Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Jamaica”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2003

Gynaecologic cancer incidence, Kingston and St Andrew, Jamaica, 1973-1997, and gynaecologic cancer mortality, Jamaica, 1999.

The incidence of gynaecologic cancers in women from Kingston and St Andrew for the period 1973-1997 were reviewed by analyzing data previously published by the Jamaica Cancer Registry. Gynaecologic cancer-related mortality statistics for the entire island for 1999 were compiled from data obtained from the Registrar General's Department (RGD) and the Statistical Institute of Jamaica (STATIN). Data were compared to gynaecologic cancer statistics for women from the United States of America for 1973-1997. A total of 2862 gynaecologic cancers were registered for the years 1973-1997, which represents 26.8% of all female cancers from Kingston and St Andrew. Cervical cancer accounted for 62% of these gynaecologic cancers. The 268 cancer-related deaths (168 due to cervical cancer) registered in Jamaican women for 1999 represent approximately 15% of all female cancer-related deaths. The present incidence (27.9 per 100,000) and mortality rate (15.8 per 100,000) of cervical cancer are much higher than that documented for American women--both African Americans and Caucasians--and signify the limited success, to date, of efforts to decrease the incidence and mortality of cervical cancer by the implementation of cervical cancer screening programmes. For the time period reviewed, an increase was noted in the incidence of cancer of the corpus uteri while decreases were recorded for the incidence of choriocarcinoma, ovarian cancer and cancers arising from the vulva, vagina and fallopian tube.

Age Factors↗
PubMed1994

Use of mammography in Jamaica. The Jamaica Cancer Society experience.

This is a study of the number of patients seen at the Jamaica Cancer Society during the year 1993. It was shown that less than one per cent of Jamaican women over the age of 20 years use this service. A lack of knowledge as well as difficulty in accessing the service, e.g. distance, appears to be the main contributing factor for this deficiency.

Adult↗
PubMed2004

A history of cardiology in Jamaica.

The history of cardiology in Jamaica is conveniently considered in decades beginning in the 1950s. The decade of the 1950s was characterized by early descriptions of the pattern of cardiac disease in adults and children in Jamaica, the establishment of a cardiac clinic at the University Hospital of the West Indies and early cardiac surgical landmarks. Extensive preparatory experimental work in the canine laboratory with respect to cardiopulmonary bypass in the early to mid-1960s culminated in the successful completion of the first open heart surgical procedure in April, 1968. Cardiac catheterization was also increasingly developed in the decade of the 1960s. A highlight of the decade of the 1970s was the establishment of the Heart Foundation of Jamaica which began contributing greatly to preventive cardiology in Jamaica by providing a variety of programmes of prevention. In the decade of the 1980s, non-invasive cardiac diagnostic facilities in Jamaica were considerably enhanced by the introduction and development of echocardiography, treadmill exercise testing and ambulatory electrocardiography. In addition, the very important National Rheumatic Fever prevention programme was established. The cardiac catheterization laboratory was re-opened in the 1990s, thus allowing the performance of coronary arteriography in Jamaica for the first time, and interventional cardiology procedures soon followed. The Jamaica Foundation for Cardiac disease was also established in this decade. The vision for the new millennium of "A heart healthy Jamaica in the 21st century" is achievable, but will require appropriate emphasis on expanded preventive and curative cardiology programmes.

Cardiac Surgical Procedures↗
PubMed1999

Standardized comparison of glucose intolerance in west African-origin populations of rural and urban Cameroon, Jamaica, and Caribbean migrants to Britain.

