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PubMed1994

Field evaluation of baits and baiting strategies for delivering oral vaccine to mongooses in Antigua, West Indies.

A field study was conducted on Antigua, West Indies, to determine the feasibility of delivering an oral rabies vaccine or population control agent to free-ranging mongooses (Herpestes javanicus). Two biomarkers (tetracycline hydrochloride [THCL] and DuPont Oil Blue A dye) and two bait types (DuPont polymer fish meal and polyurethane foam) were used to bait three study sites. Four hundred polymer baits containing both biomarkers were distributed at 36 central point bait stations (11 baits/station) on an 80 ha study site (5 baits/ha); 69% of the mongoose population consumed one or more baits. Two thousand baits containing THCL and 400 baits containing DuPont dye were distributed on two additional 100 ha study sites (24 baits/ha). Polymer fish meal baits were used on the first site and polyurethane baits on the second site. Based on the presence of biomarkers in bone or soft tissue, 96 to 97% of the mongooses at both sites consumed at least one bait. We conclude that oral baiting of mongooses is a feasible method for delivery of vaccines for the control of rabies in this species.

Adipose Tissue↗

PubMed1982

Clinical aspects of respiratory tract allergic diseases in Jamaica, West Indies.

Little information exists on allergy in the West Indies. 512 patients with allergic asthma, sinusitis and/or hay fever were seen in Jamaica over a five year period. A review of their charts revealed that these illnesses were usually perennial and immunotherapy was only effective if given in very dilute dosages (w/v 1:1,000,000).

Adolescent↗

PubMed2001

Incidence of hematological malignancies in Martinique, French West Indies, overrepresentation of multiple myeloma and adult T cell leukemia/lymphoma.

A registry of hematological malignancies is held in the unit of cytology of the University Hospital of Martinique. Human T cell lymphotropic virus type-1 (HTLV1) is endemic in this island. We determined the incidence and epidemiological features of hematological malignancies from the 715 new cases diagnosed between 1990 and 1998 among the adult population. Incidence rates per year were steady during this period. The most frequent hematological malignancies were multiple myeloma (MM) (34%), followed by non-Hodgkin's lymphoma (NHL) (23%). Among the cases of NHL with an immunohistological study, 57% had a T cell phenotype. Among these 61% were adult T cell leukemia/lymphoma. Epidemiological data on hematological malignancies in the West Indies has not been previously reported. There are two striking differences with other population-based registries: a high incidence of MM (5/100000) and a high proportion of T cell NHL among NHL (57%). The high proportion of T cell NHL is probably due to the high incidence of ATL. A low incidence of B cell NHL might also contribute to this effect. The increased incidence of MM in West Indies had not been previously reported. A similar high incidence of MM has been reported among Afro-Americans in the USA.

Adult↗

PubMed2004

[Specific diversity of plant populations at rainfed scale and crop protection: the example of banana production in the French West Indies].

Banana is a major crop in the French West Indies, where it is subjected to strong parasite pressure, resulting in pesticide pollution. An increase in plant population diversity in the cultivated ecosystem is generated by changing cultural practices. This results in a decrease in parasite pressure and hence a decrease in pollutant pesticide loads. Agricultural sustainability is therefore reinforced for better coexistence of populated, cultivated and protected areas.

Agriculture↗

PubMed1996

The genus Cephaloleia (Coleoptera:Chrysomelidae) in Central America and the West Indies.

The species of Cephaloleia Chevrolat known to occur in Central America and the West Indies are revised and a key to the 88 species is presented. Most species are illustrated. Twenty new species of Cephaloleia are described: amblys, cylindrica, eumorpha, erugatus, facetus, formosus, lepida, scitulus, and weisei from Panamá; delectabilis and presignis from México; brunnea and rubra from Trinidad; immaculata, triangularis, and viltata from Costa Rica; splendida and uhmanni from Costa Rica and Panamá; cyanea from Costa Rica, Colombia, and Venezuela; and varabilis from Panamá and Colombia. Three new synonyms are given: abscissa Uhmann (= dilaticollis Baly), beckeri Weise (= gratiosa Baly), and quadrimaculata Uhmann (= fenestrata Weise). Lectotypes are designated for eleven species: belti Baly, consanguinea Baly, elegantula Baly, fulvicollis Weise, instabilis Baly, nigropicta Baly, postuma Weise, quadrilineata Baly, separata Baly, stenosoma Baly, and vicina Baly. Two species are transferred from Demotispa to Cephaloleia: coeruleata Sanderson and costaricensis Uhmann. Cephaloleia coeruleata (Sanderson) is renamed C. sandersoni.

