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1.
Br J Ophthalmol ; 104(1): 74-80, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30914421

RESUMO

AIM: To estimate the prevalence, causes and risk factors for presenting distance and near vision impairment (VI) in Trinidad and Tobago. METHODS: This is a national, population-based survey using multistage, cluster random sampling in 120 clusters with probability-proportionate-to-size methods. Stage 1 included standardised, community-based measurement of visual acuity. Stage 2 invited all 4263 people aged ≥40 years for comprehensive clinic-based assessment. The Moorfields Eye Hospital Reading Centre graded fundus photographs and optical coherence tomography images independently. RESULTS: The response rates were 84.2% (n=3589) (stage 1) and 65.4% (n=2790) (stage 2), including 97.1% with VI. The mean age was 57.2 (SD 11.9) years, 54.5% were female, 42.6% were of African descent and 39.0% were of South Asian descent. 11.88% (95% CI 10.88 to 12.97, n=468) had distance VI (logarithm of the minimum angle of resolution [logMAR] >0.30), including blindness (logMAR >1.30) in 0.73% (95% CI 0.48 to 0.97, n=31), after adjustment for study design, non-response, age, sex and municipality. The leading causes of blindness included glaucoma (31.7%, 95% CI 18.7 to 44.8), cataract (28.8%, 95% CI 12.6 to 45.1) and diabetic retinopathy (19.1%, 95% CI 4.2 to 34.0). The leading cause of distance VI was uncorrected refractive error (47.4%, 95% CI 43.4 to 51.3). Potentially avoidable VI accounted for 86.1% (95% CI 82.88 to 88.81), an estimated 176 323 cases in the national population aged ≥40 years. 22.3% (95% CI 20.7 to 23.8, n=695) had uncorrected near VI (logMAR >0.30 at 40 cm with distance acuity <0.30). Significant independent associations with distance VI included increasing age, diagnosed diabetes and unemployment. Significant independent associations with near VI included male sex, no health insurance and unemployment. CONCLUSIONS: Trinidad and Tobago's burden of avoidable VI exceeds that of other high-income countries. Population and health system priorities are identified to help close the gap.


Assuntos
Baixa Visão/epidemiologia , Pessoas com Deficiência Visual/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cegueira/epidemiologia , Cegueira/etiologia , Cegueira/fisiopatologia , Catarata/complicações , Catarata/epidemiologia , Estudos Transversais , Retinopatia Diabética/complicações , Retinopatia Diabética/epidemiologia , Glaucoma/complicações , Glaucoma/epidemiologia , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Prevalência , Erros de Refração/complicações , Erros de Refração/epidemiologia , Fatores de Risco , Trinidad e Tobago/epidemiologia , Baixa Visão/etiologia , Baixa Visão/fisiopatologia , Acuidade Visual
3.
Transbound Emerg Dis ; 66(3): 1341-1348, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30817083

RESUMO

Fowl adenovirus (FAdV), which causes the high-impact diseases such as inclusion body hepatitis and hepatitis-hydropericardium syndrome, is of major concern to the poultry industry internationally. This study was carried out in direct response to mortality rates of up to 75% in commercial broiler flocks in Trinidad, West Indies. Symptoms in 3- to 8-week-old broilers and 13- to 18-week-old pullets pointed to infection with an immunosuppressive viral pathogen. The objectives of the study were to determine whether the infectious agent FAdV, along with other viral pathogens, was responsible for the clinical disease, and to obtain information on the serotypes of FAdV that were infecting the birds. Tissue samples from clinically affected birds from eight different farms were tested for chicken infectious anaemia virus (CIAV) and infectious bursal disease virus (IBDV) by real-time reverse transcription polymerase chain reaction (PCR) and for FAdV by conventional PCR. The birds tested positive for FAdV and CIAV, but negative for IBDV. The gene corresponding to the L1 loop of the hexon protein for FAdV was amplified and sequenced. Phylogenetic analysis of seven FAdV strains inferred that four serotypes were likely to be circulating in the chickens. Well supported genetic relatedness was observed for serotype 8a (97.8%), 8b (97.8%), 9 (95.8%) and 11 (98.8%-99.5%). This is the first published report from Trinidad and Tobago on the presence and circulation of pathogenic FAdV strains, in combination with CIAV, in poultry. The data demonstrate a possible need for the introduction of serotype-specific vaccines against FAdV, as well as vaccines against CIAV, in broilers in the region and emphasize the importance of maintaining high levels of biosecurity on farms to prevent the spread of these potentially devastating viruses between farms.


