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1.
Port-of-Spain; PAHO; 2021-10-04. (PAHO/TTO/21-0002).
No convencional en Inglés | PAHO-IRIS | ID: phr2-54949

RESUMEN

Founded in 1902 as the independent specialized health agency of the inter-American system, the Pan American Health Organization (PAHO) has developed recognized competence and expertise, providing technical cooperation to its Member States to fight communicable and noncommunicable diseases and their causes, to strengthen health systems, and to respond to emergencies and disasters throughout the Region of the Americas. In addition, acting in its capacity as the World Health Organization’s Regional Office, PAHO participates actively in the United Nations Country Team, collaborating with other agencies, the funds and programs of the United Nations system to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. This 2020 annual report reflects PAHO’s technical cooperation in the country for the period, implementing the Country Cooperation Strategy, responding to the needs and priorities of the country, and operating within the framework of the Organization’s regional and global mandates and the SDGs. Under the overarching theme of Universal Health and the Pandemic – Resilient Health Systems, it highlights PAHO’s response to the COVID-19 pandemic as well as its continuing efforts in priority areas such as communicable diseases, noncommunicable diseases, mental health, health throughout the life course, and health emergencies. It also provides a financial summary for the year under review.


Asunto(s)
Cooperación Técnica , Prioridades en Salud , Programas Nacionales de Salud , Sistemas de Salud , Acceso Universal a los Servicios de Salud , Cobertura Universal de Salud , Enfermedades Transmisibles , Enfermedades no Transmisibles , Factores de Riesgo , Salud Mental , Administración Financiera , Región del Caribe , Trinidad y Tobago
2.
Braz J Biol ; 83: e248493, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34495164

RESUMEN

Parasites of veterinary importance have been heavily focused on domesticated livestock that was introduced into the neo-tropics. The text used in the teaching parasitology to veterinary students in Trinidad has only investigated the parasites of domesticated species. In the reviewed veterinary parasitology text no mention was made on the parasites that affect wild neo-tropical animals. Information on wild neo-tropical animals had to be sourced from texts on the management of wild life animals in the Neotropics. The texts that were reviewed in this document spanned from the mid-1950s to 2020. The information presented in this review reveals the exhaustive work done on the parasites of domesticated species but also revealed little information on neo-tropical animals with the potential for domestication. In conclusion, this review reveals the gap of information that is missing from parasitology texts used in the teaching of veterinary students. In the future these parasitology texts can be revised to include chapters on the parasites of neo-tropical animals with the potential for domestication. At present students that graduate from the veterinary parasitology course has little information on the parasites of animals which are present in their 'backyards'.


Asunto(s)
Animales Salvajes , Educación en Veterinaria , Animales , Humanos , Facultades de Medicina Veterinaria , Estudiantes , Trinidad y Tobago , Universidades
4.
Artículo en Inglés | MEDLINE | ID: mdl-34360314

RESUMEN

Globally, the prevalence of diabetes has risen significantly by 62% over the last ten years. A complication of unmanaged diabetes is diabetic foot ulcer (DFU), which adversely affects the quality of life of individuals with diabetes and inflicts a huge economic burden on the family, government, and health care services. However, this complication is preventable with adequate patient knowledge and practice regarding DFU and foot care. The present study was aimed at assessing the knowledge, attitude, and practice of adults with diabetes on foot ulcers and foot care in Tobago using a qualitative exploratory design. Purposeful sampling technique was used to recruit 20 participants from the lifestyle and diabetes foot clinics of Scarborough Health Centre, Tobago. Telephone interviews were conducted with the use of a semi-structured interview guide. The data obtained from participants were analyzed using thematic content analysis. Four major themes, namely foot ulcer problems, participants' knowledge on DFU, knowledge on foot care, and practice and attitude of foot care, emerged from the study. The findings from the study revealed that the majority of participants had poor knowledge regarding DFU but exhibited awareness about foot care, especially on foot cleaning and inspection, preventing irritation after washing, appropriate footwear, and not walking barefooted. The participants had good attitudes and practices of foot care despite their poor knowledge of DFU. However, participants reported inadequate health education on DFU and foot care from healthcare personnel. There should be improved health education, information, and communication on DFU and foot care centred and tailored to the understanding of people living with diabetes. This will prevent DFU and reduce the mortality arising from this complication, which is a major target of the sustainable development goals (SDG) in mitigating the burden of non-communicable diseases (NCD) such as diabetes.


