Burden and impact of acute gastroenteritis and foodborne pathogens in Trinidad and Tobago.

Objectives of this study were to determine the burden and impact of acute gastroenteritis (AGE) and foodborne pathogens in Trinidad and Tobago. A retrospective, cross-sectional population survey, based on self-reported cases of AGE, was conducted in November-December 2008 and May-June 2009 (high- and low-AGE season respectively) by face-to-face interviews. From 2,145 households selected to be interviewed, the response rate was 99.9%. Of those interviewed, 5.1% (n = 110; 95% CI 4.3-6.2) reported having AGE (3 or more loose watery stools in 24 hours) in the 28 days prior to the interview (0.67 episodes/person-year). Monthly prevalence of AGE was the highest among children aged < 5 years (1.3 episodes/year). Eighteen (16%) persons with AGE sought medical care (4 treated with oral rehydration salts and 6 with antibiotics), and 66% reported restricted activity [range 1-16 day(s)]. The mean duration of diarrhoea was 2.3 days (range 2-10 days). One case submitted a stool sample, and another was hospitalized. Overall, 56 (10%) AGE specimens tested positive for foodbome pathogens. It was estimated that 135,820 AGE cases occurred in 2009 (84% underreporting), and for every 1 AGE case reported, an additional 6.17 cases occurred in the community. The estimated economic cost of AGE ranged from US$ 27,331 to 19,736,344. Acute gastroenteritis, thus, poses a huge health and economic burden on Trinidad and Tobago.

Direct outpatient cost per case of acute gastroenteritis in Trinidad and Tobago, 2021.

The burdens associated with acute gastroenteritis involve billions of dollars in expenses, coupled with significant morbidity and mortality globally. To reduce these burdens, health officials and policymakers require up-to-date data (health and economic) to request and allocate resources in guiding the development and implementation of preventative strategies. In 2021, the estimate for one case of acute gastroenteritis was calculated using multiple sources of data: the 2009 national health burden survey on acute gastroenteritis; a 2021 telephone survey of five major private hospitals; a 2021 telephone survey of 30 private pharmacies; and the 2021 Minimum Wages Act of Trinidad and Tobago. For each case of illness, an average cost of $1614 TTD ($238 USD) was estimated. For residents who sought private health care, the average GP visit cost was $500-$700 TTD ($73-$103 USD), while costs for medication prescribed ranged between $327 and $1166 TTD ($48-$172 USD). Productivity losses amounted to almost $21.7 million TTD ($3.2 million USD) for residents who took time off from work or required caregiving services. The overall annual cost was estimated to be $204 million TTD ($30.1 million USD) and, therefore, warrants measures by health officials to reduce the economic and social burdens of acute gastroenteritis in Trinidad and Tobago.

Wound-healing potential of an ethanol extract of Carica papaya (Caricaceae) seeds.

Carica papaya L. (Linn) (Caricaceae) is traditionally used to treat various skin disorders, including wounds. It is widely used in developing countries as an effective and readily available treatment for various wounds, particularly burns. This study evaluated the wound-healing and antimicrobial activity of C. papaya seed extract. Ethanol extract of C. papaya seed (50 mg/kg/day) was evaluated for its wound-healing activity in Sprague-Dawley rats using excision wound model. Animals were randomly divided into four groups of six each (group 1 served as control, group 2 treated with papaya seed extract, group 3 treated with a standard drug mupirocin and papaya seed extract (1:1 ratio) and group 4 treated with a mupirocin ointment. Rate of wound contraction and hydroxyproline content were determined to assess the wound-healing activity of the seed extract. The group 2 animals showed a significant decrease in wound area of 89% over 13 days when compared with groups 1 (82%), 3 (86%) and 4 (84%) respectively. The hydroxyproline content was significantly higher with the granulation tissue obtained from group 2 animals which were treated with C. papaya seed extract. Histological analysis of granulation tissue of the group 2 animals showed the deposition of well-organized collagen. The extract exhibited antimicrobial activity against Salmonella choleraesuis and Staphylococcus aureus. Our results suggest that C. papaya promotes significant wound healing in rats and further evaluation for this activity in humans is suggested.

Detection of Foodborne Pathogens in Acute Gastroenteritis Patient's Stool Samples Using the BioFire® FilmArray® Gastrointestinal PCR Panel in the Republic of Trinidad and Tobago, West Indies.