OBJECTIVE: To compare the prevalence of glucose intolerance in genetically similar African-origin populations within Cameroon and from Jamaica and Britain. RESEARCH DESIGN AND METHODS: Subjects studied were from rural and urban Cameroon or from Jamaica, or were Caribbean migrants, mainly Jamaican, living in Manchester, England. Sampling bases included a local census of adults aged 25-74 years in Cameroon, districts statistically representative in Jamaica, and population registers in Manchester. African-Caribbean ethnicity required three grandparents of this ethnicity. Diabetes was defined by the World Health Organization (WHO) 1985 criteria using a 75-g oral glucose tolerance test (2-h > or = 11.1 mmol/l or hypoglycemic treatment) and by the new American Diabetes Association criteria (fasting glucose > or = 7.0 mmol/l or hypoglycemic treatment). RESULTS: For men, mean BMIs were greatest in urban Cameroon and Manchester (25-27 kg/m2); in women, these were similarly high in urban Cameroon and Jamaica and highest in Manchester (27-28 kg/m2). The age-standardized diabetes prevalence using WHO criteria was 0.8% in rural Cameroon, 2.0% in urban Cameroon, 8.5% in Jamaica, and 14.6% in Manchester, with no difference between sexes (men: 1.1%, 1.0%, 6.5%, 15.3%, women: 0.5%, 2.8%, 10.6%, 14.0%), all tests for trend P < 0.001. Impaired glucose tolerance was more frequent in Jamaica. CONCLUSIONS: The transition in glucose intolerance from Cameroon to Jamaica and Britain suggests that environment determines diabetes prevalence in these populations of similar genetic origin.

Adult↗
PubMed1996

Development of food frequency questionnaires in three population samples of African origin from Cameroon, Jamaica and Caribbean migrants to the UK.

OBJECTIVES: To develop the methods for assessment of food and nutrient intake using standardized food frequency questionnaires (FFQ) in three African origin populations from Cameroon, Jamaica and Caribbean migrants to the United Kingdom. DESIGN: Cross-sectional assessment of diet from a representative sample in each site, using either a 2-day food diary or a 24-h recall method to determine foods for inclusion on the food frequency questionnaire. SETTING: A rural and urban site in Cameroon, Evodoula and Cite Verte in Yaounde, respectively; a district in Kingston Jamaica; African-Caribbeans living in central Manchester, UK. SUBJECTS: Aged 25-79 years, 61 from the Cameroonian urban site, 62 from the village site; 102 subjects from Jamaica (additional analysis on a subsample of 20): 29 subjects from Manchester, UK. MAIN OUTCOME MEASURES: Foods contributing to nutrients in each site to allow the development of a FFQ. RESULTS: A high response rate was obtained in each site. Comparison of macronutrient intakes between the sites showed that carbohydrate was the most important contributor to energy intake in Jamaica (55%) and the least in rural Cameroon. In rural Cameroon, fat (mainly palm oil) was the most important contributor to energy intake (44%). Manchester had the highest contribution of protein to energy (17%). Foods contributing to total energy, protein, fat and carbohydrate were determined. In rural Cameroon, the top 10 food items contributed 66% of the total energy intake compared to 37% for the top 10 foods in Manchester. Foods contributing to energy were similar in Jamaica and Manchester. Cassava contributed 44% of the carbohydrate intake in rural Cameroon and only 6% in urban Cameroon. One FFQ has been developed for use in both sites in Cameroon containing 76 food items. The FFQ for Jamaica contains 69 foods and for Manchester 108 food items. CONCLUSION: Considerable variations exist within sites (Cameroon) and between sites in foods which are important contributors to nutrient intakes. With careful exploration of eating habits it has been possible to develop standardized, but locally appropriate FFQs for use in African populations in different countries.

Adult↗
PubMed1995

The HIV/AIDS epidemic in Jamaica.

OBJECTIVE: To describe the HIV/AIDS epidemic in Jamaica. METHODS: Data from the national surveillance system for HIV infection and AIDS based in the Epidemiology Unit, Ministry of Health, were reviewed. These include case reports; HIV screening of blood donors, migrant farmworkers and US visa applicants; sentinel surveillance among antenatal clinic (ANC) attenders and sexually transmitted disease (STD) clinic attenders; and various serosurveys. RESULTS: A total of 669 AIDS cases were reported in Jamaica from December 1993 representing a cumulative AIDS case rate of 28 per 100,000 population. Since 1987 the annual AIDS case rate doubled every 2 years with 69% of individuals having died with AIDS. Heterosexual transmission predominates with the cumulative adult AIDS male-to-female case ratio declining from 2.8:1 in 1988 to 1.9:1 in 1993. A total of 55 children with AIDS account for 8.2% of all cases. The HIV infection rate per 1000 in 1993 was 3.8 among blood donors, 1.4 among ANC attenders and significantly higher among STD clinic attenders (men 6%, women 2.7%), homosexuals (9.6%), female prostitutes (12%) and individuals with repeat STD infections (10%). Consistent condom use increased from 27% in 1989 to 47% in 1993. CONCLUSIONS: HIV infection was introduced into Jamaica from abroad through several different routes including the Jamaican homosexual community, migrant farmworkers, female prostitutes, and informal commercial importers. HIV transmission is well established locally and is spreading more rapidly in Western Jamaica and along the North Coast, which may reflect increased sexual activity associated with tourism. Although awareness of AIDS and HIV is high and condom use has increased considerably, there are no grounds for complacency concerning the HIV/AIDS epidemic in Jamaica.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Health policy and eye care services in Jamaica.

