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PubMed1979

Leptospirosis in patients from Grenada, West Indies.

Evidence of leptospirosis in humans from Grenada, W.I., is reported here for the first time. Of 139 hospital patients with pyrexia of undetermined origin, 94 were jaundiced, and 16 (17%) of these were positive for hepatitis B antigen (HBsAg) and not examined further. 20 of the remaining 123 (16%) febrile patients were positive for leptospiral antibodies; 11 of them were current or recent cases. 25 of 182 (14%) afebrile out-patients showed evidence of previous exposure to leptospiral organisms. The most frequently encountered serogroups in the 45 seropositive in- and out-patients were Icterohaemorrhagiae (38%), Panama (24%) and Canicola (11%).

Adolescent↗

PubMed1981

Rabies serum neutralizing antibody in mongooses from Grenada.

During a four-year study on Grenada, 4,754 mongooses were examined, of which 100 (2.1%) were rabid. Of 1,675 mongooses tested for rabies serum neutralizing (SN) antibody, 498 (30%) were positive. During these four years (1971-74) the antibody prevalence rate increased from 20.8% to 43.2%, whereas the number of rabid mongooses decreased from 3.5% to 0.6%. Naturally acquired antibody was monitored in 20 captive mongooses for up to 35 months, and it was still circulating in 18 when monitoring ceased. The highest titre recorded was 1:1,400, and the rate of fall was greatest in mongooses with high initial titres. High titres of naturally acquired antibody suggest recent rabies activity. 14 mongooses vaccinated parenterally with 1.0 ml of attenuated ERA vaccine showed substantial increases in antibody titres; most had titres greater than 1:1,000 one month later and maintained a high titre for several months. The highest recorded was 1:34,800. The virus titres of brain material from rabid mongooses ranged from 10(1.8) to 10(4.3) and, in some cases, were only slightly lower than those of salivary gland tissue (range, 10(1) to 10(5.6).

Animals↗

PubMed1990

Reported versus recorded health service utilization in Grenada, West Indies.

Calls for household surveys to provide information on service utilization in less developed countries raise questions regarding the accuracy and reliability of reporting. This paper compares reported to recorded health service utilization for diarrhoea and any other morbidity over a 2-week and 3-month period for information obtained from a household survey in Grenada, West Indies. A sensitivity analysis is used to derive minimum and maximum estimates of the accuracy of reported utilization. Over-reporting utilization was found to be between 33 and 62% for diarrhoea and 49 and 81% for any other morbidity. Under-reporting of all utilization was estimated to be between 47 and 65%. These results cast doubt on the utility of household surveys as a reliable source of information regarding service utilization.

Child↗

PubMed1990

The ecology of health services utilization in Grenada, West Indies.

Few empirical investigations into the nature of health services utilization fully acknowledge that the home environment may act as a socio-geographic focus of both disease transmission and of learned health behavior. This paper examines the role of the home environment, as well as of personal characteristics and accessibility, in the utilization of health services in Grenada, West Indies. Bivariate and logit analyses of household survey data are employed to identify markers of high user individuals and households. Aspects of each domain of the home environment (physical and behavioral environment, demographics, and residential mobility) emerge as contributors to the utilization phenomenon in the study communities. Both etiological and socio-economic linkages are postulated to underlie the observed relationships. The implications of this work for health planning in developing countries is discussed.

Age Factors↗

PubMedDate not supplied

The effectiveness of the advanced trauma life support system in a mass casualty situation by non-trauma-experienced physicians: Grenada 1983.

Mass casualty is a sporadic event precipitated by natural or man made causes which can be defined as the need for medical care exceeding the ability to provide it. Many literature reports of mass casualty evolutions depict scenes of chaos and confusion, leading to a need for a standardized approach to assessment, triage, and initial resuscitation. Even with the advent of trained emergency medicine specialists to direct these activities, such a framework would seem highly desirable for other participating primary care specialists. Additionally, a uniform system might be particularly useful in the mass casualty situation where international rescue teams converge on one disaster site. Advanced Trauma Life Support (ATLS) is a standardized approach easily adaptable to triage and resuscitation of multiple patients. Its use and effectiveness in mass casualty, however, has not had prior mention in the literature. This paper presents the first reported adaptation of ATLS principles to mass casualty during the invasion of Grenada. The bulk of 76 patients brought to the Primary Casualty Receiving and Treatment Center (PCRTC) were triaged, stabilized, and resuscitated by three PGY-1 trained, non-trauma-experienced physicians. During the primary survey, 8 major life threatening problems were identified and immediately corrected without loss of life. The ATLS system seemed to provide a comfortable framework for these partially trained physicians. Arguments for its adaptation and use as an international system approach are discussed.

