RESUMEN
BACKGROUND: Since the onset of the coronavirus (COVID-19) pandemic its negative effects have been highlighted globally. There is little literature that examines the positive impact on daily living. AIMS: To examine the positive influences of government-imposed COVID-19 public health restrictions on adults throughout Trinidad and Tobago (TT) and their associated factors. METHOD: A cross-sectional study, using an adapted pretested online survey instrument, was conducted amongst non-institutionalised, community-dwelling adults using convenience sampling. RESULTS: Of 1287 completed and weighted responses, the mean age (S.D.) was 39.2 (14.6) years, 49% were males, and 61% completed secondary level education. The top 5 positive experiences were more time spent with family (80%), more down-time (78%), learning new skills (68%), more time for hobbies (66%), self-care (57%), more time spent with friends (55%) and eating healthier (50%). The importance of religion, working from home, and an increase in marijuana use emerged as positive correlates for certain positive experiences, while participants with chronic illness, and a positive anxiety or depression screen, were negatively associated with most positive experiences. CONCLUSIONS: Despite the negative consequences of the COVID19 pandemic, several positives were highlighted in this study. These findings have implications for social policies toward building resilience within the community.
Asunto(s)
COVID-19 , Masculino , Humanos , Adulto , Femenino , COVID-19/epidemiología , Estudios Transversales , Vida Independiente , Pandemias , Trinidad y Tobago/epidemiologíaRESUMEN
Vaginal Candidiasis and associated epidemiological risk factors prevalent among a cross section of pregnant women attending tertiary hospital in Trinidad and Tobago was evaluated. Standardized questionnaire was used to survey 492 pregnant women over a period of 10 months in 2019. Vaginal swab was collected and processed using standard microbiological laboratory methods for phenotypic identification. Data were analyzed using SPSS to identify potential risk factors. Chi-squared (ê2) test and logistic regression tests examined associations and odds ratios with corresponding 95% confidence intervals. Prevalence of vulvovaginal candidiasis was 44.9% with Candida albicans as predominant species identified (62%, N=492). Vaginal candidiasis was statistically significant for several risk factors, including second trimester (p = 0.03), age group 26 - 34 years (p=003), history of masturbation especially during the last 48hours prior to the swabbing (p=0.05), and wearing of pants as opposed to skirt clothes (p=0.04). In conclusion, several epidemiological risk factors are associated vaginal candidiasis among cross section of pregnant women in the country. Patient education, microbiological investigations and appropriate treatment will improve antenatal healthcare delivery in the country.
Asunto(s)
Candidiasis Vulvovaginal , Complicaciones Infecciosas del Embarazo , Femenino , Embarazo , Humanos , Adulto , Candidiasis Vulvovaginal/epidemiología , Mujeres Embarazadas , Trinidad y Tobago/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , Factores de RiesgoRESUMEN
OBJECTIVE: Asthma, a major cause of disability and reduced quality of life, has a high global prevalence and burden of death. Despite the propitious guidelines, a substantial portion of asthmatics reportedly have poorly controlled disease. In the current study, we have examined risk factors for uncontrolled asthma in specialty clinics and its association with impaired quality of life. METHODS: A multicentre cross-sectional survey of asthma patients, 18 years and older, was conducted in Trinidad. Asthma Control Test (ACT) and the Juniper Mini Asthma Quality of Life Questionnaire (Mini AQLQ-J) were used to assess the disease control and quality of life, respectively. Data were analyzed using the Chi-square test and multivariable logistic regression controlling for gender. RESULTS: Of a total of 428 patients included, asthma was uncontrolled in 72.4% and asthma related quality of life was moderate to severely impaired in 86% of the studied population. In the multivariate regression models, poorly controlled asthma was associated with obesity (OR 2.25; 95% CI 1.30-3.39), late-onset asthma (OR 1.72; 95% CI 1.04-2.84), features of sleep apnea (OR 1.77; 95% CI 1.01-3.07) and depression (OR 2.01; 95% CI 1.04-3.86). Impaired quality of life was associated with Indo-Caribbean ethnicity (OR 3.19; 95% CI = 1.68-6.06). CONCLUSIONS: In this Caribbean population, uncontrolled asthma was independently associated with obesity, late-onset disease, and comorbidities of sleep apnea and depression. Poor asthma-related quality of life was independently associated with Indo-Caribbean ethnicity.
