Retrospective study of Oestrus ovis larvae infestation in small ruminants in Grenada, West Indies

Oestrosis is a nasal cavity myiasis caused by Oestrus ovis larvae from Oetrus ovis diptera flies in small ruminants. The presence of the larvae in the nasal cavity is known to cause rhinitis and sinusitis which can negatively impact the productivity of small ruminants. The aim of the present study was to estimate the prevalence of Oestrus ovis larvae infestation in sheep and goats presented for necropsy. We reviewed necropsy records of sheep and goats submitted to the Veterinary Pathology diagnostic laboratory at St. George's University from 2001 to 2017. Out of 104 goat necropsy cases, Oestrus ovis larvae were observed in 8 goats giving a prevalence of 7.7% (95% confidence interval (CI):3.38% to 14.6%). Similarly, from the 47 sheep necropsies, Oestus ovis larvae were observed in 4 sheep (8.5%) (95% CI: 2.83% to 20.46%). There was no significant difference in Oestrus ovis larvae infestation rates between sheep and goats (p = 1.000, Fisher's exact test). Oestrosis was an incidental finding in all the small ruminants examined at necropsy. This is the first report on Oestrus ovis larvae infestation in small ruminants in Grenada.

Using focus groups to plan culturally acceptable primary cervical cancer screening in Grenada, West Indies

Objective

To document Grenadian women's knowledge about cervical cancer and human papillomavirus (HPV) infection, as well as their attitudes towards primary cervical cancer screening methods.

Methods

In this qualitative study, we used focus groups in Grenada to gather information concerning women's knowledge about, attitudes towards and perceptions of screening for cervical cancer and general knowledge about HPV. Ten focus groups comprising 73 participants representing 5 of the 6 parishes in Grenada were conducted with women aged 19-59. Participants were asked about pelvic exams, Pap smears, HPV, reasons for seeking or avoiding cervical cancer screening and how different modalities of testing might affect their decision-making. Responses were then coded and organized into common themes.

Results

While many respondents had heard of HPV, far fewer knew about its causative role in cervical cancer, how to prevent HPV infection or testing for the high-risk HPV types that cause almost all cases of cervical cancer. Many participants were aware that cervical cancer screening was beneficial, but numerous barriers to obtaining that screening were noted, including concerns about privacy and stigma, potential discomfort, and the cost and inconvenience involved.

Conclusions

Our findings have implications for future cervical cancer screening efforts in Grenada. Central to these efforts should be a focus on educating Grenadians about the role of HPV infection in cervical cancer and the importance of early detection through screening. In addition, addressing issues of stigma and privacy are key to eliminating cervical cancer in Grenada.

Facilitators of and barriers to COVID-19 vaccination in Grenada: a qualitative study

Objectives

To identify the factors contributing to coronavirus disease 2019 (COVID-19) vaccine hesitancy in Grenada.

Methods

A phenomenological study was conducted using semi-structured interviews at vaccination and pop-up testing clinics during a spike in COVID-19 cases on the island. Interview questions were developed using the health belief model related to perceived threat of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action. Data were analyzed using a deductive approach to identify themes, categories, and subcategories.

Results

Twenty-five interviews were transcribed and coded. In all, 68% of participants were unvaccinated, 12% were partially vaccinated, and 20% were fully vaccinated. Data analysis revealed two main themes: facilitators and barriers. Factors more likely to encourage vaccination (facilitators) included trust in medical advice and vaccine efficacy, social responsibility, and vaccine mandates for travel, employment, and social activities. Factors hindering vaccination (barriers) included: perceived low threat of COVID-19; preference for natural remedies; concerns about contraindications because of underlying health conditions; fear; mistrust of vaccines and related messaging; vaccine accessibility; and the many different information sources.

Conclusions

Overcoming vaccine hesitancy is key to combating the detrimental effects of COVID-19 in Grenada. Public health interventions and policies that address barriers and capitalize on facilitators can increase vaccine uptake.

Woman-to-woman: Feasibility of a lay health advisor program for cervical cancer education in Grenada, W.I

Objective

The aim of this study was to evaluate the impact of Woman- to-Woman, a lay health advisor (LHA)-led educational intervention on cervical cancer and human papillomavirus (HPV) knowledge in a cohort of at-risk Grenadian women.

Methods

LHAs from high-risk parishes were trained in the administration of the intervention and administered the program to 78 local women. Participants completed a pre- and post-knowledge test and a session evaluation. LHAs participated in a process evaluation focus group.

Results

Sixty-eight percent (68%) of participants obtained higher knowledge scores following the educational intervention. The difference between the pre- and post-test scores was statistically significant (p = 0.05). Almost 94% agreed that they were taught new and useful information by credible, community informed and responsive LHAs. Ninety percent (90%) indicated great satisfaction and high motivation to recommend to others. LHAs reported on the intervention and their community interactions.

