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1.
Am J Trop Med Hyg ; 102(4): 827-831, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32043449

RESUMO

Saint Lucia at one time had levels of schistosomiasis prevalence and morbidity as high as many countries in Africa. However, as a result of control efforts and economic development, including more widespread access to sanitation and safe water, schistosomiasis on the island has practically disappeared. To evaluate the current status of schistosomiasis in Saint Lucia, we conducted a nationally representative school-based survey of 8-11-year-old children for prevalence of Schistosoma mansoni infections using circulating antigen and specific antibody detection methods. We also conducted a questionnaire about available water sources, sanitation, and contact with fresh water. The total population of 8-11-year-old children on Saint Lucia was 8,985; of these, 1,487 (16.5%) provided urine for antigen testing, 1,455 (16.2%) provided fingerstick blood for antibody testing, and 1,536 (17.1%) answered the questionnaire. Although a few children were initially low positives by antigen or antibody detection methods, none could be confirmed positive by follow-up testing. Most children reported access to clean water and sanitary facilities in or near their homes and 48% of the children reported contact with fresh water. Together, these data suggest that schistosomiasis transmission has been interrupted on Saint Lucia. Additional surveys of adults, snails, and a repeat survey among school-age children will be necessary to verify these findings. However, in the same way that research on Saint Lucia generated the data leading to use of mass drug administration for schistosomiasis control, the island may also provide the information needed for guidelines to verify interruption of schistosomiasis transmission.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Esquistossomose/epidemiologia , Esquistossomose/transmissão , Criança , Feminino , Humanos , Masculino , Fatores de Risco , Santa Lúcia/epidemiologia , Saneamento , Esquistossomose/prevenção & controle , Testes Sorológicos , Inquéritos e Questionários
2.
Zootaxa ; 4425(3): 511-526, 2018 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-30313298

RESUMO

Most high volcanic islands of Lesser Antilles harbor one single genus of Anostostomatidae: Rhumosa n. gen: Rhumosa bolognei n. gen. n. sp. in Guadeloupe, Rhumosa macoucheriei n. gen. n. sp. in Dominica, Rhumosa depazei n. gen. n. sp. in Martinique, Rhumosa admiralrodneyei n. gen. n. sp. in Saint Lucia, Rhumosa captainblighei n. gen. n. sp., in Saint Vincent. These species are restricted to well preserved rainforests; species from northern islands apparently occurring at higher elevation than species of southern islands. The distribution and generic position of Rhumosa n. gen. species is discussed, as well as the generic position of Lutosa cubaensis (Haan, 1843).


Assuntos
Distribuição Animal , Ortópteros , Animais , Região do Caribe , Dominica , Guadalupe , Ilhas , Martinica , Santa Lúcia
3.
Artigo em Inglês | PAHO-IRIS | ID: phr-49079

RESUMO

[ABSTRACT]. Objectives. To more accurately determine coverage and timeliness of the second dose of measles-mumps-rubella vaccine (MMR2), while identifying factors associated with low MMR2 vaccination uptake among children in Saint Lucia. Methods. A survey was conducted in October – November 2015 targeting children born in 2004 – 2009. At 86 preschools and primary schools, two children from each grade were randomly selected, yielding an effective sample of 836 children. Health records were reviewed to assess vaccination coverage and timeliness. Parents and/or guardians and principals of all 86 schools were interviewed regarding knowledge, attitudes, and practices related to vaccination. Results. Of 767 children included, 75% were vaccinated with MMR2 (n = 572); 46.7% were vaccinated in a timely manner, i.e., by 5 years of age. Cohorts born in 2004, 2005, and 2008 reported the lowest proportion. ‘Mothers as caregivers’ was positively associated with timely MMR2 vaccination. Although 97% of principals surveyed considered vaccination important, 48.8% were not aware of national legislation requiring complete vaccination prior to school entry. Survey results concurred with the low MMR2 administrative coverage rates reported by Saint Lucia, much lower than the recommended 95%. Conclusions. Based on the results of this survey, Saint Lucia’s national immunization program has lowered the age of MMR2 to 18 months in 2016, increased advocacy with schools to enforce the school-entry law, and is working to vaccinate the cohorts of children who have not received timely MMR2.


