Molecular Investigation of Canine Parvovirus-2 (CPV-2) Outbreak in Nevis Island: Analysis of the Nearly Complete Genomes of CPV-2 Strains from the Caribbean Region.

To date, there is a dearth of information on canine parvovirus-2 (CPV-2) from the Caribbean region. During August-October 2020, the veterinary clinic on the Caribbean island of Nevis reported 64 household dogs with CPV-2-like clinical signs (hemorrhagic/non-hemorrhagic diarrhea and vomiting), of which 27 animals died. Rectal swabs/fecal samples were obtained from 43 dogs. A total of 39 of the 43 dogs tested positive for CPV-2 antigen and/or DNA, while 4 samples, negative for CPV-2 antigen, were not available for PCR. Among the 21 untested dogs, 15 had CPV-2 positive littermates. Analysis of the complete VP2 sequences of 32 strains identified new CPV-2a (CPV-2a with Ser297Ala in VP2) as the predominant CPV-2 on Nevis Island. Two nonsynonymous mutations, one rare (Asp373Asn) and the other uncommon (Ala262Thr), were observed in a few VP2 sequences. It was intriguing that new CPV-2a was associated with an outbreak of gastroenteritis on Nevis while found at low frequencies in sporadic cases of diarrhea on the neighboring island of St. Kitts. The nearly complete CPV-2 genomes (4 CPV-2 strains from St. Kitts and Nevis (SKN)) were reported for the first time from the Caribbean region. Eleven substitutions were found among the SKN genomes, which included nine synonymous substitutions, five of which have been rarely reported, and the two nonsynonymous substitutions. Phylogenetically, the SKN CPV-2 sequences formed a distinct cluster, with CPV-2b/USA/1998 strains constituting the nearest cluster. Our findings suggested that new CPV-2a is endemic in the region, with the potential to cause severe outbreaks, warranting further studies across the Caribbean Islands. Analysis of the SKN CPV-2 genomes corroborated the hypothesis that recurrent parallel evolution and reversion might play important roles in the evolution of CPV-2.

Assessment of knowledge, attitudes, and practices towards Zika virus among healthcare workers in St. Kitts.

BACKGROUND: Healthcare workers are usually the first responders during outbreaks and are instrumental in educating the populace about the prevention of different diseases and illnesses. The aim of this study was to assess the association between healthcare workers' characteristics and knowledge, attitudes and practices toward Zika virus. METHODS: This was a cross-sectional study that collected data from healthcare workers at 3 medical facilities using a validated self-administered questionnaire between July 2017 - September 2017. Logistic regression models were used to examine the association between sociodemographic and knowledge, attitudes, and practices. RESULTS: A total of 190 healthcare workers were analyzed. Of these, 60, 72.6 and 64.7% had good knowledge, positive attitudes, and good practices toward Zika virus, respectively. Healthcare workers without a formal degree were less likely to have good knowledge of Zika virus (adjusted odds ratio (AOR) = 0:49; 95% confidence interval (CI) = 0.24-0.99) compared to those with a formal degree. Reduced odds for positive attitude towards Zika virus were observed in healthcare workers with low income as compared to those with high income (AOR = 0.31; 95% CI =0.13-0.75). Being younger than 40 years old was associated with poor Zika virus practices (AOR = 0:34; 95% CI = 0.15-0.79). CONCLUSIONS: Significant association between healthcare workers' sociodemographic characteristics and Zika virus knowledge, attitudes and practices were observed. Public health interventions that seek to increase Zika virus awareness should aim to train healthcare workers who are younger, without formal degree and those earning low income.

Tyzjuan Wade: my COVID-19 experience

Tyzjuan Wade is a 14 year old from St Kitts and Nevis who participated in a virtual COVID-19 Youth Dialog on adjusting to the “New Normal”, hosted by the PAHO/WHO Office for Barbados and the Eastern Caribbean Countries. In this video Tyzjuan explains how he adapted to living under a declared state of emergency in his country, which resulted from the COVID-19 pandemic.

High detection rates and genetic diversity of picobirnaviruses (PBVs) in pigs on St. Kitts Island: Identification of a porcine PBV strain closely related to simian and human PBVs.

