Development of an agenda for research and action on climate change and health in the Caribbean.

This paper delineates the development of the Caribbean Research for Action Agenda which aims to empower Caribbean Small Island Developing States to reduce their vulnerabilities to the effects of climate change on health. The Caribbean Research for Action Agenda emerged from collaboration between nongovernmental organizations, academic institutions, and multilateral agencies that organized a conference on climate change and health in the Caribbean. This Agenda was formulated by prioritizing research areas, synthesizing evidence from conference presentations and scientific literature, and holding consultations with stakeholders and experts.

Protecting Caribbean patients diagnosed with cancer from compounding disasters.

Caribbean small island developing states are becoming increasingly vulnerable to compounding disasters, prominently featuring climate-related hazards and pandemic diseases, which exacerbate existing barriers to cancer control in the region. We describe the complexities of cancer prevention and control efforts throughout the Caribbean small island developing states, including the unique challenges of people diagnosed with cancer in the region. We highlight potential solutions and strategies that concurrently address disaster adaptation and cancer control.

Regional and global impacts of the 2007 Port-of-Spain Declaration on noncommunicable diseases.

Objective: To assess how well Caribbean regional institutions (RIs) met their commitments from the 2007 Port-of-Spain Summit (POSS) declaration on noncommunicable diseases (NCDs), and evaluate the POSS impact on the United Nations High-level Meeting (HLM) on NCDs in 2011 (2011 HLM), HLM NCD review in 2014 (2014 HLM), World Health Organization's 2025 NCD targets (2025 WHO), and 2030 Sustainable Development Goals (SDGs) agreed upon in 2015.

Methods: This study uses a method developed by the University of Toronto's Global Governance Program to measure institutions' compliance with commitments from a summit and the match with commitments from earlier summits. This approach was supplemented using data from published literature, primary documents, and semistructured key informant interviews to detail how and why Caribbean RIs met the 2007 POSS commitments, how the 2007 POSS commitments led to compliance, and how the 2007 POSS influenced international NCD commitments.

Zika virus outbreak in 19 English- and Dutch-speaking Caribbean countries and territories, 2015-2016.

Surveillance for Zika virus was enhanced in the English- and Dutch-speaking Caribbean following emergence of the virus in Brazil in May 2015. The first autochthonous case of Zika in the Caribbean was reported by Suriname in November 2015, and the virus subsequently spread rapidly throughout the region. Caribbean Public Health Agency (CARPHA) member states (CMS) reported clinically suspected cases of Zika and submitted serum specimens to the agency for laboratory investigation.

Prolonged Zika virus viremia in a patient with Guillain-Barré syndrome in Trinidad and Tobago.

An emerging mosquito-borne flavivirus, Zika virus (ZIKV) is a significant public health concern because of the syndromes associated with the infection. In addition, ZIKV is considered a major problem due to large-scale spread of the disease and the possible clinical complications for the central nervous system, especially Guillain-Barré syndrome (GBS) and microcephaly. Since the introduction of ZIKV in the Caribbean, molecular detection of the viral RNA has been utilized as a more specific and sensitive approach to demonstrating acute infection.

NCD Prevention and Control in Latin America and the Caribbean: A Regional Approach to Policy and Program Development.

This article describes efforts from the Pan American Health Organization (PAHO) that have supported progress in country-driven planning and implementing of actions to address noncommunicable diseases (NCD), as well as mechanisms that PAHO has supported for countries in the Americas to share and build on each other's experiences. The Regional Strategy and Plan of Action for NCD, approved by all member states in 2006, is the major frame for this work. The strategy has 4 lines of action: policy and advocacy; surveillance; health promotion and disease prevention; and integrated management of NCD and risk factors.

Raising the priority of chronic noncommunicable diseases in the Caribbean.

The Caribbean's long history of cooperation in health now focuses on noncommunicable diseases (NCDs), given that Caribbean Community (CARICOM) countries have the highest NCD burden in the Americas. The heads of government convened a first in the world one-day summit on NCDs, largely due to advocacy by George Alleyne and others, on the health, social, and economic impact of NCDs; the need for upstream multisectoral interventions to address the common, multifactoral risks; and the need for increased global attention to NCDs. Implementation of the NCD Summit Declaration mandates was most effective in larger countries with greater capacity, but countries of all sizes performed well, when they had regional or global support.

