COVID-19 Vaccine Intent Among Health Care Professionals of Queen Elizabeth Hospital, Barbados.

INTRODUCTION: Due to increased exposure risk and the potential impact of COVID-19 infection, health care professionals (HCP) are a target group for COVID-19 vaccination. This study aimed to examine the acceptability of COVID-19 vaccines among HCP at the Queen Elizabeth Hospital, Barbados. DESIGN AND METHODS: A cross-sectional survey of HCP was conducted between February 14 and 27, 2021 using an online questionnaire. The questionnaire included demographic information, knowledge of novel coronavirus, intention to accept the COVID-19 vaccination, vaccine literacy (VL), and perceptions and attitudes regarding COVID-19 vaccines. Mean VL scores were calculated. The relationship between socio-demographic variables and vaccine intent was assessed using a multivariable logistic regression model. RESULTS: Of 343 HCPs, 55.1% indicated they would accept the COVID-19 vaccine if it were available; 44.9% expressed hesitancy towards the COVID-19 vaccine. We assessed the impact of socio-demographic factors and previous vaccine behavior on vaccine intent; after adjustment of the multivariable logistic regression model, non-Barbadian nationality and previous flu vaccine uptake were statistically significant predictors of reported intent to take the COVID-19 vaccine. Persons who indicated that they would take the vaccine had a higher mean vaccine literacy score [3.46 95% CI (3.40, 3.52)] than those who were not ready to take the vaccine immediately [3.23 95% CI (3.15, 3.30)]. VL scores were higher among the 29.5% of HCPs who believed vaccines should be mandatory. CONCLUSION: This study highlighted vaccine hesitancy among HCPs in the sole public tertiary hospital of Barbados. As HCP perceptions may help or hinder the campaign to promote vaccine uptake in Barbados, vaccine promotion programs targeting HCPs are needed to ensure the success of the country's COVID-19 vaccination drive.

Reduction in perinatal transmission and mortality from human immunodeficiency virus after intervention with zidovudine in Barbados.

OBJECTIVES: To evaluate the impact of zidovudine (ZDV) intervention on vertical transmission and HIV-related mortality in two groups of pregnant mothers and their respective infants. METHODS: A modified long course Paediatric AIDS Clinical Trial Group 076 protocol was used. None of the infants was breast-fed. Maternal CD4 T lymphocyte counts and viral loads were not monitored. Infants were followed for clinical progress, and serial serologic testing was performed to the age of 24 months, or until two successive HIV (enzyme-linked immunosorbent assay) tests were negative. In a historically case-controlled prospective study, the transmission rate in ZDV-untreated mother-infant pairs in which infants were born during 1991 through 1995 was compared with the transmission rate in ZDV-treated mother-infant pairs in which infants were born between 1996 and 2000. RESULTS: In the 151 HIV-seropositive pregnant women and their 153 infants studied (2 pairs of twins), 93 mother-infant pairs were treated, and 59 were untreated (control group). Vertical transmission occurred in 5.5% [95% confidence interval (95% CI) 1.9 to 12.5] of the treated group of infants and in 27.1% (95% CI 16.7 to 40.5) of the untreated group. There was a 79.7% (95% CI 59.8 to 92.1%) relative reduction risk of transmission, which was statistically significant (z =3.18, two tailed P= 0.0001). Three infant deaths (3.7%) were recorded in the untreated group, and 1(1%) death was recorded in the treated group. In ZDV-untreated infants, deaths occurred at age <1 year, resulting from respiratory complications. One ZDV-treated infant died at 4 years of age with Pneumocystis carinii pneumonia. CONCLUSIONS: Our study demonstrated a statistically significant reduction in the vertical transmission of HIV after intervention with ZDV therapy.

Outcome of live-born infants in Barbados requiring neonatal care, before and after the introduction of a neonatal intensive care unit - abstract

A review of the outcome of neonatal care over a 72-month period (November, 1987 - October, 1993) was retrospectively analysed. The study looked at the changing trends of survival, as influenced by the development of a neonatal intensive care unit (NICU) at the Queen Elizabeth Hospital in November, 1990. During the study period, 4,838 neonatal admissions were analysed; 57 percent were pre-NICU and 42.5 percent post-NICU. Significantly more babies were ventilated in the post-NICU era (p < 0.00001) and survival proportionately increased (p = 0.0027). Although there was no statistical difference in the overall survival in the two eras (p = 0.435), the data indicated that the very low birth weight babies and those ultimately ventilated survived longer in the NICU era (p = 0.0018). With increased survival of premature babies, and the impact of more sophisticated neonatal care, it is likely that one will see more significant trends in the unit-specific mortality. In addition, the surviving children must be carefully looked at to determine their neurodevelopmental outcome in a society with limited health resources (AU)