We report here high rates (75.38%, 49/65) of detection of genogroup I (GI) PBVs in diarrheic pigs on the Caribbean island of St. Kitts. High quality gene segment-2 sequences encoding a significant region (~350 amino acid (aa) residues) of the putative RNA-dependent RNA polymerase (RdRp) were obtained for 23 PBV strains. The porcine PBV strains from St. Kitts exhibited high genetic diversity among themselves (deduced aa identities of 56-100%) and with other PBVs (maximum deduced aa identities of 64-97%), and retained the three domains that are conserved in putative RdRps of PBVs. The nearly complete gene segment-2 sequence (full-length minus partial 3'- untranslated region) of a porcine PBV strain (strain PO36 from St. Kitts) that is closely related (deduced aa identities of 96-97%) to simian and human GI PBVs was determined using a combination of the non-specific primer-based amplification method and conventional RT-PCR. The complete putative RdRp sequence of strain PO36 preserved the various features that are maintained in PBVs from various species. For the first time, several co-circulating PBV strains from pigs were characterized for a significant region (~350 aa) of the putative RdRp, providing important insights into the genetic diversity of PBVs in a porcine population. Taken together, these observations corroborated growing evidence that PBVs can be highly prevalent and show limited correlation globally with host species or geography. This is the first report on detection of PBVs in pigs from the Caribbean region.

Using Group Model Building to Describe the System Driving Unhealthy Eating and Identify Intervention Points: A Participatory, Stakeholder Engagement Approach in the Caribbean.

Many Small Island Developing States of the Caribbean experience a triple burden of malnutrition with high rates of obesity, undernutrition in children, and iron deficiency anemia in women of reproductive age, driven by an inadequate, unhealthy diet. This study aimed to map the complex dynamic systems driving unhealthy eating and to identify potential points for intervention in three dissimilar countries. Stakeholders from across the food system in Jamaica (n = 16), St. Kitts and Nevis (n = 19), and St. Vincent and the Grenadines (n = 6) engaged with researchers in two group model building (GMB) workshops in 2018. Participants described and mapped the system driving unhealthy eating, identified points of intervention, and created a prioritized list of intervention strategies. Stakeholders were also interviewed before and after the workshops to provide their perspectives on the utility of this approach. Stakeholders described similar underlying systems driving unhealthy eating across the three countries, with a series of dominant feedback loops identified at multiple levels. Participants emphasized the importance of the relative availability and price of unhealthy foods, shifting cultural norms on eating, and aggressive advertising from the food industry as dominant drivers. They saw opportunities for governments to better regulate advertising, disincentivize unhealthy food options, and bolster the local agricultural sector to promote food sovereignty. They also identified the need for better coordinated policy making across multiple sectors at national and regional levels to deliver more integrated approaches to improving nutrition. GMB proved to be an effective tool for engaging a highly diverse group of stakeholders in better collective understanding of a complex problem and potential interventions.

Extraintestinal Acanthocephalan Oncicola venezuelensis (Oligacanthorhynchidae) in Small Indian Mongooses (Herpestes auropunctatus) and African Green Monkeys (Chlorocebus aethiops sabaeus).

We identified multiple extraintestinal cystacanths during routine postmortem examination of 3 small Indian mongooses and 2 African green monkeys from the Caribbean island of St. Kitts. In mongooses, cystacanths were encysted or free in the subcutaneous tissue, skeletal muscle, or peritoneal or pericardial cavities, whereas in the monkeys, they were in the cavity and parietal layer of the, tunica vaginalis, skeletal muscle, and peritoneal cavity. Morphological, histological, and molecular characterization identified these cystacanths as Oncicola venezuelensis (Acanthocephala: Oligacanthorhynchidae). There was minimal to mild lymphoplasmacytic inflammation associated with the parasite in the mongooses and moderate inflammation, mineralization, hemorrhage, and fibrosis in the connective tissue between the testis and epididymis in 1 monkey. We identified a mature male O. venezuelensis attached in the aboral jejunum of a feral cat, confirming it as the definitive host. Termites serve as intermediate hosts and lizards as paratenic hosts. This report emphasizes the role of the small Indian mongoose and African green monkey as paratenic hosts for O. venezuelensis.

