Investigating under-reported human papillomavirus genotypes in Grenadian women through self-sampling for cervical cancer screening.

Objective: To compare the adequacy, agreement, and acceptability of Papanicolaou testing (cytology) for cervical cancer screening using self-collected samples compared to physician-collected samples in Grenada in the Caribbean. Furthermore, the study identifies the human papillomavirus (HPV) genotypes present among asymptomatic women testing positive for HPV, the etiologic cause of cervical cancer. Methods: Participants were divided into two groups and two cervical samples were collected from the women in each group: a self-collected sample and a physician-collected sample. Cervical specimens were tested for cytology and HPV. HPV genotyping was performed on positive specimens. Results: Self-collected samples were adequate and in agreement with physician-collected samples, showing no difference between the two sampling methods. Oncogenic high-risk HPV genotypes were identified in cervical samples which were positive for atypical squamous cells and low-grade squamous intraepithelial lesions. The high-risk HPV genotypes found, notably HPV 45 and 53, differed from those most commonly reported. Although the commonly reported high-risk genotypes HPV 16 and 18 were found, so were 31, 33, 35, 52, 66, 68, and 82. Conclusions: Using self-collection facilitated the discovery of unexpected HPV genotypes among asymptomatic women in Grenada. These findings add new information to the literature regarding cervical cancer and neoplasia screening and HPV genotypes in the Caribbean. This genotype information may impact surveillance of women with low-grade lesions, HPV vaccine selection, and possibly further vaccine research. Research regarding HPV in Caribbean pathology samples of cervical neoplasia and cancer is needed.

Using focus groups to plan culturally acceptable primary cervical cancer screening in Grenada, West Indies.

Objective: To document Grenadian women's knowledge about cervical cancer and human papillomavirus (HPV) infection, as well as their attitudes towards primary cervical cancer screening methods. Methods: In this qualitative study, we used focus groups in Grenada to gather information concerning women's knowledge about, attitudes towards and perceptions of screening for cervical cancer and general knowledge about HPV. Ten focus groups comprising 73 participants representing 5 of the 6 parishes in Grenada were conducted with women aged 19-59. Participants were asked about pelvic exams, Pap smears, HPV, reasons for seeking or avoiding cervical cancer screening and how different modalities of testing might affect their decision-making. Responses were then coded and organized into common themes. Results: While many respondents had heard of HPV, far fewer knew about its causative role in cervical cancer, how to prevent HPV infection or testing for the high-risk HPV types that cause almost all cases of cervical cancer. Many participants were aware that cervical cancer screening was beneficial, but numerous barriers to obtaining that screening were noted, including concerns about privacy and stigma, potential discomfort, and the cost and inconvenience involved. Conclusions: Our findings have implications for future cervical cancer screening efforts in Grenada. Central to these efforts should be a focus on educating Grenadians about the role of HPV infection in cervical cancer and the importance of early detection through screening. In addition, addressing issues of stigma and privacy are key to eliminating cervical cancer in Grenada.

Facilitators of and barriers to COVID-19 vaccination in Grenada: a qualitative study.

Objectives: To identify the factors contributing to coronavirus disease 2019 (COVID-19) vaccine hesitancy in Grenada. Methods: A phenomenological study was conducted using semi-structured interviews at vaccination and pop-up testing clinics during a spike in COVID-19 cases on the island. Interview questions were developed using the health belief model related to perceived threat of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action. Data were analyzed using a deductive approach to identify themes, categories, and subcategories. Results: Twenty-five interviews were transcribed and coded. In all, 68% of participants were unvaccinated, 12% were partially vaccinated, and 20% were fully vaccinated. Data analysis revealed two main themes: facilitators and barriers. Factors more likely to encourage vaccination (facilitators) included trust in medical advice and vaccine efficacy, social responsibility, and vaccine mandates for travel, employment, and social activities. Factors hindering vaccination (barriers) included: perceived low threat of COVID-19; preference for natural remedies; concerns about contraindications because of underlying health conditions; fear; mistrust of vaccines and related messaging; vaccine accessibility; and the many different information sources. Conclusions: Overcoming vaccine hesitancy is key to combating the detrimental effects of COVID-19 in Grenada. Public health interventions and policies that address barriers and capitalize on facilitators can increase vaccine uptake.

Ancylostoma ceylanicum Hookworms in Dogs, Grenada, West Indies.