From Port-of-Spain summit to United Nations High Level Meeting CARICOM and the global non-communicable disease agenda.

The English-speaking Caribbean has the highest per capita burden of chronic non-communicable diseases (CNCDs) in the region of the Americas. Building on a long history of cooperation in health among the Caribbean Community (CARICOM) and past successes in eliminating/reducing communicable diseases through collective action, non-communicable diseases (NCDs) have now been targeted CARICOM convened a "first-in-the-world" summit of Heads of Government to address NCDs, which generated the Port-of-Spain NCD Summit Declaration, "Uniting to Stop The Epidemic of Chronic Noncommunicable Diseases". This 15-point declaration calls on all of government, civil society and the private sector to jointly tackle the common risk factors for the major chronic diseases, and improve the care of such diseases.

A multistakeholder platform to promote health and prevent noncommunicable diseases in the region of the Americas: the Pan American Health Organization partners forum for action.

Noncommunicable diseases (NCDs) and obesity are the most serious health problem facing the countries of the Americas in terms of avoidable deaths as well as costs to governments, families, and business. The main causes are ageing of the population, and widespread risks such as tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol, linked to major changes in the way we live and work, to public policies, cultural norms, and private sector forces. Underlying determinants are globalization, urbanization, poverty, education, gender, ethnicity, and access to health services.

Sexually transmitted infection service use and risk factors for HIV infection among female sex workers in Georgetown, Guyana.

Objectives: To identify risk factors for HIV and sexually transmitted infection (STI) service use patterns among female sex workers in Georgetown, Guyana.

Design: A cross-sectional study was conducted among 299 female commercial sex workers.

Methods: HIV prevalence was assessed using an oral fluid test, and sociodemographic and behavioral data by interview administered by sex workers and women's group members.

Epidemic of pediatric deaths from acute renal failure caused by diethylene glycol poisoning. Acute Renal Failure Investigation Team.

Context: Contaminated pharmaceutical products can result in substantial morbidity and mortality and should be included in the differential diagnosis of deaths of unknown origin.

Objective: To investigate an outbreak of deaths among children from acute renal failure in Haiti to determine the etiology and institute control measures.

Design: Case-control study, cohort study, and laboratory toxicologic evaluation.

Outbreak of histoplasmosis among employees in a paper factory--Michigan, 1993.

In December 1993, four reported cases of histoplasmosis among employees in a Michigan pulp paper factory prompted an investigation. A cohort of employees was surveyed to identify additional cases. A case of acute histoplasmosis was defined as an influenza-like illness in a plant employee with the onset of illness during October or November 1993 and laboratory evidence of recent infection with Histoplasma capsulatum.

A survey of hepatitis B among health workers in Jamaica.

One thousand, five hundred and thirty-seven health staff, presenting for hepatitis B vaccination in Jamaica, were surveyed in 1990/91 for hepatitis B markers and/or exposure to blood or hepatitis. Antibodies to either hepatitis B surface antigen (HBsAg) or hepatitis B core (HBc) were found in 19.8% of 817 persons tested.

Attitudes and practices of pesticide users in Saint Lucia, West Indies.

This article reports the results of a Saint Lucia survey, part of a larger program, that was the first to document the prevalence of suboptimal safety practices among vector control and farm workers using pesticides in the English-speaking Caribbean. Among other things, the survey found that many of 130 pesticide users surveyed were unaware that the skin and eyes were important potential routes of absorption. Over a quarter said they had felt ill at some point as a result of pesticide use.

Epidemiological indicators and the epidemiology of measles in the English-speaking Caribbean and Suriname.

The main purpose of this article is to discuss the definitions and limitations of the indicators used to study the epidemiology of measles in the English-speaking Caribbean and Suriname. In addition, the epidemiology of measles over the past ten years is briefly reviewed, with a focus on recent epidemics. The predicted epidemiological picture of measles over the next few years is also discussed and, finally, the difference between elimination and eradication of measles is explained.

A three-year evaluation of the quality of diabetes care in the Norwich community care scheme.

The care of patients with diabetes was assessed in eight general practices intending to establish mini-clinics. Seven of these practices subsequently participated in a mini-clinic scheme incorporating continuing education and audit. After 3 years further data were collected and compared with the baseline assessment.