Asunto(s)
Diabetes Mellitus , Pie Diabético , Adulto , Pie Diabético/epidemiología , Pie Diabético/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Calidad de Vida , Trinidad y Tobago , Caminata
5.
Braz J Biol ; 83: e246780, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34378684

RESUMEN

Anthelmintic drugs have been used strategically in livestock reared in the tropics. These drugs have been used in the treatment of endoparasitism which have resulted in an increase in the animals' performance. The agouti (Dasyprocta leporina) is a neo-tropical rodent with the potential for domestication and has been farmed intensively in Trinidad. However, the objective of this research was to investigate the effect of anthelmintic use of the growth performance of the agouti. In searching the literature, it was found that this type of study on the agouti has not been done. In this experiment fourteen weaned agoutis weighing 1kg were divided into two groups randomly. The first group (T1) was not given any anthelmintic treatment but the second group (T2) was treated with Endovet Ces® subcutaneously every three months. There were no significant differences (p > 0.05) between the two groups in the carcass weight, weight gain, dressing percentage (hot and cold), heart, lungs, skin, head and feet. However, a significant difference (p < 0.05) was seen between groups in the weight of liver and pluck. To the authors knowledge this is the first time that carcass parameters has been presented in literature. The live weight of the animals at the end of the experiment ranged from 2.4 kg to 2.6 kg and animals had a dressing percentage of 57% to 55%. The results are suggestive that the use of anthelmintic drugs in agoutis reared intensively had no significant effect on weight gain and dressing percentage.


Asunto(s)
Antihelmínticos , Cuniculidae , Dasyproctidae , Animales , Roedores , Trinidad y Tobago
6.
Braz J Biol ; 83: e246781, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34378685

RESUMEN

The agouti (Dasyprocta leporina) is a rodent that is found in the Neo-tropical region. This animal is hunted for its meat but has recently been reared in captivity as a source of meat protein in rural communities. A 20-month experiment was carried out to evaluate the effect of an anthelmintic on the reproductive performance of the agouti (Dasyprocta leporina) reared in captivity. This experiment was conducted in the humid tropics of Trinidad and Tobago. Sixteen animals (15 females, 1 male) placed in each of the two treatment groups in a completely randomized study design. In treatment 1 (T1) animals were given subcutaneous injections of Endovet Ces® (Ivermectin/Praziquantel) at 0.2 mg/kg every three months. Treatment 2 (T2) was the negative control group where animals were not exposed to an anthelmintic. Reproductive data were collected at parturition which included birth weight, litter weight, litter size and gender of offspring. The results showed that there was no statistical difference (p > 0.05) between the treatment groups with respect to birth weight, litter weight, litter size and gender. However, agoutis that were dewormed had a higher birth weight (220.24 g vs 209.1 g) and litter weight (369.8 g vs 343 g). The same values were obtained for the litter size (1.7 vs 1.7) and animals that were dewormed had a higher female offspring to male offspring (2.41:1 vs 1.11:1). This experiment demonstrated that the use of an anthelmintic strategically in the management of captive reared agoutis had no statistical effect (p > 0.05) on the reproductive parameters. Therefore, these animals can be kept in captive conditions without being dewormed and produce efficiently with proper feeding and housing management.