Assuntos
Infecções por Adenoviridae/veterinária , Adenoviridae/isolamento & purificação , Vírus da Anemia da Galinha/isolamento & purificação , Galinhas/virologia , Infecções por Circoviridae/veterinária , Doenças das Aves Domésticas/virologia , Adenoviridae/genética , Adenoviridae/imunologia , Infecções por Adenoviridae/epidemiologia , Infecções por Adenoviridae/virologia , Animais , Infecções por Birnaviridae/epidemiologia , Infecções por Birnaviridae/veterinária , Infecções por Birnaviridae/virologia , Vírus da Anemia da Galinha/genética , Vírus da Anemia da Galinha/imunologia , Infecções por Circoviridae/epidemiologia , Infecções por Circoviridae/virologia , Coinfecção/veterinária , Feminino , Vírus da Doença Infecciosa da Bursa/genética , Vírus da Doença Infecciosa da Bursa/imunologia , Vírus da Doença Infecciosa da Bursa/isolamento & purificação , Filogenia , Doenças das Aves Domésticas/epidemiologia , Sorogrupo , Trinidad e Tobago/epidemiologia
4.
Parasitol Res ; 118(4): 1171-1177, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30761425

RESUMO

The agents of equine piroplasmosis, Theileria equi and Babesia caballi, are endemic in Trinidad, West Indies. While transmission is mainly by ixodid ticks, transplacental transmission of T. equi has also been reported. This disease has contributed to foetal losses as well as morbidity and mortality of neonatal foals and adult horses. Previous 18S rRNA-based phylogenetic studies indicated a noticeable degree of variation within and among B. caballi and T. equi isolates from different geographical regions. The objective of this study was to evaluate the diversity of T. equi and B. caballi obtained from horses in Trinidad by amplifying a region of the 18S rRNA gene. The phylogenetic trees for T. equi sequences obtained from horses in 2006 and 2011-2013 revealed that Trinidad sequences were of genotype A. Additionally, all of the B. caballi sequences from Trinidad were grouped together with other B. caballi sequences of genotype A. However, T. equi sequences from horses in Saint Kitts and Nevis clustered with sequences of genotype C. This study also identified two genotypes of T. equi in the equine population of Brazil. All of the T. equi and B. caballi sequences obtained from horses in Trinidad belong to genotype A and were similar to T. equi and B. caballi sequences of the same genotype that were submitted to GenBank™ databases. Countries in close proximity to Trinidad have T. equi sequences belonging to genotype C; therefore, movement of horses between these countries can introduce a new genotype of T. equi into the equid population of Trinidad.


Assuntos
Babesia/genética , Babesiose/epidemiologia , Doenças dos Cavalos/parasitologia , Cavalos/parasitologia , RNA Ribossômico 18S/genética , Theileria/genética , Theileriose/epidemiologia , Animais , Babesiose/parasitologia , Babesiose/transmissão , Brasil/epidemiologia , DNA de Protozoário/genética , Feminino , Genótipo , Ixodidae/parasitologia , Masculino , Filogenia , Análise de Sequência de DNA , Theileriose/parasitologia , Trinidad e Tobago/epidemiologia
5.
Vet Microbiol ; 229: 1-6, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30642583

RESUMO

Epizootic hemorrhagic disease virus (EHDV) is an economically important virus that can cause severe clinical disease in deer and to a lesser extent cattle. This study set out to determine and characterize which EHDV serotypes were circulating in Trinidad. Serum and whole blood samples were collected monthly for six months from a cohort of cattle imported to Trinidad from the USA. Results revealed that all the cattle seroconverted to EHDV within six months of their arrival, with EHDV RNA being detected in the samples just prior to antibodies, as expected. Serotyping assays revealed that a single serotype (EHDV-6) was circulating in the cattle. Sequencing of the surface viral protein (VP2) of EHDV-6, followed by phylogenetic analysis, revealed that the Trinidad EHDV-6 strain was closely related to EHDV-6 viruses found in Guadeloupe (2010), Martinique (2010) and USA (2006), with 96-97.2% nucleotide identity. The Trinidad EHDV-6 VP-2 shared 97.2% identity with the Australian EHDV-6 prototype strain, classifying it within the eastern topotype clade. Bayesian coalescent analysis support Australia as the most probable source for the EHDV-6 VP2 sequences in the Americas and Caribbean region and suggests that the they diverged from the Australian prototype strain around 1966 (95% HPD 1941-1979).


Assuntos
Bluetongue/complicações , Doenças dos Bovinos/virologia , Vírus da Doença Hemorrágica Epizoótica/classificação , Animais , Bluetongue/epidemiologia , Vírus Bluetongue , Proteínas do Capsídeo/genética , Proteínas do Capsídeo/metabolismo , Bovinos , Doenças dos Bovinos/epidemiologia , Feminino , Vírus da Doença Hemorrágica Epizoótica/genética , Masculino , Filogenia , RNA Viral , Sorogrupo , Trinidad e Tobago/epidemiologia
6.
BMC Psychiatry ; 19(1): 4, 2019 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-30616551

