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D Ashley

Publications and source records attributed to D Ashley.

53 records · Page 3Linked to original sources
PubMed1992

Seroprevalence of cytomegalovirus infection in a selected population in Jamaica.

The prevalence of antibodies to cytomegalovirus (CMV) was determined by the indirect enzyme-linked immunosorbent assay in a selected population of 2655 in Jamaica. The overall prevalence rate was 95%, increasing from 56.2% in children 1-4 years of age to 90% in the 15-19 years age group and by 25 years of age 97% of subjects had been exposed to CMV. The prevalence rate in children (58.4%) was significantly lower than that in blood donors (84%), sexually transmitted disease clinic attendants (95%) and antenatal women (97%) (p < 0.001). The prevalence rate in STD clinic attendants and pregnant women was also significantly higher than in blood donors (p < 0.05). The prevalence of CMV infection in the selected population, the clinical implications, routes of transmission and socioenvironmental factors are discussed.

Adolescent↗
PubMed1991

Seroprevalence of toxoplasma gondii, rubella virus, cytomegalovirus herpes simplex virus (TORCH) and syphilis in Jamaican pregnant women.

Seroprevalence of toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus infections (TORCH) and syphilis were determined in order to assess the immune/susceptibility status in Jamaican pregnant women in 1986. The positive rates were 57% (T. gondii), 69% (rubella), 97% (CMV), 91% (HSV), and 4.9% (syphilis), respectively. The rate of reactivity for syphilis ranged from 2.1% in Kingston and St. Andrew to 7.3% in rural parishes. The seropositivity rate for rubella was over 50% in all parishes, the highest being 85% in St. Thomas. The seroprevalence of T. gondii was lowest in Trelawny (37.5%). There were no significant differences in seropositivity of CMV and HSV infections between women from various parishes. The importance of seroprevalence of the TORCH group of agents and syphilis on perinatal morbidity and mortality in Jamaican women is discussed, and appropriate recommendations for prevention and control of congenital infections in Jamaica are suggested.

Adolescent↗
PubMed1990

Incidence of anencephaly in Jamaica.

Information was collected on 2,197 stillbirths and neonatal deaths on the island of Jamaica during the 12 month period September 1986 to August 1987 as part of the population based nationwide Jamaican Perinatal Morbidity and Mortality Survey. There were 14 cases of anencephalus giving an incidence of 0.26 per 1,000 total births. One of these cases was associated with the amniotic band syndrome; excluding this, the incidence would be even lower (0.24 per 1,000). There was no apparent association with social class, maternal age, or parity. The rate found in Jamaica is considerably lower than found in any other national population study.

Anencephaly↗
PubMed1990

Outbreak of Bacillus Calmette-Guérin-associated lymphadenitis and abscesses in Jamaican children.

An outbreak of axillary lymphadenitis and abscesses after Bacillus Calmette-Guérin (BCG) vaccination (Pasteur Paris, Batch N5122) occurred in 139 Jamaican children between January and July, 1988. The overall rate of this complication was 0.95%. The attack rate was 1.92% among the 0- to 6-week age group and 0.6% in the 7- to 52-week age group. Of 139 patients there were 77 males and 62 females and the mean age at presentation was 4 months. The mean size of the BCG scar, duration of healing and Mantoux reaction size differed significantly in patients compared with those of control infants (P less than 0.01). Mycobacterium bovis was isolated from 11 patients. Immunologically index patients and controls differed significantly only with respect to T lymphocyte subpopulation percentages and concanavalin A stimulation indices. Evaluation of the BCG vaccine did not reveal either increased potency or microbial contamination. We conclude that increased susceptibility to the Pasteur strain of BCG might have contributed to the increased incidence of complications in these Jamaican children and hence caution should be exercised in switching one vaccine for another as is often done in the developing countries.

Abscess↗
PubMed1990

A cluster of central nervous system defects in Jamaica.

1. Information was collected on all stillbirths and neonatal deaths on the island of Jamaica during the 12-month period between September 1986 and August 1987. 2. There were 33 such deaths with anencephaly, spina bifida and hydrocephalus out of an estimated 54,400 total births. 3. There was a statistically significant cluster in respect to time of conception in one small rural area of the island. 4. There were no obvious differences between parents involved in the cluster and the rest of the population, but particular Jamaican fruit and vegetables have been shown to be teratogenic in animals. It is postulated that the cluster may have been associated with an unripe crop.