Asunto(s)
Antihelmínticos , Dasyproctidae , Animales , Femenino , Masculino , Reproducción , Roedores , Trinidad y Tobago
7.
JCO Glob Oncol ; 7: 1206-1208, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34314227

RESUMEN

PURPOSE: Understanding the distribution of human papilloma virus (HPV) subtypes in limited-resource settings is imperative for cancer prevention strategies in these regions. The objective of our study is to compare the prevalence of cervical HPV genotypes in women across the African diaspora. METHODS: This study was approved by the African Caribbean Consortium (AC3). Six member institutions (Benin, Ethiopia, The Bahamas, Tobago, Curacao, and Jamaica) provided independently collected HPV data. Prevalence comparisons across for each nation were performed followed by an assessment of anticipated 9-valent vaccine coverage. Chi-square or Fisher's exact tests were used with significance at P < .05. RESULTS: One thousand three hundred fifty high-risk (HR) and 584 low-risk (LR) HPV subtypes were identified in the entire cohort. The most common HR HPV subtype was HPV 16 (17.9%) of infections. The distribution of HR and LR subtypes varied by country. The proportion of HR-HPV subtypes covered by the current 9-valent vaccine was lower in African countries compared with the Caribbean countries (47.9% v 67.9%; P < .01). No significant difference was seen for LR subtypes (8.1% African continent v 5.2% Caribbean; P = .20). Marked variation in the proportion of infections covered by the 9-valent vaccine persisted in individual countries. CONCLUSION: Significant variations in HPV prevalence were identified among African and Afro-Caribbean women. A large number of women in these regions are potentially uncovered by current vaccination formulation, particularly low-risk HPV infections.


Asunto(s)
Alphapapillomavirus , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Bahamas , Benin , Curazao , Etiopía , Femenino , Genotipo , Migración Humana , Humanos , Jamaica , Papillomaviridae/genética , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Trinidad y Tobago
8.
Mar Environ Res ; 170: 105411, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34298264

RESUMEN

We detail the benthic compositon of the turbid-water coral reefs of Tobago in 2016 and examine the influence of mass coral bleaching and hydro-geomorphic setting (sheltereted vs. wave-exposed) on benthic community dynamics against the 2007 baseline. In the current assessment mean hard coral cover was 14.83% ± 0.85, which ranged from 2% to 37% with few sites exceeding 20%. Mean macroalgal cover was low (6.04% ± 0.61) with most sites experiencing less than 8% macroalgal cover. Differences in benthic cover between sheltered and wave-exposed settings were mainly driven by contrasts in proportions of sponge, macroalgae and Orbicella faveolata corals. Linear mixed-effects modelling suggests stability in hard coral cover and decline in macroalgal cover across sites against the 2007 baseline. Significant spatio-temporal interactions were observed for soft coral and CTB (crustose coralline algae, turf algae and bare substrate). Overall, hard coral cover appears to have declined at some sites and macroalgal cover to have increased at other, but there is no evidence of widespread regime shift. While the hydro-geomorphic setting had a significant but weak effect (R > 0.3) on observed spatial and temporal patterns, our findings suggest that sheltered settings were less predisposed to macroalgal overgrowth compared to wave-exposed areas. In the era of climate change, targeted management should focus on strategies that mitigate macroalgal overgrowth, promote hard coral stability (or resilience) while preventing further loss.


Asunto(s)
Antozoos , Algas Marinas , Animales , Arrecifes de Coral , Trinidad y Tobago , Agua
9.
Braz J Biol ; 82: e237869, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34105674

