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1.
Kingston 7; PAHO; 2021-10-14. (PAHO/JAM/21-0001).
Non-conventional in English | PAHO-IRIS | ID: phr2-54996

ABSTRACT

Founded in 1902 as the independent specialized health agency of the inter-American system, the Pan American Health Organization (PAHO) has developed recognized competence and expertise, providing technical cooperation to its Member States to fight communicable and noncommunicable diseases and their causes, to strengthen health systems, and to respond to emergencies and disasters throughout the Region of the Americas. In addition, acting in its capacity as the World Health Organization’s Regional Office, PAHO participates actively in the United Nations Country Team, collaborating with other agencies, the funds and programs of the United Nations system to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. This 2020 annual report reflects PAHO’s technical cooperation in the country for the period, implementing the Country Cooperation Strategy, responding to the needs and priorities of the country, and operating within the framework of the Organization’s regional and global mandates and the SDGs. Under the overarching theme of Universal Health and the Pandemic – Resilient Health Systems, it highlights PAHO’s response to the COVID-19 pandemic as well as its continuing efforts in priority areas such as communicable diseases, noncommunicable diseases, mental health, health throughout the life course, and health emergencies. It also provides a financial summary for the year under review.


Subject(s)
Technical Cooperation , Health Priorities , Health Systems , National Health Programs , Health Policy , Universal Access to Health Care Services , Universal Health Coverage , Communicable Diseases , Noncommunicable Diseases , Risk Factors , Mental Health , Health Services , Financial Management , Health Administration , Caribbean Region , Jamaica
2.
Proc Natl Acad Sci U S A ; 117(3): 1587-1595, 2020 01 21.
Article in English | MEDLINE | ID: mdl-31907312

ABSTRACT

Many large-bodied marine fishes that form spawning aggregations, such as the Nassau grouper (Epinephelus striatus), have suffered regional overfishing due to exploitation during spawning. In response, marine resource managers in many locations have established marine protected areas or seasonal closures to recover these overfished stocks. The challenge in assessing management effectiveness lies largely in the development of accurate estimates to track stock size through time. For the past 15 y, the Cayman Islands government has taken a series of management actions aimed at recovering collapsed stocks of Nassau grouper. Importantly, the government also partnered with academic and nonprofit organizations to establish a research and monitoring program (Grouper Moon) aimed at documenting the impacts of conservation action. Here, we develop an integrated population model of 2 Cayman Nassau grouper stocks based on both diver-collected mark-resight observations and video censuses. Using both data types across multiple years, we fit parameters for a state-space model for population growth. We show that over the last 15 y the Nassau grouper population on Little Cayman has more than tripled in response to conservation efforts. Census data from Cayman Brac, while more sparse, show a similar pattern. These findings demonstrate that spatial and seasonal closures aimed at rebuilding aggregation-based fisheries can foster conservation success.


Subject(s)
Bass/physiology , Conservation of Natural Resources , Animals , Conservation of Natural Resources/methods , Conservation of Natural Resources/statistics & numerical data , Environmental Monitoring , Fisheries , Fishes/physiology , Models, Biological , Oceans and Seas , Population Density , Surveys and Questionnaires , West Indies
3.
Mol Ecol ; 28(7): 1637-1651, 2019 04.
Article in English | MEDLINE | ID: mdl-30636347

ABSTRACT

Ex situ management is an important conservation tool that allows the preservation of biological diversity outside natural habitats while supporting survival in the wild. Captive breeding followed by re-introduction is a possible approach for endangered species conservation and preservation of genetic variability. The Cayman Turtle Centre Ltd was established in 1968 to market green turtle (Chelonia mydas) meat and other products and replenish wild populations, thought to be locally extirpated, through captive breeding. We evaluated the effects of this re-introduction programmme using molecular markers (13 microsatellites, 800-bp D-loop and simple tandem repeat mitochondrial DNA sequences) from captive breeders (N = 257) and wild nesting females (N = 57) (sampling period: 2013-2015). We divided the captive breeders into three groups: founders (from the original stock), and then two subdivisions of F1 individuals corresponding to two different management strategies, cohort 1995 ("C1995") and multicohort F1 ("MCF1"). Loss of genetic variability and increased relatedness was observed in the captive stock over time. We found no significant differences in diversity among captive and wild groups, and similar or higher levels of haplotype variability when compared to other natural populations. Using parentage and sibship assignment, we determined that 90% of the wild individuals were related to the captive stock. Our results suggest a strong impact of the re-introduction programmme on the present recovery of the wild green turtle population nesting in the Cayman Islands. Moreover, genetic relatedness analyses of captive populations are necessary to improve future management actions to maintain genetic diversity in the long term and avoid inbreeding depression.