Anencephaly↗
PubMed1990

Fatal malformations in Jamaica.

Babies with major malformations were identified during the Jamaica Perinatal Morbidity and Mortality Survey. They were found in 96 (8.6%) of 1112 perinatal and neonatal deaths coming to necropsy and in 28 (2.6%) of 1085 no so examined. The central nervous system was most commonly affected, followed by the renal, gastrointestinal, and cardiovascular systems in decreasing order of frequency. Many infants had abnormalities in more than one system and 10 malformation syndromes/sequences were identified. Although at the present time, major malformations make only a small contribution to perinatal and neonatal mortality in Jamaica, their importance will increase when deaths from other causes, such as birth asphyxia, decline. The type of malformation currently fatal in a particular population is relevant when planning diagnostic and surgical services for neonates and infants. It is also important to any discussions about provision of prenatal diagnostic services.

Abnormalities, Multiple↗
PubMed1990

An evaluation of the domiciliary midwifery services in Jamaica.

A random sample of 78 district midwives, representing 24% of all district midwives in the government health service, were interviewed to assess their knowledge and practice of domiciliary midwifery as part of the Jamaican Perinatal Morbidity and Mortality Survey in 1986. A standard questionnaire based on the WHO guidelines on appropriate technology for birth was used. Records of their two preceding home deliveries were examined and their delivery bags inspected for availability of basic supplies and equipment. A mean of 21.5 home deliveries was attended by each rural midwife in 1986 compared with 3.8 in the urban areas. Routine laboratory tests were not done on many mothers, and there were long delays in getting results. Midwives' knowledge was average overall with one-third of them showing poor knowledge of high-risk factors in infants and newborn care. Most midwives routinely shave and give enemas to mothers. Unavailability of equipment and supplies, including vitamin K and eye drops, is common; 24% of midwives made no prenatal home visit in the previous month, and 80% fell short of the set norm of 5 postnatal home visits; 84% of midwives put the baby to the mother's breast within one hour of delivery. Essential supplies and lab investigations need to be provided and measures taken to improve domiciliary midwifery through a programme of continuing education and better supervision of midwives. A strategy to promote home deliveries under specified conditions needs to be considered.

Delivery, Obstetric↗
PubMed1989

An outbreak of acute flaccid paralysis in Jamaica associated with echovirus type 22.

An outbreak of acute flaccid paralysis in Jamaica in 1986 associated with echovirus type 22 is described. Six patients aged 1 to 27 years developed acute onset of severe flaccid paralysis, with inability to walk. Three cases had facial weakness, four required intensive care with assisted ventilation, and two died. Echovirus type 22 was isolated from the stool of two patients who showed a significant increase in antibody titre. Echovirus type 22 was also isolated from the stool of another patient who had aseptic meningitis without any neurological deficit. There was no evidence of poliovirus infection in any of these patients, most of whom were fully immunized. Of the four surviving cases with flaccid paralysis, three had residual weakness in their lower limbs and walked with an abnormal gait 3 years after the acute paralytic attack. This is the first report in the literature of acute flaccid paralysis associated with type 22 echovirus.

Acute Disease↗
PubMed1989

Maternal mortality in Jamaica. Socioeconomic factors.

Socioeconomic factors relating to all maternal deaths identified during the 12 months of the Jamaican Perinatal Morbidity and Mortality Survey were compared with a control population of over 10,000 women. The maternal mortality rate was 11.5 per 10,000 livebirths. Initial analyses revealed (a) that the risk of maternal death declined with increasing maternal education level, (b) that mothers who lived in households with direct pumped water and/or flush toilets enjoyed a reduced risk; (c) mothers who were themselves the major wage earner and (d) those living in households where the major wage earner and source of income was an agricultural worker or farmer were at increased risk of maternal death. A previous analysis showed that the mother's age, her parity and variables indicating access to medical care were important. Logistic regression showed that only maternal age and toilet facilities were independently associated with maternal mortality.