RESUMEN

Reproductive diseases have been well documented in domestic livestock such as sheep, goat, cattle and pigs. However, there is very little information on these diseases in the agouti (Dasyprocta leporina). The agouti is used for its meat in South America and the Caribbean. More recently, intensive farming of this animal is being practiced in the Neotropics. There is dearth of information on dystocia and vaginal prolapses in the agouti. This document reports on three cases of reproductive diseases in captive reared agoutis in Trinidad and Tobago. The first case was a female agouti weighing approximately 3 kg that was in the last stage of pregnancy, which was found dead in its cage. The vulva of the mother had the protruding hind-limbs of the fetus. Necroscopic evaluation of carcass revealed little fat tissue and the mother had two fetuses in the right horn of the uterus. Each fetus weighed approximately 200 g. The fetuses were well formed with fur, teeth and eyes. The placenta was attached to each fetus. The pathological findings suggested that dystocia resulted from secondary uterine inertia which was the cause of death of the adult female agouti. The second case was that of an adult female agouti weighing 2.5 kg. This female had given birth to an offspring three weeks prior and was observed to have had a vaginal prolapse. Surgery was performed and the prolapsed vagina was placed back into the pelvic cavity. Further to this intervention, the vagina prolapsed twice. Subsequent to the re-insertion of the vaginal tissue the agouti was euthanized. The third case was also that of a dystocia. However, the fetuses weighed 235 g and 165 g respectively and were in normal presentation, posture and positioning. The fetus however was unable to pass via the vagina and was trapped in the pelvic cavity. This caused secondary uterine inertia which was the cause of death. The causes of reproductive diseases in these cases are unknown but the feeding management and space allowance given to the agouti in late gestation may be contributing factors.


Asunto(s)
Dasyproctidae , Animales , Región del Caribe , Bovinos , Femenino , Embarazo , Ovinos , América del Sur , Porcinos , Trinidad y Tobago
10.
Soc Work Public Health ; 36(5): 558-576, 2021 07 04.
Artículo en Inglés | MEDLINE | ID: mdl-34182897

RESUMEN

The Novel Coronavirus Disease (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020. Trinidad and Tobago reported its first infection on March 12th 2020. This study assessed knowledge, attitudes and practices toward COVID-19 among Trinidadians during the post-lockdown period. A validated questionnaire was used to conduct a cross-sectional survey from May 25th to June 6th 2020.Most respondents (512, 96.6%) knew that COVID-19 is highly infectious. Many (523, 98.7%) identified vulnerable groups as persons 65 years and older and those with preexisting co-morbidities (480, 90.6%). Respondents identified COVID-19 symptoms as fever (498, 94.0%), dry cough (495, 93.4%), myalgia (403, 76.0%) and sore throat (441, 83.2%). Most 504 (95.1%) acknowledged that COVID-19 threatened the country's economy. Dominant practices included regular hand washing (97.2%) and social distancing (512, 96.6%).Health authorities should continue public education efforts to increase knowledge and the adoption of recommended practices.


Asunto(s)
COVID-19 , Conocimientos, Actitudes y Práctica en Salud , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Humanos , Cuarentena , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiología
11.
Ticks Tick Borne Dis ; 12(4): 101730, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33957484

RESUMEN

Hunters are at a higher risk for exposure to zoonotic pathogens due to their close interactions with wildlife and arthropod vectors. In this study, high throughput sequencing was used to explore the viromes of two tick species, Amblyomma dissimile and Haemaphysalis juxtakochi, removed from hunted wildlife in Trinidad and Tobago. We identified sequences from 3 new viral species, from the viral families Orthomyxoviridae, Chuviridae and Tetraviridae in A. dissimile.


Asunto(s)
Ciervos , Iguanas , Ixodidae/virología , Infecciones por Orthomyxoviridae/veterinaria , Orthomyxoviridae/aislamiento & purificación , Animales , Orthomyxoviridae/clasificación , Orthomyxoviridae/genética , Infecciones por Orthomyxoviridae/virología , Filogenia , Infestaciones por Garrapatas/parasitología , Infestaciones por Garrapatas/veterinaria , Trinidad y Tobago , Proteínas Virales/análisis
12.
Trends Neurosci Educ ; 23: 100155, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34006362

RESUMEN

BACKGROUND: The current COVID-19 pandemic and proliferation of misinformation regarding science highlights the importance of improving general science literacy. The continued preponderance of neuromyths among educators is of concern, especially in lower- and middle-income countries. METHOD: Using an adapted questionnaire, a cross-sectional survey was conducted among teachers in a small island developing state in the Caribbean. RESULTS: Two-thirds of the sample were unable to recognise at least 50% of the myths. Regression analysis demonstrated that higher scores in brain knowledge and exposure to prior teacher-training increased belief in neuromyths. On the other hand, specific in-service training pertaining to educational neuroscience improved scores. CONCLUSION: Neuromyths are prevalent among teachers and appear to inform their teaching practice. Further research needs to be conducted to explore not just the prevalence of these myths but in what ways they may be impacting teaching and learning outcomes in the classroom.


