Chlamydial and gonococcal infections in Curacao: prevalence and determinants

OBJECTIVE: To determine prevalence and determinants of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among asymptomatic women and men in Curacao. DESIGN AND METHODS: This was a cross-sectional population-based study. Urine samples (n=579) were collected from Antillean people, > 18 years, randomly selected from participants of a 1994 population survey (the Curacao Health Study, n=2,248). For the detection of CT and Erasmus Medical Center, Rotterdam. RESULTS: CT and NG infections were found in 6.1 percent and 1.0 percent of samples, respectively. Concomitant CT and NG infection did not occur. Most CT infections were found in persons <44 years of age, the highest prevalence was found in the 18-24 year age group, 17.4 percent (13/75). In contrast, most NG infections were found in persons >44 years. CT infection, but not NG infection, was correlated with indices of low socio-economic status. Multiple regression confirmed the association of CT infection with age and socio-economic class. CONCLUSION: In Curacao, CT and NG infections are not epidemiologically linked. CT infection is highly prevalent and calls for a screening-intervention model based on prevalence and risk factors. (Au)

HIV registration in the Netherlands Antilles 1985-1996 - abstract

The objectives of this paper are to describe the HIV/AIDS epidemiology in the Netherlands Antilles over the last decade and the problems attached to the registration of these cases in a country that is spread over five islands. Some of the problems are that the total number of persons tested for HIV are not recorded, there is a lack of concensus on what case-definition to use in AIDS cases and when to start with administration of drugs. These problems in registration and the ensuing deficiences in the current data give further rise to underestimating the HIV/AIDS epidemic. Since HIV/AIDS has profound impication on demographic, economic and social aspects of a society; and considering the fact that there is still no cure for the disease, it is important to understand and to have a clear picture of the epidemilogy and the consequences of HIV infection and AIDS for the population. From 1985 until the third quarter of 1996 the cumulative total of known HIV -infected persons in the Netherlands Antilles was 793. Most of them are between the ages of 25 and 44 years. From 1991 and 1993 the leading cause of death of in Curacao for people between 25 to 44 years was AIDS. HIV/AIDS accounted for 14 percent of all deaths in this age group in 1991-1993. Curacao and Saint Maarten account for 97.5 percent of the known HIV-infected for the Netherlands Antilles. Recommendations are made for improving the HIV/AIDS registration in the Netherlands Antilles. (AU)

Dengue in Curacao: an analysis of available data from 1993, 1995 and 1996 - abstract

Dengue is endemic in most countries of the Americas. The presentation of the disease can range from an undifferentiated fever to a more life-threatening form, ie., the dengue shock syndrome. Four serotypes of the viruses are distinguished: the most common ones in the American regon are types 2 and 4. It is transmitted primarily through the Aedes aegypti, a vector widely found in the region. Dengue is also a health problem in Curacao, where since 1973 endemicity has been established. The objective of the present study is to describe the dengue situation in Curacao with regards to the prevalence, surveillance system and vector control, as well as the evaluation of these. This was done on laboratory-based surveillance data of the years 1993, 1995 and 1996. Cases were either confirmed by laboratory results or classified as probable cases based on clinical information, using the case definition of the Pan American Health Organization. Results of the surveys on larval indices of the same years are presented. The surveillance data show that there was an outbreak in the first few months of 1993. One death was reported in February. During this outbreak, dengue types 2 and 4 were isolated. In 1995, there were two outbreaks, one in March/April and another one later in the year during the year during the months October/November. At the beginning of 1996 the last cases of the 1995 outbreak were detected, but in the second half of the year no confirmed cases were reported. Both the curent surveillance system and the vector surveys hae provided valuable data. Nevertheless, the prevalence of the disease in 1995 shows that the availability of information is not enough for the prevention of disease if not combined with a defined plan of action. (AU)

Knowledge, attitudes and behaviour on smoking and alcohol use in Curacao

The objectives of this paper are to describe the findings on knowledge and attitudes concerning substance use (tobacco and alcohol) among the participants of the Curacao Health Study and to relate these results to their behaviour. A random sample of the adult non-institutionalized population of Curacao (n=2248) were asked about their knowledge and attitudes on health lifestyle patterns and preventive behaviour. In this paper we specifically focus on smoking and use of alcohol. Men in Curacao use more alcohol and tobacco than women. The prevalence of self-reported smokers is markedly lower than, for instance, in the Dutch population and that of the U.S. and the difference between the sexes. In Curacao men generally also score lower on knowledge and attitudes regarding the use of tobacco and alcohol than women. Those actually exhibiting unhealthier lifestyles in this respect have lower scores than those having healthier lifestyles. The same relationship holds true for women, though less pronounced. Although knowledge, attitudes and behaviour are clearly associated with one another, the causal relationship between them is not unequivocal. Other factors may also play a role in influencing lifestyle changes. More research is needed to guide the further development and implementation of health promotion and intervention programmes in Curacao (AU)x

The impact of social support on mental health: results from the Curacao health study

The objective of this study was to describe the relationship between perceived social support and mental health in Curacao. A random sample (n=2248) of the non-institutionalized adult population of Curacao was surveyed through face-to-face interviews, containing items on health, social support and background variables. The prevalence of psychological distress was about 20 percent. The prevalence was higher in women, widowed persons, the chronically ill and persons from the low socio-economic classes. Perceived social support was relatively low in young persons, divorced and single persons, the chronically ill and low education groups. There was a strong inverse relationship between perceived social support and psychological distress: persons who feel they have low social support have more psychological distress. This relationship could be found in almost all subgroups, but is especially strong in young women. Prevention and intervention programmes should acknowledge the great impact of social support on mental health. In terms of prevention of psychological distress, people in stressful situations should be helped by reinforcing their social support (e.g. patient should be helped to improve their social support (e.g. halfway houses for (former) psychiatric patients) (AU)