Conclusions

Results demonstrate that a LHA-led educational intervention significantly improved participants' knowledge of cervical cancer, HPV, Papanicolaou test and vaccination against HPV. Innovations: Researchers trancreated an evidenced based intervention originally designed for Latina women for Grenadian women. There is no evidence in the literature of previous LHA- cervical cancer education studies conducted in Grenada nor the Caribbean.

Toxoplasma gondii clonal type III is the dominant genotype identified in Grenadian pigs

BACKGROUND

Toxoplasma gondii is a widespread zoonotic protozoan parasite capable of infecting all warm-blooded animals. Although the genotypes of T. gondii in pigs have been reported worldwide, there is no information on the genotypes and diversity of T. gondii in pigs in Grenada, West Indies.

OBJECTIVES

The aims of the present study were to isolate, genotype and determine the diversity of T. gondii genotypes in pigs.

METHODS

We carried out a modified agglutination test (MAT) on blood from 149 pig hearts collected from a local meat market. Myocardial tissue homogenate from pigs that tested positive for T. gondii was homogenized and inoculated into mice for isolation of the parasite. We collected mouse tissues and extracted DNA for genotyping based on 11 polymerase chain reaction-restriction fragment length polymorphism markers (SAG1, SAG2, alt. SAG2, SAG 3, BTUB, GRA6, L358, PK1, C22-8, C 29-2 and Apico).

RESULTS

Out of the 149 pig hearts, 31 (20.8%) tested positive for T. gondii on MAT. Bioassays in mice yielded 12 isolates designated TgpgGr1 to TgpgGr12. Molecular characterisation of T. gondii revealed four genotypes as follows: ToxoDB #2-clonal type III (seven isolates); ToxoDB #7 (three isolates); ToxoDB #13 (one isolate); ToxoDB #30 (1 isolate). Overall, ToxoDB #2 was the most common (58%). Toxo database (DB) # 13, which causes interstitial pneumonia in affected mice, has also been reported.

CONCLUSION

The genetic diversity of T. gondii in pigs in Grenada is lower than that in other surrounding Caribbean areas.

Ancylostoma ceylanicum Hookworms in Dogs, Grenada, West Indies

Ancylostoma ceylanicum hookworms are recognized agents of human infection in the Asia-Pacific region. We investigated prevalence of zoonotic hookworm infections in dogs in Grenada in 2021; 40.8% were infected by hookworms, including Ancylostoma ceylanicum. Surveillance of this parasite in dogs and humans is needed in tropical/subtropical countries in the Americas.

A retrospective study of canine transmissible venereal tumour in Grenada, West Indies

Background

Canine transmissible venereal tumour (CTVT) is a naturally occurring neoplasia affecting dogs worldwide. Previous CTVT studies in Grenada were limited to case records of dogs with neoplastic conditions at a veterinary diagnostic laboratory.

Objectives

The present retrospective study aimed to determine the occurrence and risk factors of CTVT in a wider population of owned dogs presented to a university‐affiliated veterinary hospital between 2008 and 2018.

Methods

Data on the age, breed, gender, and gonadectomy status were retrieved from an electronic database and analyzed using logistic regression.

Results

Of the 7180 dogs presented during the period, 102 dogs (1.4%) were diagnosed with CTVT. A higher predisposition was observed in Grenadian pothounds (odds ratio [OR] = 22.8, 95% confidence interval [CI] 10.3–50.4; p < 0.001) and mixed‐breed dogs (OR = 9.2, 95% CI 4.1–20.7; p < 0.001) in comparison to the purebreds. Neutered dogs (OR = 2.2, 95% CI 1.4–3.3; p < 0.001) were at an increased risk of CTVT than intact dogs. Age and gender were not identified as significant risk factors.

Conclusions

The percentage of dogs with CTVT in this study represents a crude estimate of the CTVT prevalence in the owned dog population in Grenada. Further studies including both owned and free‐roaming dogs are required for a more accurate estimation of the CTVT prevalence in the region. Our results indicate that breed and gonadectomy status are significant risk factors for the occurrence of CTVT in Grenada.

Caribbean Lead and Mercury Pollution Archived in a Crater Lake

Lead and mercury have long histories of anthropogenic use and release to the environment extending into preindustrial times. Yet, the timing, magnitude, and persistence of preindustrial emissions remain enigmatic, especially for mercury. Here, we quantify tropical lead and mercury deposition over the past ∼3000 years using a well-dated sediment core from a small crater lake (Lake Antoine, Grenada). Preindustrial increases in lead and mercury concentrations can be explained by varying inputs of watershed mineral and organic matter, which in turn reflect climate-driven changes in the lake level. We find no evidence that preindustrial lead and mercury use raised deposition rates in this remote ecosystem, and our results underscore the need to carefully evaluate common normalization approaches for changing lithogenic inputs and sedimentation rates. Industrial-era lead and mercury accumulation rates in Lake Antoine have been accelerated by land use and land cover change within the crater rim, yet global industrial pollution remains evident. After correcting for watershed inputs, we find that recent atmospheric lead and mercury deposition rates averaged 2925 and 24 μg/m²/y, respectively, which are in close agreement with monitoring data. Our results challenge recent assessments suggesting preindustrial mercury use raised atmospheric deposition rates globally, highlighting the unique nature of 20th Century industrial pollution.