RESUMO

BACKGROUND: Psychosocial issues are major determinants as well as consequences of cardiovascular disease (CVD). This study sought to assess the prevalence and identify factors associated with depression among patients with cardiac disease in a public health institute in Trinidad and Tobago. METHODS: A cross-sectional study was conducted with a convenience sample of 388 hospitalised, stable, adult patients with cardiac disease admitted in the only tertiary public health institute in South Trinidad. Patients were identified and interviewed 3 to 5 days after admission using a questionnaire comprising questions on demographic, medical, and lifestyle issues and the 9-item Patient Health Questionnaire (PHQ-9). RESULTS: The prevalence of clinically significant depression (PHQ-9 > 9) among hospitalised patients with cardiac disease was 40.0%. However, the prevalence of non-minimal depression (PHQ-9 ≥ 5) in this study was 78.4%. It was greater among women (83.1%) than among men (72.9%). Non-minimal depression was associated with sex (p = 0.015), employment status (p = 0.007), hypertension (p = 0.017), stressful life (p ≤ 0.001), feelings of depression (p ≤ 0.001), regular exercise (p ≤ 0.001), and living alone (p = 0.006). Age, ethnicity, education level, income, or religious affiliations were not associated (p > 0.05) with depression. Participants diagnosed with depression commonly reported feeling tired (81.2%), having trouble sleeping (74.7%), and moving/speaking slowly (73.5%). Patients with self-claimed depression (past or current) were four times more likely to have depression and those with self-reported stress and loneliness were twice as likely to have depression. Employed patients and those who exercised regularly were approximately 50% less likely to have depression. CONCLUSIONS: Clinical depression prevalence among hospitalised patients with cardiac disease was 40.0%. Approximately twice as many (78.4%) had non-minimal depression, with higher prevalence among women. Employment, sex, hypertension, stressful life, feelings of depression, regular exercise, and living alone were associated with non-minimal depression. Patients with self-claimed depression, stress, and those living alone had a much higher likelihood of having depression, while those who were employed and exercised regularly were approximately half as likely to have depression.


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Cardiopatias/epidemiologia , Cardiopatias/psicologia , Hospitais Públicos , Adulto , Idoso , Estudos Transversais , Depressão/diagnóstico , Feminino , Cardiopatias/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Prevalência , Fatores de Risco , Autorrelato , Fatores Sexuais , Inquéritos e Questionários , Trinidad e Tobago/epidemiologia
7.
Vet Microbiol ; 228: 93-100, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30593386

RESUMO

Vampire bat-transmitted human rabies was first recognized in Trinidad during a major outbreak during the first half of the 20th century. To date, Trinidad is the only Caribbean island with vampire bat-transmitted rabies. Herein, we summarized the epidemiological situation of rabies in Trinidad during the period 1971-2015 through the analysis of field and laboratory records. During the study period, 259 domestic and wild animal rabies cases were laboratory confirmed with an annual median of 2 animal rabies cases. Over the 45 years, five significant epizootic events occurred (in 1974, 1997-1998, 2000, 2010 and 2012-2013) over which there was a significant increasing trend for the occurrence of rabies cases. The highest number of cases (87 cases) occurred during the 1997-1998 event, and the rabies positive proportion, was highest (0.7, 95% CI 0.52-0.84) for the year 2000. Rabies risk was highest for cattle (negative binomial parameter estimate 4.84, 95% CI 3.45-6.76), although numerous rabies cases were seen in the caprine population during the study period. In light of this finding, consideration should be given to including the small ruminant population in the national rabies vaccination program. Outbreaks affected mainly the counties of St. Patrick and St. George East, with epidemic progression outwards, and these areas should be prioritized for prevention and control efforts.


Assuntos
Quirópteros/virologia , Surtos de Doenças/veterinária , Gado/virologia , Vírus da Raiva/fisiologia , Raiva/veterinária , Animais , Animais Domésticos , Animais Selvagens , Humanos , Raiva/epidemiologia , Raiva/prevenção & controle , Raiva/virologia , Trinidad e Tobago/epidemiologia , Vacinação/veterinária , Zoonoses
8.
Breast Cancer Res Treat ; 174(2): 469-477, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30515680

RESUMO

INTRODUCTION: Breast cancer (BC) is the leading cause of cancer death in Caribbean women. Across the Caribbean islands, the prevalence of hereditary breast cancer among unselected breast cancer patients ranges from 5 to 25%. Moreover, the prevalence of BC among younger women and the high mortality in the Caribbean region are notable. This BC burden presents an opportunity for cancer prevention and control that begins with genetic testing among high-risk women. Measured response to positive genetic test results includes the number of preventive procedures and cascade testing in family members. We previously reported data on an active approach to promote cascade testing in the Bahamas and report on preventive procedures showing moderate uptake. Here, we describe a clinically structured and community-partnered approach to the dissemination and follow-up of genetic test results including family counseling for the promotion of risk mitigation strategies and cascade testing in our Trinidadian cohort of patients tested positive for BC predisposition genes. METHODS: As a part of our initial study of BC genetic testing in Trinidad and Tobago, all participants received pre-test counseling including three-generation pedigree and genetic testing for BRCA1/2, PALB2, and RAD51C. The study was approved by the University of Miami IRB and the Ethics Committee of the Ministry of Health, Trinidad and Tobago. We prospectively evaluated a clinically structured approach to genetic counseling and follow-up of BC mutation carriers in Trinidad and Tobago in 2015. The intervention consisted of (1) engaging twenty-nine BC patients with a deleterious gene mutation (probands), and (2) invitation of their at-risk relatives to attend to a family counseling session. The session included information on the meaning of their results, risk of inheritance, risk of cancer, risk-reduction options, offering of cascade testing to family members, and follow-up of proband decision-making over two years. RESULTS: Twenty-four of twenty-nine mutation carriers (82.8%) consented to enroll in the study. At initial pedigree review, we identified 125 at-risk relatives (ARR). Seventy-seven ARR (62%) attended the family counseling sessions; of these, 76 ARR (99%) consented to be tested for their family gene mutation. Genetic sequencing revealed that of the 76 tested, 35 (46%) ARR were carriers of their family mutation. The ARR received their results and were urged to take preventative measures at post-test counseling. At 2-year follow-up, 6 of 21 probands with intact breasts elected to pursue preventive mastectomy (28.5%) and 4 of 20 women with intact ovaries underwent RRSO (20%). CONCLUSIONS: In Trinidad and Tobago, a clinically structured and partnered approach to our testing program led to a significant rate of proband response by completing the intervention counseling session, executing risk-reducing procedures as well as informing and motivating at-risk relatives, thereby demonstrating the utility and efficacy of this BC control program.