Animals↗

PubMed1983

Seroepidemiological survey of toxoplasmosis in La Guadeloupe, French West Indies.

A random survey of 1% of the total population of La Guadeloupe, French West Indies, for toxoplasmosis was carried out. Blood specimens from 3,238 individuals were collected on filter paper strips and tested for Toxoplasma antibodies by the fluorescent antibody technique. Sixty percent were positive. A gradual increase in positivity with increasing age, and high prevalence in children (50% in the 6- to 10-year age group) were observed. No differences were found among the different ethnic groups, nor among persons in different occupations. Economic status showed a highly negative correlation with antibody prevalence rates. The infection rate was not higher in individuals who consumed raw or undercooked meat, and no differences in antibody prevalence related to the sources of meat were observed. The seropositivity rates varied over a wide range (40-76%) according to the locality; higher Toxoplasma antibody rates were found in areas with higher rainfall, and toxoplasmosis prevalence rates correlated positively with mean annual rainfall but not with altitude or with rural or urban residence. A significant difference was observed between seropositivity rates when people living in houses with or without cats were compared. A higher prevalence of hookworm and Strongyloides infections--considered as evidence of closer contact with moist soil--were found in children with Toxoplasma antibodies than in age-adjusted control children without such antibodies. These results provide evidence that meat plays a negligible role in the transmission of Toxoplasma to man, and support the hypothesis that oocysts shed in cat feces are the almost exclusive mode of human infection in Guadeloupe.

Adolescent↗

PubMed2000

Autopsy rates at the University Hospital of the West Indies, 1968-1997.

Autopsy rates have not been reported at the University Hospital of the West Indies (UHWI) for more than three decades. Declining rates have been documented worldwide, and so we sought to define autopsy rates over the past three decades at UHWI. We conducted a retrospective analysis of the numbers and types of autopsies performed on deaths occurring in the institution, and calculated the relevant autopsy rates. The overall autopsy rate for the study period was 52.7%, with a statistically significant decline from 65.3% in the first decade to 39.3% in the third. The non-coroner's autopsy rate showed a concomitant decline from 57.5% to 31.5%, while the coroner's autopsy rate remained stable with a slight increase from 28.1% to 29.1%. The factors that might have led to the decline of the autopsy are discussed.

Autopsy↗

PubMed1997

Traditional botanical remedies on a small Caribbean island: Middle (Grand) Caicos, West Indies.

A descriptive survey of 18 medicinal plants utilized on Middle (Grand) Caicos Island in the West Indies revealed that each species has multiple applications. Phytochemical constituents, ascertained from published sources, suggest pharmacological/physiological efficacy in the ethnomedical treatment of various disorders. Traditional preparation procedures may enhance the chemotherapeutic value of the plant derivatives, while at the same time reducing their potential toxicity. The majority of species used in Middle Caicos are also exploited in other cultures but often for very different purposes.

Child↗

PubMed2005

Breastfeeding patterns among six-week-old term infants at the University Hospital of the West Indies.

Eighty-nine mothers attending post-natal clinics at the University Hospital of the West Indies were interviewed at six weeks postpartum regarding their breast-feeding patterns and problems. Breastfeeding was practised by 97.8% of the mothers, with 29.9% practising exclusive breastfeeding and 70.1% partial breastfeeding. Only two women were solely bottle feeding. The pattern of breastfeeding was not significantly affected by maternal parity, age, education, employment or socioeconomic status. An intention to wean later (at six months) or when the mother felt the baby was 'ready,' was associated with increasing parity, age and further education. Babies who were exclusively breastfed achieved greater weight gain compared with those who partially breastfed but this difference did not achieve statistical significance. Breastfeeding trends appear to have remained stable over the last several years.

Adult↗

PubMed1990

Casualty transit time for 100 adult walk-in patients at the University Hospital of the West Indies.

The Casualty Department of the University Hospital of the West Indies (UHWI) has evolved in an ad hoc manner over the last decade, and questions regarding its appropriateness and effectiveness as an Emergency Department persist. This study of 100 systematically-selected patients attempts to assess time utilization during transit, as dictated by the present system of patient management. Time to first contact averaged 2 hr 38 min (158 min). The mean total time was 3 hr 46 min (226 min) and mean total waiting time was 3 hr 10 min (190 min), versus a mean total utilized time of 19 min. Actual contact time with casualty officers averaged only 8.3 min. Referrals to specialist services constituted 11% of the sample, and overall mean waiting time for specialists was 2 hr 16 min (136 min) with a mean contact time of 48 min. Given that the mean total time of 3 hr 46 min is not inordinately long in a public health system such as ours, the recommendation is being made for a modified coding and triage system to reduce time to first contact for more urgent cases.

