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PubMed2003

Factors related to the 4-year risk of high intraocular pressure: the Barbados Eye Studies.

OBJECTIVE: To evaluate the 4-year risk of high intraocular pressure (IOP) and associated factors in a black population without glaucoma at baseline. DESIGN: Population-based incidence study. PARTICIPANTS: Random sample of Barbados residents aged 40 to 84 years. After 4 years, 3427 (85%) were reexamined. MAIN OUTCOME MEASURES: Development of elevated IOP (using percentile-based definitions) among individuals with an IOP of 21 mm Hg or lower and no glaucoma at baseline. Associations were evaluated using polychotomous logistic regression. RESULTS: At baseline, 2856 participants did not have glaucoma or suspected glaucoma: 361 had an IOP higher than 21 mm Hg or received treatment, and 2495 had an IOP of 21 mm Hg or lower and no treatment. At follow-up, only 58% of the 361 participants remained free of glaucoma and had an IOP higher than 21 mm Hg, whereas 30% had an IOP of 21 mm Hg or lower. Among the remaining 2495 participants, the incidence of IOP higher than 21 mm Hg or treatment (80th percentile) was 12.9% (95% confidence interval, 11.7%-14.3%). Using other definitions of elevated IOP, estimates ranged from 1.5% to 11%. Incidence increased with age, with rates 2.5 times higher at 70 years or older than at ages 40 to 49 years. Factors associated with high IOP included age, baseline IOP, hypertension, and blood pressure. Whereas participants with an IOP between 21 mm Hg and 28 mm Hg had higher blood pressure readings, those with an IOP of 21 mm Hg or lower or an IOP higher than 28 mm Hg had similar values. CONCLUSIONS: Definitions of high IOP based on percentiles may be more applicable than those based on arbitrary values. Older individuals with a higher baseline IOP were more likely to develop elevated IOP after 4 years. Although blood pressure was also associated with high IOP, the relationship may be nonlinear.

Adult↗
PubMed2005

Hyperglycemia, blood pressure, and the 9-year incidence of diabetic retinopathy: the Barbados Eye Studies.

OBJECTIVES: To evaluate factors related to the incidence of diabetic retinopathy (DR) in a population of African descent, after 9 years of follow-up. DESIGN: Population-based cohort study; 81% participation after 9 years. PARTICIPANTS: Three hundred twenty-four participants of the Barbados Eye Studies, with diabetes mellitus (DM) at baseline and at risk for developing DR during follow-up. METHODS: Diabetes-related changes were assessed by masked gradings of baseline and follow-up photographs using a standardized system. The 9-year cumulative incidence of DR was based on participants with DM and free of retinopathy at baseline; incidence rates were estimated by the product-limit approach. Cox regression models for discrete-time data were used to evaluate risk factors associated with the 9-year incidence of DR. RESULTS: Multivariate analyses revealed that older age at DM onset decreased the 9-year risk of DR development; for each 10 years of older age at onset, the risk of DR decreased by 30% (risk ratio [RR], 0.7; 95% confidence interval [CI], 0.56-0.96). The risk of DR doubled among persons with DM duration between 5 and 9 years (RR, 2.1; 95% CI, 1.2-3.6) versus those with shorter durations; it also doubled in those treated with oral medications or insulin at baseline versus those treated with diet only. Antihypertensive treatment halved the risk of DR versus no treatment (RR, 0.5; 95% CI, 0.3-0.9) and high systolic or diastolic blood pressure (BP) increased risk. Thus, DR risk increased by 30% for every 10 mmHg of higher systolic BP at baseline (RR, 1.3; 95% CI, 1.1-1.4) or of BP increase from baseline to the 4-year follow-up (RR, 1.3; 95% CI, 1.1-1.4). Diabetic retinopathy risk similarly increased with each 1% of higher glycosylated hemoglobin level at baseline (RR, 1.3; 95% CI, 1.2-1.5). CONCLUSIONS: The long-term follow-up of persons with DM in this population of African origin, where disease prevalence is high, identified important potentially modifiable risk factors for DR. Findings suggest that efforts to achieve optimal glycemic and BP control may reduce the vision-threatening complications of DM.

Adult↗
PubMed2003

Incidence of diabetic retinopathy in the Barbados Eye Studies.