Assuntos
Neoplasias da Mama/genética , Aconselhamento Genético/métodos , Testes Genéticos/métodos , Mutação em Linhagem Germinativa , Análise de Sequência de DNA/métodos , Adulto , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/diagnóstico , Proteínas de Ligação a DNA/genética , Proteína do Grupo de Complementação N da Anemia de Fanconi/genética , Feminino , Predisposição Genética para Doença , Heterozigoto , Humanos , Pessoa de Meia-Idade , Linhagem , Mastectomia Profilática/estatística & dados numéricos , Estudos Prospectivos , Trinidad e Tobago/epidemiologia , Adulto Jovem
9.
Trop Anim Health Prod ; 51(2): 369-372, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30171483

RESUMO

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is a cause of zoonotic infections in many countries. People with occupational contact with food animal production are at risk of colonization. The aim of this study was to determine the prevalence of MRSA and their frequency of resistance to other antimicrobial agents from broilers and workers at the 'pluck shops' in Trinidad. For isolation of MRSA, choanal, cloacal and pharyngeal swabs taken from broilers and nasal swabs from humans were enriched then plated on CHROMagar MRSA and Brilliance MRSA. MRSA was confirmed using the PBP2a test kit, resistance to oxacillin and cefoxitin and polymerase chain reaction (PCR) for the mecA gene. Antimicrobial resistance of the MRSA isolates to 16 antimicrobial agents was determined using the disc diffusion method. Of the 287 broilers and 47 humans sampled, MRSA was isolated at a frequency of 2 (0.7%) and 0 (0.0%) respectively. All the MRSA isolates exhibited resistance to one or more of the 16 antimicrobial agents. The study demonstrated that broilers at 'pluck shops' in Trinidad harbor MRSA. This is the first isolation of MRSA from poultry in Trinidad, West Indies, and this finding is of public health significance since occupational exposure of humans can lead to increased risk of acquiring MRSA infections.


Assuntos
Galinhas/microbiologia , Farmacorresistência Bacteriana Múltipla , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Mucosa Nasal/microbiologia , Exposição Ocupacional/análise , Animais , Antibacterianos , Cefoxitina , Estudos Transversais , Humanos , Gado , Meticilina , Testes de Sensibilidade Microbiana , Oxacilina , Reação em Cadeia da Polimerase , Prevalência , Sorogrupo , Infecções Estafilocócicas/epidemiologia , Trinidad e Tobago/epidemiologia
10.
J Infect Dev Ctries ; 13(5): 400-409, 2019 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-32053509

RESUMO

INTRODUCTION: Methicillin resistant Staphylococcus aureus (MRSA), a major cause of zoonotic infections, has emerged globally in livestock, particularly pigs. People with occupational contact with food producing animals are at high risk of colonization. The aim of this study was to determine the prevalence of MRSA in pigs and abattoir workers throughout Trinidad and Tobago as well as their resistance to other antimicrobial agents. METHODOLOGY: Nasal and skin behind the ear swabs from pigs and nasal swabs from humans were enriched in Mueller Hinton broth with 6.5% sodium chloride, followed by phenol red mannitol broth with 75 mg/L aztreonam and 5 mg/L ceftizoxime. The enriched sample was then plated on both CHROMagar MRSA and Brilliance MRSA. All incubation was at 37ºC for approximately 24 h. Suspect MRSA isolates were confirmed as MRSA using the Penicillin-Binding Protein (PBP2a) test kit and polymerase chain reaction (PCR) to detect the mecA gene. Resistance of the S. aureus and MRSA isolates to 16 antimicrobial agents was determined using the disc diffusion method. RESULTS: Of the 929 pigs and 44 humans sampled, MRSA strains were isolated at a frequency of 0.9% (8/929) and 2.3% (1/44) respectively. All isolates exhibited resistance to one or more of the 16 antimicrobial agents. CONCLUSIONS: The study demonstrated that pigs and workers at slaughter houses in Trinidad and Tobago harbour multidrug resistance S. aureus and MRSA. This is of public health significance as occupational exposure of humans can lead to an increased risk of infection and therapeutic failure.


