Cooperation in health in the Commonwealth Caribbean

Reviews past and present efforts regarding cooperation in health and proposes that the existence of a strong institutional framework is essential for the development and success of any cooperative initiatives. The existing institutional frameworks are described, viz., the University of the West Indies and the Pan American Health Organization/World Health Organization (PAHO/WHO). The priority areas of health care are outlined including environmental protection, human resources development, food and nutrition and maternal and child health. The future of health co-operation, particularly in public health, is the final area of discussions, which includes a discourse on the Commonwealth Caribbean Medical Research Council. (AU)

An analysis of pathological causes of death in 417 children under two years of age in Kingston and St. Andrew Jamaica over a two-year period between 1968 and 1970 - abstract

An analysis has been made of the causes of death of 417 children on whom autopsies were done as part of the PAHO/WHO Inter-American Investigation of Mortality in Childhood. Only adequately documented autopsies are included. Sixty-three of the deaths occurred in the first 24 hours, 80 in the next 6 days and 50 between 7 and 27 days. There were 87 deaths between 28 days and six months of age. The remaining 137 deaths occurred between 6 months and two years. The cases dying under 7 days are not representative of the KSAC Area as the majority of deaths occurring in the Victoria Jubilee Hospital are not included. Infections accounted for 56 percent of the deaths in the age group 7-27 days. Congenital malformations were responible for 38 percent of the deaths in this age group. Of those dying under two years of age, there were four main causes: gastroenteritis in 34 percent, pneumonia in 16 percent and malnutrition in 10 percent and congenital malformations in 18.5 percent. Infections are major causes of mortality in 43.4 percent of all autopsied cases under 2 years of age (AU)

An investigation of child mortality in Kingston and St. Andrew, Jamaica - abstract

This study was carried out as one of the thirteen field projects in the Inter-American Investigation of Mortality in Childhood, which was sponsored by PAHO/WHO. The objective of the study was to investigate causes of death in infancy and early childhood, taking into account nutritional, sociological and other environmental factors. This preliminary report is for the year 1969. An attempt was made to get complete data on all deaths of children under five years of age in the parishes of Kingston and St. Andrew, Jamaica - an area with total mean population of 547,500 in 1969. The investigation was carried out through interviews in homes, hospitals and clinics and with physicians so as to obtain complete records of the fatal illness, results of laboratory and other examinations and autopsy findings. The study area was sub-divided into urban and rural. The total number of deaths under five years of age for the year was 906, 835 of which were from the urban area. The demographic (provisional) of the Registrar General for 1969 reported 803 infant deaths, thus giving an infant mortality rate of 35.4, while the study had 763 infant deaths with an infant mortality rate of 33.8. There were 836 deaths (92 percent) under two years of age, with 469 (51.6 percent) in the neonatal period and 294 (32.5 percent) in the post neonatal period. In 1-4 years age group, 73 deaths occurred among the one-year olds and this represents 52.5 percent of deaths in this age group. Thus there were four times as many deaths in the post-neonatal period as there were in the second year of life and those in the second year of life were more than half of those deaths occurring in the 1-4 year old group. The geographic distribution was analysed according to postal zones for the urban area. Out of 835 urban deaths occurring in 21 postal zones, 445 (53.2 percent) occurred in zones 0, 11, 12 and 13 which accounted individually for the highest numbers of death. Hence establishing priorities in developing a maternal and child health programme to improve health services and reduce child mortality, emphasis must necessarily be given to children under two years old, and special attention to certain geographic areas (AU)

An investigation of child mortality in Kingston and St. Andrew, Jamaica: Preliminary review for 1969

It has been shown that mortality in childhood in Jamaica is declining rapidly in all parts of the island. Regional differences however are still found with higher rates in the Western parishes. This paper describes a preliminary review of deaths of children under five years of age in the corprate area of Kingston & St. Andrew, Jamaica, for the year 1969. Between the ages of six month and two years, gastro-enteritis and malnutrition still account for a high proportion of deaths. Children whose mothers lack antenatal care and whose mothers were very young, were at a greater risk of dying in the neonatal period. There was also a relative preponderance of deaths among children in a well defined geographic area of a lower socio-economic status. Prematurity and obstetrical complications were the chief causes of deaths in the neonatal period. There were also 12 deaths from gastro-enteritis and 8 from tetanus in this period, and 22 from diphtheria and whooping cough in the postneonatal and early childhood periods. Hence in establishing priorities in developing and improving a maternal and child health programme, emphasis must necessarily be given to children under two years of age and special attention to certain geographic areas. It is hoped that this report help to point out needs for preventive programmes and for other uses of the results in health planning. This preliminary analysis has been done in order to obtain some early information that would be useful to the Ministry of Health, Jamaica. (SUMMARY)

Glucose-6-Phosphate dehydrogenase phenotypes in Jamaica - abstract

The incidence of glucose-6-phosphate dehydrogenase (G6PD) deficiency was assessed in 315 individuals (212 females, 103 males) using a screening test (Sass et al, 1966) and, where necessary, assay for enzyme activity described by bishopý (1966). This was 13.7 percent (12.7 percent in females and 15.5 percent in males). G6PD phenotype frequency was calculated after electrophoresis on collegel at room temperature. In 187 females (Gd+), B was 0.5454; Gd(+), AB: 0.2139; Gd(+), A: 0.1230; Gd(+), B, A-: 0.0749; and Gd(-) A-: 0.0428, and the frequencies in 89 males Gd(+), B: 0.6517; Gd(+), A:0.2022; Gd(-), A-: 0.1348; and Gd(-), B-:0.0112. These frequencies differ slightly from those reported for Nigerians and American Negroes. The mean activity of G6PD A+ was 24.3 units (range, 19-32 units), and of G6PD B+, 26.3 units (range, 20-37 units), in 18 and 57 males respectively. No association between Hbs S and C and any G6PD phenotype was demonstrable (AU)

Systemic lupus erythematosus in Jamaica

45 cases of Systemic Lupus Erythematosus were presented and discussed. Attention was drawn to three main points. Firstly, difficulties in diagnosis; secondly, the apparent increase in incidence of the disease; and lastly, the high incidence of biologically false positive tests for Syphilis in this condition. It was also noted that the possibility exists that treatment for positive serological tests may be determined in this disorder (AU)