Eight years of antibiotic consumption at a primary care outpatient facility in Trinidad and Tobago 2011-18: a synopsis of consumption trends.

OBJECTIVES: To explore antibiotic consumption and surveillance patterns in Trinidad and Tobago. METHODS: A retrospective observational study was conducted. Stock requisition and logbooks from a District Health Facility in Trinidad were examined for the period 2011-18. Daily Defined Doses (DDDs) for each antibiotic were computed and extrapolated to represent the antibiotic consumption per 1000 residents within the population. RESULTS: The mean consumption across the years was 2.917 DDD per 1000 residents per day. The most consumed antibiotics were cefuroxime, amoxicillin/clavulanic acid, and azithromycin, with mean DDDs of 0.879, 0.695 and 0.373 respectively. The least consumed antibiotics were cefaclor and clarithromycin, with DDDs of 0.0006 and 0.0005, respectively. CONCLUSIONS: Trinidad and Tobago is not mentioned in the WHO surveillance report on antibiotic consumption. Our most recent (2018) estimate of total antibiotic consumption was 3.224 DDD per 1000 habitants per day. This figure is an underestimate, as data was derived solely from the public sector. Notwithstanding, this data is novel and can provide a baseline for future comparison and development of national surveillance programmes.

Challenges to the control of breast cancer in a small developing country.

OBJECTIVE: The aim of this study is to determine the clinicopathological features of breast cancer in two dedicated cancer treatment centers in north Trinidad. The histological types and stage at presentation were also investigated. DESIGN AND METHODS: A retrospective cohort design was used; data were collected from a review of medical records of patients meeting the entry criteria. Clinical and demographic data were extracted. RESULTS: A total of 640 patients were selected for the study and were available for the analysis. The annual cumulative incidence rate of breast cancer for the calendar years 2010 and 2011 in north Trinidad was 32.4 per 100,000 and 24.6 per 100,000 of the population. The age group between 51-60 years had the highest proportion of cases of breast cancer. There was a significant ethnic disparity in the occurrence of breast cancer, as it was more common in people of African origin than among South East Asians. Surgery and chemotherapy were the major interventions employed. CONCLUSION: Breast cancer prevalence continues to be high in Trinidad; we provide evidence of the extent of and the degree of sophistication required to care for patients with breast cancer in a health care system in a small developing country.