[RESUMEN]. Objetivos. Determinar con mayor precisión la cobertura y el respeto de los plazos de vacunación de la segunda dosis de la vacuna contra el sarampión, la rubéola y la parotiditis (triple viral), al tiempo que se detectan los factores asociados con la baja aceptación de esa vacuna en Santa Lucía. Métodos. En octubre y noviembre del 2015 se llevó a cabo una encuesta centrada en niños nacidos entre el 2004 y el 2009. En 86 centros preescolares y primarios se seleccionó al azar a dos niños de cada grado, lo que arrojó un tamaño real de la muestra de 836 niños. Se analizaron los registros de salud para evaluar la cobertura y el respeto de los plazos de vacunación. Se entrevistó a los padres o tutores y los directores de las 86 escuelas sobre conocimientos, actitudes y prácticas en materia de vacunación. Resultados. De los 767 niños incluidos, el 75% fueron vacunados con la segunda dosis de la triple viral (n = 572); el 46,7% fueron vacunados a tiempo, es decir, a los 5 años de edad. La proporción más baja se dio en las cohortes nacidas en el 2004, 2005 y 2008. Se observó que las madres cuidadoras influían positivamente en el respeto de los plazos de vacunación de la segunda dosis de la triple viral. Aunque el 97% de los directores encuestados consideraba que la vacunación era importante, el 48,8% desconocía la legislación nacional que exige la vacunación completa antes de ingresar a la escuela. Los resultados de la encuesta estaban en consonancia con las tasas bajas de cobertura administrativa de la segunda dosis de la triple viral informadas por Santa Lucía, muy por debajo del 95% recomendado. Conclusiones. Según los resultados de esta encuesta, el programa nacional de vacunación de Santa Lucía redujo la edad de la segunda dosis de la triple viral a los 18 meses en el 2016, aumentó las actividades de promoción en las escuelas para fomentar el cumplimiento de la ley que obliga a recibir la vacunación antes de ingresar a la escuela y está trabajando para vacunar a las cohortes de niños que no recibieron la segunda dosis de la triple viral en su debido momento.


[RESUMO]. Objetivos. Determinar com precisão a cobertura vacinal e o momento oportuno para ministrar a segunda dose da vacina tríplice viral (sarampo, caxumba e rubéola – SCR) e identificar os fatores associados à baixa utilização da vacina em crianças. Métodos. Uma pesquisa direcionada a crianças nascidas de 2004 a 2009 foi realizada em Santa Lúcia em outubro e novembro de 2015. Em 86 unidades de ensino infantil e fundamental, duas crianças de cada série foram selecionadas aleatoriamente, constituindo uma amostra efetiva de 836 crianças. Dados sobre a cobertura e o momento oportuno de vacinação foram obtidos das fichas de saúde. Foram conduzidas entrevistas com os pais e/ou responsáveis e os diretores das 86 escolas sobre conhecimento, atitudes e práticas relacionadas à vacinação. Resultados. Das 767 crianças incluídas na amostra, 75% foram vacinadas com a segunda dose de SCR (n = 572) e 46,7% receberam a vacina no momento oportuno (ou seja, até os 5 anos de idade). Observou-se menor proporção de vacinados nas coortes nascidas em 2004, 2005 e 2008. ‘’Mães como cuidadoras’’ teve uma associação positiva com ministrar a segunda dose de SCR no momento oportuno. Apesar de 97% dos diretores entrevistados considerarem a vacinação importante, 48,8% desconheciam a legislação nacional que exige vacinação completa para a matrícula escolar. Os resultados reforçaram a baixa cobertura vacinal da segunda dose de SCR registrada em Santa Lúcia, bem inferior ao índice recomendado de 95%. Conclusões. A partir dos resultados desta pesquisa, em 2016, o programa nacional de vacinação de Santa Lúcia reduziu para 18 meses a idade de administração da segunda dose de SCR, intensificou a recomendação para que as escolas cumpram com a legislação para matrícula escolar e está empenhado em vacinar as coortes de crianças que não receberam a segunda dose de SCR no momento oportuno.


Assuntos
Vacina contra Sarampo-Caxumba-Rubéola , Vacinação em Massa , Programas de Imunização , Santa Lúcia , Índias Ocidentais , Vacina contra Sarampo-Caxumba-Rubéola , Programas de Imunização , Santa Lúcia , Índias Ocidentais , Santa Lúcia , Vacinação em Massa , Vacina contra Sarampo-Caxumba-Rubéola , Vacinação em Massa , Programas de Imunização , Índias Ocidentais
5.
Dev World Bioeth ; 18(4): 375-384, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-28752914

RESUMO

Various forms of research are essential in emergency, disaster and disease outbreak situations, but challenges exist including the long length of time it takes to get research proposals approved. Consequently, it would be very advantageous to have an acceptable model for efficient coordination and communication between and among research ethics committees/IRBs and ministries of health, and templates for expediting (done with speed and efficiency) ethical review of research proposals in emergency and epidemic situations to be used across the Caribbean and in other low and middle income countries. This project involved a literature search and the interviewing of ministry of health officials, public health practitioners, and research ethics committee/IRB members in Jamaica and St. Lucia, to obtain suggestions for the best model for efficient coordination and communication between research ethics committees (RECs), and developed a template for expediting review of research protocols in epidemic and emergency conditions.


Assuntos
Comportamento Cooperativo , Desastres , Eficiência , Emergências , Epidemias , Revisão Ética , Saúde Pública/ética , Região do Caribe , Comunicação , Países em Desenvolvimento , Comitês de Ética em Pesquisa , Ética em Pesquisa , Órgãos Governamentais , Humanos , Jamaica , Projetos de Pesquisa , Santa Lúcia , Inquéritos e Questionários
6.
Rev. panam. salud pública ; 42: e76, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-961787