Ambulatory Care↗

PubMed1995

Country-wide prevalence of Ascogregarina culicis (apicomplexa: lecudinidae), a protozoan parasite of Aedes aegypti in Trinidad, West Indies.

The prevalence of the gregarine parasite Ascogregarina culicis was determined for Aedes aegypti populations in Trinidad, West Indies. Over 5 months, a total of 5,651 Ae. aegypti larvae were collected and identified from 419 sites throughout Trinidad as part of a national dengue surveillance program. Ascogregarina culicis infections were detected in 13.4% of 1,986 Ae. aegypti larvae dissected. In 7 of 8 counties or major subdivisions where this parasite was detected in Trinidad, the prevalence per locality ranged from 9.6 to 17.1% with an associated parasite density of 19.1-51.9 trophozoites/larva. Confirming that Ae. aegypti populations in Trinidad are highly susceptible to infection with A. culicis parasites, experimental studies showed that a strain of A. culicis from Florida readily infected 3 strains of Ae. aegypti from Trinidad with essentially no associated mortality. This report extends the known geographic range of A. culicis in Ae. aegypti populations and represents one of the first country-wide surveys for this gregarine parasite.

Aedes↗

PubMed2005

Vomiting post tonsillectomy at the University Hospital of the West Indies.

A three-year observational study of patients undergoing tonsillectomy at the University Hospital of the West Indies was conducted to determine the incidence of postoperative vomiting. Data were collected to assess possible risk factors for vomiting as well as possible alleviating agents. Two hundred and fifty-two patients were included in the study and a thirteen per cent incidence of postoperative vomiting was found. This is significantly less than that quoted in other studies (40-73%). Results also showed that steroids significantly reduced the incidence of postoperative vomiting in the study population. Muscle relaxants reversal agents and antibiotics particularly co-trimoxazole and ceftriaxone significantly increased its incidence. Usual antiemetic agents including dimenhydrinate (gravol) and promethazine (phenergan), as well as drugs known to possess antiemetic properties such as midazolam and propofol, lacked any significant protective effect against emesis. Opioid analgesia, inhalational induction and blood loss of greater than 10% of estimated blood volume appeared to increase emesis but failed to achieve statistical significance.

Adolescent↗

PubMed1999

Possible relation of atypical parkinsonism in the French West Indies with consumption of tropical plants: a case-control study. Caribbean Parkinsonism Study Group.

BACKGROUND: In Europe and North America, Parkinson's disease is the major form of parkinsonism; less than 4% of cases are progressive supranuclear palsy (PSP) and about 20% are atypical parkinsonism. The distribution of these subgroups is different in the French West Indies. We aimed to define the clinical and demographic specificity of these disorders in Guadeloupe and to investigate a postulated link with consumption of herbal tea and fruits from the Annonaceae family (Annona muricata and Annona squamosa), which contain neurotoxic benzyltetrahydroisoquinoline alkaloids. METHODS: Between September, 1996, and August, 1998, 87 consecutive patients with parkinsonism were referred to the single neurological department in Guadeloupe. After detailed clinical, neurophysiological, cognitive, and neuroradiological assessment, they were classified by generally accepted criteria as having Parkinson's disease, PSP, or atypical parkinsonism. We compared the amount of tropical fruits and herbal tea consumed by the various parkinsonian subgroups and by frequency-matched controls (patients with benign symptoms and no neurodegenerative disease). FINDINGS: Of the 87 patients, 22 had Parkinson's disease, 31 had PSP, 30 had atypical parkinsonism, and four had atypical parkinsonism associated with motor neuron disease, 44 of the patients with PSP or atypical parkinsonism were male. The patients with atypical parkinsonism had symmetrical rigidity and bradykinesia, and no levodopa peak-dose dyskinesias. Patients with PSP differed from those with atypical parkinsonism because they had supranuclear vertical down-gaze palsy, severe gait and balance problems, and frontal-lobe syndrome. 29 patients with PSP reported regular consumption of pawpaw fruit, and 26 drank herbal tea. 30 patients with atypical parkinsonism reported regular consumption of pawpaw fruit, and 24 drank herbal tea. Both of these groups consumed significantly more fruit and herbal tea than patients with Parkinson's disease (fruit: odds ratio 23.6; herbal tea: 28.2); and controls (fruit: 20.7; herbal tea: 6.48). INTERPRETATION: Our study confirms the over-representation of atypical parkinsonism and PSP in patients with parkinsonism in the French West Indies. Chronic exposure to neurotoxic alkaloids could be an important aetiological factor because these compounds induce parkinsonism in animals. A larger epidemiological study, to clarify the link between these fruits with atypical parkinsonism and PSP, is proposed.