Assuntos
Matadouros , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Doenças Profissionais/epidemiologia , Infecções Estafilocócicas/epidemiologia , Doenças dos Suínos/epidemiologia , Adulto , Animais , Estudos Transversais , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Doenças Profissionais/microbiologia , Exposição Ocupacional , Prevalência , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/veterinária , Suínos , Doenças dos Suínos/microbiologia , Trinidad e Tobago/epidemiologia , Adulto Jovem
11.
BMC Public Health ; 18(1): 1202, 2018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30359247

RESUMO

BACKGROUND: Over 60% of households (HHs) in Trinidad and Tobago (T&T) consume alcohol. These HHs were more likely to report illnesses, relationship problems, and behavioral problems with children. This study set out to determine what proportion of HHs were willing to support changes in specific policies, laws and regulations in a national alcohol campaign. METHODS: A cross-sectional convenience sample of HHs were surveyed from a random sample of enumeration districts (ED) in T&T. An interviewer-applied, field pre-tested de novo questionnaire had 5 domains and was developed over 1 1/2 years after an extensive literature review and consultation. Many of the WHO 'best buys' recommendations were included. RESULTS: One thousand six hundred ninety-five HHs (from 53 ED) responded from a total of 1837 HHs approached (response rate 92%). In a national campaign the following proportions of HHs would support: setting the legal age for drinking at 21 years (82.4%); restricting or banning alcohol advertising on TV and other media (73.1% and 54.4% respectively); banning all alcohol advertising at sports and cultural events (64.8%); banning radio stations playing songs with reference to alcohol use (71.3%); holding sellers of alcohol responsible for the amount of alcohol sold (79.5%); advocating that proof of age to be shown by persons buying alcohol (87.4%); placing more prominent warning labels on products displaying alcohol content (87.2%); placing more prominent warning labels on products showing harmful effects (88.5%); increasing taxes on alcohol sales (87.7%). Less than 50% of HH supported restrictions in density of outlets and reduction in opening times for alcohol outlets. CONCLUSIONS: Many HHs in T&T are willing to support changes in policies around alcohol, including many of the policies shown by the WHO to be effective in reducing the harmful consumption of alcohol.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/prevenção & controle , Opinião Pública , Política Pública , Adulto , Publicidade/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/epidemiologia , Bebidas Alcoólicas/economia , Estudos Transversais , Características da Família , Feminino , Humanos , Masculino , Inquéritos e Questionários , Impostos/economia , Trinidad e Tobago/epidemiologia
12.
PLoS One ; 13(8): e0202108, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30138324

RESUMO

BACKGROUND: This cross-sectional study determined the prevalence of Salmonella spp. and their serotypes on dressed chicken sold at retail outlets in Trinidad. The study also investigated the risk factors for contamination of dressed carcasses by Salmonella spp. at cottage poultry processor outlets where chickens are slaughtered and processed for sale. METHODS: A total of 133 dressed, whole chickens and 87 chicken parts from 44 cottage poultry processors and 36 dressed, whole chickens and 194 chicken parts from 46 supermarket outlets were randomly collected throughout the country. Isolation and identification of Salmonella spp. were performed using standard bacteriological techniques. Serotyping was performed by a regional reference laboratory. RESULTS: The prevalence of Salmonella spp. in chicken carcasses sampled from cottage poultry processors and supermarkets was 20.5% and 8.3% respectively (p <0.001). The frequency of isolation of Salmonella spp. at cottage poultry processors was 22.4%, 23.0%, 7.1%, and 10.0% for non-chilled whole chicken, non-chilled chicken parts, chilled whole chicken and chilled chicken parts respectively. Fresh, non-chilled chicken (22.6%) yielded a higher frequency of isolation of Salmonella spp. than chilled chickens (8.3%). For supermarket samples, the frequency of isolation of Salmonella spp. was 19.0%, 8.1%, 0.0% and 7.6% for chilled whole chickens, chill chicken parts, frozen whole chicken and frozen chicken parts respectively. The swab method of sampling yielded a statistically significantly (p = 0.029) higher frequency (3.2%) of Salmonella spp. than the rinse method (1.6%). The predominant serotypes isolated were Kentucky (30.9%) and Javiana (22.7%). Use of chilled water-bath to cool carcasses was the only risk factor significantly (p = 0.044) associated with isolation of Salmonella spp. CONCLUSION: Raw chicken carcasses purchased from cottage poultry processors pose a significantly higher risk of contamination with Salmonella spp. than those sold at supermarkets.


Assuntos
Galinhas/microbiologia , Salmonelose Animal/epidemiologia , Salmonelose Animal/microbiologia , Salmonella/classificação , Animais , Qualidade de Produtos para o Consumidor , Estudos Transversais , Contaminação de Alimentos , Microbiologia de Alimentos , Prevalência , Fatores de Risco , Salmonella/isolamento & purificação , Sorogrupo , Trinidad e Tobago/epidemiologia
13.
BMC Cancer ; 18(1): 712, 2018 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-29973176

