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1.
BMC Health Serv Res ; 19(1): 651, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500615

RESUMO

BACKGROUND: Obstetric guidelines are useful to improve the quality of care. Availability of international guidelines has rapidly increased, however the contextualization to enhance feasibility of implementation in health facilities in low and middle-income settings has only been described in literature in a few instances. This study describes the approach and lessons learned from the 'bottom-up' development process of context-tailored national obstetric guidelines in middle-income country Suriname. METHODS: Local obstetric health care providers initiated the guideline development process in Suriname in August 2016 for two common obstetric conditions: hypertensive disorders of pregnancy (HDP) and post partum haemorrhage (PPH). RESULTS: The process consisted of six steps: (1) determination of how and why women died, (2) interviews and observations of local clinical practice, (3) review of international guidelines, (4) development of a primary set of guidelines, (5) initiation of a national discussion on the guidelines content and (6) establishment of the final guidelines based on consensus. Maternal enquiry of HDP- and PPH-related maternal deaths revealed substandard care in 90 and 95% of cases, respectively. An assessment of the management through interviews and labour observations identified gaps in quality of the provided care and large discrepancies in the management of HDP and PPH between the hospitals. International recommendations were considered unfeasible and were inconsistent when compared to each other. Local health care providers and stakeholders convened to create national context-tailored guidelines based on adapted international recommendations. The guidelines were developed within four months and locally implemented. CONCLUSION: Development of national context-tailored guidelines is achievable in a middle-income country when using a 'bottom-up' approach that involves all obstetric health care providers and stakeholders in the earliest phase. We hope the descriptive process of guideline development is helpful for other countries in need of nationwide guidelines.


Assuntos
Serviços de Saúde Materna/estatística & dados numéricos , Mortalidade Materna/tendências , Complicações do Trabalho de Parto/mortalidade , Complicações na Gravidez/mortalidade , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Guias de Prática Clínica como Assunto , Gravidez , Suriname/epidemiologia
2.
BMJ Open ; 9(5): e025417, 2019 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-31101696

RESUMO

OBJECTIVE: Vaginal steam baths with herb leaves (herb use) is practised by some Surinamese women. We assessed herb use among women from the five most prevalent ethnic groups, and if herb use is associated with Chlamydia trachomatis infection. SETTING: Participants were recruited at a sexually transmitted infection (STI) clinic and a family planning clinic (FP) in Paramaribo, Suriname. PARTICIPANTS: 1040 women were included subsequently, comprising the following ethnic groups: Creole (26.7%), Hindustani (24.6%), Javanese (15.7%), Maroon (13.3%) and mixed descent (19.7%). METHODS: Nurses collected a questionnaire and vaginal swabs for nucleic acid amplification C. trachomatis testing. PRIMARY OUTCOMES: Determinants of vaginal herb use and C. trachomatis infection via univariable and multivariable logistic regression. RESULTS: Herb use was most common among Maroon (68.8%) and Creole women (25.2%). In multivariable analysis including only Maroon and Creole women, determinants significantly associated with vaginal herb use were (OR; 95% CI): Maroon ethnic descent (5.33; 3.26 to 8.71 vs Creole), recruitment at the STI clinic (2.04; 1.24 to 3.36 vs FP), lower education levels (3.80; 1.68 to 8.57 lower vs higher, and 2.02; 0.90 to 4.51 middle vs higher). Lower age and recruitment at the STI clinic were associated with C. trachomatis infection, but not vaginal herb use. CONCLUSION: In Suriname, vaginal herb use is common among Maroon and Creole women. Education, ethnic group and recruitment site were determinants for herb use. Vaginal herb use was not a determinant of C. trachomatis infection. Future research should focus on the effect of herb use on the vaginal microbiome and mucosal barrier.