Female↗
PubMed1989

Polio immunization and serological status in children and adolescents in Jamaica (1985).

A survey of immunization status and serological immunity to polio was carried out in 5 parishes in Jamaica in 1985. A sample of 2,506 children and adolescents aged 1-19 years was chosen by selecting clusters of children in enumeration districts (EDs) in each parish from the 1980 Census. Immunization status was verified by examining immunization records. Serological assay for antibodies to Polio Types 1, 2, and 3 was done. A positive neutralization test at dilution of 1:8 was taken as immunity to the polio virus. Of the 1,819 children whose immunization status was confirmed, coverage with 3 or more doses of oral polio vaccine was highest in the 1-4 year age group with 79.7% and lowest in the 15-19-year age group with 37.4%. Of the 2,506 children 81.4%, 94.7% and 72.3% were seropositive for Polio Types 1, 2 and 3 respectively. There was a significant difference in the prevalence of seropositives between individuals with and those without a history of vaccinations. No urban/rural or sex differences were noted. The study indicated a higher level of immunization status than previous surveys and a high level of serological immunity to polio.

Adolescent↗
PubMed1988

The perinatal morbidity and mortality survey of Jamaica 1986-1987.

The Jamaican Perinatal Morbidity and Mortality Survey was conducted between September 1986 and August 1987. A total of 10,310 consecutive births were identified and mothers interviewed in the first 2 months (main cohort study), 1405 neonatal admissions were evaluated over a 6-month period (morbidity study), and 1855 perinatal deaths and 73 late neonatal deaths identified over 12 months (mortality study)-55% of the deaths were given a postmortem examination. The perinatal mortality rate for the cohort study was 38.1 per 1000 births. This was 36.6 percent higher than the 1982 estimate of 27.9/1000 based on deliveries at the Victoria Jubilee Hospital, a specialist maternity institution which has at least 13,000 deliveries per annum.

Cohort Studies↗
PubMed1983

NMR analyses of the cold cataract. II. Studies on protein solutions.

Water proton relaxation studies were performed on total soluble protein (TSP) solutions and individual alpha-, beta-, and gamma-crystallin fractions derived from weanling rat lenses, 16 month, and 60- to 70-year-old normal human lenses. The effects of perturbants (temperature and acrylamide) were monitored in order to delineate further the mechanisms involved in the generation of the cold cataract phenomenon (in young lenses) and the role of acrylamide and age in preventing this phenomenon. The data demonstrate a relationship between the relative concentration of the alpha-, beta-, and gamma-crystallin fractions within the lens and the cold cataract phenomenon. It is possible that cross-linking between acrylamide and the gamma-crystallins within the lens alters one or more of the intracytoplasmic protein-water phases. The gamma-crystallin solution showed greater than 35% increase in T2 when 1% acrylamide was added; the young TSP solution T2 increased by approximately 20%. However none of the T2 values for the alpha, beta and old TSP solutions changed significantly when acrylamide was added. The unique response of gamma-crystallin in these experiments suggests a significant role for this protein fraction in the phenomenon associated with cold cataractogenesis. Our data indicate that most of the UVA radiation-induced acrylamide binding occurred with the gamma-crystallins within the lens. We have also noted that only the gamma-crystallin and the young lens TSP solutions become opaque at 4 C while the alpha, beta and "old" TSP solutions remain clear at this temperature. It is suggested that acrylamide exerts its role by cross-linking to one or more of the gamma-crystallins, thereby altering the normal protein water relationship and preventing cold opacification.

Acrylamide↗
PubMedDate not supplied

A survey of personal exposures to benzene in Mexico City.

