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At least 19 recordsLinked to original sources
PubMedDate not supplied

Diagnosis, treatment, and prevention of selected common HIV-related opportunistic infections in the Caribbean region.

The Caribbean region, like other resource-limited areas, lacks many of the diagnostic and treatment modalities taken for granted in richer areas of the world. The Caribbean Guidelines for the Treatment of Opportunistic Infections in Adults and Adolescents Infected With the Human Immunodeficiency Virus provides guidelines for the region for preventing and treating more than 20 opportunistic diseases reflecting the variable availability of diagnostic and treatment resources. Elements of diagnosis and prevention of tuberculosis, Pneumocystis jiroveci pneumonia, and other common opportunistic conditions in this resource-limited setting were discussed by Jonathan E. Kaplan, MD, at the first CHART Caribbean Conference on the Clinical Management of HIV/AIDS in Montego Bay, Jamaica, in June 2004.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Comparative analysis of Andean and Caribbean region health systems].

OBJECTIVE: Carrying out a comparative analysis of Andean and Caribbean health systems contributing towards the general panorama of Andean and Caribbean region health care system experience. METHODS: This study was aimed at carrying out a comparative analysis of health systems in Bolivia, Colombia, Ecuador, Peru, Venezuela, the Dominican Republic and Cuba between 1990 and 2004. Documentary information from secondary sources was used. Reform and changes during the aforementioned period were compared, as well as the systems' current configurations. Described typologies were used for studying the health systems. RESULTS: Different organisational designs were found for the systems: a national health system (NHS), segmented systems and systems based on mandatory insurance. The trend of reforms introduced in the 1990s and current proposals in almost all systems are directed towards adopting mandatory insurance via a basic packet of services and strengthening competition in providing services through a public and private mix. CONCLUSIONS: The organisation and structure of most systems studied have introduced and continue to introduce changes in line with international guidelines. The generality of these structures means that efforts must still be made to adopt designs strengthening them as instruments improving populations' quality of life. Comparative analysis is a tool leading to studying health systems and producing information which can nourish debate regarding current sector reform. This work took shape during the first approach to a comparative study of Andean region and Caribbean health systems.

Bolivia↗
PubMed2001

[Exogoninae (Polychaeta: Syllidae) from the Mexican Caribbean region with a key for the Gran Caribbean species].

This paper identifies the Exogoninae (Syllidae) from the Mexican Caribbean coasts and includes a key to identify all the species recorded from the Grand Caribbean Sea. The classification of the family and the composition of Exogoninae are briefly examined; the correct names of the subfamilies are Syllinae Grube, 1850, Eusyllinae Malaquin, 1893, Autolytinae Malaquin, 1893 and Exogoninae Langerhans, 1879. Exogoninae includes Anguillosyllis Day, 1963, Brania de Quatrefages, 1866, Braniella Hartman, 1963, Exogone Ørsted, 1845, Exogonella Hartman, 1961, Exogonoides Day, 1963, Parapionosyllis Fauvel, 1923, Psammosyllis Westheide, 1990, Spermosyllis Claparède, 1864, and Sphaerosyllis Claparède, 1863. Pseudexogone Augener, 1922, formerly included in the group, is not a syllid; it belongs to Pilargidae. We collected 814 specimens belonging to 3 genera, 3 subgenera and 13 species as Brania (4), Exogone (4) and Sphaerosyllis (5); five new species are described: Brania russelli n. sp, Brania uebelackerae n. sp, Brania westheidei n. sp., Exogone (Exogone) bondi n. sp. and Exogone (Parexogone) sanmartini n. sp. For each species, selected references, diagnostic features, observations on morphological variability, distribution and illustrations are provided; new species also have an english diagnosis. Most abundant species were B. uebelackerae n. sp. (295), S. taylori Perkins (169), E. (E.) dispar Webster (76), and E. (E.) bondi n sp. (72).

Animals↗
PubMedDate not supplied

[Arterial hypertension in the French Caribbean regions: gender related differences].