Assuntos
Infecções por Chlamydia/epidemiologia , Imunidade nas Mucosas/efeitos dos fármacos , Extratos Vegetais/efeitos adversos , Vagina/microbiologia , Ducha Vaginal/efeitos adversos , Administração Intravaginal , Administração Tópica , Adulto , Estudos Transversais , Grupos Étnicos , Feminino , Humanos , Microbiota/imunologia , Fitoterapia , Extratos Vegetais/administração & dosagem , Suriname/epidemiologia , Vagina/imunologia , Ducha Vaginal/métodos , Saúde da Mulher/etnologia
3.
J Infect Dis ; 220(1): 28-31, 2019 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-30753538

RESUMO

In 2015-2016, a Zika virus (ZIKV) outbreak occurred in the Americas. In 2017, we conducted a ZIKV serosurvey in Suriname in which 770 participants were recruited from 1 urban area and 2 rural villages in the tropical rainforest. All collected samples were tested for presence of ZIKV antibodies using a ZIKV immunoglobulin G enzyme-linked immunosorbent assay and a virus neutralization assay. We found that 35.1% of the participants had neutralizing antibodies against ZIKV. In 1 remote village in the rainforest, 24.5% of the participants had neutralizing antibodies against ZIKV, suggesting that ZIKV was widely spread across Suriname.


Assuntos
Infecção por Zika virus/epidemiologia , Infecção por Zika virus/imunologia , Zika virus/imunologia , Adolescente , Adulto , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Surtos de Doenças , Feminino , Humanos , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Testes de Neutralização/métodos , Estudos Soroepidemiológicos , Suriname/epidemiologia , Adulto Jovem
4.
J Child Sex Abus ; 28(4): 435-451, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30412454

RESUMO

Studies conducted to ascertain the prevalence of child sexual abuse (CSA) in the Caribbean are poorly synthesized. Present study reports on the lifetime and year prevalence of unwanted sexual experiences, the risk of CSA at different ages within adolescence, and differences between the three largest ethnic groups in Suriname. One thousand one hundred and twenty (1,120) adolescents completed a questionnaire on child maltreatment, including CSA. The study's stratified sample consisted of students (ages 12 to 17) from five districts in Suriname. More than 16% of all boys and 15% of all girls indicated that they had been exposed to some form of CSA in the past 12 months. Girls reported significantly more intrafamilial CSA by a minor than boys. Boys reported significantly more experiences of being touched or forced by a minor outside the family to look at/touch the abuser's private parts than girls. Besides, 16 and 17-year olds were the most vulnerable. An increased risk of CSA (year prevalence) was found as adolescence progresses. A significant portion of CSA constituted peer-to-peer sexual victimization. Afro Surinamese adolescents were found to report the highest rates of CSA. Appropriate legislation, policies, and services for prevention and recovery are needed in Suriname.


Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Adolescente , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Criança , Abuso Sexual na Infância/etnologia , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Suriname/epidemiologia
5.
Intern Emerg Med ; 14(2): 249-258, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30361850

RESUMO

The high cardiovascular risk burden in low- and middle-income countries is expected to lead to an explosive increase in chronic kidney disease (CKD). However, population data on CKD from these countries are scarce. Therefore, we assessed kidney health in Suriname. In the Healthy Life in Suriname (HeliSur) study, a random sample of the adult population, we collected data with standardized questionnaires, physical examination, and blood and urine samples analysed in a central laboratory. Prevalent CKD was graded with KDIGO guidelines. In addition, we assessed national data on prevalent renal replacement therapy (RRT), estimated the future need for RRT, and evaluated national kidney health work force and policies. We include 1117 participants (2.0‰ of the population), 63% women, 40% of African ancestry and 43% of Asian ancestry, with a mean age of 42.2 (SE 0.4) years. Blood pressure is elevated in 72% of the participants, 26% have diabetes or prediabetes, and 78% are obese or overweight. The prevalence of CKD is 5.4%, and around 0.3% have kidney failure, translating to approximately 1500 patients nationally (2690 per million population, pmp), with currently 516 patients (920 pmp) on dialysis. Based on the participants from the random population sample in CKD stage G3 or G4, we estimate that 6750-10,750 pmp may develop kidney failure within the next 10 years. However, specialized kidney health workforce is currently very limited, and specific national or local policies for CKD management are lacking. Since the large majority of the general population has one or more risk factors for CKD including elevated blood pressure, urgent action is needed to strengthen kidney health care and prevent a catastrophic rise in need for RRT in the coming years.