Asunto(s)
Neurociencia Cognitiva , Competencia Profesional , Maestros , COVID-19 , Comunicación , Estudios Transversales , Países en Desarrollo , Femenino , Humanos , Capacitación en Servicio , Masculino , Mitología , Neurociencias , SARS-CoV-2 , Encuestas y Cuestionarios , Formación del Profesorado , Trinidad y Tobago
13.
Vasc Health Risk Manag ; 17: 187-194, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33976549

RESUMEN

Background: Ideal cardiovascular health behaviour (CVHB) measures four ideal health behaviours (non-smoking, body mass index <85th Percentile, healthy diet, and physical activity). This study aimed to determine the prevalence, distribution, and correlates of ideal CVHB among adolescents in the Caribbean. Methods: Nationally representative cross-sectional data of 2016 or 2017 with complete CVHB measurements were analysed from 7556 school adolescents from four Caribbean countries. Results: The prevalence of 0-1 ideal metrics CVHB was 20.4%, 2 ideal metrics 48.7%, and 3-4 ideal metrics 30.8%. Only 5.0% had all 4 ideal CVHB metrics, 41.0% intermediate CVH (≥1 metric in the intermediate category and none in the poor category), and 54.0% had poor CVH (≥1 metric in poor category). In adjusted logistic regression analysis, compared to students from Dominican Republic, students from Jamaica (Adjusted Odds Ratio-AOR: 1.36, 95% confidence interval-CI: 1.01-1.85), students from Trinidad and Tobago (AOR: 1.46, 95% CI: 1.17-1.82) and male sex (AOR: 1.35, 95% CI: 1.11-1.64) were positively associated with meeting 3-4 ideal CVHB metrics. In addition, in unadjusted analysis, rarely or sometimes experiencing hunger was negatively and high peer and parent support were positively associated with meeting 3-4 ideal CVHB metrics. Conclusion: The proportion of meeting 3-4 ideal CVHB metrics was low among adolescents in four Caribbean countries. Both high-risk and school-wide intervention programmes should be implemented in aiding to improve CVHB in Caribbean countries. Several factors associated with ideal CVHB were identified, which can be targeted in school health interventions.


Asunto(s)
Conducta del Adolescente , Enfermedades Cardiovasculares/prevención & control , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Estilo de Vida Saludable , Conducta de Reducción del Riesgo , Adolescente , Factores de Edad , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Dieta Saludable , República Dominicana/epidemiología , Ejercicio Físico , Femenino , Encuestas Epidemiológicas , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Jamaica/epidemiología , Masculino , No Fumadores , Medición de Riesgo , Suriname/epidemiología , Trinidad y Tobago/epidemiología
14.
Int J STD AIDS ; 32(9): 830-836, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33890834

RESUMEN

A chart review study was conducted to determine the prevalence of syphilis and explore the associated risk factors among men who have sex with men (MSM) who attended a large HIV clinic in Trinidad during the period January-December 2019. Patients were routinely screened for syphilis annually, and demographic, clinical, and laboratory data were extracted from the medical records. Descriptive and bivariate analyses were performed, and factors significantly associated with a syphilis diagnosis were assessed using multivariate logistic regression. During the period, 218 MSM were seen, age range 19-67 years, and median age 34.0 years. The prevalence of syphilis was 41.3% (90/218), and 71.1% (64//90) of these infections were asymptomatic. Multivariate analysis using logistic regression showed that MSM living with HIV in the 30-34 years old-age group (OR, 4.32; 95% CI, 1.04-18.02), and those with a previous history of treated syphilis (OR, 10.18; 95% CI, 4.60-22.53) were more likely to be diagnosed with syphilis. The prevalence of syphilis is high among MSM attending the HIV clinic in Trinidad, and most of these infections were asymptomatic; hence, targeted and sustained interventions to reduce syphilis transmission are urgently required. Repeat episodes of syphilis may play a role in the transmission dynamics of syphilis in MSM.


Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Sífilis , Adulto , Anciano , China , Estudios Transversales , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Conducta Sexual , Sífilis/diagnóstico , Sífilis/epidemiología , Trinidad y Tobago/epidemiología , Adulto Joven
15.
Zoology (Jena) ; 146: 125923, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33901836

RESUMEN

Silks produced by webspinners (Order Embioptera) interact with water by transforming from fiber to film, which then becomes slippery and capable of shedding water. We chose to explore this mechanism by analyzing and comparing the silk protein transcripts of two species with overlapping distributions in Trinidad but from different taxonomic families. The transcript of one, Antipaluria urichi (Clothodidae), was partially characterized in 2009 providing a control for our methods to characterize a second species: Pararhagadochir trinitatis (Scelembiidae), a family that adds to the taxon sampling for this little known order of insects. Previous reports showed that embiopteran silk protein (dubbed Efibroin) consists of a protein core of repetitive motifs largely composed of glycine (Gly), serine (Ser), and alanine (Ala) and a highly conserved C-terminal region. Based on mRNA extracted from silk glands, Next Generation sequencing, and de novo assembly, P. trinitatis silk can be characterized by repetitive motifs of Gly-Ser followed periodically by Gly-Asparagine (Asn-an unusual amino acid for Efibroins) and by a lack of Ala which is otherwise common in Efibroins. The putative N-terminal domain, composed mostly of polar, charged and bulky amino acids, is ten amino acids long with cysteine in the 10th position-a feature likely related to stabilization of the silk fibers. The 29 amino acids of the C-terminus for P. trinitatis silk closely resemble that of other Efibroin sequences, which show 74% shared identity on average. Examination of hydropathicity of Efibroins of both P. trinitatis and An. urichi revealed that these proteins are largely hydrophilic despite having a thin lipid coating on each nano-fiber. We deduced that the hydrophilic quality differs for the two species: due to Ser and Asn for P. trinitatis silk and to previously undetected spacers in An. urichi silk. Spacers are known from some spider and silkworm silks but this is the first report of such for Embioptera. Analysis of hydropathicity revealed the largely hydrophilic quality of these silks and this feature likely explains why water causes the transformation from fiber to film. We compared spun silk to the transcript and detected not insignificant differences between the two measurements implying that as yet undetermined post-translational modifications of their silk may occur. In addition, we found evidence for codon bias in the nucleotides of the putative silk transcript for P. trinitatis, a feature also known for other embiopteran silk genes.


Asunto(s)
Insectos/fisiología , Seda/química , Secuencia de Aminoácidos , Animales , Ecosistema , Seda/fisiología , Especificidad de la Especie , Trinidad y Tobago
16.
AIDS Res Ther ; 18(1): 20, 2021 04 23.
Artículo en Inglés | MEDLINE | ID: mdl-33892747

