Incidence of childhood-onset IDDM in black African-heritage populations in the Caribbean. The Caribbean African Heritage IDDM Study (CAHIS) Group

OBJECTIVES: To compare incidence rates of childhood-onset IDDM among black African-heritage populations age 0-19 years in the Caribbean region. RESEARCH DESIGN AND METHODS: Population-based registries for IDDM were established on the eastern Caribbean islands of Antigua, Barbados, Dominica, St. Croix, S t. Kitts, St. Thomas, and Tortola using standardized criteria from the World Health Organization (WHO) Multinational Project for Childhood Diabetes (DiaMond). Average annual incidence rates (IR) with 95 percent CI for 0-19 years olds were computed using the DiaMond Registry program for the 5-year period from 1989 to 1993. Poisson regression analysis was used to determine differences in incidence rates. RESULTS: The highest incidence rate for 0-19 year olds was for the black African-heritage population of St. Croix (IR 10.99 per 100,000; 95 percent CI 4.35-19.89), one of the U.S. Caribbean islands. A significant (P < 0.05) 3.9 variation in IDDM incidence across the registries was found when the IR for St. Croix was compared to the IR for Barbados (IR 2.57 per 100,000; 95 percent CI 0.90-4.64). CONCLUSION: The variation in childhood-onset IDDM incidence rates among the black population of the eastern Caribbean islands is consistent with the geographic variation in IDDM incidence seen among African Americans in the U.S. Variation in incidence rates of childhood diabetes in black populations may reflect difference in level of white genetic admixture or exposure to environmental diabetogenic agents. (AU)

Alleged rape in Antigua: a 5-year review - abstract

The actual number of cases of rape that occurs annually is unknown due to the high frequency of unreported cases. This review was undertaken to document the findings of cases of reported rape. Review of the files at the pathology laboratory, Holberton Hospital, and at Police Headquarters, St. John's, revealed 101 cases for the 5-year period from 1987 to 1991, or about 20 reported cases of rape annually, including 2 cases of alleged buggery in two 3-year-old males. The average age of the victims was 20 years with a range of 3 to 68 years of age. The average age of the accused (n = 26) was 32 years with a range of 15 to 70 years. In 52 per cent of cases ( n = 44) the victims knew the accused. There were three cases of gang rape. A conviction in court was reached for only 19 per cent of the 64 cases with adequate recorded data and 30 per cent were pending court action. The despicable crime of rape with the added spectre of sexually transmitted diseases including HIV demands co-operation between doctors, lawyers, policemen and social workers, among others, to determine the causes and effects of rape with a view towards reducing the incidence (AU)

Cancer incidence and mortality in Antigua/Barbuda

An inquiry into the incidence and mortality of malignant neoplasms in Antigua/Barbuda was undertaken to document the magnitude of the disease. The top ranking cancers diagnosed in 114 males were skin (26.3 percent), prostate (22.8 percent) and upper respiratory and alimentary tract (10.5 percent). In 130 females, the 3 main cancers were breast (23.1 percent), cervix uteri (22.3 percent), and skin (15.3 percent). The main cancers causing death were stomach (22.3 percent) and prostate (17.8 percent) in 157 males; and breast (18.2 percent) and cervix uteri (14.1 percent) in 149 females. Imprecise documentation, insufficient clinico-pathological correlation and the finding of advanced cancers underscore the need for a cancer registry and cancer society in Antigua/Barbuda. (AU)

Epidemiology of HIV infection and AIDS in Antigua - abstract

In December 1985, the first case of AIDS in Antigua occurred in a homosexual male. As of March 1991, Antigua recorded 43 cases of HIV infection. Seven of these, (16.3 percent) were donors. Apart from one donor, a female, the remaining six donors had unprotected sex with prostitutes. Thirteen (30 percent) of the 43 cases were prostitutes, 10 (1.6 percent) of whom were diagnosed in a serosurvey of 622 prostitutes between January 1988 and March 1991. Despite the heterosexual/prostitute linkage, the male homosexual/bisexual group is significant: 12 (28 percent) of the 43 cases were in this category. There were 13 cases of AIDS with 6 cases (46 percent) in the male homosexual/bisexual group. This figure should be interpreted cautiously since all 13 of the HIV prostitutes returned home to Santo Domingo and the status of 12 of them was unknown. The homosexual/bisexual group does not seem to be closely associated with the heterosexual-prostitute group (AU)

Cancer incidence and mortality in Antigua/Barbuda

An inquiry into the incidence and mortality of malignant neoplasms in Antigua/Barbuda was undertaken to document the magnitude of the disease. The top ranking cancers diagnosed in 114 males were skin (26.3 percent), prostate (22.8 percent) and upper respiratory and alimentary tract (10.5 percent). In 130 females, the 3 main cancers were breast (23.1 percent), cervix uteri (22.3 percent), and skin (15.3 percent). The main cancers causing death were stomach (22.3 percent ) and prostate (17.8 percent) in 157 males; and breast (18.2 percent) and cervix uteri (14.1 percent) in 149 females. Imprecise documentation, insufficient clinico-pathological correlation and the finding of advanced cancers underscore the need for a cancer registry and cancer society in Antigua/Barbuda. (AU)

The cocaine body packer syndrome

This reports documents the medical conditions associated with toxicity following ingestion of cocaine packaged for transportation. Awareness of this syndrome is important in view of the trafficking of illicit drugs in the region (AU)

Torsion of the spermatic cord

The clinical features and pathology of four cases of torsion of the spermatic cord treated at Holberton Hospital between December 1987 and January 1988 were reviewed. The lack of prompt clinical diagnosis delayed therapy in all cases, resulting in orchidectomy. The findings re-emphasize the need for early diagnosis and surgical exploration of equivocal cases of acute unilateral scrotal pain if salvage rates are to be improved (AU)