The current prevalence and potential elimination of the soil transmitted helminth’s from Grenada

OBJECTIVE: This study formed part of a soil transmitted helminth elimination program in Grenada. The study assessed the prevalence of soil transmitted helminths (STH’s) in Grenadian primary school children. DESIGN AND METHODS: A longitudinal study was carried out on students attending 39 out of all 54 (72.2%) primary schools in Grenada, Carriacou and Petite Martinique between March 2013 and December 2014. The schools were randomly selected for inclusion in the study. Zinc Sulphate Floatation with centrifugation and Microscopy was used to assess the prevalence of STH’s in stool samples from Grenadian primary school children. RESULTS: The overall prevalence of STH was 1.3% (95% CI= 0.54-2.72). In 4 of the 8 parishes the prevalence was 0%. The highest prevalence was 3.9% (0.48-13.46) in St. Patrick. The STH identified were Ancylostoma duodenale, Ascaris lumbricoides and Trichuris trichuria. CONCLUSION: The prevalence of STH’s in the initial survey was 1.3%. This low prevalence indicates that the elimination program which utilizes a multi pronged approach including targeted chemotherapy and education may be feasible.

Analysis of cancer prevalence among women in Grenada

OBJECTIVE: To investigate prevalence of cancers affecting women in Grenada, a study was conducted using de-identified patient records from the Grenada General Hospital Histopathology Laboratory of women who visited hospital and clinic facilities during 2000 - 2010. DESIGN AND METHODS: De-identified records of 12,012 entries, 9,023 female (7,172 individuals) between ages 8 – 94 years presumably to seek preventative care or medical treatment were assessed during this cross-sectional study. Sampling without replacement resulted in approximately 3,000 entries for analysis. Prevalence of each type of cancer reported amongst women was determined. RESULTS: Of the 3,000 pathology diagnoses, 601 of the samples were classified as cancerous. The most prevalent cancer in Grenadian women from 2000 – 2010 was cervical cancer at (34%), followed by breast cancer at (31%). All other reported cancers were analyzed and their prevalence determined. CONCLUSION: Overall, the rate of cancer among Grenadian women for the ten-year period from 2000 – 2010 was determined to be 8.4%. There are implications for prevention and creation of health policies to address cancer burden in Grenada.

A retrospective case series study of the seroprevalence of Human T Lymphocyte Virus 1 and 2 from the General hospital Laboratory in Grenada

OBJECTIVE: HTLV-1 is a human retrovirus that causes adult T-cell Leukemia/Lymphoma (ATL) and some other conditions – HTLV-associated myelopathy (tropical spastic paraparesis, a multiple sclerosis-like disease), uveitis, infective dermatitis and some “auto immune” diseases. While the Caribbean has been identified as an HTLV-1 endemic area, there are no published studies on HTLV-1 from Grenada. The objective of this study was to anonymously review the General Hospital laboratory records to investigate the seroprevalence of HTLV-1 and 2 in Grenada. DESIGN AND METHODS: This was a retrospective study of the records from the General Hospital Laboratory in Grenada, where ELISA serologically positive results for HTLV 1 and 2 were recorded as a percentage of the total number of tests performed between the years 1998 - 2013. The Diasoren rapid ELISA serological test was used. RESULTS: During the 16 year review period (1998-2013) a total of 2,346 (4.7%: 95% CI: 4.5% to 4.9%) out of 49,782 patients were identified as HTLV-1 and 2 positive. Females with a median age of 34 years comprised 70% of positive cases whilst the median age for males was 43 years. The rate in Grenada has been steadily declining since 1998 and appears to be leveling off at about 3.7%. CONCLUSION: The current seroprevalence of HTLV 1 and 2 in Grenada is lower than that reported in 1991 in Jamaica (5%). The rate found is still unacceptably high and additional studies are required to determine the health consequences of HTLV-1 infection. Additionally appropriate public health programs should be applied to help reduce transmission.

Short and long term knowledge of the transmission and prevention of soil transmitted helminths in primary schoolchildren assessed using Turning Point Technologies

OBJECTIVE: This study formed part of a soil transmitted helminth (STH) elimination program in Grenada. This study assessed the short and long term knowledge of primary school children on the transmission and prevention of STH using Turning Point Technologies. DESIGN AND METHODS: A longitudinal study was carried out on schoolchildren attending 39 out of all 54 (72.2%) primary schools from Grenada, Carriacou and Petite Martinique between March and November 2014. The schools were randomly selected for inclusion in the study. Turning Point Technology was used to assess the knowledge and administer the subsequent intervention to all students. The Pre, immediate-Post and long-term Post intervention (seven months later) data was analyzed using Chi Square. RESULTS: A total of 962 students participated in March 2014 and 805 students participated in October 2014. There was no significant (p< 0.05) inter school difference in the answering of questions. This displayed a ubiquitous knowledge transfer across the primary schools. There was a significant improvement in knowledge post turning point intervention, which was maintained at 7-months post-intervention. CONCLUSION: The advantages of using turning point technologies to impart this knowledge where class responses appear instantly, anonymously and can be used for immediate discussion were numerous. These include inter alia, active engaged participation.

Attitude, behavior and practice of primary school students with regard to soil transmitted helminths in Grenada

OBJECTIVE: To identify the attitude, behaviour and practice of parents, guardians and adolescents associated with Soil Transmitted Helminth’s (STH’s). DESIGN AND METHODS: A questionnaire was completed by 811 parents /guardians. The questionnaire posed questions on the socio economic, attitudes, behavior and practices of primary school students with regard to factors that could contribute to the transmission of STH’s in Grenada. RESULTS: 534 (66%) parents/guardian reported that their children regularly washed their hands before eating, 690 (85%) had an inside water supply, 465 (57%) had indoor toilets. Also, 579 (71%) said that their children never played around outdoor latrines and 326 (40%) said their children always wore shoes outdoors. 732 (90%) of the parents/guardians reported that vegetables and fruits were always washed before cooking and 662 (82%) said that their children had previously received de-worming medication. CONCLUSION: Practical recommendations such as in-house sanitation facilities and hand washing programs can be made. This will enable limited resources to be used more efficiently to combat the problem of transmission of STH’s.