Ancylostoma ceylanicum hookworms are recognized agents of human infection in the Asia-Pacific region. We investigated prevalence of zoonotic hookworm infections in dogs in Grenada in 2021; 40.8% were infected by hookworms, including Ancylostoma ceylanicum. Surveillance of this parasite in dogs and humans is needed in tropical/subtropical countries in the Americas.

Caribbean Lead and Mercury Pollution Archived in a Crater Lake.

Lead and mercury have long histories of anthropogenic use and release to the environment extending into preindustrial times. Yet, the timing, magnitude, and persistence of preindustrial emissions remain enigmatic, especially for mercury. Here, we quantify tropical lead and mercury deposition over the past ∼3000 years using a well-dated sediment core from a small crater lake (Lake Antoine, Grenada). Preindustrial increases in lead and mercury concentrations can be explained by varying inputs of watershed mineral and organic matter, which in turn reflect climate-driven changes in the lake level. We find no evidence that preindustrial lead and mercury use raised deposition rates in this remote ecosystem, and our results underscore the need to carefully evaluate common normalization approaches for changing lithogenic inputs and sedimentation rates. Industrial-era lead and mercury accumulation rates in Lake Antoine have been accelerated by land use and land cover change within the crater rim, yet global industrial pollution remains evident. After correcting for watershed inputs, we find that recent atmospheric lead and mercury deposition rates averaged 2925 and 24 µg/m2/y, respectively, which are in close agreement with monitoring data. Our results challenge recent assessments suggesting preindustrial mercury use raised atmospheric deposition rates globally, highlighting the unique nature of 20th Century industrial pollution.

More than just nestlings: incidence of subcutaneous Philornis (Diptera: Muscidae) nest flies in adult birds.

Philornis flies Meinert (Diptera: Muscidae) have been documented parasitizing over 250 bird species, some of which are endemic species threatened with extinction. Philornis parasitism is hypothesized to affect nestlings disproportionately more than adult birds because limited mobility and exposed skin of nestlings increase their vulnerability to parasitism. We used a comprehensive literature review and our recent fieldwork in the Dominican Republic, Puerto Rico, and Grenada to challenge the idea that parasitism by subcutaneous Philornis species is a phenomenon primarily found in nestlings, a fact that has not been quantified to date. Of the 265 reviewed publications, 125 (49%) reported incidences of parasitism by subcutaneous Philornis, but only 12 included the sampling of adult breeding birds. Nine of these publications (75%) reported Philornis parasitism in adults of ten bird species. During fieldwork in the Dominican Republic, Puerto Rico, and Grenada, we documented 14 instances of parasitism of adult birds of seven avian species. From literature review and fieldwork, adults of at least fifteen bird species across 12 families and four orders of birds were parasitized by at least five Philornis species. In both the published literature and fieldwork, incidences of parasitism of adult birds occurred predominantly in females and was frequently associated with incubation. Although our findings indicate that Philornis parasitism of adult birds is more common than widely presumed, parasite prevalence is still greater in nestlings. In the future, we recommend surveys of adult birds to better understand host-Philornis relationships across life stages. This information may be essential for the development of effective control measures of Philornis to ensure the long-term protection of bird species of conservation concern.

Sarcocystis cymruensis: discovery in Western Hemisphere in the Brown rat (Rattus norvegicus) from Grenada, West Indies: redescription, molecular characterization, and transmission to IFN-γ gene knockout mice via sporocysts from experimentally infected domestic cat (Felis catus).

Rodents are intermediate hosts for many species of Sarcocystis. Little is known of Sarcocystis cymruensis that uses the Brown rat (Rattus norvegicus) as intermediate hosts and the domestic cat (Felis catus) as experimental definitive host. Here, we identified and described Sarcocystis cymruensis in naturally infected R. norvegicus from Grenada, West Indies. Rats (n = 167) were trapped in various locations in two parishes (St. George and St. David). Microscopic, thin (< 1 µm) walled, slender sarcocysts were found in 11 of 156 (7.0%) rats skeletal muscles by squash examination. A laboratory-raised cat fed naturally infected rat tissues excreted sporocysts that were infectious for interferon gamma gene knockout (KO) mice, but not to Swiss Webster outbred albino mice. All inoculated mice remained asymptomatic, and microscopic S. cymruensis-like sarcocysts were found in the muscles of KO mice euthanized on day 70, 116, and 189 post inoculation (p.i.). Sarcocysts from infected KO mice were infective for cats at day 116 but not at 70 days p.i. By transmission electron microscopy, the sarcocyst wall was "type 1a." Detailed morphological description of the cyst wall, metrocytes, and bradyzoites is given for the first time. Additionally, molecular data on S. cymruensis are presented also for the first time. Molecular characterization of sarcocysts 18S rDNA and 28S rDNA, ITS-1, and cox1 loci showed the highest similarity with S. rodentifelis and S. muris. In conclusion, the present study described the natural infection of S. cymruensis in Brown rat for the first time in a Caribbean country and provided its molecular characteristics.