Assuntos
Nível de Saúde , Insuficiência Renal Crônica/diagnóstico , Adulto , Idoso , Albuminúria/diagnóstico , Albuminúria/fisiopatologia , Países em Desenvolvimento , Feminino , Humanos , Hipertensão/complicações , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Terapia de Substituição Renal/estatística & dados numéricos , Suriname/epidemiologia , Inquéritos e Questionários
6.
Clin Nutr ; 38(1): 450-456, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29249531

RESUMO

BACKGROUND & AIMS: Cardiovascular disease (CVD) is highly prevalent in Suriname, a middle-income country with predominantly people of African and Asian ancestry. We examined whether the more comprehensive body composition measures determined by bioelectrical impedance analysis (BIA) are superior to the more traditional BMI and waist measures in relation to cardiovascular risk. METHODS: Data from the cross-sectional Healthy Life in Suriname (HELISUR) study were used to calculate BMI, waist-hip ratio, waist-to-height ratio, and waist circumference. BIA was used to estimate fat percentage, fat-free mass index, and fat-to-fat-free mass ratio. High cardiovascular risk was defined as 1) a 10-year Framingham coronary heart disease risk score ≥10% in African-Surinamese and ≥12% in Asian-Surinamese, and 2) an increased arterial stiffness (pulse wave velocity >10 m/s). Using logistic regression analysis, we pre-selected the strongest correlate (i.e. lowest p-value below 0.05) of all body composition items for both outcomes of cardiovascular risk separately, and subsequently, used forward logistic regression modelling to determine whether other measures added value to the initial model with the strongest correlate (-2 log-likelihood (-2LL) of initial model minus -2LL of new model, χ-square statistic >3.841, 1 df). Analyses were adjusted for sex, age and ethnicity. RESULTS: We examined 691 participants (65% women; 48% African-Surinamese) with a mean age of 42 (SD 14) years. Waist circumference was the strongest correlate for high 10-year CVD risk in the total group, in men and African-Surinamese. In Asian-Surinamese, fat-free mass index was the strongest correlate of high 10-year CVD risk. Increased arterial stiffness was most strongly related with waist-to-height ratio in the total group and in African-Surinamese, and with BMI in men. None of the measures were significantly associated in women (for both outcomes) and Asian-Surinamese (for increased arterial stiffness). Forward selection showed that only BMI added value next to waist-to-height ratio in the total group in relation to increased arterial stiffness. CONCLUSIONS: Waist measures, in particular waist circumference and waist-to-height ratio, and BMI should be used in African and Asian-Surinamese to identify who is at increased cardiovascular risk. Overall, we found little advantage in using BIA measures rather than simple anthropometric measures.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Asiático/etnologia , Composição Corporal/fisiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Adulto , Índice de Massa Corporal , Estudos Transversais , Impedância Elétrica , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Suriname/epidemiologia , Circunferência da Cintura
7.
Ethn Health ; 24(4): 365-377, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-28669199