PURPOSE: To examine the 4-year incidence and risk factors for diabetic retinopathy (DR) among black participants with diabetes in the Barbados Eye Studies (BES). DESIGN: Population-based incidence study. SETTING AND PARTICIPANTS: Four hundred ten persons with diabetes mellitus (DM) from the BES cohort, which was based on a simple random sample of Barbadians, 40 to 84 years of age at baseline. MAIN OUTCOME MEASURES: Development of DR, assessed by independent gradings of 30 degrees color stereo fundus photographs of the disc and macula. Associations were evaluated by logistic regression analyses. RESULTS: After 4 years, DR developed in 92 of 306 (30.1%; 95% confidence interval, 25.0%, 35.5%) persons unaffected at baseline. The incidence of DR was 31.9% in those with known DM at baseline and 20.9% in newly diagnosed DM. Clinically significant macular edema developed in 16 (4.5%) of 353 individuals at risk. Seven (6.9%) of the 101 persons with minimum or moderate DR at baseline progressed to proliferative DR. Age-specific incidence declined from 36.2% at age 40 to 49 years to 28.8% and 24.2% over the subsequent two decades, increasing to 38.2% among those >/=70 years. Risk factors for DR were increased systolic blood pressure (relative risk [RR], 1.16 [1.03, 1.31]/10 mmHg increase); use of oral hypoglycemics (RR, 2.4 [1.3, 4.2]); and use of insulin (RR, 6.1 [1.7, 22.1]) (vs. no treatment or diet only); and elevated glycated hemoglobin (GHb; RR, 6.4 [2.5, 16.0]); GHb >11.5% vs. GHb </=8%). CONCLUSIONS: High rates of incident DR were evident in the black BES population, also known to have high rates of DM. Prevention of visual loss caused by DR in this population has high priority, including optimal glycemic and blood pressure control.

Adult↗
PubMed2005

Nine-year refractive changes in the Barbados Eye Studies.

PURPOSE: To describe 9-year changes in refractive errors and estimate incidence of myopia and hyperopia in adults of African-descent, along with associated risk factors. METHODS: The 9-year follow-up of the Barbados Eye Studies (1997-2003) reexamined 2793 surviving cohort members (81% participation). Refractive errors were determined by automated refraction. Myopia/hyperopia were defined as spherical equivalent < -0.5 diopters (D)/> +0.5 D, and the cutoff for moderate-high myopia/hyperopia was 3.0 D. Incidence rates of myopia/hyperopia were estimated by the product-limit approach, based on eyes without such conditions at baseline. Risk factors were evaluated by logistic regression in discrete time hazard models. RESULTS: Nine-year refraction changes varied by age. Persons aged 40 to 49 years experienced hyperopic shifts (median, +0.38 D), whereas persons > or =60 years had myopic shifts (median, -0.75D). Overall 9-year incidence was 12.0% for myopia and 29.5% for hyperopia; rates were 3.6% and 2.0% for moderate-high myopia and hyperopia, respectively. Myopia risk increased with age, baseline nuclear lens opacities (risk ratio [RR] = 1.7; 95% confidence interval [CI]: 1.01-2.9), glaucoma (RR = 6.0, 95% CI: 3.9-9.3), and ocular hypertension (RR = 2.0, 95% CI: 1.3-3.0), while cortical lens opacities decreased risk (RR = 0.6, 95% CI: 0.4-0.9). Incidence of moderate-high myopia was also related to baseline age, nuclear opacities, glaucoma, male gender (RR = 1.7, 95% CI: 1.0-2.8), and diabetes history (RR = 1.9, 95% CI: 1.01-3.5). Hyperopia risk decreased with older age, male gender, and glaucoma diagnosis. CONCLUSIONS: Refractive errors continue to develop frequently in older adults. Nuclear lens opacities, glaucoma, and diabetes increase the risk of older-onset myopia, a result of public health relevance to this and similar African-origin populations.

Adult↗
PubMed1993

Comparison of diabetic retinopathy detection by clinical examinations and photograph gradings. Barbados (West Indies) Eye Study Group.