In 2009, the burden of illness study for acute gastroenteritis in Trinidad and Tobago highlighted that ~10% of stool samples tested were positive for a foodborne pathogen. The study also noted that limited laboratory screening for pathogens contributed to a lack of etiology as public health hospitals only routinely tested for Salmonella and Shigella, and sometimes for Escherichia coli and Campylobacter. To better understand the foodborne pathogens responsible for acute gastroenteritis, enhanced testing using the BioFire® FilmArray® Gastrointestinal PCR panel was used to screen diarrheal stool samples for 22 pathogens from patients in 2018. The five general public health hospitals (San Fernando, Mt. Hope, Port of Spain, Sangre Grande, and Tobago) were notified of research activities and diarrheal stool samples were collected from all acute gastroenteritis patients. A total of 66 stools were screened and ~30% of samples tested positive for a foodborne pathogen. The current study showed that a much wider range of enteric pathogens were associated with acute gastroenteritis in Trinidad and Tobago than previously reported in 2009. These findings can be used by health officials to guide appropriate interventions, as well as to provide evidence for adoption of the PCR panel detection method at public health hospitals to benefit patient care.

Evaluation of wound healing activity of Lantana camara L. - a preclinical study.

Lantana camara is used in herbal medicine for the treatment of skin itches, as an antiseptic for wounds, and externally for leprosy and scabies. The objective of our study was to investigate excision wound healing activity of the leaf extract of L. camara in rats. The animals were divided into two groups of 12 each in both the models. The test group animals were treated with the aqueous extract of L. camara (100 mg/kg/day) topically and the control group animals were left untreated. Wound healing efficacy was measured by determining the morphological and biochemical parameters. Wound healing time, wound contraction and synthesis of collagen were monitored periodically. Antimicrobial activities of the extract against the microorganisms were also assessed. Treatment of the wounds with extract enhanced significantly the rate of wound contraction (98%), synthesis of collagen and decreased mean wound healing time. These studies demonstrate that L. camara is effective in healing excision wounds in the experimental animal and could be evaluated as a therapeutic agent in tissue repair processes associated with skin injuries.

Impact of recreation on recreational water quality of a small tropical stream.

A study was conducted to determine the possible influence of recreation on microbiological water quality of a tropical stream. Microbiological water quality was measured at several recreational sites along the stream and a separate experiment was conducted to look at the effect of sediment resuspension on microbiological water quality. Microbiological quality of the water in the stream was generally poor and varied widely with faecal coliform and Escherichia coli levels ranging from 1 to > 16,000 and 14 to 9615 organisms 100 ml(-1) respectively. Levels of faecal coliforms were higher in the wet (median = 700 organisms 100 ml(-1)) than the dry (median = 500 organisms 100 ml(-1)) season while the reverse was true for E. coli (median = 300 and 220 organisms 100 ml(-1) in the wet and dry seasons respectively). Recreational activity resulted in reduced water quality: sites with recreation had poorer water quality than those without; water quality was generally poorer when there were high numbers of recreational users. Wading resulted in a 4-fold increase in mean E. coli densities and a 3-fold increase in total suspended sediments in the overlying water suggesting that the increases were due to suspension of bacteria from the sediments. We conclude that water quality monitoring methodology for assessing recreational water quality should be amended to factor in the effects of wading since environmental strains of bacteria can be pathogenic and thus represent a human health threat.

Topically applied myco-acaricides for the control of cattle ticks: overcoming the challenges.

In the absence of commercially viable and environmentally friendly options, the management of cattle ticks is heavily dependent on the use of chemical acaricides. Due to recent advances in production, formulation and application technology, commercial fungus-based biological pesticides (myco-insecticides, myco-acaricides) are becoming increasingly popular for the control of plant pests; however, they have not been used against animal ectoparasites. The literature clearly demonstrates that entomopathogenic fungi are pathogenic to ticks under laboratory conditions. Pasture applications have also shown promise while experiments on topical application have had variable results. These results suggest that major research hurdles still exist especially for the latter. Although literature on ticks and their interactions with entomopathogenic fungi exists, there is not a clear understanding on how this can be influenced by the microenvironment of the cattle skin surface. This paper critically reviews pathogen, tick target and host skin microenvironmental factors that potentially affect pathogenicity of the applied entomopathogen. Factors influencing the route of infection for topically applied myco-acaricides are also reviewed. Major researchable constraints and recommendations are identified and prioritized. In particular, there is the need for basic studies to understand the interaction of entomopathogenic fungi with the components of the skin microenvironment, to identify suitable strains, and to develop improved formulations to overcome the various challenges.