RESUMO

OBJECTIVE: The role of different physical activity (PA) characteristics, i.e. domain, duration and intensity in obesity prevention still requires investigation. Furthermore, ethnicity can modify the effect of PA on body composition. Therefore, we aim to describe the association between obesity and PA characteristics across the Asian- and African-Surinamese population, living in the capital of Suriname. DESIGN: Between February 2013 and July 2015, we included 1157 healthy subjects, 18-70 years, from the Healthy Life in Suriname (HELISUR) study. We measured height, weight, hip and waist circumference and defined general and central obesity according to World Health Organization (WHO) recommendations. The International Physical Activity Questionnaire was used to assess PA and to calculate the duration (minutes/week) and the total volume (METs-minutes/week) of activity. Ethnicity was self-reported. RESULTS: Out of 1157 participants we included 1079 (42.6% Asian-Surinamese, 40.1% African-Surinamese and 17.3% of other ethnicity), mean age 42.6 ± 13.6 years for analysis. Obesity prevalence ratio (PR) was significantly lower in participants meeting WHO PA recommendations [PR= 0.81 (0.68-0.97)], especially within the commuting [PR= 0.66 (0.47-0.91)] and leisure time domains [PR= 0.67 (0.47-0.94)], compared to participants that did not meet the recommendations. Active minutes/week and total volume of activity were inversely associated with obesity and waist circumference, in the overall (p < 0.05) and in the African-Surinamese population (p < 0.05), but not in the Asian-Surinamese population. CONCLUSION: Meeting PA recommendations, particularly within the commuting and leisure time domains, is associated with lower obesity prevalence in the total population. Among the African-Surinamese population, PA within the leisure time domain, more active minutes/week and higher levels of total volume are associated with a lower obesity prevalence. This is not found in the Asian-Surinamese population.


Assuntos
Exercício Físico/fisiologia , Obesidade/etnologia , Obesidade/epidemiologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Asiático/etnologia , Peso Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Suriname/epidemiologia
8.
Malar J ; 17(1): 418, 2018 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-30419901

RESUMO

BACKGROUND: Suriname has experienced a significant change in malaria transmission risk and incidence over the past years. The country is now moving toward malaria elimination. The first objective of this study is to describe malaria epidemiological trends in Suriname between 2000 and 2016. The second objective is to identify spatiotemporal malaria trends in notification points between 2007 and 2016. METHODS: National malaria surveillance data resulting from active and passive screening between 2000 and 2016 were used for the temporal trend analysis. A space-time cluster analysis using SaTScan™ was conducted on Malaria Programme-data from 2007 to 2016 comparing cases (people tested positive) with controls (people tested negative). RESULTS: Suriname experienced a period of high malaria incidence during 2000-2005, followed by a steep decline in number of malaria cases from 2005 onwards. Imported malaria cases, mostly of Brazilian nationality and travelling from French Guiana, were major contributors to the reported number of cases, exceeding the national malaria burden (94.2% of the total). Most clusters in notification points are found in the border area between Suriname and French Guiana. Clustering was also found in the migrant clinic in Paramaribo. CONCLUSIONS: Suriname has successfully reduced malaria to near-elimination level in the last 17 years. However, the high malaria import rate resulting from cross-border moving migrants is a major challenge for reaching elimination. This requires continued investment in the national health system, with a focus on border screening and migrant health. A regional approach to malaria elimination within the Guianas and Brazil is urgently needed.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Erradicação de Doenças , Malária/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/transmissão , Feminino , Humanos , Incidência , Malária/parasitologia , Malária/transmissão , Masculino , Suriname/epidemiologia , Viagem
9.
Am J Trop Med Hyg ; 99(6): 1619-1624, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30350776

RESUMO

The aim of this study was to determine the prevalence of caries among children living in the interior of Suriname and to investigate the influence of the reachability of their habitats and different ethnicities on the prevalence of caries. As part of children's regular dental check-ups, data on the prevalence of caries were registered for schoolchildren (n = 1,309) living in four different regions. Prevalence of caries was expressed by the number of decayed, missing, and filled teeth (DMFT index). Consequences of severe caries were recorded by counting the number of teeth with pulp involvement, ulcerations, fistulas, and abscesses. Depending on the habitat, the number of children with caries in their primary dentition varied between 68% and 100%, in the mixed dentition between 79% and 98%, and in their permanent dentition between 54% and 94%. After the World Health Organization criteria, the average scores of dmft were high in children with primary teeth (except for Brokopondo), moderate to high in children with mixed dentition and low to moderate in children with permanent teeth. Children in more remote areas had a greater prevalence of caries than children in less remote regions. Severe consequences of caries were seen in 14-75% of the children. Treatments were rarely performed. Children in the interior of Suriname are in great need of preventive and curative dental treatments.


