Distribution of influenza and other acute respiratory viruses during the first year after the 2009-2010 influenza pandemic in the English- and Dutch-speaking Caribbean countries.

Background: Limited specimen collection and testing for influenza occurred in the English and Dutch-speaking Caribbean countries prior to the 2009/2010 influenza pandemic. Caribbean Epidemiology Centre (CAREC) member countries rapidly mobilized to collect specimens during the pandemic and a vast majority of confirmed cases during the pandemic period were influenza A(H1N1)pdm09.

Objectives: To describe the aetiology and distribution of acute respiratory illness (ARI) among laboratory confirmed cases during the first year after the 2009/2010 influenza pandemic in the English- and Dutch-speaking Caribbean.

Cricket World Cup: a stress test for the surveillance system in the Caribbean.

Objective: To describe the development and implementation of and major findings and recommendations from, a regional mass gathering surveillance system (MGSS) in support of the International Cricket Council Cricket World Cup West Indies 2007.

Methods: The regional MGSS was developed by the Caribbean Epidemiology Centre (CAREC) and its member countries as an adaptation of the routine communicable disease surveillance system in order to rapidly detect unusual disease events during the tournament. The implementation of the MGSS required the identification of additional human and financial resources, capacity building activities, laboratory strengthening, and improved global epidemic surveillance and communication mechanisms.

The control of hookworm disease in Commonwealth Caribbean countries.

Like other countries around the globe where conditions existed for the parasites causing hookworm disease to thrive, this disease was a serious problem to settlers in countries of the Commonwealth Caribbean, i.e. those countries that were formerly part of the British Empire.

Human papillomavirus genotypes and their prevalence in a cohort of women in Trinidad.

Objective: Human papillomavirus (HPV) genotypes and their relative prevalences were determined in a cohort of 310 sexually active women in Trinidad, West Indies.

Methods: Cervical samples were collected with Ayre's spatulas and endocervical brushes. Samples were used for the conventional Papanicolaou test and for determining HPV genotypes by amplification of a section of the viral L1 gene, followed by DNA sequencing and probe hybridization.

Malaria and its vectors in the Caribbean: the continuing challenge of the disease forty-five years after eradication from the Islands.

Objectives: Given the occurrence of autochthonous malaria in non-endemic island countries in the last 10 years, this study evaluates the risk factors for malaria transmission in the malaria "endemic and "non-endemic" countries of the Caribbean region.

Design: Data on imported and autochthonous malaria for the 27-year period (1980-2006) were gathered from surveillance units in the 21 Caribbean Epidemiology Centre (CAREC) Member Countries (CMCs) via the CAREC epidemiology unit. Anopheles mosquito data were also gathered from various sources.

HIV seroprevalence among male prison inmates in the six countries of the Organization of Eastern Caribbean states in the Caribbean (OECS).

Objective: To determine HIV prevalence among male prison inmates in the six OECS countries in the Caribbean.

Subjects And Methods: Six unlinked, anonymous point prevalence surveys of a total of 1288 male inmates were conducted during a one-year period, August 2004 - August 2005. An oral fluid sample was collected and an interviewer-administered questionnaire and consent form was completed for each survey participant.

Mortality trends and potential years of life lost in the English and Dutch-speaking Caribbean, 1985-2000.

Objective: To describe mortality trends and potential years of life lost (PYLL) due to leading causes of death in 21 Caribbean countries during 1985, 1990, 1995 and 2000.

Methods: Mortality data for 1985, 1990, 1995 and 2000 were analyzed to identify regional mortality trends using crude, age-specific and age-adjusted death rates and potential years of life lost. The variables used were age, gender and underlying cause of death.

A knowledge, attitude and practices study of the issues of climate change/variability impacts and public health in Trinidad and Tobago, and St Kitts and Nevis.

Objective: To determine the level of understanding of the issues of climate change (CC)/variability (CV) and public health by populations of St Kitts and Nevis (SKN) and Trinidad and Tobago (T&T) and to find whether respondents would be willing to incorporate these values into strategies for dengue fever (DF) prevention.

Design And Methods: Using a cluster sampling system, representative samples of the communities of SKN (227) and T&T (650) were surveyed for responses to a questionnaire document with questions on the impact of climate variability on health, the physical environment, respondents' willingness to utilize climate issues to predict and adapt to climate variability for DF prevention. Data were analyzed by Epi Info.

Estimating the burden of acute gastroenteritis, foodborne disease, and pathogens commonly transmitted by food: an international review.

The burden of foodborne disease is not well defined in many countries or regions or on a global level. The World Health Organization (WHO), in conjunction with other national public health agencies, is coordinating a number of international activities designed to assist countries in the strengthening of disease surveillance and to determine the burden of acute gastroenteritis. These data can then be used to estimate the following situations: (1) the burden associated with acute gastroenteritis of foodborne origin, (2) the burden caused by specific pathogens commonly transmitted by food, and (3) the burden caused by specific foods or food groups.

Evidence for the interruption of transmission of lymphatic filariasis among schoolchildren in Trinidad and Tobago.

This study was carried out to provide some evidence for the interruption of transmission of lymphatic filariasis (LF) among schoolchildren in Trinidad and Tobago. A cross-sectional survey for LF antigenaemia was performed among 63 (13.2%) of the 479 primary schools located in eight administrative (and geographical) regions of Trinidad and Tobago.

