HIV seroprevalence in antenatal women in Barbados - abstract

Barbados has reported, up to the end of September 1991, a total of 231 cases of the acquired immune deficiency syndrome (AIDS), with 162 deaths from the disease. This is one of the highest incidences reported by countries to the World Health Organization. In order to bring the disease under control, one has to estimate the gravity of the problem in at-risk groups within the society. This calls for an organized programme of counselling and testing of individuals and groups who have been exposed, knowingly or unknowingly, to the human immunodeficiency virus - the causitive agent of AIDS. In pursuance of the above objective, the Ministry of Health in Barbados has launched a programme whereby pregnant women are being screened for the virus after they have been counselled, and informed consent obtained. This programme was commenced early in 1991 at the Winston Scott Polyclinic, which serves a catchment area with an estimated population of 58,000 which compares with the total population of 256,000. In addition, a questionnaire, covering the basic demographic and sexual behaviour patterns of the women was completed for each of the participants. During the first ten months of 1991 a total of 401 antenatal women were counselled and 400 tested for HIV. Six (6) were found to be HIV-positive, giving a prevalence rate of 1.5 per cent. One woman refused to be tested. The findings of the questionnaire showed that a large number of respondents were unmarried and had had multiple sexual contacts. Their partners were occasional users of condoms. The findings support the need for more health educaton in relation to the practise of safe sex in the population of women attending the polyclinic (AU)

Antibiotic resistance patterns of gram-negative aerobic bacilli: a Caribbean collaborative study - abstract

As part of a systemic study of antibiotic resistance pattern of bacteria in the Caribbean, organisms were collected from hospital laboratories in Barbados and Trinidad in May-June, 1991. Three hundred and twenty-eight gram-negative aerobic bacilli (BNB) were tested for antibiotic resistance by Kirby-Bauer disc susceptibility test method. The percentage of resistance to ampicillin, carbenicillin and amoxicillin/clavulanic acid was 63 percent, 52 percent and 27 percent, respectively. The gentamicin resistance of GNB was 7.6 percent, and none of the isolates were resistant to amikacin. The percentage resistance of GNB isolates from Trinidad against all antibiotics was higher than the isolates tested from Barbados. Interestingly, 26 percent of isolates obtained from outpatients were resistant to cotrimoxzole as compared to 16 percent in inpatients in Trinidad. A systematic study of antibiotic resistance among gram-negative bacteria in the Caribbean is recommended for prudent use of antibiotics (AU)

Hepatitis B antibody levels in health-care workers of a large general hospital in Barbados

In order to assess the immune status to Hepatitis B in a general hospital population in the Caribbean, we studied the antibody level to Hepatitis B surface antigen (anti HBs) and to core antigen (anti HBc) in 90 health-care workers at the Queen Elizbeth Hospital in Barbados, West Indies. There was one asymptomatic carrier with Hepatitis B antigen (HBsAg). Thirteen (14.6 percent) of the remaining 89 possessed anti HBs; 10 of these (11.2 percent) were considered to be immune, and three non-immune. The 10 immune subjects were also positive for anti HBc whereas the other three "non-immune" positives were not. One person in the study had strong anti HBc immunity but was negative for anti HBs. There appeared to be no relationship between immunity and age, sex, profession or duration of work years. From the study, 76 individuals (84 percent were easily identified as being susceptible to Hepatitis B and were candidates for HBV vaccine. (AU)

The prevalence of severe leptospirosis among humans on Barbados

Leptospirosis was confirmed by the Leptospira Laboratory in 138 hospital patients on Barbados between early November 1979 and the end of 1982 (annual average 43.6 cases). These were the great majority of severe cases occurring on the island during that time. The crude incidence rate ranged between 15 and 23 per 100,000 population per year (average 17.6). 26 of the patients died (15 males, 11 females), giving an over-all case fatality rate of 18.8 percent, and an average of 8.2 deaths per year. 68 percent of all cases were in males. The highest percentages of cases were in males aged 20 to 24 and females aged 55 to 59, but the incidence of the disease in both sexes increased with age up to 60 years. Previous figures recorded on the island by the Ministry of Health for 1975-79 were considerably lower, with a mean of 23.6 cases per year and a crude annual incidence of 9.5 per 100,000. 15 of the patients died (13 males, 2 females), giving an over-all fatality rate of 12.7 percent and an average of 3 deaths per year. 74 percent of all cases were in males. The highest percentages of cases were in the 20 to 29 and 50 to 59 year age groups for male and females, respectively, i.e., similar to those in the present series. In both sexes the incidence of leptospirosis increased with age up to 60 years. 11 of 14 strains isolated from patients' blood, urine or dialysate fluid were subsequently identified as follows: Serogroup Autumnalis, eight (one belonged to serovar bulgarica and seven to a new serovar within that group); Serogroup Icterohaemorrhagiae, serovar copenhageni, two; Serogroup Canicola, serovar canicola, one. Serological tests on patients' sera resulted in predominantly single serogroup reactions in 97 of the 138 cases and indicated that 72 percent of the 97 infections were due to strains of Autumnalis, while 20 percent were of Icterohaemorrhagiae, 6 percent Ballum, 1 percent Canicola and 1 percent Grippotyphosa serogroups

Histoplasmosis in the eastern Caribbean: a preliminary survey of the incidence of the infection

A preliminary survey of the incidence of histoplasmosis in the eastern Caribbean was carried out. The percentages of positive histoplasmin skin test reactors in the populations studied were as follows: Barbados (4 percent), Trinidad (42 percent) and Guyana (29 percent). In Trinidad 69 percent of individuals under 60 had positive tests. However a lower proportion (4 percent) had serological evidence of past infection with Histoplasma capsulatum. The organism was not isolated from the soil although it had been found previously in Trinidad. On this island five previously diagnosed cases of histoplasmosis were identified. The study confirmed the presence of the infection in the area and further investigations are suggested (AU)

The problem of human leptospirosis in Barbados

The results of a retrospective study of human leptospirosis cases occurring in Barbados during the period 1968-74, and of serological findings among high risk occupational groups, fever cases and health care patients monitored for the disease during 1975-77, indicate that infection by serotype fort-bragg of the Autumnalis group is widespread in this Caribbean island. The occupational groups most affected are sanitation workers and sugar-cane workers. Results of serological tests conducted at the principle hospital are comparable with the results obtained by the microscopic agglutination reference test procedure conducted at the Pan American Zoonosis Centre (CEPANZO) Summary