Assuntos
Cárie Dentária/epidemiologia , Criança , Índice CPO , Feminino , Geografia , Humanos , Masculino , Prevalência , População Rural/estatística & dados numéricos , Suriname/epidemiologia
10.
J Glob Health ; 8(2): 020403, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30237875

RESUMO

Background: The Amazonian Amerindian populations living in the southern and southwestern hinterlands of Suriname (South America) have come into contact with western health care since approximately fifty years ago. In this study, secondary data were used to assess the impact of Medical Mission's fifty-year old primary health care program on the health status of these populations. Methods: Using data from the primary health care facilities of Medical Mission for 1965-1970, 1973-1977, 1982-1985, and 1997-2014, temporal trends in incidence and mortality of respiratory tract infections, gastroenteritis, and malaria; population composition; birth and death rates; and polyclinic consultations in these communities have been assessed over the period between 1965 and 2014. Results: In the period covered by this study, the incidence of respiratory tract infections and gastroenteritis declined by about 75% and 53%, respectively, while malaria incidence rose sharply from the 1980s through 2005 but subsequently declined to levels approximating elimination. Crude death rates dropped by about 70% while birth rates declined by about 50% in the 1980s and since then remained at this level. The population doubled in size and increased in all age groups, particularly in the age group of ≥59 years. The infant mortality rate declined by 50%. In addition, the average yearly number of polyclinic visits per person decreased 6- to 7-fold during this period. Conclusions: The significant reduction of the infectious disease burden; the doubling of the population size and the growth of the proportion of elderly individuals due to the declining death rates; the declining infant mortality rates to levels comparable to the national average as well as the decline in average numbers of polyclinic consultations per person, indicate that Medical Missions health service provision achieved its goal of improving the health and survival of the indigenous people by providing free, accessible and permanent medical services. Building upon this successful experience Medical Mission could be instrumental in addressing potential contemporary life-style related health threats.


Assuntos
Índios Sul-Americanos/estatística & dados numéricos , Morbidade/tendências , Mortalidade/tendências , Atenção Primária à Saúde , Floresta Úmida , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Suriname/epidemiologia , Adulto Jovem
11.
J Clin Endocrinol Metab ; 103(10): 3783-3791, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30113646

RESUMO

Context: Type 2 diabetes and cardiovascular disease occur more frequently and at a younger age in South-Asians than Europeans. This may be related to differences in regulation of the fatty acid metabolism during aging. We compared age-related acylcarnitine and amino acid concentrations in Dutch and South-Asian Surinamese study participants. Methods: We measured types of acylcarnitine and amino acid concentrations in plasma (by tandem mass spectrometry) in a random subsample of 350 Dutch and 350 South-Asian Surinamese origin participants of the Healthy Life in an Urban Setting study (Amsterdam, Netherlands). We derived principal components (PCs) from the metabolites. Linear regression was used to assess differences in PCs and individual metabolite concentrations, and their age trends between the groups by sex. We adjusted for body mass index and intake of fat and total energy. Results: Mean age was 44.8 (SD, 13.3) years. Amino acid concentrations were higher among South-Asian Surinamese women compared with Dutch women; acylcarnitine and amino acid levels were higher among South-Asian Surinamese men than Dutch men. Metabolite levels increased similarly with age in both ethnic groups. Results remained similar after adjustment. Conclusion: Ethnic differences in metabolite concentrations suggest that fatty acid and amino acid metabolism are more dysregulated among South-Asian Surinamese compared with Dutch from a young age. During adulthood, metabolites increase similarly in both ethnic groups.