PURPOSE: To test the hypothesis that access to and amount of eye care services in Jamaica are inadequate and that this is related to insufficient eye care personnel and legal limitations on optometric practice in Jamaica. METHODS: An eye care provider survey, a consumer survey, and a literature search were used for data collection. The consumer sample consisted of 500 subjects (aged 16 to 84 years or older) recruited from a stratified random sample of food markets in Jamaica. The provider sample consisted of 10 ophthalmologists and 10 optometrists, randomly selected from licensing rosters. Adequacy of amount of eye care services was measured by comparing the frequency of eye examinations in Jamaica with professional practice guidelines. Access was measured by the eye provider to population ratio compared with calculated need for adequate care. RESULTS: Only 38.6% of the study population had received an eye examination within 3 years and only 23.4% reported having eye examinations at least once every 3 years. Over 43% had never received an eye examination. The total eye care provider/population ratio was only 2.04/100,000 and only 1.32/100,000 when optometrists are excluded. CONCLUSION: Access to and amount of eye care services are severely inadequate in Jamaica. Outdated optometric laws governing the activities of eye care professionals compounds the problem.

Adolescent↗
PubMed2006

Predicted declines in sickle allele frequency in Jamaica using empirical data.

The high frequency of the sickle allele in some parts of Africa is understood to be a consequence of high malarial endemicity. One corollary of this is that the sickle allele frequency should be declining in populations of African ancestry that are no longer exposed to malaria. We have previously shown that there has been no change in sickle allele frequency in malaria-free Jamaica between two large-scale neonatal screening exercises conducted in 1973-1981 and 1995-2003. To evaluate the determinants of, and derive expected values for, sickle allele frequency in Jamaica, local empirical data were used to estimate the parameters of deterministic models of allele frequency decline. We found that although model predictions were broadly consistent with observed values in the 1973-1981 cohort, the predicted change in allele frequency between the two cohorts was larger than the observed, nonsignificant, reduction. Close agreement between predicted and observed values was only achieved by simulating a recent, marked increase in HbSS fitness. Thus, the "unexpected" persistence of the sickle allele in Jamaica may reflect the fact that the actual fitness among SS individuals is higher than that previously realized. If true, our models suggest that without substantial changes in current screening and counseling practice, there will be little "natural" reduction in sickle allele frequency for several hundred years. Better estimates of relative fitness will be helpful in refining these predictions and may aid in assigning health care priorities in Jamaica and the African Diaspora.

Alleles↗
PubMed2001

Jamaica's disappearing forests: physical and human aspects.

Jamaica is a small island that is losing its forest cover at a rapid rate. Due to the dependency of its largely poor population on the many services and functions its forests provide, this loss threatens to have substantial socioeconomic and ecological consequences for the country. Despite these basic facts, the problem of Jamaican deforestation has received very little attention from the scientific community. This article presents results of an island-wide, satellite-based study of forest change for Jamaica for the period 1987-1992, which was supplemented by a field trip to the island in 1999 to assess the overall accuracy of the estimate. Landsat MSS images, which are available only up until 1992, have proved to be an invaluable and cost-effective resource for mapping forest change in the tropics, particularly in large areas. A supervised classification indicates that Jamaica experienced an average annual deforestation rate of 3.9% for this period, a figure higher than existing estimates based on partial ground surveys but lower than the FAO's 1990 Tropical Forest Assessment of 5.3% for 1981-1990. Deforestation estimates for Jamaica's 14 parishes are also presented, based on the integration of satellite-derived forest classification maps with a parish administrative boundaries map of the island in a GIS. A correlation analysis between parish deforestation estimates and socioeconomic and land use/quality indicators derived from official sources suggests that deforestation is occurring most rapidly in highly populated areas possessing large numbers of small farmers who live and work under resource-poor conditions. By providing a sense of the magnitude of and main forest loss hotspots, it is hoped that these national and subnational level forest estimates will draw scientific attention to the problem of deforestation on the island. In addition, the socioeconomic analysis may provide policy-makers and planners with some sense of the relative contribution of underlying driving process in this deforestation as a first step toward the creation of effective social programs to combat the problem.

