Does Intra-Uterine Exposure to the Zika Virus Increase Risks of Cognitive Delay at Preschool Ages? Findings from a Zika-Exposed Cohort from Grenada, West Indies.

Maternal infection with Zika virus (ZIKV) is associated with a distinct pattern of birth defects, known as congenital Zika syndrome (CZS). In ZIKV-exposed children without CZS, it is often unclear whether they were protected from in utero infection and neurotropism. Early neurodevelopmental assessment is essential for detecting neurodevelopmental delays (NDDs) and prioritizing at-risk children for early intervention. We compared neurodevelopmental outcomes between ZIKV-exposed and unexposed children at 1, 3 and 4 years to assess exposure-associated NDD risk. A total of 384 mother-child dyads were enrolled during a period of active ZIKV transmission (2016-2017) in Grenada, West Indies. Exposure status was based on laboratory assessment of prenatal and postnatal maternal serum. Neurodevelopment was assessed using the Oxford Neurodevelopment Assessment, the NEPSY® Second Edition and Cardiff Vision Tests, at 12 (n = 66), 36 (n = 58) and 48 (n = 59) months, respectively. There were no differences in NDD rates or vision scores between ZIKV-exposed and unexposed children. Rates of microcephaly at birth (0.88% vs. 0.83%, p = 0.81), and childhood stunting and wasting did not differ between groups. Our results show that Grenadian ZIKV-exposed children, the majority of whom were without microcephaly, had similar neurodevelopmental outcomes to unexposed controls up to at least an age of 4 years.

Zoonotic helminths of dogs and risk factors associated with polyparasitism in Grenada, West Indies.

Canine soil-transmitted helminths (STHs) cause important zoonoses in the tropics, with varying degrees of intensity of infection in humans and dogs. This study aimed to investigate the prevalence and associated risk factors for STHs in community dogs residing in Grenada, West Indies. In May 2021, 232 canine fecal samples were examined for zoonotic helminths by microscopy (following flotation), and genomic DNA from a subset of 211 of these samples were subjected to multiplex qPCR for the detection and specific identification of hookworms, Toxocara spp. and Strongyloides. Microscopic examination revealed that 46.5% (108/232, 95% CI 40­52.9), 9% (21/232, 95% CI 5.35­12.7) and 5.2% (12/232, 95% CI 2.3­8) of the samples contained eggs of Ancylostoma spp., Toxocara spp. and Trichuris vulpis, respectively. Multiplex qPCR revealed that, 42.2% (89/211, 95% CI 35.5­48.8) were positive for at least 1 zoonotic parasite. Of these, 40.8% (86/211, 95% CI 34.1­47.3) of samples tested positive for Ancylostoma spp., 36% (76/211, 95% CI 29.5­42.9) were positive for A. caninum, 13.3% (28/211, 95% CI 9­18.6) for A. ceylanicum, 5.7% for T. canis (12/211, 95% CI 2.97­8.81) and 1% (2/211, 95% CI 0­2.26) for Strongyloides spp. (identified as S. stercoralis and S. papillosus by conventional PCR-based Sanger sequencing). Using a multiple logistic regression model, a low body score and free-roaming behaviour were significant predictors of test-positivity for these parasitic nematodes in dogs (P < 0.05). Further studies of zoonotic STHs in humans should help elucidate the public health relevance of these parasites in Grenada.

Factors Associated with Chikungunya Infection among Pregnant Women in Grenada, West Indies.

Neonates are vulnerable to vector-borne diseases given the potential for mother-to-child congenital transmission. To determine factors associated with chikungunya virus (CHIKV) infection among pregnant women in Grenada, West Indies, a retrospective cohort study enrolled women who were pregnant during the 2014 CHIKV epidemic. In all, 520/688 women (75.5%) were CHIKV IgG positive. Low incomes, use of pit latrines, lack of home window screens, and subjective reporting of frequent mosquito bites were associated with increased risk of CHIKV infection in bivariate analyses. In the multivariate modified Poisson regression model, low income (adjusted relative risk [aRR]: 1.05 [95% CI: 1.01-1.10]) and frequent mosquito bites (aRR: 1.05 [95% CI: 1.01-1.10]) were linked to increased infection risk. In Grenada, markers of low socioeconomic status are associated with CHIKV infection among pregnant women. Given that Grenada will continue to face vector-borne outbreaks, interventions dedicated to improving living conditions of the most disadvantaged will help reduce the incidence of arboviral infections.