Subject(s)
Breeding , Conservation of Natural Resources/methods , Genetic Variation , Genetics, Population , Turtles/genetics , Animals , DNA, Mitochondrial/genetics , Endangered Species , Female , Haplotypes , Microsatellite Repeats , West Indies
4.
Cancer Causes Control ; 29(1): 87-92, 2018 01.
Article in English | MEDLINE | ID: mdl-28918559

ABSTRACT

INTRODUCTION: The common tool for diagnosing prostate cancer is prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing are the problems in clinical practice. There are no proper guidelines to investigate the suspected prostate cancer in the Cayman Islands. We correlated PSA levels with the incidence of prostate cancers by tissue diagnosis and proposed logical protocol for prostate screening by using PSA test in this small population. MATERIALS AND METHODS: A total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. The patients were divided into subgroups by baseline PSA levels as follows: <4, 4.1-10, 10.1-20, 20.1-50, 50.1-100, and >100 ng/mL and were correlated to the age and presence of cancer. RESULTS AND DISCUSSION: Benign lesions had lower PSA levels compared to cancer which generally had higher values. Only three cases that had less than 4 ng/mg were turned out to be malignant. When PSA value was more than 100 ng/mL, all the cases were malignant. Between PSA values of 4-100 ng/mL, the probability of cancer diagnosis was 56.71% (76 cancers out of 134 in this range). Limitation of PSA testing has the risk of over diagnosis and the resultant negative biopsies owing to poor specificity. Whereas the cutoff limit for cancer diagnosis still remains 4 ng/mL from our study, most of the patients can be assured of benign lesion below this level and thus morbidity associated with the biopsy can be prevented. When the PSA value is greater than 100 ng, biopsy procedure was mandatory as there were 100% cancers above this level. On the background of vast literature linking PSA to prostate cancer and its difficulty in implementing in clinical practice, we studied literature of this conflicting and complex topic and tried to bring relevant protocols to the small population of Cayman Islands for the screening of prostate cancer. In this study, a total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. As a result of this research work, it can be concluded that a benign diagnosis can be given with a fair certainty when the PSA was below 4 ng/mL and a level of 100 ng/mL can be very unfavorable for the patients. This study helped to solidify the cancer screening protocols in Cayman Islands. CONCLUSION: The PSA level can reassure and educate the patients towards the diagnosis of cancer of prostate in Cayman Islands. Benign diagnosis can be given with a fair certainty when the PSA was below 4 ng/mL and a level of 100 ng/mL can be very unfavorable for the patients. This study helped to solidify the cancer screening protocols in Cayman.


Subject(s)
Early Detection of Cancer , Mass Screening , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnosis , Aged , Aged, 80 and over , Biopsy , Humans , Male , Middle Aged , Probability , Prostate/pathology , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Retrospective Studies , Sensitivity and Specificity , West Indies
6.
J Parasitol ; 101(1): 50-6, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25302790

ABSTRACT

Recently, Pterois volitans, a Pacific species of lionfish, invaded the Atlantic Ocean, likely via the aquarium trade. We examined for internal and external parasites 188 individuals from 8 municipalities of Puerto Rico collected during 2009-2012, 91 individuals from Little Cayman, Cayman Islands, collected during the summers of 2010 and 2011, and 47 individuals from Lee Stocking Island, Bahamas, collected during the summer of 2009. In total, 27 parasite taxa were found, including 3 previously reported species from lionfish, the digenean Lecithochirium floridense, the leech Trachelobdella lubrica, and an Excorallana sp. isopod. We also report another 24 previously unreported parasite taxa from lionfish, including digeneans, monogeneans, cestodes, nematodes, isopods, a copepod, and an acanthocephalan. Among these parasites, several were previously unreported at their respective geographic origins: We report 5 new locality records from Puerto Rico, 9 from Cayman Islands, 5 from the Bahamas, 5 from the Caribbean, and 3 from the subtropical western Atlantic region. Three parasites are reported to associate with a fish host for the first time. The parasite faunas of P. volitans among our 3 study sites were quite different; most of the species infecting lionfish were generalists and/or species that infect carnivorous fishes. Although our study did not assess the impact of parasites on the fitness of invasive lionfish, it provides an important early step. Our results provide valuable comparative data for future studies at these and other sites throughout the lionfish's invaded range.