Increased taxation on cigarettes in Grenada: potential effects on consumption and revenue.

OBJECTIVE: To investigate the feasibility of addressing the public health concerns of tobacco consumption through increased taxation, while preserving or augmenting government revenues in Grenada. METHODS: Purposive sampling methods were used to ensure data availability and geographical representativeness. Average price per 20-pack of the most-sold brands of cigarettes was calculated using data from three major supermarkets. The World Health Organization's Tax Simulation Model was used, with excise tax rates adjusted to effect 5%, 10%, and 15% consumption decreases. RESULTS: A 17% to 117% excise tax increase on the cost, insurance, and freight (CIF) value would achieve a 5% consumption decrease. Total government revenues would grow 8.7% and excise tax revenues would increase 11%. The average excise tax per 20-pack would move from EC$ 3.24 (2014 US$ 1.20) to EC$ 3.80 (US$ 1.41), while the average price per pack would increase to EC$ 9.21 (US$ 3.41) from EC$8.48 (US$ 3.14). In the 10% and 15% consumption reduction scenarios, excise taxes would have to be increased by 33% and 50% (to 133% and 150% of CIF, respectively), pushing the average excise tax per pack to EC$ 4.37 (US$ 1.62) and EC$ 4.90 (US$ 1.81), respectively. CONCLUSION: In Grenada, consumption can be reduced alongside growth in government revenues, making available additional resources for health. This aligns with the literature, which indicates that taxation can be effective in pursuing the public health objective of reduced incidence of smoking-related illnesses via reduced consumption.

Twenty-first century cancer patterns in small island nations: Grenada and the English-speaking Caribbean.

PURPOSE: Grenada is a small island nation of 105,000 in the Caribbean with one single general hospital and pathology laboratory. This study assesses cancer incidence on the island based on existing pathology reports, and compares the cancer mortality burden between Grenada and other Caribbean nations. METHODS: Age-adjusted overall and site-specific cancer "incidence" rates (based on pathology reports) and mortality rates were calculated and compared for 2000-2009. Next, mortality rates for a more recent period, 2007-2013, were calculated for Grenada and a pool of English-speaking, majority African-ancestry Caribbean island nations. Lastly, for direct mortality comparisons by cancer site, mortality rate ratios were computed using negative binomial regression modeling. RESULTS: The pathology reports alone do not suffice to calculate national incidence rates but cancer mortality rates are rapidly increasing in Grenada. The leading causes of cancer mortality were prostate and lung cancers among men, and breast and cervical cancers among women. Overall cancer mortality is significantly higher for both male and female Grenadians than their Caribbean counterparts: RR 1.43 (95% CI 1.32-1.55) and RR 1.26 (95% CI 1.15-1.38), respectively. High prostate and non-Hodgkin's lymphoma rates are concerning. CONCLUSIONS: Given the small existing cancer infrastructure, excessive mortality in Grenada compared to its neighbors may be disproportionately more attributable to low survival than a high cancer risk. Global solutions will be required to meet the cancer control needs of geographically isolated small nations such as Grenada.

Incidence and 5-year survival rate for head and neck cancers in Grenada compared to the African American population over the period 1991-2010.

