A point prevalence survey of health associated infections and antimicrobial use in a public health institution in Trinidad

Objective: The point prevalence survey is a validated tool for measuring the quality of prescribing in the hospital setting. The objectives were to estimate the prevalence of hospital acquired infections, to assess the antimicrobial agent prescribed and determine if prescribers followed existing evidence-based antimicrobial policies subsequent to diagnosis of infection in patients. Design and Methodology: Day-of-survey records of patients in the intensive care unit and medical/surgical wards were examined at the institution, retrospectively. The extracted clinical data were recorded on the standardized data collection instruments (hospital, ward and patient forms) and analysed. Results: Of the 130 patients surveyed, 30 had an infection which occurred within 48 hours of admission. The most commonly reported infection type was urinary tract infections, evident in 9 (30.0%) patients, caused by Escherichia coli in 7 patients and Klebsiella pneumonia in 2 patients. Out of the 30 patients, 10 (33.3%) were awaiting laboratory reports at the time of the survey. Resistance was noted for Staphylococcus aureus and Escherichia coli, both of which were seen in 2 patients and Enterococcus spp. in 1 patient. The antimicrobial agent selected to treat these microorganisms should have been queried. Conclusions: Results of this survey imply that public health surveillance and prevention activities should be implemented to address appropriate treatment of hospital acquired infections. Recommendations to minimize the risk of resistance include: improving the availability of alcohol-based hand rub, the provision of single room and isolation capacity, antimicrobial guidelines for treatment of infection, judicious prescribing and proper surveillance of prescribed antimicrobials.

National alcohol survey of households in Trinidad and Tobago (NASHTT): the impact of alcohol on households

OBJECTIVE: To determine the distribution of alcohol use among households (HHs) in Trinidad and Tobago (T&T) and, whether the HHs where alcohol was used were more likely to suffer negative psychological, social or physical events. DESIGN AND METHODS: A cross-sectional convenience sample of HHs was surveyed from a random sample of enumeration districts (ED). The interviewer-applied, field pre-tested de novo questionnaire had 5 domains and was developed over 1 1/2 years after literature review and consultation. RESULTS: 1695 HHs (from 53 EDs) responded with a response rate (RR) of 92%. Sixty-two (62%) percent of HHs consumed alcohol, distributed with 1-2 users (46%), 3-4+ users (16%). Viewpoints and experiences about alcohol included: 'alcohol consumption at family gatherings is a normal occurrence' (70%). 29% of HHs consumed alcohol in the presence of children. HHs that consumed alcohol were significantly more likely to report in the last 12 months HHs members falling sick, experiencing lifestyle related illnesses, having relationship problems between partners, having strained relationships within the HH, HH members calling in sick to work, behavioural problems of children at home, anti-social problems of children at home/school and violent behaviour by a member of the HH (p

The national alcohol survey of households in Trinidad and Tobago (NASHTT): willingness to support changes in policy, laws and regulations

OBJECTIVE: This study set out to determine what proportion of Trinidad and Tobago (T&T) households (HHs) were willing to support changes in specific policies, laws and regulations in a national alcohol campaign. DESIGN AND METHODS: A cross-sectional convenience sample of HHs were surveyed from a random sample of enumeration districts (ED) in T&T. The interviewer-applied, field pre-tested de novo questionnaire had 5 domains and was developed over 1 1/2 years after extensive literature review and consultation. Many of the WHO 'best buys' were included. RESULTS: 1695 HHs (from 53 ED) responded from a total of 1837 HHs approached, a response rate (RR) of 92%. In a national campaign the following proportions of HHs would support: setting the legal age for drinking at 21 years (82.4%); restricting (73.1%), banning (54.4%) alcohol advertising on TV and other media; banning all alcohol advertising at sports and cultural events (64.8%); banning radio stations playing songs with reference to alcohol use (71.3%); holding sellers of alcohol responsible for the amount of alcohol sold (79.5%); advocating that proof of age to be shown by persons buying alcohol (87.4%); placing more prominent warning labels on products displaying alcohol content (87.2%); placing more prominent warning labels on products showing harmful effects (88.5% ); increasing taxes on alcohol sales (87.7% ). CONCLUSIONS: HHs in T&T were willing to support changes in policies around alcohol, including many of the policies shown by the WHO to be effective in reducing the harmful consumption of alcohol.

Knowledge, awareness and attitudes of guardians in the community towards distribution of the HPV vaccine to primary and secondary school children in Trinidad

OBJECTIVE: To investigate the knowledge, awareness and attitudes of guardians towards the distribution of Gardasil to school children in the North Central Regional Health Authority jurisdiction of Trinidad. DESIGN AND METHODS: A cross sectional study utilizing a questionnaire was employed to collect data from 368 participants who reside in the North Central division of Trinidad. The statistical analysis included chi square tests and logistical regression. RESULTS: There was an increase in the approval rate of Human Papillomavirus (HPV) vaccine (32.4%) after the participants received further education. Guardians preferred the 12-14 (24.2%) and 9-11 (23.1%) age groups for vaccination. Religion did not influence the decision to vaccinate. About half (49.2%) of parents believed vaccination would not cause promiscuity. Women were more likely to approve of the vaccine (p=0.023). Most participants did not talk to a doctor about the vaccine (70.7%). The general opinion (44.9%) was that insufficient information was imparted for an informed decision to be made. CONCLUSION: There was approval of the HPV vaccine despite risks and lack of knowledge. A more effective vaccination program requires prolonged sensitization of the public on the HPV vaccine.