Subject(s)
Fish Diseases/parasitology , Parasitic Diseases, Animal/parasitology , Perciformes/parasitology , Animals , Atlantic Ocean/epidemiology , Bahamas/epidemiology , Fish Diseases/epidemiology , Gastrointestinal Tract/parasitology , Gills/parasitology , Introduced Species , Parasitic Diseases, Animal/epidemiology , Prevalence , Puerto Rico/epidemiology , Skin/parasitology , West Indies/epidemiology
7.
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).
Monography in English | MedCarib, MedCarib | ID: med-18004

ABSTRACT

OBJECTIVE: To explore the experiences of mental health professionals counseling young survivors of sexual abuse in the Cayman Islands; how they navigated challenges in their experiences and sustained themselves through their work with young survivors of sexual abuse. DESIGN AND METHODS: The present study incorporated a qualitative approach using a phenomenological design to elicit a description of the experiences of mental health professionals who counseled young survivors of sexual abuse in the Cayman Islands. Five mental health professionals were recruited using purposive sampling methods. Semi-structured interviews were facilitated to answer the research questions centered on describing their experiences in counseling young survivors of sexual abuse in the Cayman Islands. Data analysis resulted in four core themes that described their lived experiences as notably punctuated with both significant systemic challenges and significant posttraumatic growth. RESULTS: The findings indicated that mental health professionals compensated for the systemic influences such as patriarchal belief systems and oppressive and complicit attitudes objectifying children by diversifying and expanding their interventions. CONCLUSION: The present study supported recent literature from the Caribbean region that described the embedded oppressive belief systems and traditional patriarchal attitudes that have perpetuated abusive treatment of children. Furthermore, the study provided a greater understanding of mental health professionals’ experiences in the Cayman Islands that also supported expanding the scope of the mental health professions to include social justice and advocacy efforts.


Subject(s)
Counseling , Mental Health , Sex Offenses , Caribbean Region
8.
West Indian Med J ; 63(4): 325-8, 2014 Aug.
Article in English | MEDLINE | ID: mdl-25429475

ABSTRACT

OBJECTIVE: To describe the unusual clustering of systemic lupus erythematosus (SLE) in a family from the Cayman Islands. METHOD: An observational retrospective study of SLE was done following an index case of mixed connective tissue disease in a 51-year old West Indian woman of African descent. Her two daughters of the same father, who is of Cayman Islands origin, were also diagnosed with SLE. A family tree was subsequently drawn up to 1890 to identify other cases in the same family. RESULTS: There were 13 cases identified and all occurred between the 6th and the 8th generation. A family tree linked all cases to a man from the Cayman Islands who died in 1890. The nine cases with full medical records showed eight females and one male (8:1). The mean age at diagnosis was 29 years; polyarthritis occured in all nine patients (100%), kidney involvement in 6/9 (66.6%), skin rash in 6/9 (66.6%), pleuritis and pericarditis in 6/9 (66.6%) and anaemia in 6/9 (66.6%). The autoantibodies were mainly ANA in all patients (100%) and anti-dsDNA in 8/9 (88.8%). CONCLUSION: The unusual extensive familial clustering in this study represents the first to be described in a West Indian population where SLE is most prevalent and may suggest a genetic predisposition.

9.
Am Heart J ; 167(5): 770-4, 2014 May.
Article in English | MEDLINE | ID: mdl-24766989

ABSTRACT

We describe a new health care campus under development in the Cayman Islands, Health City, based on the low-cost "focused factory" model. The construction of a multispecialty hospital opening in February 2014 less than a 4-hour flight away from the United States and convenient to both Central and South America for patients who already travel to the United States for clinical care could reshape the US health care marketplace and enhance access to affordable specialty health care in the region.


Subject(s)
Delivery of Health Care/organization & administration , Health Services Accessibility/organization & administration , Cardiovascular Diseases/therapy , Humans , Internationality , West Indies
11.
PAHO.
In. Pan American Health Organization. Health in the Americas. Washington, PAHO, 2012; 2012. p.88-91. (Scientific and technical publication No. 636^ien, 636).
Monography in English | MedCarib, MedCarib | ID: med-18204

ABSTRACT

The Cayman Islands, a British Overseas Territory, comprises the islands of Grand Cayman, Cayman Brac, and Little Cayman. The territory is located in the western Caribbean Sea, about 240 km south of Cuba and 290 km west of Jamaica. The total land area is 250 km2. Grand Cayman is the largest and most populous island, with an area of 197 km2. The country has a parliamentary democratic form of government. The Governor, who represents the Queen of the United Kingdom, heads the territorial government and presides over the Cabinet. The capital is George Town (located on Grand Cayman), and the country is divided into nine administrative districts.