Microbial quality of popular locally processed meats sold in retail outlets in Trinidad, West Indies.

A total of 480 samples of locally produced processed meats, including chicken franks, chicken bologna, and bacon from brands A and B, was collected from 8 supermarkets across the island of Trinidad over a 1-year period and subjected to a range of microbiological analyses. The results showed that 54.2, 0.4, and 1.7% of the samples exceeded recommended limits for aerobic bacteria, Escherichia coli and Staphylococcus aureus, respectively. Listeria spp. were detected in 19.4% of samples, whereas L. monocytogenes was present at a prevalence rate of 7.5%. Brand A products had lower microbiological quality, accounting for 100% of samples positive for L. monocytogenes, E. coli, and S. aureus; and 75% for Listeria spp. and coliforms. Bacon was the product that most frequently exceeded microbiological limits, and accounted for 100% of samples positive for E. coli, 83.3% for L. monocytogenes, 72% for Listeria spp., 62.5% for S. aureus, and 61.9% for coliforms.

Partial 16S rRNA gene sequence diversity and numerical taxonomy of slow growing pigeonpea (Cajanus cajan L Millsp) nodulating rhizobia.

An investigation was carried out to determine the diversity of 30 isolates of slow growing pigeonpea nodulating rhizobia based on variations in partial sequences of the 16S rRNA gene and numerical analysis of 80 phenotypic traits. Phylogenetic analysis using molecular sequences of 23 isolates showed that ARPE1 separated from the other isolates at an average distance of >14% divergence level. The other isolates were all within 5% divergence from each other but separated into four main groups, with group 1 containing 16 of the 23 isolates. Comparisons to sequences of reference strains revealed that the group 1 isolates were phylogenetically closely related to the slow growing soybean nodulating rhizobia belonging to Bradyrhizobium elkanii, although only three of these isolates were able to nodulate soybean. Numerical analysis of phenotypic data of 19 isolates showed that 14 isolates clustered together in one branch of the phenogram, which included the group 1, group 2 and group 4 isolates from the phylogenetic analysis. The group 3 isolates were highly variable in the phenogram with similarity levels lower than 50% among these isolates.

Microbiological hazard analysis of ready-to-eat meats processed at a food plant in Trinidad, West Indies.

BACKGROUND: A bacteriological assessment of the environment and food products at different stages of processing was conducted during the manufacture of ready-to-eat (RTE) chicken franks, chicken bologna and bacon at a large meat processing plant in Trinidad, West Indies. METHODS: Samples of air, surfaces (swabs), raw materials, and in-process and finished food products were collected during two separate visits for each product type and subjected to qualitative or quantitative analysis for bacterial zoonotic pathogens and fecal indicator organisms. RESULTS: Staphylococcus aureus was the most common pathogen detected in pre-cooked products (mean counts = 0.66, 1.98, and 1.95 log10CFU/g for franks, bologna, and bacon, respectively). This pathogen was also found in unacceptable levels in 4 (16.7%) of 24 post-cooked samples. Fifty percent (10 of 20) of pre-cooked mixtures of bacon and bologna were contaminated with Listeria spp., including four with L. monocytogenes. Pre-cooked mixtures of franks and bologna also contained E. coli (35 and 0.72 log10 CFU/g, respectively) while 5 (12.5%) of 40 pre-cooked mixtures of chicken franks had Salmonella spp. Aerobic bacteria exceeded acceptable international standards in 46 (82.1%) of 56 pre-cooked and 6 (16.7%) of 36 post-cooked samples. Both pre-and post-cooking air and surfaces had relatively high levels of aerobic bacteria, Staphylococcus aureus and coliforms, including equipment and gloves of employees. A drastic decrease in aerobic counts and Staphylococcus aureus levels following heat treatment and subsequent increase in counts of these bacteria are suggestive of post-cooking contamination. CONCLUSION: A relatively high level of risk exists for microbial contamination of RTE meats at the food plant investigated and there is a need for enhancing the quality assurance programs to ensure the safety of consumers of products manufactured at this plant.