Asunto(s)
Asma/epidemiología , Depresión/epidemiología , Obesidad/epidemiología , Síndromes de la Apnea del Sueño/epidemiología , Adolescente , Adulto , Edad de Inicio , Anciano , Asma/etnología , Comorbilidad , Estudios Transversales , Depresión/etnología , Etnicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/etnología , Calidad de Vida , Factores de Riesgo , Síndromes de la Apnea del Sueño/etnología , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiología , Trinidad y Tobago/etnología , Adulto JovenRESUMEN
Cancer is one of the leading causes of deaths worldwide (1); in 2012, an estimated 65% of all cancer deaths occurred in the less developed regions of the world (2). In the Caribbean region, cancer is the second leading cause of mortality, with an estimated 87,430 cancer-related deaths reported in 2012 (3). The Pan American Health Organization defines the Caribbean region as a group of 27 countries that vary in size, geography, resources, and surveillance systems.* CDC calculated site- and sex-specific proportions of cancer deaths and age-standardized mortality rates (ASMR) for 21 English- and Dutch-speaking Caribbean countries, the United States, and two U.S. territories (Puerto Rico and the U.S. Virgin Islands [USVI]), using the most recent 5 years of mortality data available from each jurisdiction during 2003-2013. The selection of years varied by availability of the data from the countries and territories in 2015. ASMR for all cancers combined ranged from 46.1 to 139.3 per 100,000. Among males, prostate cancers were the leading cause of cancer deaths, followed by lung cancers; the percentage of cancer deaths attributable to prostate cancer ranged from 18.4% in Suriname to 47.4% in Dominica, and the percentage of cancer deaths attributable to lung cancer ranged from 5.6% in Barbados to 24.4% in Bermuda. Among females, breast cancer was the most common cause of cancer deaths, ranging from 14.0% of cancer deaths in Belize to 29.7% in the Cayman Islands, followed by cervical cancer. Several of the leading causes of cancer deaths in the Caribbean can be reduced through primary and secondary preventions, including prevention of exposure to risk factors, screening, early detection, and timely and effective treatment.
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Neoplasias/mortalidad , Región del Caribe/epidemiología , Causas de Muerte/tendencias , Femenino , Humanos , Masculino , Distribución por SexoRESUMEN
INTRODUCTION: Lung age, a simple concept for patients to grasp, is frequently used as an aid in smoking cessation programs. Lung age equations should be continuously updated and should be made relevant for target populations. We observed how new lung age equations developed for Australian populations performed when utilizing the Burden of Obstructive Lung Disease (BOLD)-Australia dataset compared to more commonly used equations. METHODS: Data from a cross-sectional population study of noninstitutionalized Australians aged ≥40 years with analysis restricted to Caucasians <75 years. Lung age calculated using equations developed by Newbury et al. and Morris and Temple was compared with chronological age by smoking status and within smoking status. RESULTS: There were 2,793 participants with a mean age of 57 (±10 SD) years. More than half (52%) ever smoked, and 10.4% were current smokers. Prevalence of chronic obstructive pulmonary disease stage I or higher was 13.4% (95% confidence interval = 12.2, 14.7). For both genders, newer Newbury equations estimated lung ages significantly higher than actual age across all smoking groups (p < .05). Morris and Temple equations resulted in lung age estimates significantly lower than chronological age for nonsmokers (p < .05) but no difference among current smokers. Both equations showed exposure to smoking had lung ages higher than never-smokers (p < .001). Lung age also increased with increased pack-years. CONCLUSIONS: This supports the use of updated equations suited to the population of interest. The Australian Newbury equations performed well in the BOLD-Australia dataset, providing more meaningful lung age profile compared to chronological age among smokers. Using equations not developed or ideally suited for our population is likely to produce misleading results.
