Trends and factors associated with HIV testing among women aged 15-49 years in Belize: an analysis using the Multiple Indicator Cluster Survey 2006, 2011, and 2015-2016.

BACKGROUND: Belize has one of the highest human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome prevalence rates in Central America, with women of reproductive age being particularly vulnerable to HIV. Therefore, this study examined the factors associated with HIV testing among women of reproductive age in Belize and trends in HIV testing in 2006, 2011, and 2015-2016. METHODS: Cross-sectional data were analyzed using three Belize Multiple Indicator Cluster Surveys. The number of participants were 1,675, 4,096, and 4,699 women aged 15-49 years in 2006, 2011, and 2015-2016, respectively. We used variance-weighted least-squares regression to estimate annual changes. Multivariate logistic regression analysis was performed to evaluate the associated factors. Analyses were conducted using Stata version 15, and weights were applied for generalization to the population. RESULTS: HIV testing rates increased from 47.7% in 2006 to 66.5% in 2015, with an average annual change of 0.082 (95% confidence interval: 0.07-0.09). Logistic regression models showed that women aged 15-24 years were less likely to have been tested for HIV compared to women aged 25-34 years. Women from the Mayan ethnic group were less likely to have been tested than those from other ethnic groups. Compared to women who spoke Spanish, those who spoke English/Creole were more likely to have been tested for HIV; additionally, those who spoke minority languages were less likely to have been tested. Being married and having given birth were associated with increased odds of HIV testing. Living in rural areas and households with the poorest wealth indices were associated with decreased odds of being tested for HIV. Women with good HIV knowledge and accepting attitudes towards people living with HIV were more likely to be tested. CONCLUSIONS: From 2006 to 2015, HIV testing in women of reproductive age showed an increasing trend in Belize. We recommend interventions to expand HIV testing for women of reproductive age in Belize, particularly those aged 15-24 years, speaking minority languages, living in rural areas, and having a low socioeconomic status.

Cancer Demographics and Time-to-Care in Belize.

BACKGROUND: Belize is a middle-income Caribbean country with poorly described cancer epidemiology and no comprehensive cancer care capacity. In 2018, GO, Inc., a US-based NGO, partnered with the Ministry of Health and the national hospital in Belize City to create the first public oncology clinic in the country. Here, we report demographics from the clinic and describe time intervals to care milestones to allow for public health targeting of gaps. PATIENTS AND METHODS: Using paper charts and a mobile health platform, we performed a retrospective chart review at the Karl Heusner Memorial Hospital (KHMH) clinic from 2018 to 2022. RESULTS: During this time period, 465 patients with cancer presented to the clinic. Breast cancer (28%) and cervical cancer (12%) were most common. Most patients (68%) presented with stage 3 or 4 disease and were uninsured (78%) and unemployed (79%). Only 21% of patients ever started curative intent treatment. Median time from patient-reported symptoms to a biopsy or treatment was 130 and 189 days. For the most common cancer, breast, similar times were seen at 140 and 178 days. Time intervals at the clinic: <30 days from initial visit to biopsy (if not previously performed) and <30 days to starting chemotherapy. CONCLUSION: This study reports the first clinic-based cancer statistics for Belize. Many patients have months between symptom onset and treatment. In this setting, the clinic has built infrastructure allowing for minimal delays in care despite an underserved population. This further affirms the need for infrastructure investment and early detection programs to improve outcomes in Belize.

Belize Covid-19 report for November 1-7, 2022, having 15 new cases, confirming 68,972 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for November 1-7, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for November 8-14, 2022, having 16 new cases, confirming 68,988 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report update on Covid-19 consisting of PCR and rapid tests done in Belize for November 8-14, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for November 15-22, 2022, having 24 new cases, confirming 69,012 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for November 15-22, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 25-31, 2022, having 14 new cases, confirming 68,957 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 25-31, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 1-4, 2022, having 30 new cases, confirming 68,884 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 1-4, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 5-11, 2022, having 25 new cases, confirming 68,909 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 5-11, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 12-17, 2022, having 24 active cases [17 new], confirming 68,926 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 12-17, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 18-24, 2022, having 17 new cases, confirming 68,943 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 report for October 18-24, 2022

Two (2) new infographic daily report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 18-24, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for September 24-27, 2022, having 42 new cases, confirming 68,826 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for September 24-27, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for September 28-30, 2022, having 28 new cases, confirming 68,854 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for September 28-30, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Performance of passive case detection for malaria surveillance: results from nine countries in Mesoamerica and the Dominican Republic.

BACKGROUND: In malaria elimination settings, available metrics for malaria surveillance have been insufficient to measure the performance of passive case detection adequately. An indicator for malaria suspected cases with malaria test (MSCT) is proposed to measure the rate of testing on persons presenting to health facilities who satisfy the definition of a suspected malaria case. This metric does not rely on prior knowledge of fever prevalence, seasonality, or external denominators, and can be used to compare detection rates in suspected cases within and between countries, including across settings with different levels of transmission. METHODS: To compute the MSCT, an operational definition for suspected malaria cases was established, including clinical and epidemiological criteria. In general, suspected cases included: (1) persons with fever detected in areas with active malaria transmission; (2) persons with fever identified in areas with no active transmission and travel history to, or residence in areas with active transmission (either national or international); and (3) persons presenting with fever, chills and sweating from any area. Data was collected from 9 countries: Belize, Colombia (in areas with active transmission), Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, and Panama (September-March 2020). A sample of eligible medical records for 2018 was selected from a sample of health facilities in each country. An algorithm was constructed to assess if a malaria test was ordered or performed for cases that met the suspected case definition. RESULTS: A sample of 5873 suspected malaria cases was obtained from 239 health facilities. Except for Nicaragua and Colombia, malaria tests were requested in less than 10% of all cases. More cases were tested in areas with active transmission than areas without cases. Travel history was not systematically recorded in any country. CONCLUSIONS: A statistically comparable, replicable, and standardized metric was proposed to measure suspected malaria cases with a test (microscopy or rapid diagnostic test) that enables assessing the performance of passive case detection. Cross-country findings have important implications for malaria and infectious disease surveillance, which should be promptly addressed as countries progress towards malaria elimination. Local and easy-to-implement tools could be implemented to assess and improve passive case detection.