Assuntos
Aminoácidos/metabolismo , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Carnitina/análogos & derivados , Grupos Étnicos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Doenças Metabólicas/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Biomarcadores/análise , Carnitina/metabolismo , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Doenças Metabólicas/metabolismo , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prevalência , Prognóstico , Suriname/epidemiologia , Adulto Jovem
12.
PLoS One ; 13(7): e0200281, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29990331

RESUMO

BACKGROUND: Sepsis was the main cause of maternal mortality in Suriname, a middle-income country. Objective of this study was to perform a qualitative analysis of the clinical and management aspects of sepsis-related maternal deaths with a focus on the 'golden hour' principle of antibiotic therapy. METHODS: A nationwide reproductive age mortality survey was performed from 2010 to 2014 to identify and audit all maternal deaths in Suriname. All sepsis-related deaths were reviewed by a local expert committee to assess socio-demographic characteristics, clinical aspects and substandard care. RESULTS: Of all 65 maternal deaths in Suriname 29 (45%) were sepsis-related. These women were mostly of low socio-economic class (n = 23, 82%), of Maroon ethnicity (n = 14, 48%) and most deaths occurred postpartum (n = 21, 72%). Underlying causes were pneumonia (n = 14, 48%), wound infections (n = 3, 10%) and endometritis (n = 3, 10%). Bacterial growth was detected in 10 (50%) of the 20 available blood cultures. None of the women with sepsis as underlying cause of death received antibiotic treatment within the first hour, although most women fulfilled the diagnostic criteria of sepsis upon admission. In 27 (93%) of the 29 women from which sufficient information was available, substandard care factors were identified: delay in monitoring in 16 (59%) women, in diagnosis in 17 (63%) and in treatment in 21 (78%). CONCLUSION: In Suriname, a middle-income country, maternal mortality could be reduced by improving early recognition and timely diagnosis of sepsis, vital signs monitoring and immediate antibiotic infusion (within the golden hour).


Assuntos
Mortalidade Materna , Sepse/mortalidade , Adulto , Antibacterianos/uso terapêutico , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Humanos , Gravidez , Complicações na Gravidez/mortalidade , Qualidade da Assistência à Saúde , Fatores de Risco , Sepse/tratamento farmacológico , Sepse/terapia , Fatores Socioeconômicos , Suriname/epidemiologia , Inquéritos e Questionários , Adulto Jovem
13.
Malar J ; 17(1): 56, 2018 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-29378594

RESUMO

BACKGROUND: Suriname has moved from being the country with the highest annual parasite index in the Americas to one on the threshold of elimination. The progress toward elimination in the stable populations of Suriname between 2000 and 2015 is reviewed. METHODS: Data was obtained from the Medical Mission and the Ministry of Health Malaria Programme case-reporting systems, and analysed with a focus on disease burden and differentiation of the disease geographically, by malaria species, age, gender, ethnicity, incidence and gametocytaemia. RESULTS: Between 2000 and 2015 there were 57,811 locally acquired cases of malaria in the stable populations of Suriname. A significant reduction in indigenous malaria cases was observed from 2006 to 2015. The number of imported malaria cases saw a relative increase compared to the number of autochthonous cases. In 2015 over 95% of the cases reported in stable communities are imported, mainly from neighbouring French Guiana, a department of France. The overall decline in malaria case incidence followed the mass-distribution of free long-lasting insecticide-impregnated mosquito nets and increased awareness building efforts, improved access to malaria services as a result of the introduction of Rapid Diagnostic Tests and the implementation of active case detection in high risk areas. In addition, improved management of Plasmodium falciparum infections was achieved with the introduction of artemisinin combination therapy. CONCLUSIONS: The existence of a network of policlinics in the interior ran by Medical Mission, for the indigenous population, allowed the rapid implementation of the strategy in stable communities. The success of malaria control in Suriname indicates that the availability at local level, of prompt and adequate prevention, diagnosis and treatment is a key requirement for the elimination of malaria.