OBJECTIVE: To compare the use of clinical examination and fundus photograph gradings in detecting diabetic retinopathy in a population that includes persons with and without diabetes. DESIGN: Population-based epidemiologic study. SETTING: Sir Winston Scott Polyclinic, Bridgetown, Barbados, West Indies. PARTICIPANTS: Subset of a random sample of the country's population aged 40 to 86 years. RESULTS: Among 1168 black persons with fundus photograph evaluations, ophthalmologic examinations, diabetes history, and glycated hemoglobin data, 21% reported a history of diabetes; 9.5% had definite diabetes (glycated hemoglobin > 11.5%); and 13.3% had a diabetes history and glycated hemoglobin value less than or equal to 11.5%. The frequency of diabetic retinopathy in this group was 7.7% (90/1168) by clinical examination, 8.7% (102/1168) by photograph gradings, and 6.7% (78/1168) by both methods. CONCLUSIONS: These results suggest that in certain populations that include diabetics and nondiabetics, a clinical examination by an ophthalmologist will detect most cases of diabetic retinopathy identified by disc and macula photographs read by skilled graders. However, it will lead to an underestimate of prevalence. Staff availability and cost, issues not examined in this study, should determine which approach is selected.

Adult↗
PubMed2001

Inheritance of open-angle glaucoma in the Barbados family study.

The majority of genetic studies on open-angle glaucoma (OAG) have been conducted in primarily white populations, with investigations of inheritance patterns largely based on self-reported information. The Barbados Family Study of Open-Angle Glaucoma (BFSG) is the first study to investigate the transmission pattern(s) for OAG in a predominantly black population, based on standardized examinations. Each BFSG participant received a comprehensive examination including anthropometric and other measurements, best-corrected visual acuity, perimetry, tonometry, lens gradings, fundus photography, venipuncture, an extensive interview including ocular, medical and family history information and a comprehensive ophthalmologic evaluation. Conservative criteria were used to define glaucoma status, including the presence of both visual field defects and optic disc damage. The study included 207 OAG-affected probands (median age: 68 years) and 1,056 of their relatives (median age: 47 years). Among the relatives examined 10% (n = 106) had OAG and 13% (n = 141) had probable OAG. Segregation analyses were performed to determine the mode of inheritance for glaucoma in these families. The results indicate that transmission of OAG or probable OAG is most likely due to a major codominant gene. Both age and gender are shown to be significant factors as well; with an increase in risk being associated with each year of age over 54 years and an increase in risk for all ages and genotypes observed in males. These analyses do not, however, preclude the possible existence of an environmental component or other genetic determinants in OAG. Further evidence for the existence of a major gene may be obtained by additional follow-up of the relatively young cohort of relatives, as well as ongoing linkage analyses.

Adult↗
PubMed1982

Osteology of a slave burial population from Barbados, West Indies.

A unique seventeenth-nineteenth century slave cemetery population from Newton plantation, Barbados, allows examination of craniodental characters in relation to ethnohistorical data. Age-at-death estimates suggest life expectancy at birth of 29 years and low infant mortality; historical demography, however, suggests life expectancy of 20 years and very high infant mortality. Tooth decay, bilateral tooth loss, periodontal disease, root hypercementosis, and severe enamel hypoplasia are high in frequency. The teeth yield evidence of such cultural practices as pipe-smoking and incisor mutilation. Several skeletal features reflect periodic near-starvation. Directional and fluctuating dental asymmetry, relative tooth size, and hypoplasia distribution suggest slaves experienced considerable weaning trauma; metabolic stress at this time exceeded that of prenatal and immediate postnatal periods. Odontometrics and dental and cranial nonmetric traits indicate that modern Blacks are intermediate between the ancestral slaves and modern Whites but more similar to the latter, suggesting effects of environmental covariance exceed those of genetic admixture. Nonmetric trait distributions show nonrandom patterns according to area of burial in the cemetery, a possible result of family segregation.

Adolescent↗
PubMed1987

Implications of tooth root hypercementosis in a Barbados slave skeletal collection.

A 17th- to 19th-century cemetery sample of 104 slaves from Newton Plantation (Barbados) shows uniquely high hypercementosis prevalence, as well as unexpectedly high and variable skeletal lead content. A variety of biological and archeological factors indicates that individuals with lower amounts of these anomalies (relative to age at death) were probably African-born, first-generation slaves. The hypercementosis is related to the progression of periodontal disease as assessed from alveolar bone. Although the hypercementosis is endemic in the Caribbean black population, it does not as yet have a clear explanation. We suggest the etiology might relate to chronic malnutrition involving periodic, seasonal rehabilitation.

