, it may also be an option to contextualize the issue of the virus, vector, prevention and control into a broader context. CONCLUSION: As evidenced by the increasing number of mosquito-borne diseases on the island, it appears that knowledge amongst the lay community may not be transferred into 30 action. This may be attributed to the perception of the Sint Eustatius populations that mosquitoes and the viruses they carry are not a high priority in comparison to other health concerns.