RESUMEN

BACKGROUND: Patients who default from HIV care are usually poorly adherent to antiretroviral treatment which results in suboptimal viral suppression. The study assessed the outcomes of retention in care and viral suppression by expansion of an intervention using two patient tracers to track patients lost to follow up at a large HIV clinic in Trinidad. METHODS: Two Social Workers were trained as patient tracers and hired for 15 months (April 2017-June 2018) to call patients who were lost to follow up for 30 days or more during the period July 2016-May 2018 at the HIV clinic Medical Research Foundation of Trinidad and Tobago. RESULTS: Over the 15-month period, of the of 2473 patients who missed their scheduled visits for 1 month or more, 261 (10.6%) patients were no longer in active care-89 patients dead, 65 migrated, 55 hospitalized, 33 transferred to another treatment clinic and 19 incarcerated. Of the remaining 2212 patients eligible for tracing, 1869 (84.5%) patients were returned to care, 1278 (68.6%) were virally unsuppressed (viral load > 200 copies/ml) and 1727 (92.4%) were re-initiated on ART. Twelve months after their return, 1341 (71.7%) of 1869 patients were retained in care and 1154 (86.1%) of these were virally suppressed. Multivariate analysis using logistic regression showed that persons were more likely to be virally suppressed if they were employed (OR, 1.39; 95% CI 1.07-1.80), if they had baseline CD4 counts < 200 cells/mm3 (OR, 1.71; 95% CI 1.26-2.32) and if they were retained in care at 12 months (OR, 2.48; 95% CI 1.90-3.24). Persons initiated on ART for 4-6 years (OR, 3.09; 95% CI 1.13-8.48,), 7-9 years (OR, 3.97; 95% CI 1.39-11.31), > 10 years (OR, 5.99; 95% CI 1.74-20.64 were more likely to be retained in care. CONCLUSIONS: Patient Tracing is a feasible intervention to identify and resolve the status of patients who are loss to follow up and targeted interventions such as differentiated care models may be important to improve retention in care.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Fármacos Anti-VIH/uso terapéutico , Recuento de Linfocito CD4 , Estudios de Seguimiento , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Trinidad y Tobago/epidemiología , Carga Viral
17.
Anthropol Med ; 28(1): 47-61, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33886376

RESUMEN

Drawing on ethnographic fieldwork in Trinidad, this paper examines how the framing of a particular apocalyptic future provided a moral commentary and model for wellbeing in contemporary everyday life. Changing social, political, and economic circumstances and relations had brought a range of new risks and anxieties into daily life. These more recent problems originating from beyond the village (such as climate change, criminality, inequality, pollution, neglect by the State) could not be resolved through working with obeah spirits as might have been used previously for more local issues, or through the long-established Catholic and Anglican churches. Instead evangelical Christian cosmology and practices gave a means of making sense of such issues and for protecting oneself. The development of a strong individual relationship with God connected individuals to a greater power and a global community, framing such problems not only as the work of the Devil but as evidence of the coming of the End of Days. Political protest or attempts at wider change were futile therefore; individuals should focus on their own practices to develop a strong relationship with God. Health and wellbeing relied on an individualised and deep relationship with the Holy Spirit. This was developed through practices that both drew on, and helped create, a type of neoliberal logic and global subjectivity to understand and live within current times, evangelical Christianity promoting ways of living without anxiety in the present through understandings of an apocalyptic future.


Asunto(s)
Ansiedad/etnología , Cristianismo , Filosofías Religiosas , Antropología Médica , Humanos , Trinidad y Tobago/etnología
18.
BMJ Open ; 11(4): e044397, 2021 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-33849850

RESUMEN

OBJECTIVES: To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic. DESIGN: Cross-sectional online survey. SETTING: HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago. PARTICIPANTS: 395 HCWs aged ≥18 years. MAIN OUTCOME MEASURES: Depression, anxiety and stress scores. RESULTS: Among the 395 HCWs, 42.28%, 56.2% and 17.97% were found to have depression, anxiety and stress, respectively. In the final stepwise regression model, contact with patients with confirmed COVID-19, p<0.001 (95% CI 3.072 to 6.781) was reported as significant predictors of depression. Further, gender, p<0.001 (95% CI 2.152 to 5.427) and marital status, p<0.001 (95% CI 1.322 to 4.270) of the HCWs were considered to be correlated with anxiety. HCWs who had contact with patients with suspected COVID-19 had lower depression, p<0.001 (95% CI -5.233 to -1.692) and stress, p<0.001 (95% CI -5.364 to -1.591). CONCLUSIONS: This study has depicted the prevalence and evidence of depression, anxiety and stress among HCWs during the COVID-19 pandemic. The findings of the study will serve as supportive evidence for the timely implementation of further planning of preventative mental health services by the Ministry of Health, for frontline workers within the public and private health sectors.