Black or African American↗
PubMed1992

Congenital syphilis in the past: slaves at Newton Plantation, Barbados, West Indies.

Hutchinson's incisors and Moon's molars are specific lesions of congenital syphilis. The extensive but fragmentary clinical literature on these conditions describes reduced dimensions and thin enamel in the permanent incisors and first molars, crowding and infolding of the first molar cusps, notching of the upper incisors, and apical hypoplasias of the permanent canines. A Barbados slave cemetery (ca. 1660-1820 AD) includes three individuals with these features, suggesting a frequency at birth of congenital syphilis in the population approaching 10%. These three cases show triple the frequency of all hypoplasias and more than seven times the frequency of pitting hypoplasia present in the remainder of the series. The recognizable congenital syphilis cases account for much of the remarkably high frequency of hypoplasias in the series as a whole. We infer that syphilis contributed substantially to morbidity, infant mortality, and infertility in this population. Presence or absence of congenital syphilis may account for much of the variability in health and mortality seen among nineteenth century African-American populations.

Adolescent↗
PubMed1995

A twelve-year study of leptospirosis on Barbados.

Between November 1979 and December 1991, 398 cases of severe leptospirosis were confirmed on Barbados (range for 1980-1991 23-56; mean 32.7; incidence 13.3/100,000/year). For the six-year periods 1980-1985 and 1986-1991 there was no significant change in incidence with time. Incidence is unlikely to change significantly in the next decade. Monthly average case numbers ranged from 1.4 (July) to 4.3 (November). The average (2.8) for June to December (the 7 wetter months) was not significantly higher than that (2.5) for January to May (the 5 drier months). The age range was 7-86. There were three times as many male cases (302) as female (96), and nearly 10 times as many in those < 35. Although the highest number of cases (69) was in males aged 15-24, the highest incidence was in the older age groups, particularly the male 65-74 year-olds, and the female 55-64 year-olds. Leptospirosis was the proven cause of death in 55 (13.8%) hospital patients (annual range 0-13, mean 4.5). Some of a further 39 fatalities might have been cases. Death from leptospirosis was nearly twice as common among the women as among the men. Only one patient under 20 years of age died. Leptospira were isolated and identified from 117 (29.4%) of the 398 sick patients. The infecting organisms were bim (serogroup Autumnalis--75), copenhageni (Icterohaemorrhagiae-26), arborea (Ballum-14) and bajan (Australis-2). These infecting serovars could not be distinguished clinically, but infection was milder in children than in adults. Despite its predominance in surveyed children, serogroup Panama was virtually absent in this study. Rainfall is the major factor affecting the distribution of cases; not surprisingly, sanitation workers and agricultural workers appear to be the groups at highest risk. The general lack of clear-cut risk factors reflects the ubiquity of leptospires in the environment and the fact that the disease is not entirely occupational.

Adolescent↗
PubMed1979

A study of leptospirosis among animals in Barbados W.I.

Microscopic agglutination tests performed during 1971 and 1972 on Barbadian livestock showed positive serological reactions for leptospirosis as follows: cattle 51%, pigs 13%, sheep 18%, horses 64% and goats 19%. The serogroup Autumnalis predominated in all but horses in which the reactions to the Pyrogenes group appeared slightly higher. After the isolation of a strain of Leptospira serotype fort-bragg (Barbadian strain No. 119) of the Autumnalis serogroup in 1973, and its subsequent inclusion in our test battery of leptospiral antigens, high percentages of cattle, dogs, mongooses and man showed sero-positive reactions against the strain. Attention is called to the wide dissemination of the fort-bragg serotype on the island and to the role of rodents and the mongoose in its spread. 74 clinically affected Barbadian cattle from three herds were studied during 1975-76; 60 (81%) were serologically positive and nine different serogroups were represented. Predominant sero-positive reactions to Hebdomadis, Autumnalis, Ballum and Pyrogenes antigens were recorded. The highest titres were against Autumnalis, Hebdomadis and Pomona. Hebdomadis and Pomona serogroup antibodies may be due to many importations of cattle with those infections into Barbados.

Agglutination Tests↗
PubMed1979

The problem of human leptospirosis in Barbados.