RESUMO

ABSTRACT Objectives To more accurately determine coverage and timeliness of the second dose of measles-mumps-rubella vaccine (MMR2), while identifying factors associated with low MMR2 vaccination uptake among children in Saint Lucia. Methods A survey was conducted in October - November 2015 targeting children born in 2004 - 2009. At 86 preschools and primary schools, two children from each grade were randomly selected, yielding an effective sample of 836 children. Health records were reviewed to assess vaccination coverage and timeliness. Parents and/or guardians and principals of all 86 schools were interviewed regarding knowledge, attitudes, and practices related to vaccination. Results Of 767 children included, 75% were vaccinated with MMR2 (n = 572); 46.7% were vaccinated in a timely manner, i.e., by 5 years of age. Cohorts born in 2004, 2005, and 2008 reported the lowest proportion. 'Mothers as caregivers' was positively associated with timely MMR2 vaccination. Although 97% of principals surveyed considered vaccination important, 48.8% were not aware of national legislation requiring complete vaccination prior to school entry. Survey results concurred with the low MMR2 administrative coverage rates reported by Saint Lucia, much lower than the recommended 95%. Conclusions Based on the results of this survey, Saint Lucia's national immunization program has lowered the age of MMR2 to 18 months in 2016, increased advocacy with schools to enforce the school-entry law, and is working to vaccinate the cohorts of children who have not received timely MMR2.


RESUMEN Objetivos Determinar con mayor precisión la cobertura y el respeto de los plazos de vacunación de la segunda dosis de la vacuna contra el sarampión, la rubéola y la parotiditis (triple viral), al tiempo que se detectan los factores asociados con la baja aceptación de esa vacuna en Santa Lucía. Métodos En octubre y noviembre del 2015 se llevó a cabo una encuesta centrada en niños nacidos entre el 2004 y el 2009. En 86 centros preescolares y primarios se seleccionó al azar a dos niños de cada grado, lo que arrojó un tamaño real de la muestra de 836 niños. Se analizaron los registros de salud para evaluar la cobertura y el respeto de los plazos de vacunación. Se entrevistó a los padres o tutores y los directores de las 86 escuelas sobre conocimientos, actitudes y prácticas en materia de vacunación. Resultados De los 767 niños incluidos, el 75% fueron vacunados con la segunda dosis de la triple viral (n = 572); el 46,7% fueron vacunados a tiempo, es decir, a los 5 años de edad. La proporción más baja se dio en las cohortes nacidas en el 2004, 2005 y 2008. Se observó que las madres cuidadoras influían positivamente en el respeto de los plazos de vacunación de la segunda dosis de la triple viral. Aunque el 97% de los directores encuestados consideraba que la vacunación era importante, el 48,8% desconocía la legislación nacional que exige la vacunación completa antes de ingresar a la escuela. Los resultados de la encuesta estaban en consonancia con las tasas bajas de cobertura administrativa de la segunda dosis de la triple viral informadas por Santa Lucía, muy por debajo del 95% recomendado. Conclusiones Según los resultados de esta encuesta, el programa nacional de vacunación de Santa Lucía redujo la edad de la segunda dosis de la triple viral a los 18 meses en el 2016, aumentó las actividades de promoción en las escuelas para fomentar el cumplimiento de la ley que obliga a recibir la vacunación antes de ingresar a la escuela y está trabajando para vacunar a las cohortes de niños que no recibieron la segunda dosis de la triple viral en su debido momento.


RESUMO Objetivos Determinar com precisão a cobertura vacinal e o momento oportuno para ministrar a segunda dose da vacina tríplice viral (sarampo, caxumba e rubéola - SCR) e identificar os fatores associados à baixa utilização da vacina em crianças. Métodos Uma pesquisa direcionada a crianças nascidas de 2004 a 2009 foi realizada em Santa Lúcia em outubro e novembro de 2015. Em 86 unidades de ensino infantil e fundamental, duas crianças de cada série foram selecionadas aleatoriamente, constituindo uma amostra efetiva de 836 crianças. Dados sobre a cobertura e o momento oportuno de vacinação foram obtidos das fichas de saúde. Foram conduzidas entrevistas com os pais e/ou responsáveis e os diretores das 86 escolas sobre conhecimento, atitudes e práticas relacionadas à vacinação. Resultados Das 767 crianças incluídas na amostra, 75% foram vacinadas com a segunda dose de SCR (n = 572) e 46,7% receberam a vacina no momento oportuno (ou seja, até os 5 anos de idade). Observou-se menor proporção de vacinados nas coortes nascidas em 2004, 2005 e 2008. "Mães como cuidadoras" teve uma associação positiva com ministrar a segunda dose de SCR no momento oportuno. Apesar de 97% dos diretores entrevistados considerarem a vacinação importante, 48,8% desconheciam a legislação nacional que exige vacinação completa para a matrícula escolar. Os resultados reforçaram a baixa cobertura vacinal da segunda dose de SCR registrada em Santa Lúcia, bem inferior ao índice recomendado de 95%. Conclusões A partir dos resultados desta pesquisa, em 2016, o programa nacional de vacinação de Santa Lúcia reduziu para 18 meses a idade de administração da segunda dose de SCR, intensificou a recomendação para que as escolas cumpram com a legislação para matrícula escolar e está empenhado em vacinar as coortes de crianças que não receberam a segunda dose de SCR no momento oportuno.