Very little data exist on the incidence and burden of cancer in the individual Caribbean countries. Some data are available for larger areas, reported under a bigger geographical region; Latin America and the Caribbean, but many of the individual countries are not included. One of the main reasons is a lack of official cancer registries. Data are usually collected from hospital records or private physician records, and since it is not in an official registry, these data are not always accessible for inclusion in databases such as SEER and GLOBOCAN. Grenada is one of the countries that currently does not have a registry. Our aim is to report on the incidence for head and neck cancer with subcategories; hypopharynx, oropharynx, oral cavity, salivary glands, and larynx from data collected by the sole ear nose and throat specialist over a 20-year period. The age adjusted incidence per 100,000 for these cancers, whether combined or individually, is lower than that of similar populations. The incidence in males is only slightly higher than those reported in some parts of Africa. In females, only Eastern Africa is reported to have a lower incidence than that found in our study. While the incidence of oral cancers is lower than that of African Americans, the survival rate is comparable. Socioeconomic status, lack of infrastructure, and advanced stage at diagnosis appear to be closely related to the survival rate. Incidence reports suggest that incidence of head and neck cancers in individuals of African descent is lower than other populations. It is therefore not surprising that the incidence in Grenada is relatively low, although the incidence may be underestimated.

Campylobacter Species Isolated from Pigs in Grenada Exhibited Novel Clones: Genotypes and Antimicrobial Resistance Profiles of Sequence Types.

Infections caused by Campylobacter species pose a severe threat to public health worldwide. However, in Grenada, the occurrence and characteristics of Campylobacter in food animals, including pigs, remain mostly unknown. In this study, we identified the sequence types (STs) of Campylobacter from young healthy pigs in Grenada and compared the results with previous studies in Grenada and other countries. Antimicrobial resistance patterns and diversity of the Campylobacter clones were evaluated. Ninety-nine Campylobacter isolates (97 Campylobacter coli and 2 Campylobacter jejuni) were analyzed by multilocus sequence typing. Eighteen previously reported STs and 13 novel STs were identified. Of the 18 previously reported STs, eight STs (ST-854, -887, -1068, -1096, -1445, -1446, 1556, and -1579) have been associated with human gastroenteritis in different geographical regions. Among these 18 previously reported STs, ST-1428, -1096, -1450, and -1058 predominated and accounted for 18.2%, 14.1%, 11.1%, and 8.1% of all isolates, respectively. Of the 13 novel STs, ST-7675 predominated and accounted for 20% (4 of 20 isolates), followed by ST-7678, -7682, and -7691, each accounting for 10% (2 of 20 isolates). Antimicrobial resistance testing using Epsilometer test revealed a low resistance rate (1-3%) of all C. coli/jejuni STs to all antimicrobials except for tetracycline (1-10.1%). Some of the C. coli STs (13 STs, 24/99 isolates, 24.2%) were resistant to multiple antimicrobials. This is the first report on antimicrobial resistance and multidrug resistance patterns associated with Campylobacter STs recovered from swine in Grenada. This study showed that pigs in Grenada are not major reservoirs for STs of C. coli and C. jejuni that are associated with human gastroenteritis worldwide.

Outcomes of a Falls Prevention Education Program Among Older Adults in Grenada.

In Latin America and the Caribbean, there is a scarcity of data on falls, the leading cause of death as a result of unintentional injuries, among older adults aged 65+ years of age. By 2050, 80 % of the 2 billion older adults worldwide are expected to be living in this region; therefore, it is imperative that this issue receive urgent attention from community health practitioners, health educators and policy makers. Guided by Pillar 1-awareness of the WHO fall prevention model for community-dwelling older adults, the purpose of this paper was to describe the feasibility of implementing a falls prevention awareness educational initiative in the Eastern Caribbean Island of Grenada. Sixty-two older adults, average age 67, participated in a falls awareness workshop. An anonymous pre-workshop falls assessment checklist was distributed to establish baseline information followed by an interactive workshop. Eight fall risks were identified and 52 % of the participants reported a history of falls. Based on the group's eagerness to participate, we are encouraged that falls prevention intervention initiatives are feasible among others of similar characteristics in Grenada and plan to implement Pillar II-objective falls assessment and Pillar III-on-going interventions.

The 2009/2010 Caribbean drought: a case study.

The impacts of drought in the Caribbean have not been as dramatic as in some other parts of world, but it is not exempt from the experiences of drought. As a result of the effects of a prolonged drought in 2009/2010, the agenda for the 21st Inter-Sessional Meeting of the Caribbean Community (CARICOM) paid particular attention to the issue of drought. This paper reviews the management framework for responding to drought disasters in five CARICOM countries. The paper also reports on some of the effects of the 2009/2010 drought with particular reference to Grenada and the Grenadines. During the drought in these islands there were numerous bush fires with devastating effects on agriculture, severe water shortages that impacted on the tourism industry and other social effects. It is evident that there was inadequate preparation for the event. Greater planning and investment are therefore required to reduce future impacts.