Benzene is a widely distributed environmental contaminant that causes leukemia. It is an important component in gasoline, it is used frequently as a solvent or chemical feedstock in industry, and it is emitted as a product of incomplete combustion. In Mexico City, investigators suspect that benzene exposure might be elevated and may pose a risk to the population; however, no published data are available to confirm or disconfirm this suspicion. We, therefore, conducted a survey in 3 occupational groups in Mexico City. Forty-five volunteers who used portable passive monitors measured their personal exposure to benzene during a workshift. None of the participants smoked during the monitoring period. Benzene exposure was significantly higher among service-station attendants (mean = 359.5 microg/m3 [standard deviation = 170.4 microg/m3]) than among the street vendors (83.7 microg/m3 and 45.0 microg/m3, respectively) and office workers (45.2 microg/m3 and 13.3 microg/m3, respectively). However, the benzene exposure levels observed among office workers were substantially higher than levels reported elsewhere for general populations. Our results highlight the need for more complete studies by investigators who should assess the potential benefits of setting environmental standards for benzene in Mexico.

Adolescent↗
PubMedDate not supplied

A child-to-child programme in rural Jamaica.

A child-to-child programme was carried out in six rural schools in Jamaica. School children in grades 4 and 5 were taught concepts of nutrition, environmental and personal hygiene, and child development. The children were encouraged to take messages home to their parents and improve the care of their younger siblings. Four hundred and twenty-three children and 90 mothers and guardians from four of the project schools were evaluated and compared with 199 children and 47 parents from two control schools. The project children showed higher scores on a test of knowledge in the topics at the end of the year. They also improved in some practices at home. The mothers improved in knowledge in some areas but not in their practices. We consider the results sufficiently encouraging to justify incorporating the programme into the country's education curriculum for primary schools.

Adult↗
PubMedDate not supplied

Perinatal mortality in Jamaica 1986-1987.

A large population-based study of all stillbirths and neonatal deaths occurring on the island of Jamaica during a 12 month period is described. During this time, 2069 perinatal deaths were identified in an estimated total of 54,400 infants born giving a perinatal death rate of 38.0 per 1000 births. The death rate was 5 times higher among twins than singletons. An attempt was made to obtain detailed postmortem examination of as many cases as possible. In the event, 51% of the infants who died perinatally had such postmortem examination. Postmortem rate was affected by sex, multiplicity of the infant, time of death, month of death and area of delivery. Deaths were classified using the Wigglesworth scheme. The distribution of categories was similar in the months when the postmortem rate was 70% to the rest of the time period when the post-mortem rate was only 40%. The Wigglesworth classification of deaths identified those associated with intrapartum asphyxia as the most important group, accounting for over 40% of deaths overall and 59% of deaths in infants of more than 2500 g birthweight. Antepartum fetal deaths were the second largest group, comprising 20% of deaths. Sixty percent of the infants in this group weighed less than 2500 g at birth. Major malformations were responsible for few perinatal deaths in Jamaica. This simple classification is important as it focuses attention on details of labour and delivery that may require change and is useful in planning future delivery of obstetric and neonatal care.

Asphyxia Neonatorum↗
PubMedDate not supplied

Histopathology of sinonasal and lung cancers in nickel refinery workers.

Histopathological diagnoses were compiled for 100 sinonasal cancers and 259 lung cancers in nickel refinery workers, including cases from Wales, Canada, and Norway. The sinonasal cancers comprised squamous cell carcinomas (48 percent), anaplastic and undifferentiated carcinomas (39 percent), adenocarcinomas (6 percent), transitional cell carcinomas (3 percent), and other malignant tumors (4 percent). The lung tumors comprised squamous cell carcinomas (67 percent), anaplastic, small cell, and oat cell carcinomas (15 percent), adenocarcinomas (8 percent), large cell carcinomas (3 percent), other malignant tumors (1 percent), and cancers not otherwise specified (6 percent). Possible selection bias in these data cannot be excluded, since the histological diagnoses represent 63 percent, 68 percent, and 100 percent of cases of sinonasal cancer and 24 percent, 47 percent, and 86 percent of cases of lung cancer in the Welsh, Canadian, and Norwegian workers. This study suggests that (a) the sinonasal cancers in nickel refinery workers conformed to the usual distribution of histological types observed in the general population (in contrast to the predilection for adenocarcinomas in wood workers), and (b) the lung cancers in nickel-refinery workers showed preponderance of squamous cell carcinomas and deficit of adenocarcinomas, compared to prevalent proportions of these neoplasms, possibly reflecting the paucity of women in the cohorts and temporal trends during the six decades in which the tumors were diagnosed.

Adenocarcinoma↗