Dengue viruses in the Caribbean. Twenty years of dengue virus isolates from the Caribbean Epidemiology Centre.

The first isolate of a dengue virus in the Americas was obtained in Trinidad and Tobago in 1953, and several dengue virus isolates were obtained in subsequent years. However, the systematic isolation and typing of dengue viruses in support of virus surveillance and outbreak investigations did not start until the creation of the Caribbean Epidemiology Centre (CAREC) in 1975. Since then, over two thousand viral isolates have been obtained and typed from many countries in the English and Dutch-speaking Caribbean.

Characterization of HIV type 1 clades in the Caribbean using pol gene sequences.

To date, 11 HIV-1 M group clades, A to K, have been characterized, displaying different distributions, prevalences, and biological properties. Approximately 90% of new HIV-1 infections occur in developing countries, including the Caribbean. However, information on HIV-1 subtypes from this region is limited.

The sexual behaviour of youth in Tobago. A report on the development of a health promotion project.

The development of a health promotion project to meet the sexual health needs of youth in Tobago is described. Quantitative and qualitative research was conducted by and with young people, followed by a process of feedback and consultation with adult and youth stakeholders. Key results of the sexual health research are presented.

Seroprevalence of toxocariasis in schoolchildren in Trinidad.

The seroprevalence of toxocariasis was investigated in 1997/98 in 1009 schoolchildren (aged 5-12 years) throughout Trinidad. Infection, as measured by titre, was found to be high compared to values obtained from children in other countries. Using an excretory-secretory antigen and performing an ELISA test, it was found that 62.

Outbreak of Norwalk virus in a Caribbean island resort: application of molecular diagnostics to ascertain the vehicle of infection.

In 1998, an outbreak of gastroenteritis affected at least 448 persons including 122 staff at a resort hotel in Bermuda. A survey among staff indicated that gastroenteritis was associated with eating or drinking at the hotel (OR = 60, 95% CI = 2.4-15.

American cutaneous leishmaniasis in Guyana, South America.

The 185 patients who presented at the dermatology clinic of Georgetown Public Hospital, Guyana, between 1992 and 1998, with skin ulcers indicative of American cutaneous leishmaniasis (ACL) were retrospectively reviewed. The laboratory-confirmed cases of ACL were identified and the corresponding data were analysed for risk factors such as age, gender, areas of residence and of possible exposure to the causative agent (Leishmania braziliensis guyanensis), ethnic origin, longevity of the ulcers, and treatment regimes prior to the definitive diagnosis. Eighty-one (43%) of the 185 subjects were confirmed to be infected with Le.

Emergence of Salmonella enteritidis phage type 4 in the Caribbean: case-control study in Trinidad and Tobago, West Indies.

A prospective case-control study involving 46 case patients and 92 age- and neighborhood-matched control subjects was conducted in Trinidad and Tobago (T&T) between March 1998 and May 1999 to determine the etiology, sources, and risk factors for Salmonella enteritidis (SE) infection. SE infection in T&T was found to be associated with the consumption of shell eggs, and in particular raw or undercooked eggs. SE isolates from 30 (88%) of 34 patients and from 9 implicated egg or egg-containing food samples were phage type 4.

Lymphatic filariasis in the Caribbean region: the opportunity for its elimination and certification.

In order to support the case for a certification of elimination of lymphatic filariasis (LF) in some Caribbean countries, we compared the prevalence of circulating Wuchereria bancrofti antigen in communities in Guyana, Suriname, and Trinidad. For the study, we assayed school children in six communities in Guyana, five communities in Suriname, and three communities in Trinidad for the prevalence of circulating W. bancrofti antigen, using a new immunochromatographic test for LF.

Molecular diagnosis of dengue by reverse transcriptase-polymerase chain reaction.

The techniques of reverse transcriptase-polymerase chain reaction (RT-PCR) and subsequent PCR were employed in the analysis of serum samples from a range of patients from the Caribbean Epidemiology Centre (CAREC) member countries. Results were compared with those from viral isolation and immunofluorescence. In the second part of the study, ten serum samples were stored for one week under four sets of conditions: -20 degrees C, 4 degrees C, 25 degrees C, and thawed (20 degrees C) and frozen (-20 degrees C) daily.

Spatial distribution of insecticide resistance in Caribbean populations of Aedes aegypti and its significance.

To monitor resistance to insecticides, bioassays were performed on 102 strains of the dengue vector Aedes aegypti (L.) from 16 countries ranging from Suriname in South America and through the chain of Caribbean Islands to the Bahamas, where the larvicide temephos and the adulticide malathion have been in use for 15 to 30 years. There was wide variation in the sensitivity to the larvicide in mosquito populations within and among countries.

A comparison of surveillance systems for the dengue vector Aedes aegypti in Port of Spain, Trinidad.

When the currently used larval surveillance system (visual inspection) for the dengue vector Aedes aegypti was compared with the surveillance for the presence of eggs by ovitrapping in Port of Spain, Trinidad, it was found that the latter (39.1%) was significantly more sensitive than the visual inspection system (10.1%).