Ancylostoma ceylanicum Hookworms in Dogs, Grenada, West Indies.

Ancylostoma ceylanicum hookworms are recognized agents of human infection in the Asia-Pacific region. We investigated prevalence of zoonotic hookworm infections in dogs in Grenada in 2021; 40.8% were infected by hookworms, including Ancylostoma ceylanicum. Surveillance of this parasite in dogs and humans is needed in tropical/subtropical countries in the Americas.

A retrospective study of canine transmissible venereal tumour in Grenada, West Indies.

BACKGROUND: Canine transmissible venereal tumour (CTVT) is a naturally occurring neoplasia affecting dogs worldwide. Previous CTVT studies in Grenada were limited to case records of dogs with neoplastic conditions at a veterinary diagnostic laboratory. OBJECTIVES: The present retrospective study aimed to determine the occurrence and risk factors of CTVT in a wider population of owned dogs presented to a university-affiliated veterinary hospital between 2008 and 2018. METHODS: Data on the age, breed, gender, and gonadectomy status were retrieved from an electronic database and analyzed using logistic regression. RESULTS: Of the 7180 dogs presented during the period, 102 dogs (1.4%) were diagnosed with CTVT. A higher predisposition was observed in Grenadian pothounds (odds ratio [OR] = 22.8, 95% confidence interval [CI] 10.3-50.4; p < 0.001) and mixed-breed dogs (OR = 9.2, 95% CI 4.1-20.7; p < 0.001) in comparison to the purebreds. Neutered dogs (OR = 2.2, 95% CI 1.4-3.3; p < 0.001) were at an increased risk of CTVT than intact dogs. Age and gender were not identified as significant risk factors. CONCLUSIONS: The percentage of dogs with CTVT in this study represents a crude estimate of the CTVT prevalence in the owned dog population in Grenada. Further studies including both owned and free-roaming dogs are required for a more accurate estimation of the CTVT prevalence in the region. Our results indicate that breed and gonadectomy status are significant risk factors for the occurrence of CTVT in Grenada.

Molecular detection and characterization of Anaplasma platys and Ehrlichia canis in dogs from the Caribbean.

Anaplasma platys is a tick-transmitted rickettsial pathogen, which is known to be the etiologic agent for cyclic thrombocytopenia in its primary canine host. Infections with this pathogen are also reported in cats, cattle and people. Similarly, Ehrlichia canis is another tick-borne rickettsial pathogen responsible for canine monocytic ehrlichiosis and is also reported to cause infections in people. We describe infections in dogs with these two pathogens on the Caribbean island of Grenada, West Indies by detection using molecular methods. We utilized a 16S rRNA gene-based PCR assay to detect both Ehrlichia and Anaplasma species by screening 155 canine blood samples from asymptomatic dogs. We found 18.7 % of the dogs to be positive for A. platys and 16.8 % for E. canis. Samples that tested positive for A. platys were further assessed by sequence analysis targeting 16S rRNA, 23S rRNA, citrate synthase (gltA) and heat shock protein (groEL) genes. Phylogenetic analysis revealed high correlation of A. platys 16S rRNA and gltA gene sequences with the geographic origins, while 23S rRNA and groEL gene sequences clustered independent of the geographic origins. This study represents an important step in defining the widespread distribution of active rickettsial infections in Caribbean dogs with no apparent clinical signs, thus posing a high risk for canine health and to a lesser extent to humans, as most dogs in the Caribbean are free-roaming.

Faculty Perceptions: A Qualitative Study of the Perceived Need, Opportunities, and Challenges of Developing "One Health-One Medicine" in the Medical, Veterinary, and Public Health Curricula.

INTRODUCTION: The conceptual framework of One Health (OH) provides a strategy for promoting collaboration across the nexus of animal, human, and environmental health, which is essential for tackling emerging disease threats, such as COVID-19. However, there is no accreditation requirement for OH to prepare students across the professions for collaborative practice. This study aimed to explore the perspectives of faculty across the medical, veterinary, and public health programs about the need, opportunities, and challenges of developing OH in the curricula. METHODS: In this qualitative study, faculty across the three disciplines were invited to participate in audio-recorded, focus group interviews. Recordings were transcribed verbatim and analyzed using inductive and deductive thematic analysis. RESULTS: All participants recognized the need for OH as a critical concept for preparing students for collaborative practice. Opportunities were identified for shared learning and research across the disciplines, particularly through the use of interprofessional education. The lack of an accreditation mandate for OH in the medical curriculum was perceived to be the greatest challenge, leading to an anticipation of significant resistance among medical educators and students. DISCUSSION: Successful development of OH in all three curricula is vital to prepare students for current and future threats to global health. The role of accreditation bodies in ensuring medical, veterinary, and public health curricula prepare students for these threats is crucial. Implications for practice include strategies for persuading medical educators and medical students to embrace OH in the curriculum and promote a culture of shared learning.

Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study.

OBJECTIVE: To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN: Retrospective observational study. SETTING: Grenada. POPULATION: Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS: This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES: Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS: Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (µ = 898 days, σ = 277 days) compared with infections outside of pregnancy (µ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION: CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT: Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.

Use of infectious disease surveillance reports to monitor the Zika virus epidemic in Latin America and the Caribbean from 2015 to 2017: strengths and deficiencies.

OBJECTIVES: To summarise the occurrence of congenital Zika syndrome (CZS) in Latin America and the Caribbean from 2015 to 2017 using two outcome measures derived from infectious disease surveillance reports and to assess the completeness of these reports. DESIGN: Surveillance study. SETTING: Pan American Health Organization (PAHO)/WHO epidemiology reports on confirmed and suspected Zika virus infection and cases of CZS. PARTICIPANTS: Populations of 47 countries in the South and Central Americas, Mexico and the Caribbean. PRIMARY AND SECONDARY OUTCOME MEASURES: The number of CZS cases per 1000 births (using 2016-2017 births as a denominator) and the number of CZS cases per 1000 births in women with Zika virus infection during pregnancy. RESULTS: By 4 January 2018, 548623 suspected and 239063 confirmed Zika virus infections had been reported to PAHO/WHO from 47 countries. In 25 countries, over 80% of infections were reported as suspected. There were 3617 confirmed CZS cases in 25 countries; 2952 (82%) had occurred in Brazil. The number of CZS cases per 1000 births varied considerably with Brazil and several Caribbean island communities (Puerto Rico, St Martin, Martinique, Guadeloupe and Grenada) having the highest CZS prevalence above 0.5 per 1000 births. Analysing the number of CZS cases per 1000 births in women infected with Zika virus during their pregnancy highlighted the inaccuracies of the data, with Venezuela likely to have had severe under-reporting of CZS. CONCLUSIONS: Expressing data on CZS in relation to total births, rather than as absolute numbers, better illustrates the burden of disease, providing that under-reporting of CZS is not too severe. Data on infections in pregnant women enable potential under-reporting of CZS to be identified. Both measures are recommended for future PAHO/WHO publications. Evidence of severe under-reporting of Zika virus infections and CZS makes interpretation of the data and comparisons between countries challenging.

Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure.

Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongside a parallel group of normocephalic unexposed children [Unexposed Children (UC)]. We compared the incidence rate of epilepsy among EC and UC at one year of life to global incidence rates. Pregnant women were recruited from public health centers during the ZIKV outbreak in Grenada, West Indies and assessed for prior ZIKV infection using a plasmonic-gold platform that measures IgG antibodies in serum. Normocephalic children born to mothers with positive ZIKV results during pregnancy were classified as EC and those born to mothers with negative ZIKV results during and after pregnancy were classified as UC. Epilepsy screening procedures included a pediatric epilepsy screening questionnaire and video electroencephalography (vEEG). vEEG was collected using a multi-channel microEEG® system for a minimum of 20 minutes along with video recording of participant behavior time-locked to the EEG. vEEGs were interpreted independently by two pediatric epileptologists, who were blinded to ZIKV status, via telemedicine platform. Positive screening cases were referred to a local pediatrician for an epilepsy diagnostic evaluation. Epilepsy screens were positive in 2/71 EC (IR: 0.028; 95% CI: 0.003-0.098) and 0/71 UC. In both epilepsy-positive cases, questionnaire responses and interictal vEEGs were consistent with focal, rather than generalized, seizures. Both children met criteria for a clinical diagnosis of epilepsy and good seizure control was achieved with carbamazepine. Our results indicate that epilepsy rates are modestly elevated in EC. Given our small sample size, results should be considered preliminary. They support the use of epilepsy screening procedures in larger epidemiological studies of children with congenital ZIKV exposure, even in the absence of microcephaly, and provide guidance for conducting epilepsy surveillance in resource limited settings.

Pre and postnatal exposure to Chikungunya virus does not affect child neurodevelopmental outcomes at two years of age.

