Correction: Implementation of Genomic Surveillance of SARS-CoV-2 in the Caribbean: Lessons learned for sustainability in resource-limited settings

[This corrects the article DOI: 10.1371/journal.pgph.0001455.].

Implementation of genomic surveillance of SARS-CoV-2 in the Caribbean: Lessons learned for sustainability in resource-limited settings

The COVID-19 pandemic highlighted the importance of global genomic surveillance to monitor the emergence and spread of SARS-CoV-2 variants and inform public health decision-making. Until December 2020 there was minimal capacity for viral genomic surveillance in most Caribbean countries. To overcome this constraint, the COVID-19: Infectious disease Molecular epidemiology for PAthogen Control & Tracking (COVID-19 IMPACT) project was implemented to establish rapid SARS-CoV-2 whole genome nanopore sequencing at The University of the West Indies (UWI) in Trinidad and Tobago (T&T) and provide needed SARS-CoV-2 sequencing services for T&T and other Caribbean Public Health Agency Member States (CMS). Using the Oxford Nanopore Technologies MinION sequencing platform and ARTIC network sequencing protocols and bioinformatics pipeline, a total of 3610 SARS-CoV-2 positive RNA samples, received from 17 CMS, were sequenced in-situ during the period December 5th 2020 to December 31st 2021. Ninety-one Pango lineages, including those of five variants of concern (VOC), were identified. Genetic analysis revealed at least 260 introductions to the CMS from other global regions. For each of the 17 CMS, the percentage of reported COVID-19 cases sequenced by the COVID-19 IMPACT laboratory ranged from 0·02% to 3·80% (median = 1·12%). Sequences submitted to GISAID by our study represented 73·3% of all SARS-CoV-2 sequences from the 17 CMS available on the database up to December 31st 2021. Increased staffing, process and infrastructural improvement over the course of the project helped reduce turnaround times for reporting to originating institutions and sequence uploads to GISAID. Insights from our genomic surveillance network in the Caribbean region directly influenced non-pharmaceutical countermeasures in the CMS countries. However, limited availability of associated surveillance and clinical data made it challenging to contextualise the observed SARS-CoV-2 diversity and evolution, highlighting the need for development of infrastructure for collecting and integrating genomic sequencing data and sample-associated metadata.

Antibiotic Resistance in Trinidad: A population-based survey of adults

Objectives: Antibiotic resistance (ABR) is a growing public health issue globally. This study aimed to ascertain the public’s knowledge of antibiotic resistance and to determine any associated demographic factors. Method: A cross-sectional survey was undertaken in Trinidad using a modified version of a World Health Organization questionnaire. Five hundred and fifty participants aged 16 years and older were interviewed. Data were analysed using SPSS Version-22. Results: The response rate was 91% (502/550). Most responders (53%) reported having taken antibiotics during the 6-month period prior to the survey. Almost 60% of responders believed that sore throat and colds/flu can be treated with antibiotics. Sixty-seven percent of responders believed that they had no individual role in combating the issue. Responders with a primary level education or older respondents were more likely than responders with a higher level of education or younger to agree that antibiotic resistance only affects those who use antibiotics frequently (p= 0.002 and p=0.017 respectively). Income level was also significantly associated with knowledge levels, the higher the income the more knowledgeable the responder. Conclusion: Our study found that public knowledge of antibiotic resistance is low. Age, income and educational levels were significantly associated with certain knowledge parameters. Much work needs to be done to change the attitudes of responders who believe they have no role to play in the fight against this national and global threat. These findings may be useful to health education professionals and government antimicrobial resistance programmes.

Zika virus disease-knowledge, attitudes and practices among pregnant women-implications for public health practice

OBJECTIVE

Mosquito-borne diseases continue to pose a threat to Latin America and the Caribbean. Zika virus disease entered the Caribbean in 2013 with increased reporting of cases across the region in 2016, affecting more than 50 countries. This study aimed to ascertain the knowledge of, attitudes and practices towards Zika virus disease among antenatal clinic attenders in Trinidad and Tobago during the 2016 outbreak.

STUDY DESIGN

A cross-sectional questionnaire survey was undertaken.

METHODS

A knowledge attitudes and practices survey was conducted among antenatal clinic attenders at publicly funded primary care health centres. All counties of Trinidad (except St Patrick, Caroni and Victoria) and Tobago were included in the study. Within each county, three health centres were selected at random. At the antenatal clinic of each selected health centre, antenatal clients were selected by randomly selecting their patient file from that day's antenatal clinic patient files. Data collection occurred from September to November 2016. The knowledge, attitudes and practice survey was administered by an interviewer-administered questionnaire. The World Health Organization Knowledge, Attitudes and Practice surveys Zika virus disease and potential complications Resource pack was adapted for use as the data collection tool. All data collected were analysed using SPSS software, version 23. Tests with P-values less than 0.05 were deemed significant.

RESULTS

Seventy-four percent (74%) of responders did not think there was a link between sexual transmission and Zika. About 19% stated that abstaining could prevent Zika but only 6.6% actually practiced this. Seventy-six percent knew the risk of microcephaly, and this knowledge of the risk of microcephaly was found to be significantly associated with the number of weeks' gestation. Less than 40% knew the risk of Guillain-Barre syndrome. Doctors at health centres followed by private doctors were the top two trusted information sources for responders. Responders thought that the government could spray insecticide, clean drains, educate community members and clean overgrown vacant lots of land.

CONCLUSION

The government and healthcare workers need to reach specific target groups with accurate messages to minimize the associated morbidity and thereby safeguarding national and global health security.

Characteristics of a rural area community mental health programme County Caroni

The paper describes characteristics and trends in a rural area Community Mental Health programme. Research done by the mental health team supports some of the previously held notions on alcoholism and dispels some myths about parasuicide and suicide. Education at all levels continues to be an important preventative measure in the fight against drug abuse. The effort to set up an Alcohol and Referral Center is partly thwarted by poor community resources. The mental health team has had to enlist the support of service organizations in their educational programmes. More work needs to be done in the area of psychogeriatrics, rehabilitation and family life. The need for closer links between governmental agencies and the community is emphasized.