Infections and pathology of free-roaming backyard chickens on St. Kitts, West Indies.

Free-roaming chickens on Caribbean islands are important sentinels for local avian diseases and those introduced by birds migrating through the Americas. We studied 81 apparently healthy unvaccinated free-roaming chickens from 9 parishes on St. Kitts, an eastern Caribbean island. Using commercial ELISAs, no chickens had antibodies against avian influenza virus, West Nile virus, or Salmonella Enteritidis, although seropositivity was high to infectious bursal disease virus (86%), infectious bronchitis virus (84%), Mycoplasma (37%), and avian avulavirus 1 (Newcastle disease virus, 31%). Examination of small and large intestinal contents revealed cestodes in 79% and nematodes in 75% of the chickens. Although ectoparasites and endoparasites were common (74% and 79%, respectively), only a few chickens had lesions at postmortem examination, mainly intestinal serosal nodules (12%) and feather loss (6%). Histologic examination of 18 organs from each bird revealed lesions in high percentages of organs, mainly the liver (86%), lung (75%), spleen (60%), small intestine (56%), skin (42%), and kidney (40%). Lesions included degenerative, reactive, inflammatory, and neoplastic, and were not correlated with the serologic status of the chickens except in one case of infectious bursal disease. Microscopically, Paratanaisia bragai was seen in the kidneys of 3 chickens and intestinal coccidiasis in 1 chicken. Pulmonary silicate aggregates were common, were present in intestinal serosal nodules, and were suggestive of environmental exposure.

The prevalence of ultrasonographic abnormalities and histopathologic lesions is high in testes of yearling tropical hair rams.

Ultrasonography is commonly used to examine testes as part of a breeding soundness examination in sheep, especially, in cases of infertility or when gross testicular abnormalities are present. A descriptive, prospective, prevalence study was conducted to characterize the ultrasonographic, histopathologic, and spermatozoal morphology abnormalities present in a group of yearling tropic hair rams on the island of St. Kitts. Hyperechoic and shadowing abnormalities increased over a 6 month study period. Hyperechoic abnormalities were present in one or both testes in 89% (25/28) of yearling rams and 71% (40/56) of testes at castration. Shadowing abnormalities were present in one or both testes in 46% (13/28) of rams and 34% (19/56) of testes at castration. Shadowing was present more with moderate and severe hyperechoic abnormalities, with few testes in the mild category having any shadowing. As hyperechoic and shadowing abnormalities increased in severity, so did the severity of microscopic lesions including increased interstitial cellularity/fibrosis, interstitial mineralization, seminiferous tubules mineralization (hyperechoic only), and chronic lymphoplasmacytic orchitis. There were no spermatozoal morphologic abnormalities other than an increase in distal cytoplasmic droplets. The study findings detail a pathologic event in this group of yearling rams that has an unknown etiology. Potential causes may include scrotal insulation, trauma, infectious causes, immunity alterations, nutritional imbalances, and ingestion of a toxin. Further studies are required to elucidate the causative agent.

Epidemiology of Leptospira infection in livestock species in Saint Kitts.

This pilot study describes the prevalence of Leptospira infection and exposure in livestock species, cattle, pig, sheep, and goats in Saint Kitts in the Caribbean region. Serum and kidney samples were collected from cattle, pigs, sheep, and goats at a local abattoir between September 2016 and March 2017. Cattle had the highest seroprevalence (79.8%) followed by pigs (64.8%), sheep (39.4%), and goats (24.8%). Highest seroprevalence was observed to serovars, Mankarso in cattle, Bratislava in pigs, Hardjo in sheep, and goats. Leptospira DNA was amplified from kidney samples of 18/99 cattle (18.2%), 11/106 pigs (10.4%), 4/106 sheep (3.8%), and 2/105 goats (1.9%). Our findings warrant further studies to assess leptospirosis associated economic burden to subsistence farmers and public health impact.

Dengue in the campus community of an overseas American university: A cross-sectional study.