Assuntos
Humanos , Vacinação em Massa/organização & administração , Programas de Imunização/provisão & distribução , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Índias Ocidentais , Santa Lúcia/epidemiologia
7.
Geneva; World Health Organization; 2018. (WHO/CCU/18.02/Saint Lucia).
em Inglês | WHO IRIS | ID: who-272545
8.
Rev Panam Salud Publica ; 41: e70, 2017 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-28614479

RESUMO

Objectives: In the Caribbean country of Saint Lucia, umbilical-cord-blood screening for sickle cell disease (SCD) was the testing method that health care workers (HCWs) on the maternity wards of the hospitals preferred until the new heel prick (HP) testing method was introduced in the country in 2014. This SCD study sought to assess HCWs' knowledge of and attitude toward HP screening and also determine new mothers' favorability toward HP screening. Methods: A total of 70 HCWs and 132 new mothers answered survey questionnaires in three hospitals. In addition, four focus group discussions were held, two with HCWs and two with the mothers. Results: Among the HCWs interviewed, 85.7% of them had knowledge of the HP test. However, only 25.7% had attended training sessions on the procedure. Among the HCWs, 64.3% of them felt the HP test should be mandatory, 27.1% said it should not be mandatory, and 8.6% did not know if it should be mandatory. In their focus groups, the HCWs said they believed the mothers would accept the HP method. For their part, 22.0% of the mothers said they had heard about the HP test, and 63.6% reported knowing the reason why the baby would be tested. Further, 83.3% indicated that the test would be beneficial for the baby. In addition, 88.6% of the mothers said that more information on the HP test was needed. In their focus group discussions, the mothers said they were generally not concerned about the pain the heel prick method might cause the baby. Conclusions: The HCWs' knowledge of the HP screening method was high. The mothers trust HCWs, and the mothers would accept the HP procedure irrespective of their knowledge of the test and any discomfort associated with this screening method.


Assuntos
Anemia Falciforme/sangue , Anemia Falciforme/induzido quimicamente , Coleta de Amostras Sanguíneas/métodos , Conhecimentos, Atitudes e Prática em Saúde , Mães , Triagem Neonatal/métodos , Adulto , Estudos Transversais , Calcanhar , Humanos , Recém-Nascido , Santa Lúcia , Autorrelato , Adulto Jovem
9.
Artigo em Inglês | PAHO-IRIS | ID: phr-34038

RESUMO

Objectives. In the Caribbean country of Saint Lucia, umbilical-cord-blood screening for sickle cell disease (SCD) was the testing method that health care workers (HCWs) on the maternity wards of the hospitals preferred until the new heel prick (HP) testing method was introduced in the country in 2014. This SCD study sought to assess HCWs’ knowledge of and attitude toward HP screening and also determine new mothers’ favorability toward HP screening. Methods. A total of 70 HCWs and 132 new mothers answered survey questionnaires in three hospitals. In addition, four focus group discussions were held, two with HCWs and two with the mothers. Results. Among the HCWs interviewed, 85.7% of them had knowledge of the HP test. However, only 25.7% had attended training sessions on the procedure. Among the HCWs, 64.3% of them felt the HP test should be mandatory, 27.1% said it should not be mandatory, and 8.6% did not know if it should be mandatory. In their focus groups, the HCWs said they believed the mothers would accept the HP method. For their part, 22.0% of the mothers said they had heard about the HP test, and 63.6% reported knowing the reason why the baby would be tested. Further, 83.3% indicated that the test would be beneficial for the baby. In addition, 88.6% of the mothers said that more information on the HP test was needed. In their focus group discussions, the mothers said they were generally not concerned about the pain the heel prick method might cause the baby. Conclusions. The HCWs’ knowledge of the HP screening method was high. The mothers trust HCWs, and the mothers would accept the HP procedure irrespective of their knowledge of the test and any discomfort associated with this screening method.


Objetivos. No país caribenho de Santa Lúcia, o exame de sangue de cordão umbilical para detecção da doença falciforme (DF) era o método de triagem preferido pelos profissionais da saúde atuantes em maternidades, até a introdução do “teste do pezinho” (TP) no país em 2014. Este estudo sobre DF buscou avaliar o conhecimento e atitudes de profissionais da saúde em relação à triagem pelo TP e também determinar a favorabilidade das novas mães em direção à triagem de TP. Métodos. Setenta profissionais da saúde e 132 novas mães responderam a questionários de pesquisa em três hospitais. Além disso, foram realizadas quatro discussões com grupos focais: dois de profissionais da saúde e dois de mães. Resultados. Entre os profissionais da saúde entrevistados, 85,7% tinham conhecimento acerca do TP. Porém, somente 25,7% haviam comparecido às sessões de capacitação sobre o procedimento. Entre os profissionais da saúde, 64,3% opinaram que o TP deveria ser obrigatório, 27,1% disseram que não deveria ser obrigatório e 8,6% não sabiam se deveria ser obrigatório. Em seus grupos focais, os profissionais da saúde disseram acreditar que as mães aceitariam o método do TP. Por sua vez, 22,0% das mães disseram ter ouvido falar sobre o TP, e 63,6% relataram saber o motivo pelo qual o exame seria realizado; ademais, 83,3% indicaram que o exame seria benéfico para o bebê. Além disso, 88,6% das mães disseram que precisavam de maiores informações sobre o TP. Em seus grupos focais, as mães disseram que, em geral, não estavam preocupadas com dor que o teste do pezinho poderia causar ao bebê. Conclusões. Os profissionais da saúde apresentaram alto nível de conhecimento acerca do método de triagem pelo TP. As mães confiam nos profissionais da saúde, e aceitariam o procedimento de TP independentemente de seu conhecimento acerca do teste e de qualquer desconforto associado a este método de triagem.