Assuntos
Doenças Endêmicas , Malária Falciparum , Adolescente , Adulto , Criança , Pré-Escolar , Erradicação de Doenças , Doenças Endêmicas/prevenção & controle , Doenças Endêmicas/estatística & dados numéricos , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Malária Falciparum/epidemiologia , Malária Falciparum/prevenção & controle , Masculino , Estudos Retrospectivos , Suriname/epidemiologia , Adulto Jovem
15.
[Paramaribo]; Suriname. Bureau of Public Health; 2018. 3 p. ilus, tab.
Não convencional em Holandês | MedCarib | ID: biblio-906738

RESUMO

The information provided in this document by the Suriname Bureau of Public Health (BOG), is intended for the management and staff of hospitals and care homes with regard to the prevention and control of mosquito breeding sites. It focuses on the mosquitoes, and more specifically, the Aedes mosquito, which is a carrier of serious diseases such as Dengue, Chikungunya and Zika viruses. Symptoms of these viruses include fever, headaches, joint and muscle aches, and skin rashes. The core intent of the information is to prevent the spread of diseases carried by this insect vector via elimination of breeding grounds and the environment in which they thrive, such as small water objects like cups, cans, trays, vases, flower pot coasters, car tires and water barrels to name a few. Systematic, sustained implementation of an anti-mosquito program is crucial to the successful control of Dengue, Chikungunya and Zika viruses, particularly for hospitals and care homes. The key rationale is to raise awareness of the danger of transmission, and encourage widespread participation towards control and eventual elimination of the breeding grounds. A comprehensive list of strategies to eliminate breeding grounds is included in the publication...(AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Controle de Mosquitos , Controle de Mosquitos/métodos , Controle de Mosquitos/organização & administração , Controle de Mosquitos/normas , Aedes , Suriname/epidemiologia , Controle de Vetores
16.
[Paramaribo]; Suriname. Bureau of Public Health; [2018?]. 3 p. tab, ilus.
Não convencional em Holandês | MedCarib | ID: biblio-906740

RESUMO

The information provided in this document by the Department of Entomology of the Suriname Bureau of Public Health (BOG), is intended for the management and staff of government buildings as relates to the prevention and control of mosquito breeding sites. It focuses on the Aedes Aegypti mosquito. The insect vector responsible for transmission of Dengue, Chikungunya and Zika viruses. The intent of the information bulletin is to provide information and greater awareness towards prevention of the spread of diseases carried by this insect vector and assist in the effort towards elimination of breeding grounds and environments in which the mosquito thrives.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Controle de Mosquitos , Controle de Mosquitos/métodos , Controle de Mosquitos/organização & administração , Aedes , Controle de Mosquitos/normas , Suriname/epidemiologia
17.
[Paramaribo]; [Suriname. Ministry of Health]; [2018]. 1 p.
Não convencional em Inglês | MedCarib | ID: biblio-909454

RESUMO

This document outlines the typical symptoms of the Zika virus as well as some of the surveillance strategies being adopted by the Epidemiology Department of the Bureau of Public Health (BOG) at the Ministry of Health, Suriname at both primary and secondary levels of the health care system


Assuntos
Humanos , Masculino , Feminino , Atenção à Saúde , Controle de Mosquitos , Zika virus , Suriname/epidemiologia
18.
BMC Pediatr ; 17(1): 189, 2017 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-29137607

RESUMO

BACKGROUND: Scaling up neonatal care facilities in developing countries can improve survival of newborns. Recently, the only tertiary neonatal care facility in Suriname transitioned to a modern environment in which interventions to improve intensive care were performed. This study evaluates impact of this transition on referral pattern and outcomes of newborns. METHODS: A retrospective chart study amongst newborns admitted to the facility was performed and outcomes of newborns between two 9-month periods before and after the transition in March 2015 were compared. RESULTS: After the transition more intensive care was delivered (RR 1.23; 95% CI 1.07-1.42) and more outborn newborns were treated (RR 2.02; 95% CI 1.39-2.95) with similar birth weight in both periods (P=0.16). Mortality of inborn and outborn newborns was reduced (RR 0.62; 95% CI 0.41-0.94), along with mortality of sepsis (RR 0.37; 95% CI 0.17-0.81) and asphyxia (RR 0.21; 95% CI 0.51-0.87). Mortality of newborns with a birth weight <1000 grams (34.8%; RR 0.90; 95% CI 0.43-1.90) and incidence of sepsis (38.8%, 95% CI 33.3-44.6) and necrotizing enterocolitis (NEC) (12.5%, 95% CI 6.2-23.6) remained high after the transition. CONCLUSIONS: After scaling up intensive care at our neonatal care facility more outborn newborns were admitted and survival improved for both in- and outborn newborns. Challenges ahead are sustainability, further improvement of tertiary function, and prevention of NEC and sepsis.