Asunto(s)
Ansiedad/epidemiología , COVID-19/psicología , Depresión/epidemiología , Personal de Salud/psicología , Estrés Laboral/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Prevalencia , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiología
19.
Arch Virol ; 166(6): 1661-1669, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33811529

RESUMEN

Zucchini yellow mosaic virus (ZYMV) is a member of the genus Potyvirus that is becoming a serious pathogen of pumpkin and other cucurbits in Trinidad and Tobago and the entire Caribbean region. In this study, four ZYMV isolates infecting pumpkin in Trinidad and Tobago were characterized by complete genome sequencing. Phylogenetic analysis showed 5.9-6.0% nt and 7.7-7.9% aa sequence divergence in comparison to the most closely related isolates NAT and AG from Israel and SE04T from Slovakia. Based on the variations in the complete genome sequence as well as individual gene sequences, a new genotype, designated ZYMV-Trini, is proposed for these isolates. Among the gene sequences of ZYMV-Trini isolates, the greatest variation was observed in the HC-Pro gene, with 20.8% aa sequence divergence from their closest relatives, whereas the least variation was observed in the NIb, P3, and CP genes, with 1.8-2.2% aa sequence divergence. This study also showed that transmission of ZYMV can occur through seeds, but this was less common than transmission via the aphid Aphis gossypii. The progression of ZYMV in pumpkin seedlings was quantified by RT-qPCR, which showed a rapid surge in viral load after 37 days. From recombination analysis, it could be concluded that the isolates SE04T from Slovakia, NAT from Israel, and AG from Israel have made major contributions to the genome architecture of ZYMV-Trini isolates.


Asunto(s)
Cucurbita/virología , Genoma Viral , Virus del Mosaico/genética , Enfermedades de las Plantas/virología , Animales , Genotipo , Filogenia , Trinidad y Tobago
20.
Cancer Causes Control ; 32(7): 763-772, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33835281

RESUMEN

PURPOSE: The aim of this study is to determine the demographic, pathological, and treatment-related factors that predict recurrence and survival in a Trinidadian cohort of breast cancer patients. METHODS: The inclusion criteria for this study were female, over 18 years, and with a primary breast cancer diagnosis confirmed by a biopsy report occurring between 2010 and 2015 at Sangre Grande Hospital, Trinidad. Univariate associations with 5-year recurrence-free survival and 5-year overall survival were calculated using the Kaplan-Meier method for categorical variables and Cox Proportional Hazards for continuous variables. A multivariate model for prediction of recurrence and survival was determined using Cox regression. RESULTS: For the period 2010-2015, 202 records were abstracted. Five-year overall survival and recurrence-free survival rates were found to be 74.3% and 56.4%, respectively. Median times from first suspicious finding to date of biopsy report, date of surgery, and date of chemotherapy were 63 days, 125 days, and 189 days, respectively. In the univariate analysis, age (p = 0.038), stage (p < 0.001), recurrence (p = 0.035), surgery (p = 0.016), ER (p < 0.001) status, PR status (p < 0.001), and subtype (p < 0.001) were significantly associated with survival. Additionally, stage (p = 0.004), N score (p = 0.002), ER (p = 0.028) status, PR (p = 0.018) status, and subtype (p = 0.025) were significantly associated with recurrence. In the Cox multivariate model, Stage 4 was a significant predictor of survival (HR 6.77, 95% CI [0.09-2.49], p = 0.047) and N3 score was a significant predictor of recurrence (HR 4.47, 95% CI [1.29-15.54], p = 0.018). CONCLUSION: This study reports a 5-year breast cancer survival rate of 74.3%, and a recurrence-free survival rate of 56.4% in Trinidad for the period 2010-2015.


Asunto(s)
Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/mortalidad , Recurrencia Local de Neoplasia/epidemiología , Recurrencia Local de Neoplasia/mortalidad , Neoplasias de la Mama/terapia , Demografía , Supervivencia sin Enfermedad , Femenino , Hospitales Públicos , Humanos , Estimación de Kaplan-Meier , Registros Médicos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/terapia , Supervivencia sin Progresión , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Tasa de Supervivencia , Trinidad y Tobago/epidemiología
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