Assuntos
Anemia Falciforme , Santa Lúcia , Índias Ocidentais , Anemia Falciforme , Pessoal de Saúde , Comunicação em Saúde , Pessoal de Saúde , Comunicação em Saúde , Índias Ocidentais
10.
Rev. panam. salud pública ; 41: e70, 2017. graf
Artigo em Inglês | LILACS | ID: biblio-845690

RESUMO

ABSTRACT Objectives In the Caribbean country of Saint Lucia, umbilical-cord-blood screening for sickle cell disease (SCD) was the testing method that health care workers (HCWs) on the maternity wards of the hospitals preferred until the new heel prick (HP) testing method was introduced in the country in 2014. This SCD study sought to assess HCWs’ knowledge of and attitude toward HP screening and also determine new mothers’ favorability toward HP screening. Methods A total of 70 HCWs and 132 new mothers answered survey questionnaires in three hospitals. In addition, four focus group discussions were held, two with HCWs and two with the mothers. Results Among the HCWs interviewed, 85.7% of them had knowledge of the HP test. However, only 25.7% had attended training sessions on the procedure. Among the HCWs, 64.3% of them felt the HP test should be mandatory, 27.1% said it should not be mandatory, and 8.6% did not know if it should be mandatory. In their focus groups, the HCWs said they believed the mothers would accept the HP method. For their part, 22.0% of the mothers said they had heard about the HP test, and 63.6% reported knowing the reason why the baby would be tested. Further, 83.3% indicated that the test would be beneficial for the baby. In addition, 88.6% of the mothers said that more information on the HP test was needed. In their focus group discussions, the mothers said they were generally not concerned about the pain the heel prick method might cause the baby. Conclusions The HCWs’ knowledge of the HP screening method was high. The mothers trust HCWs, and the mothers would accept the HP procedure irrespective of their knowledge of the test and any discomfort associated with this screening method.


RESUMEN Objetivo En el país caribeño de Santa Lucía, el hemocribado del cordón umbilical para la detección de la anemia de células falciformes o drepanocitosis era el método de tamizaje preferido por el personal de salud en las salas de maternidad de los hospitales hasta que se introdujo la nueva prueba del talón en el 2014. Este estudio sobre la anemia de células falciformes tuvo por objetivo evaluar el conocimiento y las actitudes del personal de salud hacia la prueba del talón, así como determinar si las madres tenían una actitud favorable hacia este método de tamizaje. Método Un total de 70 trabajadores de salud y 132 madres participaron en los cuestionarios realizados en tres hospitales. Además, se celebraron cuatro grupos de debate: dos con el personal de salud y dos con las madres. Resultados Del personal de salud entrevistado, 85,7% tenía conocimientos acerca de la prueba del talón. Sin embargo, únicamente 25,7% había asistido a sesiones de capacitación sobre el procedimiento. Además, 64,3% del personal de salud opinaba que la prueba debía ser obligatoria, 27,1% afirmaba que no debía ser obligatoria y 8,6% manifestó que no lo sabía. En los grupos de debate, el personal de salud manifestó su creencia de que las madres aceptarían este método de tamizaje. Por su parte, 22,0% de las madres afirmaron conocer la prueba del talón y 63,6% manifestó conocer los motivos por los que se sometería al bebé a dicha prueba. Asimismo, 83,3% de las madres señaló que la prueba sería beneficiosa para el bebé. Además, 88,6% de las madres indicó que era necesaria más información sobre la prueba del talón. En sus grupos de debate, las madres expresaron que, por lo general, no les preocupaba el dolor que pudiese suponer para el bebé la prueba del pinchazo en el talón. Conclusiones El personal de salud tiene un nivel alto de conocimiento acerca de la prueba del talón. Las madres confían en el personal de salud, y aceptarían este procedimiento independientemente de sus conocimientos sobre la prueba y cualquier malestar asociado a este método de tamizaje.