Subject(s)
Health Profile
12.
Int Urol Nephrol ; 42(2): 461-4, 2010 Jun.
Article in English | MEDLINE | ID: mdl-19350410

ABSTRACT

There has been no documentation on the epidemiology of end stage renal disease (ESRD) in the Cayman Islands. We retrospectively surveyed all facilities providing renal replacement therapy in the Cayman Islands in order to define the epidemiology of kidney failure in this setting. The prevalence of ESRD in this population was 0.975 persons per 1,000 population. There were 48 patients with kidney failure who received replacement therapy either by chronic hemodialysis (36) or kidney transplants (12). The method of access for maintenance hemodialysis was tunneled internal jugular catheter access (3), native arteriovenous fistulae (13) and prosthetic arteriovenous grafts (20). Currently, there is a low prevalence of maintenance hemodialysis by native fistulae (36.1%). A directed effort to increase the use of native fistulae is now necessary to meet the goals set by the National Kidney Foundation and Center for Medicaid Services. Otherwise, renal replacement therapy for patients with ESRD in the Cayman Islands exceeds the standards recommended by the National Kidney Foundation. In order to ensure continued delivery of modern quality care, further audits of the local practice will be required at regular intervals.


Subject(s)
Kidney Failure, Chronic/therapy , Renal Replacement Therapy , Disease Progression , Female , Humans , Kidney Failure, Chronic/epidemiology , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , West Indies
13.
Int J Angiol ; 18(2): 71-4, 2009.
Article in English | MEDLINE | ID: mdl-22477497

ABSTRACT

OBJECTIVE: In the Cayman Islands, a vascular access service was created in 2005 to facilitate the creation of vascular access for hemodialysis by local surgeons. The present retrospective audit aims to establish the outcomes of this practice in the Cayman Islands. METHODS: Data from the operative log of the Cayman Islands Hospital was collected over a period of 36 months. The data were analyzed using SPSS version 12.0 (SPSS Inc, USA). Statistical analyses were performed using Student's t tests and Fisher's exact tests. RESULTS: A total of 19 operative procedures were performed to create vascular accesses in 12 men and seven women. Thirteen procedures (68%) created autogenous arteriovenous fistulas (AVFs) and six (32%) involved the insertion of a prosthetic arteriovenous graft (AVG). There were six incident dialysis patients, all of whom had an AVF created. The remaining 13 prevalent dialysis patients had new accesses in the form of AVFs (n=7) or AVGs (n=6). The statistical analyses were limited by sample size, but with AVFs, there were trends toward reduced incidence of secondary failure (four of 13 versus four of six), thrombosis (four of 13 versus two of six), infectious morbidity (zero versus two of six) and less demand for interventions to maintain patency (one of 13 versus two of six) with AVFs. There were also trends toward superior primary (461 days versus 227 days) and secondary (803 days versus 205 days) patency rates for AVFs. CONCLUSIONS: In this setting, the rate of AVF creation exceeds the goals set by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative and the Fistula First Breakthrough Initiative. To ensure continued delivery of modern quality care, further audits of the local practice will be required at regular intervals.

15.
Am J Trop Med Hyg ; 69(1): 105-14, 2003 Jul.
Article in English | MEDLINE | ID: mdl-12932107

ABSTRACT

We conducted a population genetic analysis of Aedes albopictus collected from 20 sites in Brazil, the United States (Florida, Georgia, and Illinois), and the Cayman Islands. Using isoenzyme analysis, we examined genetic diversity and patterns of gene flow. High genetic differentiation was found among Brazilian samples, and between them and North American samples. Regression analysis of genetic differentiation according to geographic distances indicated that Ae. albopictus samples from Florida were genetically isolated by distance. Infection rates with dengue and yellow fever viruses showed greater differences between two Brazilian samples than between the two North American samples or between a Brazilian sample and a North American sample. Introductions and establishments of new Ae. albopictus populations in the Americas are still in progress, shaping population genetic composition and potentially modifying both dengue and yellow fever transmission patterns.


Subject(s)
Aedes/genetics , Aedes/virology , Dengue/transmission , Genetic Variation/genetics , Insect Vectors/genetics , Insect Vectors/virology , Yellow Fever/transmission , Animals , Brazil/epidemiology , Dengue/virology , Dengue Virus/physiology , Female , Flavivirus/physiology , United States/epidemiology , West Indies/epidemiology , Yellow Fever/virology
16.
S.l.; PAHO; 2003.
Non-conventional in English | PAHO-IRIS | ID: phr3-55761

ABSTRACT

[Introducción] The islands, though separated, operate along the same lines as regards solid waste management services. The Department of Health (DEH) has worked continuously with consultants, on inter agency level and with the wider society to have a hybrid integrated solid waste management system. Additionally, the Department has been making progress in implementing some of the strategies and recommendations brought out by the various studies. Some of these include equipment procurement and instituting a waste processing facility to recycle some non - biodegradable materials. Evaluation 2002 will be another way by which the sector can be inventoried and some of the activities that occurred in the evaluation period 1996-2001 can be highlighted that will continue to assist the Government to maintain its focus and also enable greater involvement by external entities in the process.


