ABSTRACT
Around half of the population of Suriname, who are mainly of African and South Asian descent, migrated to the Netherlands at the end of the previous century, where they face higher perinatal and maternal mortality and up to 5 years lower life expectancy than European-Dutch. Analyses by ancestry are needed to address these inequalities, but the law prohibits registration by ancestry. Therefore, a list of Surinamese surnames was compiled and validated to identify the largest groups, African-Surinamese or South Asian-Surinamese ancestry in health research. A complete database of Surinamese surnames was provided by the National Population Registry of Suriname. Surname recognition by researchers of Surinamese ancestry was used. Disagreement was resolved using historical registers and through discussion. The list was further validated against contemporary lists of Surinamese surnames with self-defined ancestry, obtained during population and clinical studies in Suriname and the Netherlands. All 71,529 Surinamese surnames were encoded, as African-Surinamese (34%), South Asian-Surinamese (18%), Brazilian or other Iberian (17%), Indonesian-Surinamese (13%), Chinese-Surinamese (5%), First Nation (2%), and other (10%). Compared to self-defined ancestry, South Asian-Surinamese surname coding had 100% sensitivity, 99.8% specificity, and 99.9% accuracy. For African-Surinamese, who may have Dutch surnames, these values depended on geocoding. With a known Surinamese origin, sensitivity, specificity, and accuracy were, respectively, 97.3%, 100%, and 98.6%, but without this information, there was interference of African-Surinamese with European-Dutch surnames in the Dutch validation sample. In conclusion, the Surinamese Surname List has a high accuracy in identifying persons of Surinamese ancestry. This quick, inexpensive, and nonintrusive method, which is unaffected by response bias, might be a valuable tool in public health research to help address the profound health disparities by ancestry.
ABSTRACT
INTRODUCTION: High blood pressure (BP) is known to be the greatest modifiable risk factor of cardiovascular diseases, of which 80% occur in low-resource and middle-resource settings. Yet, BP measurement in these countries remains extremely poor. In 2005, a WHO committee invited manufacturers to produce devices especially for use in low-resource settings. Our study assesses the accuracy, performance, and acceptability of two submitted oscillometric devices under field circumstances in Suriname (South America), namely, the Microlife BP 3AS1-2 and Omron HEM-SOLAR. METHODS: We compared BP measurements of test devices using a conventional Mercury sphygmomanometer, performed by local healthcare workers under field circumstances. Three hundred and forty-two individuals were included. Statistics included t-tests, analysis of variance, and Bland-Altman plots. RESULTS: The mean systolic/diastolic BP differences (SD) were -3.5 (8.0)/-7.0 (6.0) for Omron versus Mercury and -6.4 (7.8)/-6.5 (6.0) mmHg for Microlife versus Mercury. Microlife was more accepted by healthcare workers, and both devices performed adequately under field conditions. DISCUSSION AND CONCLUSION: The acceptability, durability, and performance of both test devices were adequate. However, Microlife BP 3AS1-2 underestimated systolic pressure almost twice as much compared with Omron HEM-SOLAR, with identical diastolic underestimations. Guaranteed global availability, users could make a choice between the Omron HEM-SOLAR being more accurate in BP measurement, and Microlife BP 3AS1-2 being more accepted by healthcare workers.