RESUMO

BACKGROUND: Cancer is the second leading cause of death in the Caribbean, including the islands of Trinidad and Tobago (TT). The population of TT consists of over 1.3 million people with diverse ancestral and sociocultural backgrounds, both of which may influence cancer incidence and mortality. The objective of this study was to examine incidence and mortality patterns and trends in TT. METHODS: Cancer surveillance data on 29,512 incident cancer cases reported to the Dr. Elizabeth Quamina Cancer Registry (population-based cancer registry of TT) between 1995 and 2009 were analyzed. Age-standardized rates, overall and by sex, ancestry, and geography, were reported. RESULTS: The highest incidence and mortality rates were observed for cancers related to reproductive organs in women, namely, breast, cervical, and uterine cancers, and prostate, lung and colorectal cancers among men. Average incidence rates were highest in areas covered by the Tobago Regional Health Authority (TRHA) (188 per 100,000), while average mortality rates were highest in areas covered by the North West Regional Health Authority (108 per 100,000). Nationals of African ancestry exhibited the highest rates of cancer incidence (243 per 100,000) and mortality (156 per 100,000) compared to their counterparts who were of East Indian (incidence, 125 per 100,000; mortality, 66 per 100,000) or mixed ancestry (incidence, 119 per 100,000; mortality, 66 per 100,000). CONCLUSIONS: Our findings highlight the need for national investment to improve the understanding of the epidemiology of cancer in Trinidad and Tobago, and to ultimately guide much needed cancer prevention and control initiatives in the near future.


Assuntos
Neoplasias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Detecção Precoce de Câncer , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/mortalidade , Neoplasias/prevenção & controle , Trinidad e Tobago/epidemiologia
14.
Cancer Causes Control ; 29(7): 685-697, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29774450

RESUMO

PURPOSE: In Trinidad and Tobago (TT), prostate cancer (CaP) is the most commonly diagnosed malignancy and the leading cause of cancer deaths among men. TT currently has one of the highest CaP mortality rates in the world. METHODS: 6,064 incident and 3,704 mortality cases of CaP occurring in TT from January 1995 to 31 December 2009 reported to the Dr. Elizabeth Quamina Cancer population-based cancer registry for TT, were analyzed to examine CaP survival, incidence, and mortality rates and trends by ancestry and geography. RESULTS: The age-standardized CaP incidence and mortality rates (per 100,000) based on the 1960 world-standardized in 2009 were 64.2 and 47.1 per 100,000. The mortality rate in TT increased between 1995 (37.9 per 100,000) and 2009 (79.4 per 100,000), while the rate in the US decreased from 37.3 per 100,000 to 22.1 per 100,000 over the same period. Fewer African ancestry patients received treatment relative to those of Indian and mixed ancestry (45.7%, 60.3%, and 60.9%, respectively). CONCLUSIONS: Notwithstanding the limitations surrounding data quality, our findings highlight the increasing burden of CaP in TT and the need for improved surveillance and standard of care. Our findings highlight the need for optimized models to project cancer rates in developing countries like TT. This study also provides the rationale for targeted screening and optimized treatment for CaP to ameliorate the rates we report.


Assuntos
Neoplasias da Próstata/epidemiologia , Idoso , Países em Desenvolvimento , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Trinidad e Tobago/epidemiologia
15.
Injury ; 49(6): 1188-1192, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29704953

RESUMO

Popliteal artery trauma is uncommon but is associated with a high risk of limb loss depending on the scenario involving blunt or penetrating trauma as well as the severity and extent of injury that has occurred. In our setting there is a significant amount of gang and civilian warfare resulting in Vascular Trauma. There were 32 patients over a decade who sustained traumatic injury to the popliteal artery consisting of 30 males (94%) and 2 females with an age range 16-59 years with a mean of 32. There were 20 cases of penetrating trauma (63%) and 12 cases of blunt trauma (37%). Of the penetrating trauma, 18 were due to gunshot wounds (GSWs) (90%) and 2 stabs. The majority (7/12; 58%) of blunt trauma was due to falls, and 42% (5/12) secondary to motor vehicular accidents (MVAs). In terms of extent of injury, 21 of 32 patients (65%) sustained an isolated popliteal artery injury, whilst 6 (19%) had injury to both the popliteal artery and vein and another 5 (16%) had combined popliteal artery, vein and nerve injuries. There were 14 cases with associated orthopaedic injuries: 7 posterior knee dislocations, 1 fracture/dislocation of the knee, 2 femoral fractures, 2 tibial plateau fractures and 2 tibia/fibula fracture. Methods of repair included 14 reversed vein grafts, 16 polytetrafluoroethylene (PTFE) grafts and 2 primary. The overall amputation rate was 28% (9 patients). Of the penetrating trauma patients 25% required amputations composed of 5 GSWs, 33% of the blunt trauma patients required amputations. It was noted that factors associated with (but not statistically significant) poor outcomes included combined artery/vein injury, artery/vein/nerve injury, concomitant fracture/dislocation and delayed transfer to a Vascular Surgery Unit. The type of graft or repair did not affect outcome. The incidence of popliteal artery trauma was calculated at 2.46 per 100,000 population per year.