BACKGROUND: Arterial hypertension is a frequent disease, responsible for a significant morbidity, in the French Caribbean regions. Today, epidemiological studies on this topic remain few. OBJECTIVES: To analyse the prevalence, awareness, treatment and control of arterial hypertension in the French Caribbean regions. METHODS: Analysis of the INHAPAG cohort (Incidence of Arterial Hypertension in the Working population Antillo-Guyanaise) carried out in 2001, and including 6113 active subjects recruited in Guadeloupe, Martinique and Guyana. The procedure of diagnosis of arterial hypertension comprises two visits, with a series of three measurements of the blood pressure at each visit. RESULTS: Prevalence of hypertension is estimated to be 18.9% among women and 19.5% among men. The rates of treatment are higher among women (74.8 vs 34.4%) than among men, resulting in a much better control rate (61.3% vs 38.6% among men). An analysis of factors associated with the presence of arterial hypertension shows a noxious role of low education level among women. CONCLUSION: Our study finds marked differences between women and men in the treatment and control of arterial hypertension and underline the need for improving blood pressure management of the latter.

Adult↗
PubMed2005

Prevalence and therapeutic control of hypertension in French Caribbean regions.

OBJECTIVE: To describe characteristics of hypertension in French Caribbean regions. DESIGN: A cross-sectional worksite study. SETTING AND PARTICIPANTS: A random sample of 6136 workers referred for annual check-up from Martinique, French Guyana and Guadeloupe. An average of three consecutive measurements was taken as the blood pressure (BP) level. An additional visit was required in subjects not taking antihypertensive medications with an average BP over 140/90 mmHg. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Hypertension prevalence, awareness, treatment and control. RESULTS: The age-specific prevalence of hypertension, based on two visits, increased from 3.2% in men below 30 years to 46.9% in those older than 50 years. The corresponding values found in women were 1.8 and 42.6%. The overall prevalence was 19.5% in men and 18.9% in women. The rate of awareness remained low while age increased. The use of antihypertensive medications slowly increased with age, but overall the rate remained lower in men compared with women. Up to 71% of hypertensive women received antihypertensive medications. Compared with previous studies, a high proportion of adequately treated patients was found among women (44.9%). Only 30.4% of hypertensive men were treated, and as a result the control rate was lower (13.3%). CONCLUSION: Major sex-related differences are found in the control of high BP, with an unexpected high rate observed among Caribbean women. Better awareness and higher treatment rates play an important role in explaining such results. This may be important, especially in developing countries, where poor control of hypertension is a major cause of cardiovascular diseases.

Adult↗
PubMed2000

[Serpulids (Polychaeta: Serpulidae) from the Northwestern Caribbean with keys to the Grand Caribbean region: Salmacina, Ficopomatus, Pomatoceros, Pomatostegus, Protula, Pseudovermilia, Spirobranchus and Vermiliopsis].

From the revision of more than 1,250 serpulids, 15 species from the Grand Caribbean Region were identified and characterized. Thirteen species were collected along the shores of the Yucatan Peninsula and eight were found in other localities in the Gulf of Mexico, seven others are from Cuba and comments on type specimens of two species are also included. Three morphometric analyses were made to evaluate some characters. The first on Pomatostegus stellatus (Abildgaard), and related species and subspecies: P. brachysoma Schmarda, P. macrosoma Schmarda, P. s. fruticosa Mörch, P. s. pentapoma Mörch and P. s. tetrapoma Mörch, indicated that they are conspecific. Another one on Spirobranchus de Blainville species: S. dendropoma Mörch, S. giganteus (Pallas), S. polycerus (Schmarda) and S. polycerus augeneri ten Hove; indicated that S. giganteus differs from the other three taxa. The third analysis was made on Vermiliopsis annulata (Schmarda) sensu lato; it allowed the recognition of three different forms. Several incomplete specimens might belong to an undescribed genus. A key for identification of all the species recorded in the Grand Caribbean Region is also included.

Animals↗
PubMed1994

Breastfeeding in Africa and the Latin American and Caribbean region: the potential role of urbanization.