Aged↗

PubMed1990

Testicular and paratesticular tumours at the University Hospital of the West Indies.

A review of tumours of the testis and paratesticular region diagnosed at the University Hospital of the West Indies over a 30-year period revealed 14 of the former and 22 of the latter. The testicular tumours were all malignant, with 50 per cent of them being germ-cell neoplasms. Seventeen of the 22 paratesticular tumours, (77.3%) were benign. The histological types, racial incidence and possible aetiological factors are discussed and compared with the findings of other series.

Adolescent↗

PubMed1988

Study of HLA antigens in systemic lupus erythematosus in the French West Indies.

As incidence of SLE is high in Blacks, we studied HLA and SLE associations in the French West Indies, whose population is racially mixed. Forty-seven coloured SLE patients have been typed in HLA A,B,C and DR. We observed B8 association in nearly all of the studies. B15 association, more frequent in Caucasians, was found, also B53 association, a Black variant of B5 more frequent in Blacks. We did not find any class II association.

HLA Antigens↗

PubMed1984

Antibodies to HTLV-I p24 in sera of blood donors, elderly people and patients with hemopoietic diseases in France and in French West Indies.

Human T-cell lymphoma/leukemia virus type I (HTLV-I) is a type-C retrovirus originally isolated from patients with leukemia or lymphoma involving mature T lymphocytes. Epidemiological studies have shown that HTLV-I infection occurs not only in leukemic but also in normal people in at least two areas of the world: the Caribbean basin and the South-West of Japan. We report here the results of a large seroepidemiological study of HTLV-I infection in normal French blood donors, elderly subjects living in institutions and patients with various malignant hemopathies, obtained by the classical HTLV-I p24 radioimmunoassay. We were unable to demonstrate antibodies to HTLV-I in 510 sera from French volunteer blood donors born and living in continental France or in sera from 262 blood donors born in other countries (mainly in Europe and North Africa) and living in continental France at the time of collection. In contrast, among 131 sera from blood donors born in French overseas territories (French Guiana, French West Indies, and Reunion) but living at the time of collection in continental France, 2 (1.5%) were found to possess anti-HTLV-I antibodies. In a sample of 2,597 blood donors from Martinique, 39 (1.5%) were positive. A positive correlation with age was observed whereas no statistical relationship was found between HTLV-I antibodies and sex, red cell blood groups or the place of residence in Martinique. On the other hand, a very high level of positive values was observed in Martinique among old people living in institutions, 14% of those aged over 60 years being positive. HTLV-I-associated hematological malignancies have not been observed in patients born and living in continental France whereas a large number exist in the French West Indies. In the same area, the presence of anti-HTLV-I antibodies in 12% of patients with myeloma, a typical B-cell disease, merits attention.

Adolescent↗

PubMed1993

Evaluation of baits for oral rabies vaccination of mongooses: pilot field trials in Antigua, West Indies.

A field study was conducted on the island of Antigua, West Indies, to evaluate baits for delivering an oral rabies vaccine to the small Indian mongoose (Herpestes auropunctatus). Tracking tiles were used to determine that mongooses were nonselective and took both egg-flavored polyurethane baits and fish-flavored polymer baits containing several different food materials. A high proportion of baits were taken the day of placement with minimal disturbance by nontarget species. DuPont Oil Blue A dye was an effective short-term biomarker for use in baits; based on its subsequent detection in mongooses, some of the population had consumed and not cached or discarded baits. Central point baiting stations showed promise as an alternative delivery technique.

Administration, Oral↗

PubMed2003

Recent upsurge of tuberculosis in paediatric admissions at the University Hospital of the West Indies.

These case reports describe the clinical course of eight children who were admitted to the University Hospital of the West Indies, Kingston, Jamaica, between July 2000 and November 2001 because of a diagnosis of tuberculosis. This represented an increase in the incidence of the disease in children at this institution. The purpose of this report is to make healthcare workers aware of the resurgence of tuberculosis. The diagnosis of paediatric tuberculosis is challenging and requires a high index of suspicion in the presence of suggestive clinical and laboratory findings. The diagnosis should not be limited to the immunocompromised patient, as in this report the majority of the patients were HIV negative.

Antitubercular Agents↗