Agriculture↗
PubMed2002

Emergency contraception among university students in Kingston, Jamaica: a survey of knowledge, attitudes, and practices.

Emergency contraceptives (ECs) are an important option for young women in Jamaica, where rates of unplanned pregnancy are high. Few previous studies of EC exist in Jamaica. We surveyed a random sample of 205 students living on campus at the University of the West Indies in Kingston, Jamaica, to learn more about students' knowledge and opinions of EC pills (ECPs). General awareness of ECPs was high (84%), although many students were unaware of specific details regarding the method's appropriate use, such as the time frame. Twenty students (10%) had used ECPs themselves or had a partner who had used them. Most had used ECPs for the first time because they lacked contraception or because of contraceptive failure. Following their first use of ECPs, 55% adopted an ongoing method of contraception. Most students felt ECPs were an important option for women in Jamaica; however, some feared ECPs might be overused. Future educational campaigns should provide Jamaican university students with detailed information about this method.

Adolescent↗
PubMed1999

Perceptions of veterinarians regarding privatization of veterinary services delivery in Ghana and Jamaica.

There are on-going reforms in the delivery of veterinary services in many developing countries, with privatization of certain veterinary activities as one of the approaches. In Jamaica, with the support of veterinarians, clinical aspects of veterinary services were privatized in 1992. In contrast, Ghanaian veterinarians are generally wary of the government's on-going privatization process. The objective of this study was to find out if perceptions of the veterinarians from these two countries on certain issues of privatization were sufficiently different to explain the willingness or reluctance to go into private practice. The response proportions for predominantly self-administered questionnaires were 83% (121/145) and 92% (35/38) for Ghana and Jamaica, respectively. There was a very good (92%) agreement in the perceptions of veterinarians in Ghana and Jamaica on a battery of 24 responses pertaining to privatization of veterinary services. Generally, the perceptions of the veterinarians in Ghana and Jamaica were similar even though the predominant delivery systems for animal health services were different. Therefore, reasons other than those examined in this study may explain the differences in willingness to go into private practice. The need to account for these other reasons is discussed.

Animals↗
PubMed2001

Salt fluoridation and dental caries in Jamaica.

PURPOSE: In 1987, Jamaica initiated a comprehensive island-wide salt fluoridation program. A survey was conducted in 1995 to monitor the impact of salt fluoridation among children in Jamaica. METHODS: Dental examinations of 1,120 children aged 6-8, 12, and 15 years were conducted according to World Health Organization criteria to assess dental caries, fluorosis, the presence of and need for dental sealants, and Community Periodontal Treatment Needs (CPI). RESULTS: Age specific DMFT means observed in 1995 were 0.2 at age 7, 0.4 at age 8, 1.1 at age 12 and 3.0 at age 15. The mean DMFT scores in children 6, 12 and 15 years of age were dramatically lower than the corresponding scores of 1.7, 6.7 and 9.6 obtained at the baseline examination in 1984 for children of the same age groups, respectively (baseline data for 7- and 8-year-olds were not collected). The mean percentage of sound permanent teeth for all age groups was 90% in 1995. The percentage of children caries-free at baseline was 27.6% for 6 years, 2.8% for 12 years and 0.3% for 15 years of age. In 1995, the percentage of caries-free children (permanent teeth) was 61%. In 1984, 23 children were scored as having very mild or mild fluorosis. In 1995, five children were scored in the same categories of fluorosis, using Dean's criteria; thus, fluorosis remained at negligible levels in 1995. CONCLUSIONS: The oral health survey conducted in Jamaica in 1995 indicated a significant decline in dental caries compared with findings in 1984. The major change in Jamaica during the interval was the introduction of salt fluoridation in 1987. Dental fluorosis was low in the 1995 survey.

Adolescent↗
PubMed2001

Habitual diet in four populations of African origin: a descriptive paper on nutrient intakes in rural and urban Cameroon, Jamaica and Caribbean migrants in Britain.