Assuntos
Mortalidade Infantil/tendências , Unidades de Terapia Intensiva Neonatal/normas , Terapia Intensiva Neonatal/normas , Melhoria de Qualidade/estatística & dados numéricos , Encaminhamento e Consulta/tendências , Centros de Atenção Terciária/normas , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Melhoria de Qualidade/organização & administração , Estudos Retrospectivos , Suriname/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos
19.
Am J Hypertens ; 30(11): 1133-1140, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-28985247

RESUMO

BACKGROUND: Hypertension is the leading risk factor responsible for premature death worldwide, but its burden has shifted to low- and middle-income countries. Therefore, we studied hypertension and cardiovascular risk in the population of Suriname, a middle-income country with a predominantly urban population of African and Asian ancestry. METHODS: A random sample of 1,800 noninstitutionalized men and women aged 18-70 years was selected to be interviewed at home and examined at the local hospital for cardiovascular risk factors, asymptomatic organ damage, and cardiovascular disease. RESULTS: The 1,157 participants examined (37% men) were mainly of self-defined Asian (43%) or African (39%) ancestry, mean age 43 years (SD 14). The majority of the population (71%) had hypertension or prehypertension, respectively, 40% and 31%. Furthermore, 72% was obese or overweight, while 63% had diabetes or prediabetes. Only 1% of the adult population had an optimal cardiovascular risk profile. Hypertension awareness, treatment, and control were respectively 68%, 56%, and 20%. In line with this, 22% of the adult population had asymptomatic organ damage, including increased arterial stiffness, left ventricular hypertrophy, microalbuminuria, or asymptomatic chronic kidney disease. CONCLUSIONS: In this first extensive cardiovascular assessment in the general population of this middle-income Caribbean country, high prevalence of hypertension with inadequate levels of treatment and control was predominant. The findings emphasize the need for collaborative effort from national and international bodies to prioritize the implementation of affordable and sustainable public health programs that combat the escalating hypertension and cardiovascular risk factor burden.


Assuntos
Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Hipertensão/epidemiologia , Fatores Socioeconômicos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Grupo com Ancestrais do Continente Asiático , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Causas de Morte , Comorbidade , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/diagnóstico , Hipertensão/mortalidade , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Suriname/epidemiologia , Adulto Jovem
20.
IDCases ; 10: 117-121, October 16, 2017. tab
Artigo em Inglês | MedCarib | ID: biblio-906532

RESUMO

Acute Zika virus (ZIKV) infection is usually mild and self-limiting. Earlier, we reported three cases of fatal acute ZIKV infection in patients without typical signs of ZIKV, but rather with criteria of systemic inflammation response syndrome (SIRS). To follow up these observations, we prospectively included patients at the emergency room with temperature instability and suspected to have acute ZIKV infection, SIRS, or both. A total of 102 patients were included of whom N =21 (21%) were suspected of acute ZIKV infection, N =56 (55%) of acute ZIKV infection with SIRS criteria, and N =25 (24%) of SIRS alone. ZIKV-PCR was positive in N =21 (20%) patients. Eight (38%) ZIKV-positive patients needed admission to the hospital of whom four (50%) presented with SIRS alone. One ZIKV-positive patient had vascular co-morbidity and died following shock and severe coagulopathy. We confirm the hypothesis that acute ZIKV infection can present atypical and severely with systemic inflammation and have lethal course particularly amongst patients with significant prior disease...(AU)


Assuntos
Humanos , Masculino , Feminino , Zika virus , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Relatos de Casos , Técnicas de Laboratório Clínico/estatística & dados numéricos , Coinfecção , Evolução Fatal , Testes Sorológicos , Suriname/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/complicações
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