Subject(s)
Solid Waste , Solid Waste Collection , Solid Waste Processing , West Indies
17.
Genet Test ; 6(3): 211-5, 2002.
Article in English | MEDLINE | ID: mdl-12490062

ABSTRACT

Sanfilippo A syndrome is an autosomal recessive lysosomal storage disease. This disease was reported in the Cayman Islands population with carrier frequency of 1/7 to 1/10 in the West Bay district of Grand Cayman. The carrier testing of Sanfilippo A disease for families at risk was carried out using the thermal characteristics of sulfamidase activity. In the present study, a search for mutations in the sulfamidase gene in an index family was performed. In addition, 77 individuals, relatives of children with Sanfilippo A syndrome, were also studied by single-strand conformation polymorphism (SSCP), restriction fragment-length polymorphism (RFLP) analyses, and sequencing. A single mutation, G746A (R245H), was found in the family, with the patient being homozygous and both parents and 1 of the 3 siblings being carriers. Among the 77 family members of the patient with Sanfilippo syndrome, the same mutation was found among carriers of the disease. The finding of a single mutation supports the idea of a founder effect, which facilitates accurate carrier identification of Sanfilippo A syndrome in the population of Cayman Islands.


Subject(s)
Amino Acid Substitution , Founder Effect , Mucopolysaccharidosis III/genetics , Mutation, Missense , DNA Mutational Analysis , Female , Heterozygote , Humans , Hydrolases/genetics , Male , Pedigree , West Indies
18.
West Indian med. j ; 50(Suppl 4): 34-9, Sept. 2001. tab
Article in English | MedCarib, MedCarib | ID: med-285

ABSTRACT

This paper reviews the development of mental health services in the Cayman Islands throughout a twelve-year period (1989 to 2001). I was appointed the resident consultant psychiatrist to the islands in 1989, after which time a consultative process between the Ministry of Health, Senior Management of the George Town Hospital and myself allowed the development and establishment of a comprehensive community-based mental health service delivery system (MHSDS), specifically designed to suit the needs of the Cayman Islands. The framework for the service is outlined, and the concerns and objectives of the MHSDS are discussed, along with short-term and long-term goals. (AU)


Subject(s)
Humans , Community Mental Health Services/trends , Delivery of Health Care/trends , Caribbean Region , Patient Care/trends , Community Health Services/organization & administration
19.
West Indian med. j ; 50(Supl.4): 34-39, Sept. 2001.
Article in English | LILACS | ID: lil-333352

ABSTRACT

This paper reviews the development of mental health services in the Cayman Islands throughout a twelve-year period (1989 to 2001). I was appointed the resident consultant psychiatrist to the islands in 1989, after which time a consultative process between the Ministry of Health, Senior Management of the George Town Hospital and myself allowed the development and establishment of a comprehensive community-based mental health service delivery system (MHSDS), specifically designed to suit the needs of the Cayman Islands. The components of the MHSDS and their evolution in the absence of adequate facilities are reported. The framework for the service is outlined, and the concerns and objectives of the MHSDS are discussed, along with short-term and long-term goals.


Subject(s)
Humans , Delivery of Health Care/trends , Community Mental Health Services/trends , Patient Care/trends , Community Mental Health Services , Community Mental Health Services/organization & administration , West Indies
20.
West Indian Med J ; 50 Suppl 4: 34-9, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11824014

ABSTRACT

This paper reviews the development of mental health services in the Cayman Islands throughout a twelve-year period (1989 to 2001). I was appointed the resident consultant psychiatrist to the islands in 1989, after which time a consultative process between the Ministry of Health, Senior Management of the George Town Hospital and myself allowed the development and establishment of a comprehensive community-based mental health service delivery system (MHSDS), specifically designed to suit the needs of the Cayman Islands. The components of the MHSDS and their evolution in the absence of adequate facilities are reported. The framework for the service is outlined, and the concerns and objectives of the MHSDS are discussed, along with short-term and long-term goals.


Subject(s)
Community Mental Health Services/trends , Delivery of Health Care/trends , Community Mental Health Services/organization & administration , Humans , Patient Care/trends , West Indies , Workforce
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