RESUMO Objetivos No país caribenho de Santa Lúcia, o exame de sangue de cordão umbilical para detecção da doença falciforme (DF) era o método de triagem preferido pelos profissionais da saúde atuantes em maternidades, até a introdução do “teste do pezinho” (TP) no país em 2014. Este estudo sobre DF buscou avaliar o conhecimento e atitudes de profissionais da saúde em relação à triagem pelo TP e também determinar a favorabilidade das novas mães em direção à triagem de TP. Métodos Setenta profissionais da saúde e 132 novas mães responderam a questionários de pesquisa em três hospitais. Além disso, foram realizadas quatro discussões com grupos focais: dois de profissionais da saúde e dois de mães. Resultados Entre os profissionais da saúde entrevistados, 85,7% tinham conhecimento acerca do TP. Porém, somente 25,7% haviam comparecido às sessões de capacitação sobre o procedimento. Entre os profissionais da saúde, 64,3% opinaram que o TP deveria ser obrigatório, 27,1% disseram que não deveria ser obrigatório e 8,6% não sabiam se deveria ser obrigatório. Em seus grupos focais, os profissionais da saúde disseram acreditar que as mães aceitariam o método do TP. Por sua vez, 22,0% das mães disseram ter ouvido falar sobre o TP, e 63,6% relataram saber o motivo pelo qual o exame seria realizado; ademais, 83,3% indicaram que o exame seria benéfico para o bebê. Além disso, 88,6% das mães disseram que precisavam de maiores informações sobre o TP. Em seus grupos focais, as mães disseram que, em geral, não estavam preocupadas com dor que o teste do pezinho poderia causar ao bebê. Conclusões Os profissionais da saúde apresentaram alto nível de conhecimento acerca do método de triagem pelo TP. As mães confiam nos profissionais da saúde, e aceitariam o procedimento de TP independentemente de seu conhecimento acerca do teste e de qualquer desconforto associado a este método de triagem.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Conhecimentos, Atitudes e Prática em Saúde , Anemia Falciforme/induzido quimicamente , Anemia Falciforme/sangue , Santa Lúcia
12.
BMC Med Educ ; 16: 112, 2016 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-27116929

RESUMO

BACKGROUND: Continuing education (CE) is crucial for quality improvement in health care. The needs assessment of CE helps ensure effectiveness. However, such an assessment necessitates certain techniques that are unfamiliar to health care communities in developing countries. This study identifies the needs of providing CE to health care personnel in Saint Lucia. METHODS: This study was designed as a questionnaire survey to investigate the demographics, training needs, and preferred approaches to improve performance of the target population. The study population included the health care professionals of major public health care facilities in Saint Lucia. We used the World Health Organization-adopted Hennessy Hicks Training Needs Analysis Questionnaire, a self-reported close-ended structured questionnaire with a core set of 30 items. These items refer to tasks that are central to the role of health care professionals and are categorized into six superordinate categories: research/audit, communication/teamwork, clinical skills, administrative, managerial/supervisory, and continuing professional education. RESULTS: In total, 208 questionnaires were distributed; the response rate was 66.8%, and most respondents were nurses. The need for continuing professional education was rated the highest priority, followed by research/audit activities. The evidence suggests that most respondents required training in communication skills, management, clinical skills, and research methods. CONCLUSIONS: Providing training according to the needs is vital, particularly in developing countries. The present research methodology and findings offer perspectives on how to conduct needs assessment and offer reference points for developing countries whose background and health care environment are similar to those of Saint Lucia.


Assuntos
Países em Desenvolvimento , Educação Continuada , Determinação de Necessidades de Cuidados de Saúde , Adulto , Competência Clínica , Comunicação , Feminino , Humanos , Masculino , Pesquisa/educação , Santa Lúcia , Inquéritos e Questionários
13.
PLoS One ; 11(2): e0148928, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26859690

RESUMO

Social behaviors can significantly affect population viability, and some behaviors might reduce extinction risk. We used population viability analysis to evaluate effects of past and proposed habitat loss on the White-breasted Thrasher (Ramphocinclus brachyurus), a cooperatively breeding songbird with a global population size of <2000 individuals. We used an individual-based approach to build the first demographic population projection model for this endangered species, parameterizing the model with data from eight years of field study before and after habitat loss within the stronghold of the species' distribution. The recent habitat loss resulted in an approximately 18% predicted decline in population size; this estimate was mirrored by a separate assessment using occupancy data. When mortality rates remained close to the pre-habitat loss estimate, quasi-extinction probability was low under extant habitat area, but increased with habitat loss expected after current plans for resort construction are completed. Post-habitat loss mortality rate estimates were too high for projected populations to persist. Vital rate sensitivity analyses indicated that population growth rate and population persistence were most sensitive to juvenile mortality. However, observed values for adult mortality were closest to the threshold value above which populations would crash. Adult mortality, already relatively low, may have the least capacity to change compared to other vital rates, whereas juvenile mortality may have the most capacity for improvement. Results suggest that improving mortality estimates and determining the cause(s) of juvenile mortality should be research priorities. Despite predictions that aspects of cooperative systems may result in variation in reproduction or juvenile mortality being the most sensitive vital rates, adult mortality was the most sensitive in half of the demographic models of other avian cooperative breeders. Interestingly, vital rate sensitivity differed by model type. However, studies that explicitly modeled the species' cooperative breeding system found reproduction to be the most sensitive rate.


Assuntos
Aves Canoras , Animais , Comportamento Animal , Comportamento Cooperativo , Ecossistema , Espécies em Perigo de Extinção , Extinção Biológica , Feminino , Masculino , Modelos Estatísticos , Dinâmica Populacional , Reprodução , Santa Lúcia , Aves Canoras/fisiologia
14.
Int J Environ Res Public Health ; 13(1): ijerph13010037, 2015 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-26703647

RESUMO

St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157), and health care providers/clinic administrators (n = 42), were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations.