Asunto(s)
Envejecimiento/patología , Pulmón/patología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Fumar/epidemiología , Fumar/patología , Adulto , Anciano , Australia/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fumar/efectos adversos , Cese del Hábito de Fumar/métodos , Estadística como Asunto/métodos , Encuestas y CuestionariosRESUMEN
Purpose: Tobacco smoking is the major risk factor for COPD, and it is common for other risk factors in never-smokers to be overlooked. We examined the prevalence of COPD among never-smokers in Australia and identified associated risk factors. Methods: We used data from the Australia Burden of Obstructive Lung Disease (BOLD) study, a cross-section of people aged ≥40 years from six sites. Participants completed interviews and post-bronchodilator spirometry. COPD was primarily defined as an FEV1/FVC ratio <0.70 and secondarily as the ratio less than the lower limit of normal (LLN). Results: The prevalence of COPD in the 1656 never-smokers who completed the study was 10.5% (95% CI: 9.1-12.1%) [ratioAsunto(s)
Asma
, Enfermedad Pulmonar Obstructiva Crónica
, Femenino
, Masculino
, Humanos
, Adulto
, Persona de Mediana Edad
, Niño
, Fumadores
, Enfermedad Pulmonar Obstructiva Crónica/diagnóstico
, Enfermedad Pulmonar Obstructiva Crónica/epidemiología
, Oportunidad Relativa
, Australia/epidemiología
RESUMEN
Persons with chronic non-communicable diseases (NCDs) were identified as particularly at risk of severe morbidity and mortality during the COVID-19 pandemic. Little is written about the impact of COVID-19 on this sub-population in the Caribbean, where the prevalence of NCDs is disproportionately high. This study aimed to ascertain COVID-related concerns, and the mental health impact of the pandemic among persons with and without NCDs in Trinidad and Tobago, during the acute period of COVID-19 lockdowns early in the pandemic. An anonymous online survey collected cross-sectional data from a convenience sample nationwide. Of 1287 respondents, 219 self-identified as having an NCD. Findings suggest that the pandemic was experienced unequally by persons with NCDs, who were more likely to be concerned about health and wellbeing and to report health inequalities-unemployment, social isolation and negative effects of government restrictions. Compared to those without NCDs, they were more likely to increase use of marijuana during the lockdown period, and to report severe anxiety/depression that can result in exacerbation of NCDs. Interventions for persons with NCDs must address the mental health consequences of any pandemic, including increased drug use, and also address social inequalities to reduce sustained post-pandemic mental health impact and negative health outcomes.
Asunto(s)
COVID-19 , Enfermedades no Transmisibles , Humanos , Trinidad y Tobago/epidemiología , Enfermedades no Transmisibles/epidemiología , Estudios Transversales , Salud Mental , Pandemias , COVID-19/epidemiología , Control de Enfermedades TransmisiblesRESUMEN
Smoking cessation remains a health promotion target. Applying the Transtheoretical Model to Australian Burden of Obstructive Lung Diseases (BOLD) data, we examined differences in stages of change (SoC) and readiness to quit decisional behaviours. Factors were identified likely to influence readiness of smokers, ≥40 years old, to quit. Analysis was restricted to current smokers classified to one of three stages: pre-contemplation (PC), contemplation (C) or preparation (P) to quit. Their ability to balance positive and negative consequences was measured using decisional balance. Among 314 smokers, 43.0% females and 60.8% overweight/obese, the distribution of SoC was: 38.1% PC, 38.3% C and 23.5% P. Overweight/obesity was associated with readiness to quit in stages C and P and there were more negative than positive attitudes towards smoking in those stages. Males were significantly heavier smokers in PC and C stages. Females used smoking cessation medication more frequently in PC stage, were more embarrassed about smoking and had greater negative reinforcements from smoking. Age started smoking and factors related to smoking history were associated with readiness to quit and increased the odds of being in stage C or P. An overweight/obese smoker was likely to be contemplating or preparing to quit. In these stages, smokers have more negative attitudes toward smoking. Starting smoking later, taking advice on cessation from health providers and using quit medications indicate increased readiness to quit. Evaluating these factors in smokers and developing cessation gain-framed messages may prove useful to healthcare providers.