Assuntos
Amputação/estatística & dados numéricos , Traumatismos da Perna/fisiopatologia , Salvamento de Membro/métodos , Artéria Poplítea/lesões , Lesões do Sistema Vascular/cirurgia , Ferimentos não Penetrantes/fisiopatologia , Ferimentos Penetrantes/fisiopatologia , Adolescente , Adulto , Feminino , Hospitais de Ensino , Humanos , Traumatismos da Perna/complicações , Traumatismos da Perna/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Trinidad e Tobago/epidemiologia , Procedimentos Cirúrgicos Vasculares/métodos , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/fisiopatologia , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/complicações , Ferimentos Penetrantes/cirurgia , Adulto Jovem
16.
Asian Pac J Cancer Prev ; 19(S1): 51-55, 2018 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-29682921

RESUMO

Background: Underage alcohol use is a pervasive problem with serious health, social and safety consequences. This study was undertaken to assess alcohol use by primary school children in Trinidad and Tobago, and to identify associated risk factors. Methods: We analysed data collected from 40 primary schools in Trinidad and Tobago by the National Alcohol and Drug Abuse Prevention Programme (NADAPP). The sample comprised of children aged 8 -15 years old, in standards 3, 4 and 5. Result: Out of the 2052 children, 648 (31.6%) have consumed alcohol in their lifetime, and same proportion reported ever being drunk (31.6%). Male gender was significantly associated with lifetime alcohol use (AOR =1.60, 95% CI= 1.25 - 2.05). Children not living with their father (AOR= 2.45, 95% CI=1.86- 3.24) and those whose fathers have either primary or secondary education (AOR = 1.88, 95%CI=1.07 - 3.31; AOR= 1.58, 95%CI=1.12 - 2.23 respectively) were at higher risk for lifetime alcohol consumption. However, age group 8 ­ 11 years was significantly inversely associated with lifetime alcohol consumption (AOR= 0.67, 95% CI=0.48 - 0.94). Conclusion: Being a male student, not living with father, and father attaining either primary or secondary education level were significantly associated with increased likelihood for lifetime alcohol use. However, children between 8 ­ 11 years were less likely to consume alcohol.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Instituições Acadêmicas , Estudantes/psicologia , Adolescente , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Fatores de Risco , Inquéritos e Questionários , Trinidad e Tobago/epidemiologia
17.
BMJ Open ; 8(2): e018288, 2018 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-29472257

RESUMO

OBJECTIVE: To investigate the dementia prevalence in a country with high levels of cardiovascular risk factors DESIGN AND METHODS: Older people in Trinidad are recognised to have particularly high levels of cardiovascular risk factors. We carried out a survey in a nationally representative sample of people aged ≥70 years using household enumeration. Dementia status was ascertained using standardised interviews and algorithms from the 10/66 schedule and age-specific prevalence were compared with identically defined output from the 10/66 surveys of 16 536 residents in eight other low-income and middle-income countries. RESULTS: Of 1832 participants (77.0% response rate), dementia was present in 442 (23.4%). Prevalences were 12.0% in persons aged 70-74 years, 23.5% at 75-79, 25.8% at 80-84, 41.3% at 85-89 and 54.0% in those aged ≥90 years. Prevalence ratios compared with averages from 10/66 surveys in these age groups were 2.2, 2.6, 1.6, 1.7 and 1.6, respectively, and were 2.7, 2.8, 1.7, 1.4 and 0.8, respectively, compared with previously published consensus estimates for the Latin American region. Dementia was significantly associated with reported stroke and diabetes in logistic regression models adjusted for sociodemographic status and other vascular risk factors (OR (95% CI) 4.40 (2.70 to 7.19) and 1.56 (1.20 to 2.03), respectively). Projected national numbers of people with dementia (18 206) were 70%-100% higher than those estimated using most recent regional consensus prevalences. CONCLUSION: In a nation with high levels of vascular risk, dementia prevalence is higher than expected, particularly at the lower end of the 70+ age range. International prevalence projections may need to take into account risk status as well as age structures.


Assuntos
Envelhecimento/psicologia , Doenças Cardiovasculares/epidemiologia , Demência/epidemiologia , Diabetes Mellitus/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Cognição , Estudos Transversais , Demência/complicações , Países em Desenvolvimento , Feminino , Humanos , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , Distribuição por Sexo , Inquéritos e Questionários , Trinidad e Tobago/epidemiologia
18.
Prev Vet Med ; 149: 75-81, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29290303

RESUMO

Viruses affecting poultry cause significant levels of disease leading to severe economic losses among poultry farmers worldwide. The Americas region continues to be vulnerable to the spread of poultry viruses across the continents and Caribbean island chains. In Trinidad and Tobago (T&T) there is limited information on the viruses circulating in poultry. Many flock are vulnerable to infection and there are occasional outbreaks of disease resulting in high levels of morbidity and mortality. This study aims to identify important viruses of poultry circulating in T&T through a broad-based surveillance approach. Serum samples from 29 layer farms in Trinidad and 14 layer farms in Tobago were collected from the eldest laying hens. Samples were tested from unvaccinated birds for antibodies by enzyme-linked immunosorbent assay (ELISA) against Avian influenza virus (AIV), Infectious bronchitis virus (IBV), Newcastle disease virus (NDV), Infectious laryngotracheitis virus (ILTV), Avian pneumovirus (APV), Infectious bursal disease virus (IBDV), Fowl adenovirus Gp1 (FADV) and Egg drop syndrome virus (EDSV). In Trinidad, the estimated true seroprevalence levels of antibodies were 0% (CI 95%: 0-0%) for AIV, 100% (CI 95%: 97-100%) for IBV, 79.8% (CI 95%: 70.6-86.9%) for NDV, 1% (CI 95%: 0-2.6%) for ILTV, 67.55% (CI 95%: 62.3-72.4%) for APV, 94.93% (CI 95%: 88.0-98.6%) for IBDV, 100% (CI 95%: 99.7-100%) for FADV and 67.8% (CI 95%: 62.4-72.8%) for EDSV. In Tobago, seroprevalence levels were 0% (CI 95%: 0-0%) for AIV, 100% (CI 95%: 95.6-100%) for IBV, 80.5% (CI 95%: 70.1-88.5%) for NDV, 29.9% (CI 95%: 20.8-40.6%) for ILTV, 100% (CI 95%: 97.7-100%) for APV, 97.1% (CI95%: 89.9-100%) for IBDV, 100% (CI 95%: 97.5-100%) for FADV and 100% (CI 95%: 99-100%) for EDSV. The results reveal strong evidence for the circulation of IBV, NDV, APV, IBDV, FADV and EDSV in layer poultry on both islands, as well as ILTV in Tobago.