BACKGROUND: The 2005-06 chikungunya virus (CHIKV) outbreak in La Réunion suggested that mothers could transmit CHIKV to their neonates while viremic during the intrapartum period, and more than half of the infected neonates showed impaired neurodevelopment at two years of age. However, data sparsity precluded an overview of the developmental impact of vertical infection within the whole prenatal period. OBJECTIVE & METHODS: The current study assessed two-year old children born to mothers who were infected during the 2014 CHIKV outbreak in Grenada to determine the neurodevelopmental impact of perinatal CHIKV infection throughout gestation. Mother and child infection status were confirmed by serologic testing (IgG and IgM) for CHIKV. Cognitive, fine motor, gross motor, language and behavioral outcomes were assessed at two years of age on the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA). RESULTS: No differences in neurodevelopmental outcomes were observed between two-year-old children born to mothers infected with CHIKV during gestation (n = 149) and those born to mothers not infected with CHIKV (n = 161). No differences were found in INTER-NDA scores between children infected with CHIKV (n = 47) and children not infected with CHIKV (n = 592). Likewise, there were no differences between children infected with CHIKV post-partum (n = 19) versus children not infected with CHIKV (n = 592). CONCLUSION: Our findings suggest that children exposed and/or infected with CHIKV outside of the intrapartum period experience no significant neurodevelopmental delay at two years of age, as measured by the INTER-NDA, compared to their unexposed and/or uninfected peers. These results complement those of previous studies which showed a neurodevelopmental risk only for children infected during the intrapartum period, while the mother was highly viremic. These results might be reassuring for women of childbearing age and public health officials in CHIKV-endemic regions.

An analysis of time trends for canine heartworm disease in Grenada and its associated risk factors based on veterinary clinical pathology laboratory data base records between 2003 and 2015.

Canine heartworm (CHW) disease is a common parasitic infection in dogs in the Caribbean islands. However, studies on temporal trends and risk factors are limited for this region. This study represents the time trends in laboratory prevalence and risk factors of canine heartworm infections between 2003 and 2015. In this case series, 662 cases of laboratory-diagnosed heartworm were compared to 662 dogs without a laboratory diagnosis of heartworm (controls). One hundred and seventy two frozen serum positive samples were later analyzed for heartworm antigens using Heska solo® Step CH, and all 172 cases of microfilariae were confirmed as Dirofilaria immitis. Annual prevalence, linear trends and odds ratios (OR) for CHW were estimated using EPIINFO version 7 at a significance level of α = 0.05. Logistic regression was used to assess the association of CHW with variables showing a statistically significant univariate relationship. Laboratory prevalence of CHW decreased from 72 cases per 1000 dogs per year in 2003 to 15 cases per 1000 dogs per year in 2015 [X2 for linear trend = 151.8, p < 0.0001], with the occurrence of an epidemic of CHW between 2008 and 2010. The odds of CHW were higher among adult dogs [(OR) = 3.9 (95% CI, 2.9-7.0)] and geriatric dogs [OR = 2.1 (95% CI, 1.1-4.3)] compared to puppies. The odds of CHW were higher [OR = 1.3 (95% CI, 1.1-1.6)] among male dogs than female dogs, but the odds for CHW were lower among neutered dogs [OR = 0.4 (95% CI, 0.2 - 0.6)] compared to intact dogs. The odds of a dog being diagnosed with CHW were elevated [OR = 4.1 (95% CI, 3.2-5.2)] during the dry season compared to the rainy season. Our findings show that canine heartworm is extensive in laboratory submissions in Grenada. However, the laboratory prevalence of CHW decreased between 2003 and 2015, with an epidemic occurring between 2008 and 2010. Age of the dog, sex, neutered status, and seasonality of diagnosis were significantly associated CHW in Grenada.

Salmonella serovars associated with Grenadian tree boa (Corallus grenadensis) and their antimicrobial susceptibility.

Cloacal swabs from 45 Grenada bank tree boas (Corallus grenadensis) were sampled during a 12-month period (2011-2012) from the rain forests and scrublands of Grenada. Cloacal swabs were examined by enrichment and selective culture for the presence of Salmonella spp. In all, 16 (35.6%) of the snakes were positive for Salmonella, and six serovars of Salmonella were isolated. The most common serovar was Rubislaw (31.3%), the most frequent serovar recently isolated from green iguanas in Grenada, followed by serovar Braenderup (18.8%), and serovar IV:48:g,z51:- (formerly, S. Marina) (18.8%), also found in green iguanas in this country. The remaining three less frequent serovars were, IV:53:g,z51:-, I:6,7:e,h:- and IIIb:38:i:z. Antimicrobial susceptibility tests conducted by a disc diffusion method against amoxicillin-clavulanic acid, ampicillin, cefotaxime, ciprofloxacin, enrofloxacin, gentamicin, imipenem, nalidixic acid, streptomycin, tetracycline and trimethoprim-sulfamethoxazole showed that drug resistance is minimal, with intermediate susceptibility, only to streptomycin. This is the first report of isolation and antimicrobial susceptibilities of Salmonella serovars from wild Grenadian tree boas.