Assuntos
Diabetes Mellitus/terapia , Educação em Saúde/métodos , Equidade em Saúde , Política de Saúde , Disparidades nos Níveis de Saúde , Hipertensão/terapia , Vigilância em Saúde Pública , Adulto , Doença Crônica , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Masculino , Projetos Piloto , Prevalência , Pesquisa Qualitativa , Santa Lúcia/epidemiologia , Estados Unidos
15.
Epilepsy Behav ; 51: 267-72, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26312988

RESUMO

Very little has been reported about the health resources available for patients with epilepsy in the five English-speaking southern Caribbean countries of Trinidad and Tobago, Barbados, Grenada, Saint Vincent and the Grenadines, and Saint Lucia. There is no comprehensive resource describing their health systems, access to specialty care, antiepileptic drug (AED) use, and availability of brain imaging and EEG. The purpose of this study was to profile epilepsy care in these countries as an initial step toward improving the standard of care and identifying gaps in care to guide future policy changes. In each southern Caribbean country, we conducted study visits and interviewed health-care providers, government health ministers, pharmacy directors, hospital medical directors, pharmacists, clinic staff, radiologists, and radiology and EEG technicians. Health-care providers completed extensive epilepsy care surveys. The five countries all have integrated government health systems with clinics and hospitals that provide free or heavily subsidized care and AEDs for patients with epilepsy. Only Trinidad and Tobago and Barbados, however, have neurology specialists. The three smaller countries lack government imaging and EEG facilities. Trinidad had up to one-year waits for public MRI/EEG. Government formularies in Grenada, Saint Vincent and the Grenadines, and Saint Lucia are limited to first-generation AEDs. One or more second-line agents are formulary in Trinidad and Barbados. Nonformulary drugs may be obtained for individual patients in Barbados. Grenada, Saint Lucia, and Saint Vincent and the Grenadines participate in an Organization of Eastern Caribbean States formulary purchasing system, which added levetiracetam following the survey. Newer generic AED formulations with the lowest risks for pregnancy malformation were not in use. In conclusion, patients with epilepsy in the southern Caribbean have excellent access to government clinics and hospitals, but AED choices are limited. Local medical providers reported that the major limitations in care were lack of specialty care, lack of imaging and EEG services, financial barriers to care, long wait times for care, and limited access to additional AEDs.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Epilepsia/epidemiologia , Epilepsia/terapia , Anticonvulsivantes/provisão & distribução , Barbados , Região do Caribe/epidemiologia , Países em Desenvolvimento , Uso de Medicamentos , Eletroencefalografia , Feminino , Formulários Farmacêuticos como Assunto , Pessoal de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Neurologia/estatística & dados numéricos , Gravidez , Santa Lúcia , São Vicente e Granadinas
16.
Int J Biometeorol ; 59(1): 37-45, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24671407

RESUMO

The largest market segment of global tourism is coastal tourism, which is strongly dependent on the destination's thermal climate. To date, outdoor bioclimatic comfort assessments have focused exclusively on local residents in open urban areas, making it unclear whether outdoor comfort is perceived differently in non-urban environments or by non-residents (i.e. tourists) with different weather expectations and activity patterns. This study provides needed insight into the perception of outdoor microclimatic conditions in a coastal environment while simultaneously identifying important psychological factors that differentiate tourists from everyday users of urban spaces. Concurrent micrometeorological measurements were taken on several Caribbean beaches in the islands of Barbados, Saint Lucia and Tobago, while a questionnaire survey was used to examine the thermal comfort of subjects (n = 472). Universal Thermal Climate Index (UTCI) conditions of 32 to 39 °C were recorded, which were perceived as being "slightly warm" or "warm" by respondents. Most beach users (48 to 77 %) would not change the thermal conditions, with some (4 to 15 %) preferring even warmer conditions. Even at UTCI of 39 °C, 62 % of respondents voted for no change to current thermal conditions, with an additional 10 % stating that they would like to feel even warmer. These results indicate that beach users' thermal preferences are up to 18 °C warmer than the preferred thermal conditions identified in existing outdoor bioclimatic studies from urban park settings. This indicates that beach users hold fundamentally different comfort perceptions and preferences compared to people using urban spaces. Statistically significant differences (p ≤ .05) were also recorded for demographic groups (gender, age) and place of origin (climatic region).


Assuntos
Praias , Sensação Térmica , Adolescente , Adulto , Idoso , Barbados , Feminino , Humanos , Umidade , Masculino , Microclima , Pessoa de Meia-Idade , Percepção , Santa Lúcia , Inquéritos e Questionários , Temperatura , Trinidad e Tobago , Vento , Adulto Jovem
17.
MEDISUR ; 13(3)2015.
Artigo em Espanhol | CUMED | ID: cum-62156

RESUMO

El internacionalismo, como valor social, constituye uno de los rasgos esenciales que ha caracterizado a la salud pública cubana desde el triunfo de la Revolución. En noviembre de 2005 se inició la colaboración cubana en materia de salud a la atención de pacientes con insuficiencia renal crónica en Santa Lucía, enfermedad que constituye un importante problema de salud en ese país del Caribe. El objetivo de este artículo está dirigido a destacar el rol de la colaboración cubana en la asistencia al problema de la insuficiencia renal crónica en Santa Lucía, a partir de la realización de diversas intervenciones bien definidas, con énfasis en el impacto de dicha cooperación en la Unidad Renal del Hospital Victoria(AU)