Education, Medical, Graduate↗

PubMed1988

Recent developments in the Grenada mental health program.

The activities of a multidisciplinary team of mental health professionals during their initial year of work to upgrade the mental health system in the English-speaking Caribbean nation of Grenada are described. Improvement of services at the islands only psychiatric hospital received top priority. The team helped Grenadian staff to sharpen basic techniques of active treatment, which included assessment of psychiatric symptoms, development of treatment plans, and intervention with patients. Maintenance of medical records was improved, procedures for medication and seclusion were standardized, weekly ward rounds were routinized, and regular staff meetings were urged. Among the obstacles faced by the team in implementing these changes were staffs delayed acceptance of collaborative interdisciplinary team-work, as well as shortages of money and personnel.

Community Mental Health Services↗

PubMed1980

A malaria outbreak due to Plasmodium malariae on the Island of Grenada.

An outbreak of Plasmodium malariae malaria occurred in Grenada some 16 years after the end of a malaria eradication campaign, probably due to renewal of transmission from recrudescent cases. Serological studies were used in addition to blood film surveys in defining the outbreak, and their value in such surveillance situations is emphasized.

Adolescent↗

PubMed1977

Rabies virus and antibody in bats in Grenada and Trinidad.

Rabies virus was detected by fluorescent-antibody and mouse inoculation tests in the brain of one bat, Artibeus jamaicensis, collected at La Tante, Grenada on 19 June 1974. No rabies virus was found in the brains and/or salivary glands of 411 other Grenadian bats of 6 species tested, including 56 A. jamaicensis. Rabies neutralizing antibody was detected by the rapid fluorescent focus inhibition test (RFFIT) in 27 of 353 Grenadian bats. Positives occurred in each of the 6 species sampled, with 40.5% prevalence in A. jamaicensis. In 11 of 86 Trinidadian bats of 4 species known to carry rabies, positive sera occurred only in A. jamaicensis (18.6%) and A. lituratus (18.1%). The potential use of the REFIT indetermining rabies activity is discussed.

Animals↗

PubMed1979

Salmonella in wildlife from Trinidad and Grenada, W.I.

Forty-four of 219 animals from Trinidad and Grenada, W.I., yielded 20 serotypes of Salmonella, 16 of which are known to have been associated with human infection in the United States in recent years. Toads (Bufo marinus) provided the greatest number of isolates. Other carriers were mammals, vultures, lizards, a tree-frog and a cave cockroach.

Animal Population Groups↗

PubMed1983

Leptospires in wildlife from Trinidad and Grenada.

Serum samples from 894 wild animals (representing 31 species) from Trinidad and Grenada were examined by the microscopic agglutination test for leptospiral antibodies; 198 were positive. These included 39 bats, 88 mongooses, six opossums, 10 peridomestic rodents, 15 forest rodents, 10 lizards, and 30 toads. Thirteen pathogenic serogroups were involved. Thirty-nine Leptospira isolates were reported from mongooses, opossums, rodents and toads.

Agglutinins↗

PubMed1990

Airborne tactical medical support in Grenada.

On October 24, 1983, clinical fillers rapidly integrated into the 82d Airborne Division, deployed to the Island of Grenada, and significantly contributed to the tactical medical support mission during Operation Urgent Fury. However, the medical community's unfamiliarity with the airborne division's operational requirements and the 307th Medical Battalion's capabilities have created questions which must be addressed to provide a clearer understanding of what occurred at the division level of medical support (DLMS) during the initial 4 days of the operation. This article outlines key aspects for DLMS to the U.S. Army airborne division and briefly reviews DLMS during Operation Urgent Fury.

Humans↗

PubMed1989

An outbreak of hookworm infection associated with military operations in Grenada.

During 1983, a multinational military intervention took place on Grenada. After deployment, troops from several U.S. Army units noted signs and symptoms consistent with soil-transmitted helminthic infection. Of 684 soldiers screened five to seven weeks post-deployment, over 20% reported abdominal pain and/or diarrhea during or after the action. Eosinophilia of at least 10% was observed in 119 (22.5%) of 529 soldiers evaluated further; eosinophilia of 5-9% was documented in another 126 (23.8%) of the 529 soldiers. Stool examinations confirmed hookworm infection in 35 soldiers. One case of strongyloidiasis was also documented. Infection was attributed to ground exposure near homes with compromised sanitation. Units that joined the operation after the initial assault phase were at low risk of hookworm infection.

Disease Outbreaks↗

PubMed2007