Assuntos
Galinhas , Doenças das Aves Domésticas/epidemiologia , Viroses/veterinária , Animais , Feminino , Doenças das Aves Domésticas/virologia , Prevalência , Estudos Soroepidemiológicos , Trinidad e Tobago/epidemiologia , Viroses/epidemiologia , Viroses/virologia
19.
BMC Public Health ; 18(1): 161, 2018 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-29351744

RESUMO

BACKGROUND: The relative importance of coronary artery disease (CAD) risk varies globally. The aim of this study was to determine CAD risk factors for acute myocardial infarction (AMI) among patients in public health care institutions in Trinidad using a case-control type study design. METHODS: The sample comprised 251 AMI patients hospitalized between March 1, 2011 and April 30, 2012 and 464 age- and sex-matched non-AMI patients with no terminal or life-threatening illness and who did not undergo treatment for CAD. SPSS version 19 was used for data analysis that included chi-square tests, unadjusted and adjusted odds ratios (OR) and conditional multiple binary logistic regression. RESULTS: There was no difference in age between AMI and non-AMI patients (p = 0.551). Chi-square test revealed that clinical and lifestyle variables including stressful life, diabetes, hypertension, hypercholesterolaemia, ischaemic heart disease (IHD), a family history of IHD (p ≤ 0.001), smoking (p = 0.007) and alcohol consumption (p = 0.013) were associated with AMI; sex (p = 0.441), ethnicity (p = 0.366), age group (p = 0.826) and renal failure (p = 0.487) were not. Both unadjusted and adjusted (for age) ORs showed that the odds of hypertension, IHD and alcohol consumption were greater among AMI patients than among non-AMI patients for males; diabetes and IHD for females; and that the odds of a stressful life was greater among non-AMI patients and were the same for both groups with respect to sex, age > 45 years, hypercholesterolemia, renal insufficiency, and family history of IHD. Conditional multiple logistic regression showed that smoking [OR: 0.274, p ≤ 0.001, 95% CI for OR (0.140, 0.537)], a stressful life [OR: 2.697, p ≤ 0.001, 95% CI for OR (1.585, 4.587)], diabetes [OR: 0.530, p = 0.020, 95% CI for OR (0.310, 0.905)], hypertension [OR: 0.48, p = 0.10. 95% CI for OR (0.275, 0.837)] and IHD [OR: 0.111, p ≤ 0.001, 95% CI for OR (0.057, 0.218)] were the only useful AMI predictors. CONCLUSIONS: Smoking, diabetes, hypertension, IHD and decrease stress are useful AMI predictors.


Assuntos
Infarto do Miocárdio/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Feminino , Hospitalização , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Isquemia Miocárdica/epidemiologia , Fatores de Risco , Fumar/epidemiologia , Estresse Psicológico/epidemiologia , Trinidad e Tobago/epidemiologia , Adulto Jovem
20.
Eur J Trauma Emerg Surg ; 44(4): 567-571, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28717984

RESUMO

PURPOSE: While falls are common in older people, causing significant mortality and morbidity, this phenomenon has not been extensively studied in the Caribbean. This study aimed to compare falls in older and younger people in this setting. METHODS: We conducted a prospective observational study of older trauma patients in Trinidad, comparing older and younger patients sustaining falls. RESULTS: 1432 adult trauma patients were included (1141 aged 18-64 years and 291 aged 65 years and older). Older fallers were more likely to be female (66.7 vs 47.2%; p < 0.001), suffer from multiple pre-existing diseases (24.7 vs 2.4%; p < 0.001) and take multiple medications (16.1 vs 0.8%; p < 0.001). They also sustained more severe injuries and presented with higher acuity than younger fallers. Admission rates were higher among older fallers (29.9 vs 13.1%; p < 0.001). CONCLUSIONS: In our study, older patients who fell were a distinct group from younger falls victims, with unique demographic, clinical and injury related characteristics. Their increased risk of injury within the home, coupled with their propensity for more severe injuries made them a high risk patient group. More research is needed to better understand this patient group and plan specific preventive interventions.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Acidentes por Quedas/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Países em Desenvolvimento , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Trinidad e Tobago/epidemiologia
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