This paper compares breastfeeding patterns in Africa (AFR) and the Latin American and Caribbean region (LATCAR) based on demographic and health surveys conducted in 23 countries between 1986 and 1990. Results indicate that the proportion of infants who are never breastfed is twice as high in LATCAR than in AFR. The average median breastfeeding duration is 1.64 times higher in AFR (19.3 months) than in LATCAR (11.8 months). The longer breastfeeding duration found in AFR was due to a better lactation performance in both rural and urban areas. In both LATCAR and AFR 71 per cent of the 0-4-month infants were not breastfed exclusively during the first 4 months of life and breastfeeding duration was longer in rural than in urban areas. However, the degree of urbanization had a stronger negative effect on breastfeeding in LATCAR than in AFR. It is concluded that: (a) while LATCAR is in great need of breastfeeding promotion programmes, breastfeeding in AFR should be protected as it becomes more urbanized; (b) the promotion of exclusive breastfeeding remains a priority in both regions; and (c) the magnitude of the inverse association between urbanization and breastfeeding is likely to vary among regions with different socio-economic and cultural backgrounds.

Africa↗
PubMed2003

A new scale for measuring dynamic patterns of sexual partnership and concurrency: application to three French Caribbean regions.

BACKGROUND: Quantitative assessment of multiple sexual partnerships and concurrency may help to elucidate the large observed differences in the prevalence of AIDS among population subgroups and countries. GOAL: The goals of the study were (1) to develop a global scale of dynamic patterns of sexual partnerships, including concurrency with new partners and stable concurrency; (2) to apply this scale to three Caribbean regions characterized by different cumulative rates of incidence of AIDS; and (3) to compare the concurrency rates given by this scale with those of other published methods. STUDY DESIGN: We defined an individual scale based on 6 patterns of sexual behavior over the previous 12-month period, by using a simple algorithm to combine 7 variables. We then applied this scale to cross-sectional data collected from men living in three French Caribbean regions: Guadeloupe, Martinique, and Guyana. RESULTS: We found that all adults of all age classes in the three regions studied frequently had multiple (>2) and concurrent partnerships. The patterns of sexual behavior in the three regions were consistent with the respective cumulative incidence rates of AIDS, and a lower rate of concurrency with new partners and a higher rate of stable partnership concurrency were noted in Martinique, especially among 45- to 59-year-olds. The rate of concurrent partnerships was found to depend on the criteria used to define them and on the observation period (a given moment, or a defined period). Our definition gave a higher rate of concurrency than previously published indicators. CONCLUSION: The proposed scale can be applied to easy-to-collect data in cross-sectional population surveys and takes into account a wide variety of behaviors, including different types of concurrency.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Sea surface temperature 1871-2099 in 38 cells in the Caribbean region.

Sea surface temperature (SST) data with monthly resolution are provided for 38 cells in the Caribbean Sea and Bahamas region, plus Bermuda. These series are derived from the HadISST1 data set for historical time (1871-1999) and from the HadCM3 coupled climate model for predicted SST (1950-2099). Statistical scaling of the forecast data sets are performed to produce confluent SST series according to a now established method. These SST series are available for download. High water temperatures in 1998 killed enormous amounts of corals in tropical seas, though in the Caribbean region the effects at that time appeared less marked than in the Indo-Pacific. However, SSTs are rising in accordance with world-wide trends and it has been predicted that temperature will become increasingly important in this region in the near future. Patterns of SST rise within the Caribbean region are shown, and the importance of sub-regional patterns within this biologically highly interconnected area are noted.

Caribbean Region↗
PubMed2005

Global child survival initiatives and their relevance to the Latin American and Caribbean Region.