Internationalism, as a social value, is one of the essential characteristics of Cuban public health since the triumph of the Revolution. In November 2005, Cuban medical cooperation in the care of patients with chronic renal failure began in Saint Lucia. This disease constitutes a major health problem in the Caribbean nation. The aim of this article is to highlight the role of Cuban cooperation in assisting chronic renal failure patients in Santa Lucia through various well-defined interventions, emphasizing on the impact of such cooperation in the Renal Unit of the Victoria Hospital(AU)


Assuntos
Humanos , Cooperação Internacional , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/prevenção & controle , Insuficiência Renal Crônica/terapia , Serviços de Saúde , Serviços de Saúde/normas , Serviços de Saúde , Santa Lúcia , Cuba
18.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17927

RESUMO

OBJECTIVE: To determine nutritional status and eating habits among public primary school children aged 9-13 years as well as food choices and preferences of their parents/guardians. DESIGN AND METHODS: A total of 555 participants (380 children, 175 parents) took part in the study. Participants, who returned written consent forms were allowed to complete a questionnaire consisting of 17 questions on eating habits; Questionnaires were structured to obtain food preferences and nutrition knowledge where photographs of foods were included. Participants were categorized into percentiles using WHO Body Mass Index (BMI) for age growth charts, where BMI for age was plotted and body fat was categorized with the use of body fat reference curves chart for children 7-18 years. Linear regression was used to analyze the relationship between age, gender, consumption patterns of the participants with BMI. RESULTS: Food consumption patterns and preferences of children were similar to those of their parents except for juice drinks, sugary foods, fatty foods, water, salty foods and whole wheat bread. High preference for energy dense foods both by children and their parents was found. 61.7% of overweight participants were female i.e.; their weight exceeded the WHO suggested ≥85th percentile overweight value. 60.4% of obese participants were female (≥95th percentile as per WHO age and gender specific reference). CONCLUSION: Participants with higher salty food consumption had a higher BMI as compared to those who abstained from the intakes of such foods.


Assuntos
Estado Nutricional , Criança , Comportamento Alimentar , Santa Lúcia
19.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17984

RESUMO

OBJECTIVE: Several agencies have recommended integrating early child development interventions with health services. We developed and evaluated a parent training programme integrated into primary health visits. DESIGN AND METHODS: A cluster randomised trial conducted in Jamaica, Antigua and St Lucia with health centre as the unit of randomization. Fifteen centres were randomised to control (n=250 mother-child pairs) and 14 to intervention (n=251). Participants were recruited at the 6-8 week child health visit. Intervention was provided at routine health visits from age 3-18 months and comprised short films of child development messages followed by discussion and demonstration led by community health workers, and mothers’ practice of activities. Nurses distributed message cards and a few play materials. Primary outcomes were child development, measured 2 weeks after the 18 month visit, with the Griffiths Mental Development Scales and the Communicative Development Inventory (CDI). RESULTS: 85% of enrolled children were tested (control = 210; intervention=216). Loss did not differ by group. Multilevel analyses showed significant intervention benefits for cognitive development, (3.09 points; 95% CI 1.31, 4.87), effect size 0.30 SD. There were no benefits to language or hand and eye subscales, or CDI vocabulary score. Of six secondary outcomes there was a significant benefit to parenting knowledge, treatment effect 1.59 (95% CI 1.01 to 2.17), effect size 0.40. CONCLUSION: An innovative parenting intervention, requiring no additional clinic staff or mothers’ time, can be integrated into health services, with benefits to cognitive development and parent knowledge.


Assuntos
Poder Familiar , Atenção Primária à Saúde , Desenvolvimento Infantil , Jamaica , Antígua e Barbuda , Santa Lúcia
20.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17994

RESUMO

OBJECTIVE: To create a sustainable model for community health education, tracking and monitoring of selected health conditions (diabetes and mental health), research training, and health policy action in St. Lucia, which may be applicable to underserved African Americans in the U.S. DESIGN AND METHODS: Phase one of this pilot study included a mixed methods analytic approach. Adult clients at risk for or diagnosed with diabetes (n=157) and health care providers/clinic administrators (n=39) were recruited from 5 diverse healthcare facilities in St. Lucia to assess their views on health status, health care services and existing challenges/opportunities to improve health equity. Content analyses of the qualitative data were conducted. RESULTS: Preliminary analyses of qualitative data indicated an awareness of the relatively high prevalence of diabetes and other chronic illnesses. Patients generally acknowledged that one’s socioeconomic status (SES) has an overall impact on health outcomes, though anyone, regardless of SES, may be diagnosed with a chronic disease. Finally, participants indicated desire for better accessibility to healthcare services and improvements to existing healthcare infrastructures to provide better services. CONCLUSION: Findings from this pilot project could serve as a model to help advance health equity among diverse populations through evidence based, culturally tailored community education and prevention efforts. These activities may play a vital role in improving the health status and healthcare among St. Lucians with chronic health conditions and inform similar strategies that may be effective in the United States.


Assuntos
Educação em Saúde , Monitoramento , Estados Unidos , Santa Lúcia
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