INTRODUCTION: After a large outbreak of dengue virus (DENV) serotype-3 in Saint Kitts and Nevis (SKN) in 2008, we performed a cross-sectional study to determine the prevalence of anti-DENV immunoglobulin G (IgG) antibodies in expatriate and local persons affiliated with an American veterinary school there. METHODOLOGY: This campus community comprised mostly expatriate students and faculty and Kittitian administrative staff. In 2009, a stratified random sample of students, faculty and staff was invited to complete an electronic survey to assess risk factors for DENV and provide blood for testing for anti-DENV IgG antibodies by an enzyme-linked immunosorbent assay. IgG-positive specimens were also tested by a 90% plaque reduction neutralization test (PRNT90) to determine immunoreactivity to DENV (1-4) serotypes and West Nile virus. Risk factors for anti-DENV IgG seropositivity were determined using simple and adjusted logistic regression. RESULTS: Of the 118 participants, the overall prevalence of DENV IgG antibodies was 44.1% (95% confidence interval [CI]: 35.1-53.0%), ranging from 30.1% in students, 100.0% in staff and 57.9% in faculty (p < 0.001). Duration of residence in St. Kitts was the only variable significantly associated with seropositivity on multiple logistic regression (adjusted odds ratio [95% CI]: 1.21 [1.07-1.37]). The serotype of DENV was determined in 11 persons: DENV-1 (n = 4), DENV-2 (n = 3), and DENV-3 (n = 4). CONCLUSIONS: Expatriate students and faculty moving to St. Kitts from non-endemic areas were at high risk of DENV infection. There is a need for increased emphasis on pre-travel mosquito-borne virus prevention education for persons moving to St. Kitts to study and work.

Mind-body therapies: an intervention to reduce work-related stress in veterinary academia.

Studies investigating perceived stress and mindfulness awareness support mind-body therapy (MBT) effectiveness in reducing stress and anxiety and, thus, has potential to decrease work-related stress. A pre/postexperimental design involved 30 faculty and staff working at Ross University School of Veterinary Medicine, Saint Kitts and Nevis, who experienced a two-day MBT intervention programme. An additional 16 faculty and staff not involved in MBT who went about their daily work schedules served as contemporary controls. Demographics, Perceived Stress Scale 10 (PSS-10), Mindful Attention Awareness Scale (MAAS), 16 Personality Factor (16PF) Openness to Change subscale and saliva cortisol concentrations were analysed. Control participants reported significantly perceived less stress (PSS-10: M=13; sd=1.4) than intervention participants (M=20; sd=6.6) during pretest. However, at post-test the intervention group reported a significant decrease in perceived stress (M=11; sd=6.0). MAAS pretest results indicated the intervention group displayed a lower average score (M=54; sd=15.3) than control participants (M=68; sd=2.0). Post-MAAS intervention scores showed improvements in mindfulness (M=63; sd=15.3). Correlations between the 16PF Openness to Change subscale and MAAS were r=0.03 and r=-0.17 for the intervention and control groups, respectively. Mean concentrations of saliva cortisol indicated a larger and significant decline in cortisol for the intervention group both during day 1 (P=0.0001) and day 2 (P=0.0008). In conclusion, these preliminary results provide support that MBTs in veterinary academia can improve psychological and physiological aspects of personal wellbeing.

Freedom from Tritrichomonas foetus infection in cattle in St. Kitts.

Trichomonosis is an endemic disease in cattle that are reared under extensive conditions and bred by natural mating. It causes profound economic losses to the producers by increasing calving interval, increasing embryo losses, and decreasing pregnancy rates. The aim of this study was to determine whether Tritrichomonas foetus infections were absent from cattle in St. Kitts. Using the modified hypergeometric method, preputial samples from bulls (n = 78) were tested using the InPouch™ culture for presence of T. foetus. Results highlighted an absence of trichomoniasis in bulls on St. Kitts with a 95% confidence.

High Leptospira seroprevalence in captive and wild-caught vervet monkeys ( Chlorocebus sabeus) on the Caribbean island of Saint Kitts.