We review two series of papers published by The Lancet: the Child Survival Series (2003) and the Neonatal Survival Series (2005). Both series drew attention to the nearly 11 million annual deaths of children under the age of five years, and to the fact that almost 4 million of these deaths occur in the first month of life. We show that two thirds of these deaths could be prevented through universal coverage with existing, low-cost interventions that are failing to reach most children in the world. The series also highlighted the importance of reducing inequities both between and within countries. The relevance of these series to Latin America and the Caribbean is examined. Although substantial progress has been made in reducing mortality and improving coverage, two major challenges remain: how to improve the quality of health interventions, and how to reach the most disadvantaged children in the Latin American and Caribbean Region.

Caribbean Region↗
PubMed2002

Transforming family planning services in the Latin American and Caribbean region.

The 1994 International Conference on Population and Development held in Cairo has generated widespread commitment to changing family planning programs from categorical and medically focused service organizations to reproductive health initiatives that embrace a wide range of social and human services. This article uses qualitative data analysis to review the experience of nine family planning association projects in the Latin American and Caribbean region that have made a successful organizational transition from services focused on family planning to a gender-based and sexual health approach. A conceptual framework is proposed, including factors external to the organization. Factors that can promote a pilot intervention's becoming fully institutionalized include: the need for commitment from high-level staff and members of the board of directors, the creation of partnerships with other agencies, and an emphasis on monitoring and evaluation. Lessons from this experience and their potential relevance to other settings are reviewed and discussed.

Caribbean Region↗
PubMed2004

Phylogenetic reconstruction of Mycobacterium tuberculosis within four settings of the Caribbean region: tree comparative analyse and first appraisal on their phylogeography.

In order to compare phylogenetic methods and to reconstruct the evolutionary history of the tubercle bacilli, a set of macro-array-based genotyping data of Mycobacterium tuberculosis clinical isolates (called spoligotyping for spacer oligonucleotide typing, which assays the variability of the Direct Repeat -DR- locus), was analyzed in four settings of the Caribbean region (Guadeloupe, Martinique, Cuba and Haiti). A set of 47 alleles, split into 26 shared and 21 unique alleles) representative of 321 individual M. tuberculosis clinical isolates from patients residing in the above regions was studied. The following methods (and software in brackets) were investigated: numerical taxonomy distance methods (TAXOTRON), maximum parsimony procedure (PAUP), median-joining networks (NETWORK), and nested clade analysis (GEODIS). Results using these methods were analyzed, compared and discussed. The latter method (GEODIS) was investigated in detail by introducing geographical data together with genetic variability results to detect a link between population structure and population history, and to test the null hypothesis of no association between geography and genotypes. Irrespective of the methods used, our findings demonstrate that a core structure of four families (or clades) of M. tuberculosis strains is highly prevalent within the islands studied, indirectly reflecting passed colonization history of these different settings. Specificity of M. tuberculosis genotypes in each of the islands is discussed in the light of their respective colonial and contemporary histories.

Bacterial Typing Techniques↗
PubMed1997

[Participation in the IEC Workshop on Adolescent Sexual Health--a challenge to protect reproductive health/right in Latin America and Caribbean Region].

In order to explore the possibility of new global activity in nursing/midwifery to be performed by the WHO Collaborating Center for Nursing Development in Primary Health Care at St. Luke's College of Nursing, the center sent two faculty members to attend the IEC Workshop on Adolescent Sexual Health held in November 1996 in Mexico. The two representatives took part as resource persons and reported to the workshop on the activities of nurses and midwives for adolescent sexual health in Japan. During the session, they obtained information on the actual situation of adolescent sexual health in Latin America and Caribbean region and the novel strategies which were carried out in cooperation between governmental and non governmental organizations. The workshop also provided a good opportunity for international communication and information exchange with health workers in the region about adolescent sexual health. By participating in the workshop, we obtained first-hand information on various aspects of cooperation in international health.

Adolescent↗
PubMed1991

Promotional strategies in occupational health. Can it be extrapolated to general preventive medicine in the Caribbean Region?

This article highlights promotional strategies that are currently in use in occupational health which have yielded positive results in terms of cost-effectiveness and the prevention of occupational disease. Suggestions are offered on the possible extrapolation of these strategies to disease prevention programmes in medical practice in the Caribbean Region.

Health Promotion↗