The results of a retrospective study of human leptospirosis cases occurring in Barbados during the period 19-68-74, and of serological findings among high risk occupational groups, fever cases and health centre patients monitored for the disease during 1975-77, indicate that infection by serotype fort-bragg of the Autumnalis group is widespread in this Caribbean island. The occupational groups most affected are sanitation workers and sugar-cane workers. Results of serological tests conducted at the principle hospital are comparable with the results obtained by the microscopic agglutination reference test procedure conducted at the Pan American Zoonosis Centre (CEPANZO).

Adolescent↗
PubMed1984

The prevalence of severe leptospirosis among humans on Barbados.

Leptospirosis was confirmed by the Leptospira Laboratory in 138 hospital patients on Barbados between early November 1979 and the end of 1982 (annual average 43.6 cases). These were the great majority of severe cases occurring on the island during that time. The crude incidence rate ranged between 15 and 23 per 100,000 population per year (average 17.6). 26 of the patients died (15 males, 11 females), giving an over-all case fatality rate of 18.8%, and an average of 8.2 deaths per year. 68% of all cases were in males. The highest percentages of cases were in males aged 20 to 24 and females aged 55 to 59, but the incidence of the disease in both sexes increased with age up to 60 years. Previous figures recorded on the island by the Ministry of Health for 1975-79 were considerably lower, with a mean of 23.6 cases per year and a crude annual incidence of 9.5 per 100,000. 15 of the patients died (13 males, 2 females), giving an over-all case fatality rate of 12.7% and an average of 3 deaths per year. 74% of all cases were in males. The highest percentages of cases were in the 20 to 29 and 50 to 59 year age groups for males and females, respectively, i.e., similar to those in the present series. In both sexes the incidence of leptospirosis increased with age up to 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Social integration of the physically disabled in Barbados.

An emergent concern with the rehabilitation and social integration of disabled people in developing nations has created a need to identify cultural beliefs and behaviors which may affect the integration of the disabled into normative social roles. The focus of this study is the social integration of physically disabled adults among the nonelite, colored population of Barbados, West Indies. This paper analyses the role participation of 30 physically disabled adults within the context of Barbadian beliefs and behaviors related to the disabled and to the 'normal' adult. Although village Barbadians do not expect the physically disabled to fulfill normative adult roles, some disabled individuals in this study do perform adult activities, such as maintaining employment and engaging in sexual relationships. However, very few of them participate in the reciprocal relationships among peers and neighbors through which village Barbadians achieve status and 'respect' as adults.

Activities of Daily Living↗
PubMed2005

Evaluation of the CD14/-260 polymorphism and house dust endotoxin exposure in the Barbados Asthma Genetics Study.

BACKGROUND: Both a functional promoter polymorphism in the gene encoding CD14 (C-260T) and exposure to endotoxin are believed to play key roles in modulating the immune response and expression of atopic disease. OBJECTIVE: We aimed to evaluate the role of the CD14 C-260T polymorphism in a population of African descent and to test for interaction between this genotype and house dust endotoxin (HDE) exposure on atopic phenotypes. METHODS: Asthmatic probands and their families were recruited as part of the Barbados Asthma Genetics Study. The C-260T polymorphism and two additional CD14 promoter markers (G-1461T, C-1721T) were genotyped. Endotoxin was measured in house dust samples. RESULTS: Using a Family-Based Association Test, the C-260T allele appeared to be protective against asthma ( z = -2.444; P = .015) and asthma severity ( z = -2.615; P = .009) under a recessive model. No significant associations were observed for the G-1461T and C-1721T markers both individually and in haplotypes. In a case-control analysis, the CD14 TT genotype was found to reduce risk of asthma compared with the CD14 CC/CT genotypes (odds ratio [OR], 0.26; 95% CI, 0.14-0.49) and was associated with lower asthma severity scores ( P < .002). The TT genotype might protect against asthma for individuals with low HDE (OR, 0.09; 95% CI, 0.03-0.24), but may be a risk factor for individuals with high HDE (OR, 11.66; 95% CI, 1.03-131.7), suggesting a gene-environment interaction. CONCLUSION: These data suggest that the CD14-260 polymorphism may play a role in controlling risk to atopic disease and underscore the importance of incorporating key environmental exposures into studies of genetic risk factors.

Adult↗
PubMed2001

Patterns of open-angle glaucoma in the Barbados Family Study.