Leptospirosis is a zoonotic disease of global importance. Very little information is available on Leptospira infection in nonhuman primates. We report herein a high seroprevalence (49.4%; 95% confidence interval: 41.6-57.2%) to Leptospira serovars in vervet monkeys ( Chlorocebus sabeus) on the Caribbean island of Saint Kitts. Monkeys bred in captivity ( n = 81) had a significantly higher seroprevalence compared to wild-caught monkeys ( n = 81; p < 0.05). Seroprevalence to serovar Bataviae was significantly higher in monkeys bred in captivity and was higher to serovar Bratislava in wild-caught monkeys ( p < 0.05). Our data confirm that exposure to various Leptospira serovars and seroconversion occurs in wild and captive vervet monkeys on the Caribbean island of Saint Kitts. Further studies are warranted to better understand epidemiology, transmission, pathology, and possible reservoir status in this species.

Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries.

OBJECTIVE: To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. METHODS: Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. RESULTS: High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. CONCLUSIONS: These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

Chronic kidney disease and risk factor prevalence in Saint Kitts and Nevis: a cross-sectional study.

BACKGROUND: The prevalence of chronic kidney disease (CKD) in St. Kitts and Nevis, islands of the West Indies, is unknown. We sought to determine estimates of CKD and its risk factors (e.g. diabetes, hypertension and obesity) in St. Kitts and Nevis. METHODS: This was a chronic disease screening program. Three community-based locations in St. Kitts and Nevis were included in the program. Participants were adult community residents aged ≥18 years. The main outcome measures were estimated CKD prevalence (by serum creatinine-based estimated glomerular filtration rate (eGFR) and dipstick urine albumin); and estimated prevalence of CKD risk factors (diabetes, hypertension and obesity). Logistic regression was used to determine independent predictors of CKD. RESULTS: One thousand nine hundred seventy eight persons, from Nevis (n = 950) and St. Kitts (n = 1028) were screened by the Caribbean Health and Education Foundation. Participants' mean age was 49 ± 15 years, 65% were female, and 99% were black. Fully, 21.5% had diabetes and 53.1% had hypertension; and 40.3% were obese. Mean estimated eGFR was 98 ml/min/1.73 m2 (standard deviation = 30) and 4.7% had an eGFR <60 ml/min/1.73 m2, indicating CKD. Age [Odds Ratio (OR) = 1.08, 95% Confidence Interval (CI) 1.05-1.11], hypertension (OR = 2.89, 95% CI 1.18-7.07) and diabetes (OR = 3.12, 95% CI 1.80-5.43) were independent predictors of reduced eGFR in models adjusted for age, gender and obesity status. Of those with urine testing in Nevis (n = 929), 13.5% had urine albumin ≥30 mg/dL, and diabetes was an independent predictor of this finding (OR = 2.43, 95% CI 1.53-3.87). CONCLUSIONS: CKD and its risk factors were prevalent among adults in St. Kitts and Nevis. Public policy strategies for prevention and treatment of these conditions may be needed to reduce their associated morbidity, mortality and costs.

Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries / Prevalencia del virus del papiloma humano de alto riesgo en las mujeres de dos países del Caribe de habla inglesa / Prevalência do papilomavírus humano de alto risco em mulheres em dois países do Caribe anglófono

ABSTRACT Objective To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Methods Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. Results High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. Conclusions These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study’s results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