Woman to Woman: Implementation of a Cervical Cancer Education Training Program for Grenadian Lay Health Advisors.

The reduction in cervical cancer (CC) in developed countries, due mainly to Pap testing, has not filtered down to Caribbean countries including Grenada despite accessible screening. This is attributed to a lack of knowledge and low screening. Researchers in low resource settings successfully trained lay health advisors (LHAs), using theory-based, culturally relevant interventions to reverse this trend. The use of LHAs in Grenada was not documented in the literature; therefore, the purpose of this study was to implement and evaluate a culturally relevant curriculum in an effort to educate Grenadian LHAs on CC. Using convenience sampling, 8 Grenadian women were recruited from the parishes with the highest rates of CC. They participated in Woman to Woman (W2W), a 2-day CC, and human papilloma virus (HPV) prevention education program facilitated by local content experts. W2W was adapted from an evidence-based curriculum and tailored for the Grenadian context. Training consisted of modules on CC and HPV. Knowledge of LHAs was measured pre- and post-intervention. Summative evaluation was assessed using a focus group discussion. There was a significant increase in CC knowledge among LHA post-training (p < 0.05) and LHAs had positive opinions about the intervention. They had an enhanced sense of self-efficacy and valued feeling part of a team. The W2W results indicated that an evidence-based and culturally tailored educational intervention has the potential for significant gains in CC and HPV knowledge. Future research will evaluate the LHA-led CC and HPV educational intervention in the community setting.

Prevalence of Cryptosporidium spp. in asymptomatic small ruminants in Grenada, West Indies.

Cryptosporidium spp. is a protozoan parasite that causes enteric infection in a wide range of hosts, including livestock and humans. The aim of this cross-sectional study was to estimate the prevalence of Cryptosporidium spp. in small ruminants in Grenada, West Indies. Fecal samples were collected from 100 sheep and 202 goats from 32 farms. The fecal samples were tested using an Enzyme-linked immunosorbent assay (ELISA) for qualitative detection of antigens in feces (Diagnostic Automation Inc., USA). The overall prevalence of Cryptosporidium spp. was 19.5% [95% confidence interval (CI): 15.4% to 24.4%] in both sheep and goats. The prevalence of Cryptosporidium spp. in sheep and goats was 14% (95% CI: 8.4% to 22.3%) and 22.3% (95% CI: 17.1% to 28.5%), respectively. There was no significant difference in the prevalence of Cryptosporidium spp. infection between sheep and goats (p = .42, Fisher's exact test) in Grenada. Of the 32 farms visited, 19 (59.4%) had at least one Cryptosporidium spp. positive animal.

Knowledge, attitudes, and practices regarding rabies in Grenada.

OBJECTIVE: While Grenada attained a zero-human-rabies case status since 1970, the authors conducted the first study to assess knowledge, attitudes, and practices that may contribute to this status as well as to receive feedback on the rabies control program in Grenada. METHODOLOGY: A cross-sectional survey was conducted in July, 2017 with 996 households on the mainland. A questionnaire was administered to collect information on knowledge of rabies and prevention, vaccination practices, perception of institutional responsibilities for rabies control, and evaluation of the anti-rabies program. RESULTS: Of the 996 households, 617 (62%) had owners of animals that can be infected with rabies and were included in the analysis. Respondents were very aware of rabies as a disease that can infect animals and humans. The rate of participation in the vaccination program was 51.6% for pets and 38.0% for livestock. About 40% of respondents were knowledgeable about the extent of protection from the rabies vaccine. Respondents did not demonstrate exceptionally high levels of knowledge about animals that were likely to be infected with rabies, neither the anti-rabies programs that were conducted in Grenada. The three most frequent recommendations made to improve the rabies-control programs were: increase education programs, control the mongoose population, and expand the vaccination period each year. CONCLUSIONS: Conducting a comprehensive national rabies education program, expanding the vaccination program, and increasing the rate of animal vaccination are important steps that need to be taken to maintain the current zero-human-case status.