OBJECTIVE: To describe the Barbados Family Study of open-angle glaucoma (OAG) and present risk factors for OAG in siblings of study probands. DESIGN: Observational study of families of probands with OAG. PARTICIPANTS: Two hundred thirty probands and 1056 relatives (from 207 families). METHODS: Probands and their family members underwent standardized examinations, including automated perimetry, applanation tonometry, ophthalmologic evaluation, fundus photography, blood pressure, interview, and genotyping. Generalized estimation equation methods were used to evaluate risk factors. MAIN OUTCOME MEASURES: Presence of OAG in the relatives, as defined by both visual field and optic disc findings, after ophthalmologic exclusion of other causes. RESULTS: The median ages of probands and relatives were 68 and 47 years, respectively. In the 207 families, 29% of the probands had one relative with OAG and 10% had two or more relatives affected. Of the 1056 family members, 10% had OAG, 13% had suspect OAG, and 6% had ocular hypertension. One fifth of the 338 siblings had OAG (n = 67); they tended to be older and more often were male. Multivariate comparisons between siblings with and without OAG found that age, higher intraocular pressure (IOP), myopia, and lower diastolic blood pressure-IOP differences were related to OAG, whereas hypertension and diabetes were not. CONCLUSIONS: Based on standardized protocols and examinations, approximately one quarter of the relatives had OAG or suspected OAG, despite their relatively young age. Risk factors for OAG in siblings were similar to risk factors in unrelated individuals. Analyses are ongoing to determine OAG inheritance and to localize potential gene(s) involved.

Adult↗
PubMed2001

Prevalence and causes of visual impairment in The Barbados Eye Study.

OBJECTIVE: To determine the prevalence and causes of low vision and blindness in a predominantly black population. DESIGN: Population-based prevalence study of a simple random sample of Barbados-born citizens aged 40 to 84 years. PARTICIPANTS: Four thousand seven hundred nine persons (84% participation). METHODS: The standardized protocol included best-corrected visual acuity (with a Ferris-Bailey chart), automated perimetry, lens gradings (LOCS II), and an interview. Participants with visual acuity of worse than 20/30, other positive findings, and a 10% sample also had an ophthalmologic examination that evaluated the cause and extent of vision loss (resulting from that cause), if any. MAIN OUTCOME MEASURES: Low vision and blindness were defined as visual acuity in the better eye between 6/18 and 6/120 and visual acuity worse than 6/120, respectively (World Health Organization [WHO] criteria). RESULTS: Of the 4631 participants with complete examinations, 4314 (93%) reported their race as black, 184 (4%) reported their race as mixed (black and white), and 133 (3%) reported their race as white or other. Low vision was found in 5.9% of the black, 2.7% of the mixed, and 3.0% of white or other participants. Bilateral blindness was similar for black and mixed race participants (1.7% and 1.6%, respectively) and was not found in whites. Among black and mixed participants, the prevalence of low vision increased with age (from 0.3% at 40-49 years to 26.8% at 80 years or older). The prevalence of blindness was higher (P < 0.001) for men than women at each age group (0.5% versus 0.3% at ages 40-49 and 10.9% versus 7.3% at 80 years or more). Sixty percent of blindness was due to open-angle glaucoma and age-related cataract, each accounting for more than one fourth of cases. Other major causes were optic atrophy or neuropathy and macular and other retinal diseases. Few cases of blindness were due to diabetic retinopathy (1.4%), and none were due to age-related macular degeneration. CONCLUSIONS: Using the WHO criteria, prevalence of visual impairment was high in this African-origin population, particularly at older ages. Most blindness was due to open-angle glaucoma and cataract, with open-angle glaucoma causing a higher proportion of blindness than previously reported. The increased prevalence of blindness in men may be due to the increased male prevalence of glaucoma in this population and warrants further investigation. Results underline the need for blindness prevention programs, with emphasis on effective treatment of age-related cataract and enhancing strategies for early detection and treatment of open-angle glaucoma.

Adult↗
PubMed1991

Leptospires isolated from toads and frogs on the Island of Barbados.

Four pathogenic strains of leptospires were isolated from the kidneys of toads (Bufo marinus) and seven from frogs (Eleutherodactylus johnstonei). Isolates from two toads and one frog belonged to serovar bim, the causative agent of most cases of severe leptospirosis on Barbados. The other eight strains belonged to a new serovar within the Australis serogroup. The name bajan is proposed for this new serovar of Leptospira interrogans.

Agglutination Tests↗