RESUMEN Objetivo Caracterizar la infección por el virus del papiloma humano (VPH) de alto riesgo en una muestra de mujeres de dos países pequeños del Caribe de habla inglesa: Saint Kitts y Nevis, y San Vicente y las Granadinas. Métodos Participaron en el estudio mujeres sexualmente activas ≥ 30 años que acudieron a centros de atención primaria. Se realizó un examen ginecológico a todas las participantes y se le tomaron dos muestras cervicouterinas: 1) una muestra para efectuar la prueba de Papanicolaou y 2) células cervicouterinas exfoliadas para efectuar la prueba de ADN del VPH, mediante la prueba de detección del VPH de alto riesgo en tiempo real (HPV High Risk Screen Real-TM, Sacace). Se evaluaron los genotipos de alto riesgo del VPH en 404 mujeres en Saint Kitts y Nevis, y en 368 mujeres en San Vicente y las Granadinas. Resultados Se detectó VPH de alto riesgo en 102 de 404 mujeres (25,2%) de Saint Kitts y Nevis, y en 109 de 368 (29,6%) de San Vicente y las Granadinas. Los genotipos 52, 35, 51, 45 y 31 de VPH de alto riesgo fueron los detectados con más frecuencia en Saint Kitts y Nevis. En San Vicente y las Granadinas, los más frecuentes fueron los genotipos 45, 35, 31, 18 y 51. Se observó una relación significativa entre la edad actual y la infección por el VPH de alto riesgo en los dos países. Además, en San Vicente y las Granadinas, se halló que la multiparidad (> 3 embarazos) y los resultados anómalos de la prueba de Papanicolaou son factores de riesgo independientes de la infección por el VPH de alto riesgo. Conclusiones Estos resultados aportan datos acerca de la prevalencia del VPH en los estados insulares pequeños del Caribe y respaldan la introducción acelerada de la vacuna nonavalente contra el VPH en los dos países y en los demás países del Caribe de habla inglesa. Se recomienda aplicar los resultados de este estudio para guiar la formulación de políticas con respecto a la incorporación de las pruebas de detección del VPH como método primario de tamizaje en las mujeres mayores.

RESUMO Objetivo Caracterizar as infecções pelo papilomavírus humano (HPV) de alto risco em uma amostra de mulheres de dois países pequenos do Caribe anglófono: São Cristóvão e Nevis e São Vicente e Granadinas. Métodos Mulheres sexualmente ativas com ≥ 30 anos de idade atendidas em unidades básicas de saúde participaram do estudo. Cada participante foi submetida a exame ginecológico e coleta de duas amostras do colo do útero: (1) uma amostra para exame de Papanicolau e (2) uma amostra de citologia esfoliativa para teste de DNA do HPV, utilizando o kit HPV High Risk Screen Real-TM (Sacace). A presença de genótipos de HPV de alto risco foi avaliada em 404 mulheres em São Cristóvão e Nevis e 368 mulheres em São Vicente e Granadinas. Resultados HPV de alto risco foi detectado em 102/404 mulheres (25,2%) em São Cristóvão e Nevis e em 109/368 (29,6%) em São Vicente e Granadinas. Os genótipos 52, 35, 51, 45 e 31 do HPV foram os tipos de alto risco mais comuns em São Cristóvão e Nevis. Em São Vicente e Granadinas, os genótipos do HPV de alto risco mais comuns foram 45, 35, 31, 18 e 51. Foi constatada associação significante entre idade atual e infecção por HPV de alto risco em ambos os países. Além disso, em São Vicente e Granadinas, multiparidade (>3 gestações) e Papanicolau anormal foram fatores de risco independentes para o HPV de alto risco. Conclusões Esses resultados contribuem informações sobre a prevalência do HPV nas pequenas nações insulares do Caribe e apoiam a introdução acelerada da vacina nonavalente contra o HPV nestes dois países e no restante do Caribe anglófono. Recomenda-se o uso dos resultados deste estudo para orientar a formulação de políticas com relação à implementação do exame de HPV como modalidade primária de triagem para mulheres mais velhas.

Toxoplasma gondii in livestock in St. Kitts and Nevis, West Indies.

BACKGROUND: Toxoplasma gondii is a ubiquitous protozoan parasite capable of infecting all warm-blooded animals including livestock. In these animals, the parasite forms cysts in the tissues which may pose a risk to public health if infected meat is consumed undercooked or raw. The aim of this study was to determine the exposure of livestock to T. gondii in St. Kitts and Nevis. METHODS: Sera and/or heart tissue and meat juice were collected from pigs (n = 124), sheep (n = 116) and goats (n = 66) at the St. Kitts Abattoir. Sera and meat juice were screened for reactive antibodies to T. gondii using an in-house ELISA. Heart tissue was screened for T. gondii DNA using quantitative PCR and positive samples were genotyped using RFLP. RESULTS: Antibodies to T. gondii were detected in sera from 48% of pigs, 26% of sheep and 34% of goats tested. Antibodies were also detected in the meat juice from 55% of pig hearts, 22% of sheep hearts and 31% of goat hearts tested. There was a significant positive correlation between serology and meat juice results. T. gondii DNA was detected in heart tissue of 21% of pigs, 16% of sheep and 23% of goats tested. Preliminary PCR-RFLP analysis identified a predominance of the Type III genotype of T. gondii. CONCLUSIONS: These results suggest widespread environmental contamination with T. gondii oocysts and that livestock could be a potentially important source of T. gondii infection if their infected meat is consumed (or handled) undercooked.