The Issue of Leptospirosis in Grenada.

The aim of this study was to conduct a literature and secondary data review regarding leptospirosis and its impact in Grenada. The data analysed consisted of a published secondary source of animal investigations. The results of this investigation suggested that the burden of this disease is quite substantial and significant for the population of Grenada, as well as its global visitors. An examination into the literature related to public health policies and practices that could be suited to a developing nation like Grenada was then conducted. Recommendations were made regarding these analysed public health programmes revolving around surveillance, vector control, sanitation and education.

Prevalence of Congenital Malformations in Grenada.

OBJECTIVES: To determine the prevalence of congenital malformations in Grenada for the period January 2000-December 2004. METHODS: The study included neonates diagnosed with congenital malformations as well as those who were part of the Grenada Heart Foundation for the same time period. Patient delivery records from the three government hospitals were reviewed. Parents were contacted and a questionnaire administered to obtain demographic and maternal history related to the birth. RESULTS: The prevalence of birth defects was 0.78% (95%CI: 0.61, 0.98) for the five-year period among the 9004 live births. Cardiovascular malformations were the most prevalent (0.32%; 95% CI: 0.22, 0.45%), with abnormalities of the genitourinary system being the least prevalent (0.04%; 95% CI: 0.01, 0.11%). CONCLUSION: The prevalence of congenital malformations in Grenada is low in comparison to other developed and developing countries.

Disseminated Sarcocystis miescheriana infection in a finisher pig in Grenada.

Sarcocystis miescheriana infection is an important cause of carcass condemnation during meat inspection. The infection can cause morbidity and mortality in domestic pigs. In this study, an 8-month-old finisher pig was presented to a local abattoir for slaughter. Multiple white nodular lesions affecting the meat were observed, resulting in the condemnation of the carcass. Consequently, half of the carcass was submitted to the necropsy diagnostic laboratory in the School of Veterinary Medicine for further evaluation. Grossly, all superficial and deep muscle groups had severe multifocal macrocysts (3 mm × 2 mm × 1 mm) on the surface and extending deep into the skeletal musculature. Histopathology revealed moderate multifocal granulomatous and eosinophilic myositis with intralesional degenerated and intact parasites. Sample genomic DNA sequence analysis of the 18S RNA gene showed 100% identity to S. miescheriana in the GenBank. This is the first report of S. miescheriana in Grenada, West Indies.

Retrospective study of Oestrus ovis larvae infestation in small ruminants in Grenada, West Indies.

Oestrosis is a nasal cavity myiasis caused by Oestrus ovis larvae from Oetrus ovis diptera flies in small ruminants. The presence of the larvae in the nasal cavity is known to cause rhinitis and sinusitis which can negatively impact the productivity of small ruminants. The aim of the present study was to estimate the prevalence of Oestrus ovis larvae infestation in sheep and goats presented for necropsy. We reviewed necropsy records of sheep and goats submitted to the Veterinary Pathology diagnostic laboratory at St. George's University from 2001 to 2017. Out of 104 goat necropsy cases, Oestrus ovis larvae were observed in 8 goats giving a prevalence of 7.7% (95% confidence interval (CI):3.38% to 14.6%). Similarly, from the 47 sheep necropsies, Oestus ovis larvae were observed in 4 sheep (8.5%) (95% CI: 2.83% to 20.46%). There was no significant difference in Oestrus ovis larvae infestation rates between sheep and goats (p = 1.000, Fisher's exact test). Oestrosis was an incidental finding in all the small ruminants examined at necropsy. This is the first report on Oestrus ovis larvae infestation in small ruminants in Grenada.

Non-invasive sampling reveals low mitochondrial genetic diversity for an island endemic species: The critically endangered Grenada Dove Leptotila wellsi.