Role of Rats ( Rattus norvegicus) in the Epidemiology of Toxoplasma gondii Infection in Grenada, West Indies.

Rodents are known to be reservoir hosts of Toxoplasma gondii infection for other animals, such as cats and pigs. From February to July 2017, 167 rats ( Rattus norvegicus) were trapped in Grenada, and serum, heart, skeletal muscle, and brain were examined for T. gondii infection by serological examination (modified agglutination test, 1:25) for T. gondii antibodies and for viable parasites by bioassay in mice. Samples of heart, skeletal muscle, and brain of all rats were bioassayed in Swiss Webster (SW) outbred albino mice and interferon gamma gene knockout (KO) mice. Toxoplasma gondii was isolated from heart and brain from 1 rat; this was the only seropositive rat. The T. gondii strain was avirulent for SW mice but killed KO mice. Tissue cysts were detected in the brains of SW mice, and tachyzoites were detected in the lungs of KO mice that died of acute toxoplasmosis. The strain was propagated in cell culture, and DNA derived from cell-cultured tachyzoites was genotyped using the 10 PCR restriction fragment length polymorphisms (SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico). The strain was a clonal Type III (ToxoDB genotype no. 2) strain. Although the prevalence of T. gondii in humans and animals in Grenada is high, rats seem to have little importance in the transmission of T. gondii on this island.

The HIV/AIDS epidemic in Grenada: A cross-sectional approach used to measure response variation regarding sexual behavior and health depending on the method of data collection.

The objective of this study was to determine the association between high-risk sexual behavior in relation to HIV transmission and prevalence among different groups of people in Grenada. In addition, this study intends to increase the involvement and improved services by Grenadian chapter of the Caribbean HIV/AIDS Partnership (GrenCHAP).A cross-sectional study was conducted over a 2-month period in Grenada, West Indies, to measure the responsive nature of different populations to an inquiry about HIV and sexual behavior. The 2 methods used to collect the data were online (via social media) and through an in-person interaction with local NGO GrenCHAP personnel. Survey responses were recorded via SurveyMonkey ending on April 11, 2014.The findings of the study were that there was an increased degree of frankness and demographic diversity in participants who responded online as opposed to in-person.People who responded online were more likely to engage in high-risk sexual behavior. GrenCHAP has the opportunity to contribute in the collection of invaluable data concerning HIV and other STIs because of its NGO status and anonymity.

Bartonella henselae in small Indian mongooses (Herpestes auropunctatus) from Grenada, West Indies.

Many mammals are established hosts for the vector borne bacterial genus, Bartonella. Small Indian mongooses (Herpestes auropunctatus) have only been reported as a possible host for Bartonella henselae in southern Japan. Confirming Bartonella presence in mongooses from other regions in the world may support their role as potential reservoirs of this human pathogen. Specifically, documenting Bartonella in Caribbean mongooses would identify a potential source of zoonotic risk with mongoose-human contact in the New World. Using serological and molecular techniques, we investigated B. henselae DNA and specific antibody prevalence in 171 mongooses from all six parishes in Grenada, West Indies. Almost a third (32.3%, 54/167) of the tested mongooses were B. henselae seropositive and extracted DNA from 18/51 (35.3%) blood pellets were PCR positive for the citrate synthase (gltA) and/or the ß subunit of RNA polymerase (rpoB) genes. All sequences were identical to B. henselae genotype I, as previously reported from Japan. This study confirms the role of small Indian mongooses as a natural reservoir of B. henselae in the New World.

Prevalence of sickle cell disease among Grenadian newborns.

Objective To establish the birth prevalence of sickle cell disease in Grenada, with a view to assess the requirement for a population-based neonatal screening programme. Methods A two-year pilot neonatal screening programme, involving the Ministry of Health of Grenada, the Sickle Cell Association of Grenada, and the diagnostic laboratory of hemoglobinopathies of the University Hospital of Guadeloupe, was implemented in 2014-2015 under the auspices of the Caribbean Network of Researchers on Sickle Cell Disease and Thalassemia. Results Analysis of 1914 samples processed identified the following abnormal phenotypes: 10 FS, 2 FSC, 183 FAS, 63 FAC. These data indicate ßs and ßc allele frequencies of 0.054 and 0.018, respectively. Conclusion Neonatal screening conducted in the framework of this Caribbean cooperation can allow rapid detection and earlier management of affected children.