First report of Toxoplasma gondii seroprevalence in wild-caught Caribbean African green monkeys.

BACKGROUND: Toxoplasma gondii is a protozoan parasite capable of infecting all warm-blooded animals. Humans can become infected by ingesting infective oocysts from the environment or contaminated food or water, or by ingesting tissue cysts in undercooked infected meat or by handling infected meat. Caribbean African green monkeys (Chlorocebus sabaeus) are present in large numbers on the island of St. Kitts in the Caribbean, and it is not uncommon for these animals to be trapped and eaten by islanders. The aim of this study was to determine T. gondii infection in Caribbean African green monkeys. FINDINGS: Sera collected from 79 wild-caught Caribbean African green monkeys were examined for T. gondii antibodies by ELISA. Antibodies were detected in 38 out of 79 (48.1%) monkeys. Significantly more females were infected than males but there was no significant effect of age or location on antibody status. CONCLUSIONS: Results indicate that Caribbean African green monkeys can be infected with T. gondii and that there is widespread environmental contamination of St. Kitts with oocysts. These monkeys could present a potential source of T. gondii infection if their meat is consumed undercooked. This is the first report of T. gondii antibodies in this species.

Fatal septicemia caused by the zoonotic bacterium Streptococcus iniae during an outbreak in Caribbean reef fish.

An outbreak of Streptococcus iniae occurred in the early months of 2008 among wild reef fish in the waters of the Federation of St Kitts and Nevis, lasting almost 2 months. Moribund and dead fish were collected for gross, histological, bacteriological, and molecular analysis. Necropsy findings included diffuse fibrinous pericarditis, pale friable livers, and serosal petechiation. Cytological and histological analysis revealed granulocytic and granulomatous inflammation with abundant coccoid bacterial organisms forming long chains. Necrosis, inflammation, and vasculitis were most severe in the pericardium, meninges, liver, kidneys, and gills. Bacterial isolates revealed ß-hemolytic, Gram-positive coccoid bacteria identified as S. iniae by amplification and 16S ribosomal RNA gene sequencing. Results from biochemical and antimicrobial susceptibility analysis, together with repetitive element palindromic polymerase chain reaction fingerprinting, suggest that a single strain was responsible for the outbreak. The inciting cause for this S. iniae-associated cluster of mortalities is unknown.

Tick-borne pathogens and disease in dogs on St. Kitts, West Indies.

Between 2009 and 2011, we conducted a case-control study of ticks and tick-associated pathogens affecting dogs on the island of St. Kitts, eastern Caribbean, including 55 cases of clinically suspected tick-borne disease (TBD) and 110 presumably healthy animals presented for elective surgeries. Rhipicephalus sanguineus caused year-round infestations of dogs, and 36% of the dogs in the study were infested at the time of examination. Overall, 62% of suspected TBD cases and 24% of presumably healthy dogs tested positive by PCR for infections with: Anaplasma platys (0% and 4%), Babesia canis vogeli (20% and 6%), Babesia gibsoni (18% and 5%), Ehrlichia canis (35% and 7%), and Hepatozoon canis (5% and 2%). Co-infections were documented in 15% of these PCR-positive dogs. Antibodies against A. platys or E. canis were noted in 36% of the dogs. Thrombocytopenia was the most common sign of infection, followed by anemia. This is the first detection of A. platys, B. canis vogeli, or H. canis on St. Kitts and the first detection of B. gibsoni in the Caribbean. We conclude that tick-borne pathogens of dogs are highly prevalent in this region and may present in dogs that appear healthy, in spite of hematologic abnormalities that may increase surgical risk.