As an island endemic with a decreasing population, the critically endangered Grenada Dove Leptotila wellsi is threatened by accelerated loss of genetic diversity resulting from ongoing habitat fragmentation. Small, threatened populations are difficult to sample directly but advances in molecular methods mean that non-invasive samples can be used. We performed the first assessment of genetic diversity of populations of Grenada Dove by (a) assessing mtDNA genetic diversity in the only two areas of occupancy on Grenada, (b) defining the number of haplotypes present at each site and (c) evaluating evidence of isolation between sites. We used non-invasively collected samples from two locations: Mt Hartman (n = 18) and Perseverance (n = 12). DNA extraction and PCR were used to amplify 1751 bps of mtDNA from two mitochondrial markers: NADH dehydrogenase 2 (ND2) and Cytochrome b (Cyt b). Haplotype diversity (h) of 0.4, a nucleotide diversity (π) of 0.00023 and two unique haplotypes were identified within the ND2 sequences; a single haplotype was identified within the Cyt b sequences. Of the two haplotypes identified, the most common haplotype (haplotype A = 73.9%) was observed at both sites and the other (haplotype B = 26.1%) was unique to Perseverance. Our results show low mitochondrial genetic diversity and clear evidence for genetically isolated populations. The Grenada Dove needs urgent conservation action, including habitat protection and potentially augmentation of gene flow by translocation in order to increase genetic resilience and diversity with the ultimate aim of securing the long-term survival of this critically endangered species.

Transcranial Doppler Ultrasonography-Related Research in the Caribbean Region.

Transcranial Doppler (TCD) ultrasonography is a non-invasive ultrasound technique that uses high-frequency sound waves to measure blood flow velocities in the cerebral vasculature. This review analyzes TCD research in the Caribbean region using a bibliometric analysis of 29 articles from PubMed. The articles were analyzed using Microsoft Excel 2016 and the VOSviewer software (Van Eck and Waltman, Leiden University, Centre for Science and Technology Studies (CWTS), www.vosviewer.com) and characterized various aspects of TCD research, including countries, research themes, authorship, journals, affiliations, and keywords. The majority of the 29 publications came from Cuba (38%), followed by the French West Indies (22%) and Jamaica (20%). Most TCD research focused on sickle cell disease (SCD), accounting for 45% of the studies, followed by 21% of articles on vasospasm and subarachnoid hemorrhage. The use of TCD in brain death and neuro-intensive care was also explored, constituting 17% of the studies. Alternative TCD-monitored treatment options for SCD, such as stem cell transplantation and hydroxyurea, were also frequently investigated. The most productive institutions were Hospital Clínico-Quirúrgico Hermanos Ameijeiras in Havana, Cuba, the Sickle Cell Unit at the University of West Indies (UWI) Mona in Jamaica, the Medical-Surgical Research Center (CIMEQ) in Havana, Cuba, and the SCD Reference Center in Guadeloupe and Martinique in the French West Indies. TCD has been identified as a cost-effective tool for real-time monitoring of cerebral blood flow in many clinical settings, including stroke and SCD, which are prevalent in the Caribbean. Although there is an increase in the trend of using TCD for neuromonitoring in the Caribbean, gaps still exist. Capacity-building initiatives, such as training programs for healthcare providers and the development of local TCD research networks, can improve access to TCD in resource-constrained settings to treat and neuromonitor patients cost-effectively.

A retrospective study of canine transmissible venereal tumour in Grenada, West Indies.

BACKGROUND: Canine transmissible venereal tumour (CTVT) is a naturally occurring neoplasia affecting dogs worldwide. Previous CTVT studies in Grenada were limited to case records of dogs with neoplastic conditions at a veterinary diagnostic laboratory. OBJECTIVES: The present retrospective study aimed to determine the occurrence and risk factors of CTVT in a wider population of owned dogs presented to a university-affiliated veterinary hospital between 2008 and 2018. METHODS: Data on the age, breed, gender, and gonadectomy status were retrieved from an electronic database and analyzed using logistic regression. RESULTS: Of the 7180 dogs presented during the period, 102 dogs (1.4%) were diagnosed with CTVT. A higher predisposition was observed in Grenadian pothounds (odds ratio [OR] = 22.8, 95% confidence interval [CI] 10.3-50.4; p < 0.001) and mixed-breed dogs (OR = 9.2, 95% CI 4.1-20.7; p < 0.001) in comparison to the purebreds. Neutered dogs (OR = 2.2, 95% CI 1.4-3.3; p < 0.001) were at an increased risk of CTVT than intact dogs. Age and gender were not identified as significant risk factors. CONCLUSIONS: The percentage of dogs with CTVT in this study represents a crude estimate of the CTVT prevalence in the owned dog population in Grenada. Further studies including both owned and free-roaming dogs are required for a more accurate estimation of the CTVT prevalence in the region. Our results indicate that breed and gonadectomy status are significant risk factors for the occurrence of CTVT in Grenada.