BACKGROUND: The prevalence of chronic diseases is increasing in West Africa, the Caribbean and its migrants to Britain. This trend may be due to the transition in the habitual diet, with increasing (saturated) fat and decreasing fruit and vegetable intakes, both within and between countries. OBJECTIVE: We have tested this hypothesis by comparing habitual diet in four African-origin populations with a similar genetic background at different stages in this transition. DESIGN: The study populations included subjects from rural Cameroon urban Cameroon Jamaica and African-Caribbeans in Manchester, UK all aged 25-74 years. Habitual diet was assessed by a food-frequency questionnaire, specifically developed for each country separately. RESULTS: Total energy intake was greatest in rural Cameroon and lowest in Manchester for all age/sex groups. A tendency towards the same pattern was seen for carbohydrates, protein and total fat intake. Saturated and polyunsaturated fat intake and alcohol intake were highest in rural Cameroon, and lowest in Jamaica, with the intakes in the UK lower than those in urban Cameroon. The percentage of energy from total fat was higher in rural and urban Cameroon than in Jamaica and the UK for all age/sex groups. The opposite was seen for percentage of energy from carbohydrate intake, the intake being highest in Jamaica and lowest in rural Cameroon. The percentage of energy from protein increased gradually from rural Cameroon to the UK. CONCLUSIONS: These results do not support our hypothesis that carbohydrate intake increased, while (saturated) fat intake decreased, from rural Cameroon to the UK.

Adult↗
PubMed2005

Comparative development and impact of transgenic papayas in Hawaii, Jamaica, and Venezuela.

We present data concerning the creation of transgenic papayas resistant to Papaya ringspot virus (PRSV) and their adoption by three different countries: the United States (e.g., Hawaii), Jamaica, and Venezuela. Although the three sets of transgenic papayas showed effective resistance to PRSV, the adoption rate in each country has varied from full utilization in Hawaii to aggressive testing but delay in deregulating of the product in Jamaica to rejection at an early stage in Venezuela. Factors that contributed to the rapid adoption in Hawaii include a timely development of the transgenic product, PRSV causing severe damage to the papaya industry, close collaboration between researchers and the industry, and the existence of procedures for deregulating a transgenic product. In Jamaica, the technology for developing the initial field-testing of the product progressed rather rapidly, but the process of deregulation has been slowed down owing to the lack of sustained governmental efforts to complete the regulatory procedures for transgenic crops. In Venezuela, the technology to develop and greenhouse test the transgenic papaya has moved abreast with the Jamaica project, but the field testing of the transgenic papaya within the country was stopped very early on by actions by people opposed to transgenic products. The three cases are discussed in an effort to provide information on factors, other than technology, that can influence the adoption of a transgenic product.

Amino Acid Sequence↗
PubMed2001

Benign fibro-osseous lesions of the jaw bones in Jamaica: analysis of 32 cases.

OBJECTIVE: It is intended to analyse all the cases of benign fibro-osseous lesions seen at the two major public hospitals in Jamaica over a 15-year period and to compare our result with what has been previously documented by other authors. No such analysis has been carried out in Jamaica or elsewhere in the English-speaking Caribbean. MATERIALS AND METHODS: The case files of patients histologically diagnosed to have a fibro-osseous lesion at both the Kingston Public Hospital and the Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about these lesions was documented. The WHO classification for benign fibro-osseous lesions was used. RESULTS: A total of 32 cases of benign fibro-osseous lesions were recorded over the 15-year period. Of these, 15 were histologically reported as fibrous dysplasia, 10 as ossifying fibroma, three as gigantiform cementoma, one each as periapical cemental dysplasia and cementoblastoma, and two cases of recurrent fibrous dysplasia. With the exception of gigantiform cementoma the age at presentation for these lesions is not consistent and this can be particularly noted for ossifying fibroma and fibrous dysplasia, both of which occurred between the age of 10 and 68 years. CONCLUSION: These lesions are more common in females, furthermore it is suggested that the inconsistent age at presentation for some of these lesions may be peculiar to Jamaica, and may be due to delay in reporting a lesion by the patient, as routine dental examination is not a common practice.

Adolescent↗
PubMed1982

Higher prices in Jamaica.