Belize Covid-19 daily report for April 7, 2021 confirming 12,485 cumulative positive cases since the first case in March 2020 with three (3) descriptive infographics

Three (3) infographic daily report updates on Covid-19 and SARSCoV 2 lab screenings done in Belize for April 7, 2021 depicting the heat map by districts, total persons tested, negative persons, new positive cases, cumulative reports, those under investigation and overall percentages

Ministry of Health and Wellness Announces Approved COVID-19 Testing Sites January 20, 2021

On January 14, 2021, the Ministry of Health and Wellness announced plans to expand testing to include persons requiring negative COVID-19 tests for entry to other countries. To this end, the Ministry has published a list of approved COVID-19 testing sites.

The Botfly, A Tropical Menace: A Distinctive Myiasis Caused by Dermatobia hominis.

Dermatobia hominis, also known as the human botfly, is native to tropical and subtropical Central and South America and seen in travelers from endemic to temperate regions including the United States and Europe. Cutaneous infestation botfly myiasis involves the development of D. hominis larvae in the skin and is common in tropical locations. The distinct appearance of a cutaneous D. hominis infestation facilitates early diagnosis and intervention where cases are common. However, the identification of D. hominis in temperate regions may prove challenging due to its rarity. D. hominis may be misdiagnosed as folliculitis, an epidermal cyst, or an embedded foreign object with secondary impetigo. One should have a heightened suspicion in someone returning from a vacation in an endemic area, such as Belize. Here we describe the presentation, differential diagnosis, and treatment and encourage enhanced preventative measures among tourists when visiting tropical and subtropical regions. Additionally, we propose a novel classification system for assessing the various stages of infestation and suggest that patients reporting travel to Latin America and experiencing pain disproportionate to an insect bite should lead physicians to consider myiasis caused by D. hominis.

Is it time to use nucleic acid amplification tests for identification of persons with sexually transmitted infections?: evidence from seroprevalence and behavioral epidemiology risk surveys in men with chlamydia and gonorrhea.

Chlamydia and gonorrhea are common sexually transmitted infections (STIs) that can cause multiple problems, and can be easily treated, but frequently present without symptoms. Because of this, commonly used syndromic diagnosis misses a majority of infected persons. Previously, diagnostic tests were expensive and invasive, but newer nucleic-acid amplification tests (NAATs) are available that use urine to non-invasively test for these infections. These analyses used data from seroprevalence studies conducted in five militaries. Data included self-reported current symptoms of STIs as well as chlamydia and gonorrhea NAAT results. A total of 4923 men were screened for chlamydia and gonorrhea from these 5 militaries during April 2016 to October 2017. The combined prevalence of chlamydia and gonorrhea in these five militaries ranged from 2.3% in Burundi to 11.9% in Belize. These infections were not successfully identified by symptomology; for example, only 2% of cases in Belize reported symptoms. In three of the five countries there was no statistical association between symptoms and positive NAAT results. The majority of individuals with these infections (81% to 98%) would be undiagnosed and untreated using only symptomology. Therefore, using symptoms alone to diagnose cases of chlamydia and gonorrhea is not an effective way to control these infections. We propose that automated, cartridge-based NAATs, be considered for routine use in diagnosing those at risk for STIs.

Barriers and facilitators to past six-month HIV testing among men who have sex with men in Belize.

Prevalence of HIV in Belize is high, and men who have sex with men (MSM) are disproportionately impacted by HIV. HIV testing is critical in curbing the epidemic; however, little is known about factors associated with testing among MSM in Belize. Working with a non-governmental organization in a large, urban city within Belize, snowball sampling was applied to recruit Belizean MSM to complete a self-administered survey. Multivariable logistic regression analysis was employed to understand associations with HIV screening behavior. Access to healthcare, HIV knowledge, and reporting having heard of Section 53 of the Criminal Code of Belize (once outlawing same-sex sexual behavior), but not experiencing any negative impact from Section 53 were significantly positively associated with having received an HIV test in the past six months. Healthcare maltreatment (lifetime), depression symptomology, and shame were significantly negatively associated with having received a HIV test in the past six months. Findings suggest that multiple factors associated with stigma and discrimination negatively affect testing strategies among MSM in Belize.

Suspension of All Lotteries including Games of Chance and Government Lotteries

The Ministry of Economic Development, Petroleum, Investment, Trade, and Commerce, as the Ministry responsible for Lotteries, informs the public that due to the state of emergency in place in response to COVID-19, all lotteries, including games of chance and Government Lotteries (Boledo, Jackpot and Ordinary), are suspended until further notice.

Belize SARSCOV2 Lab Screenings 23rd April 2020

This document is an infographic of COVID-19, detailing Belize SARSCOV2 Lab Screening relating to Tests Done, Negative Tests, Positive Tests, Recovered, Deaths, and the cases Under Investigation for the period 23rd April 2020 (AU)