The neuro-development abilities of very low-birth-weight children in Trinidad - abstract

In this study of neuro-development ability of very low-birth-weight (VLBW) Trindadian children, 33 randomly selected matched pairs of classmates who were either term or VLBW at birth were tested at age 68 to 88 months using the McCarthy Scales of Children's Abilities. Index and control children showed no difference in gender, ethnicity or growth retardation. The 1-minute Apgar score was significantly lower in the index children (6.5[SD1.0] vs 7.7[1.2], p<0.01. The results show that the index children had significantly lower scores in perpetual performance, quantitative, motor and GCI sub-tests and these differences may be a reflection of the method of teaching primary schools or child rearing practices in Trinidad or the test being inappropriate for our population. It is planned to reassess the study children at 9 years of age. (AU)

Bacterial-aetiology of neonatal conjunctivitis in Trinidad - abstract

This prospective, consecutive survey of 3,645 babies delivered at the Mount Hope Women's Hospital from March 1 to November 8, 1990 was to determine the aetiology of neonatal conjunctivitis and to compare 3 methods for detection of Chlamydial infection in material from affected eyes. One hundred and twenty babies presented with purulent conjunctivitis within the first four weeks of life and were investigated for bacterial infection including chlamydia trachomatis. Material from infected eyes was examined for the presence of aerobic bacteria by standard bacteriological methods and for chlamydial infection by fluorescein antibody (FA) test, ELISA method and tissue culture. Staphylococcus aureus (40 percent) and Chlamydia trachomatis (11 percent) were the commonest organisms isolated. The prevalence rate of chlamydia trachomatis was 3.84 percent per 1,000 live births. Tissue culture and ELISA methods were more sensitive than the immuno-fluorescence technique. The cost per test for chlamydia trachomatis by the 3 methods varied from a minimum of TT$37.44 to a maximum of TT$63.11. In spite of the cost, it is recommended that testing for Chlamydial as well as bacterial infections should be a routine part of investigating neonatal conjunctivitis (AU)

A perinatal information system - abstract

A feasibility study was carried out on the use of a perinatal information system at the Mt. Hope Women's Hospital (MHWH). This system consists of the Simplified Perinatal Clinical Record (SPCR), a personal computer and a specially designed software package. The information system identifies high-risk pregnancies and provides statistical analysis on perinatal mortality and morbidity. Data from 1,000 consecutive deliveries at the MHWH from the 1st January to 28th February, 1986, were collected on the SPCR forms and analysed on a personal computer. The syste was easy to use. The results obtained indicated an apparent increase in the stillbirth rate in 1986 as compared to 1981 - 1984. It identified chronic anaemia (13.4 percent) and pre-eclampsia (8.0 percent as the two main causes of maternal pathology. It is recommended that this perinatal information system, with slight modification, should be introduced generally in Trinidad and Tobago and the rest of the Caribbean. (AU)

Chlamydia trachomatis in antenatal women at Mount Hope Women's Hospital in Trinidad and Tobago: prevalence and perinatal transmission

Chlamydia trachomatis infection is being increasingly recognized as an important public health problem worldwide. The prevalence and rate of perinatal transmission of chlamydia was examined in 200 women attending antenatal clinic at the Mt. Hope Women's Hospital using tissue culture (TC), ELISA and fluorescent antibody (FA) methods. 27 (13.6 percent) women were found to be chlamydia positive by TC. 13 of the babies born to these mothers were also found to be positive, giving a vertical transmission rate of 48 percent. Compared to TC, the ELISA test was 96 percent sensitive and 100 percent specific while FA was 67 percent sensitive and 99 percent specific. Chlamydial infection was significantly associated (p<0.001) with being of Afro-Trinidadian descent, age <25 years, being unmarried and having two or more sexual partners in the past five years. The association with ethnicity could be explained on the basis of numbers of sexual partners and marital status. Chlamydia is often asymptomatic and no association was found with a history of previous STD, vaginitis or lower abdominal pain. It is recommended that women attending antenatal, family planning and STD clinics be screened for chlamydia infection and treated, together with their sexual partners, as an effective way of prevention. Enhanced chlamydia surveillance and strengthened laboratory capabilities are also recommended. (AU)