Price increases in the Jamaica CSM program went into effect on August 31, 1981. The program began in 1975. While the need for higher prices has been under discussion for the past 3 years, this is the 1st time the requisite approval from the Jamaica Price Commission has been obtained. The Jamaica National Family Planning Board (JNFPB) reports that the Panther 3-pack (condom) is up US$0.15 to US$0.30. Each Perle package (oral contraceptive) was increased by US$0.20. Single cycle Perle now sells for US$0.50, and 3-pack Perle sells for US$1.10. The 6-year price stagnation experienced by the CSM program resulted in a decreasing operational budget as program costs continued to rise. Marketing costs alone during this period escalated by 100-300%. For example, Panther pop-up display cartons cost the project US 16U each in 1975. By 1979 the same product cost US 49U. Newspaper advertisements have increased from the 1975 cost of US$68.00 to nearly $200.00 per placement. The overall inflation rate in Jamaica during the last 5 years has averaged more than 20% annually. In the face of these rising costs, outlet expansion for Perle has been prevented, wholesaler margins have been unavailable, and new retailer training has been discontinued. It is projected that the new prices will result in an annual increased revenues of US$80,000 which will be used to reinstate these essential marketing activities. The JNFPB is also planning to introduce a Panther 12-pack and Panther strips to the CSM product line. According to Marketing Manager Aston Evans, "We believe the public is now ready for this type of packaging" which is scheduled to be available soon. Panther is presently only available in a 3-pack, but annual sales have been steady. The new 12-pack will be stocked on supermarket shelves to provide higher product visibility and wider distribution. The selling price has been set as US$1.20 and is expected to yield a 25% increase in sales during the 1st year. A complete sales promotion and advertising campaign will accompany the 12-pack introduction. The marketing plan for Panther strips emphasizes placement in government and private sector offices and factories throughout the country. In the deep rural areas the strips will be available for sale in shops, bars, nightclubs, and other distribution points.

Americas↗
PubMedDate not supplied

Chronic diseases management in the Jamaican setting: HOPE worldwide Jamaica's experience.

The prevalence of hypertension and diabetes in Jamaica is very high. Hypertension is present in 3 out of 10 Jamaicans over the age of 30 years while the prevalence of diabetes mellitus varies between 13% and 18% for Jamaicans over 15 years. HOPE worldwide Jamaica is a 7-year-old private voluntary organization that collaborates with the government of Jamaica to provide a mobile medical service to poor rural communities. The records between January 1999 and December 1999 of 1091 chronic disease patients aged > 30 years were reviewed. The average recorded age of the patients was 64 years and 82% among them were females. 60% had hypertension, 16% had diabetes and 24% had both diabetes and hypertension. There were 2390 visits for hypertension, with an average of 2 visits per patient. 34% of patients had a blood pressure of < or = 140/90 mmHg while 43% had a blood pressure < 160/95 mmHg. Compliance was defined as daily consistency in taking prescribed medication. 44% of the patients with hypertension were non-compliant at the time of their visit. Antihypertensive treatment included thiazide diuretics (65%), reserpine (50%), angiotensin converting enzyme (ACE) inhibitors (30%) and alpha-methyldopa (5%). There were 1122 visits for diabetes, with an average of 2 visits per patient. Among the diabetic patients 23% were controlled to a fasting blood glucose (FBG) level of less than 6.7 mmol/l and 38% to below 8 mmol/l. 30% of the diabetic patients were non-compliant at the time of their visit. The most frequently used oral hypoglycaemic agents were metformin (78%), glyburide (43%) and chlorpropamide (30%). 14% of the diabetic patients were on treatment with insulin: insulin 70/30 (12%) and lente insulin (2%). Electrocardiograms (ECGs) were done in the previous two years on 267 patients (29%), among whom 38% had evidence of left ventricular hypertrophy and 16% of ischaemic heart disease. The level of blood pressure and blood glucose control was inadequate despite the provision of regular monitoring, surveillance and improved access to medication. It is perceived that poor socioeconomic conditions, lack of education, cultural beliefs and some other factors continue to militate against improved compliance and control. HOPE worldwide Jamaica is currently implementing programs to improve patient education, especially in compliance, to provide access to more effective medication with convenient once-daily dosage regimens, and to develop support groups among chronic disease patients in order to improve compliance and control.

Chronic Disease↗