GENETIC AND MORPHOLOGIC CHARACTERIZATION OF DIASCHISTORCHIS PANDUS (DIGENEA: PRONOCEPHALIDAE) TREMATODES EXTRACTED FROM HAWKSBILL TURTLES, ERETMOCHELYS IMBRICATA (TESTUDINES: CHELONIIDAE), IN GRENADA, WEST INDIES

The hawksbill turtle Eretmochelys imbricata is a critically endangered species with a worldwide distribution. Limited information is available about the naturally occurring intestinal parasites of this species and what impact these parasites may have on the health of the hawksbill turtle. Diaschistorchis pandus was identified postmortem in 5 hawksbill turtles from Grenada, West Indies, using morphologic characterization. Sanger sequencing was performed for conserved ribosomal regions (5.8S, ITS2, 28S) and the mitochondrial cytochrome c oxidase subunit 1 gene (COI). Phylogenetic analysis of the 28S rRNA gene sequence data shows D. pandus clustering with other trematodes in the family Pronocephalidae, corroborating morphological classification. No genetic sequences have been previously reported for this trematode species, which has limited the collection of objective epidemiological data about this parasite of marine turtles.

Non-native rats detected on uninhabited southern Grenadine islands with seabird colonies

Seabirds are among the most endangered avian groups, with populations declining worldwide because of various threats, including invasive nest predators. Similar decreasing trends are occurring in the Southern Grenadines; however, the causes of decline remain uncertain, although non-native rats have been suspected. Therefore, our objective was to determine whether non-native rats are present on five Southern Grenadine islands that harbor seabird colonies, during May-July 2014-2017, using four methods (chew cards, tunnels, cameras, and questionnaires). Les Tantes East and Lee Rocks were the only two islands where cameras detected black rats (Rattus rattus). Although rat occupancy was low (0.125 ± 0.061) and the number of individuals and nesting attempts increased (except in 2017) for most species, the low detection probability and small number of nests prevented any inference about rat impact on seabirds. Rats might have affected seabird colonies, but other factors, such as seabird harvest, prey availability, or climatic fluctuations, could have also driven previous seabird population declines in the Southern Grenadines. However, non-native rats are present and future research should focus on estimating their density and distribution on these and other islands of the region before an appropriate rat eradication program can be implemented.

Potential for Scombroid Poisoning from Ingestion of Selar crumenophthalmus Due to Increased Histamine Levels in Grenada, West Indies

ABSTRACT

In scombroid poisoning, a seafood-associated disease, consumption of fish that contains high levels of histamine results in allergy-like symptoms that range from mild to occasionally severe. To date, there is no published information on scombroid poisoning from Selar crumenophthalmus on the Caribbean island of Grenada, West Indies. S. crumenophthalmus is of particular interest because it is a common and heavily consumed fish that has been implicated in scombroid poisoning in Hawaii. Preliminary data on S. crumenophthalmus in Grenada have demonstrated the presence of Photobacterium damselae, a bacterium associated with scombroid poisoning. The present study further tested S. crumenophthalmus purchased in Grenada for factors that would indicate the potential for scombroid poisoning, including increased histamine levels in fish muscle and DNA evidence of bacteria associated with scombroid poisoning. Histamine levels between 7,160 and 66,688 ppm were found after temperature abuse at 37°C for 19 h; this far exceeds the acceptable limit for the United States (50 ppm) and the European Union (100 to 200 ppm). Even after 4 h of incubation at ambient temperature (28.9°C) during a time-point study, histamine levels exceeded U.S. acceptable limits (>50 ppm), and five samples used for temperature-abuse studies had elevated histamine levels (ranging from 141 to 2,510 ppm) at 0 h. PCR and sequence analysis of bacteria in temperature-abused fish identified P. damselae and Morganella morganii, which are histamine-producing bacteria known to be implicated in scombroid poisoning. These results suggest the potential for scombroid poisoning in Grenada and the need for promoting awareness about this disease.

HIGHLIGHTS

Sickle cell disease in Grenada: Quality of life and barriers to care

BACKGROUND

Grenada is a small, resource-limited Caribbean country with a high incidence of sickle cell disease (SCD). Since little is known about the challenges facing individuals living with SCD in the West Indies, we sought to assess barriers to healthcare and the impact of SCD on quality of life in Grenada.

METHODS

Both adults aged 18+ (n = 19) and caregivers of children aged 2-17 (n = 26) completed validated survey measures regarding barriers to care and quality of life, along with a genetics knowledge questionnaire. Caregivers also completed a caregiver burden scale. Survey scores were calculated, and responses were analyzed for an association between demographic variables.

RESULTS

The Barriers to Care Questionnaire, in which lower scores indicate more barriers, revealed that both adults (mean = 69.9) and children (mean = 75.5) with SCD experienced reduced access to care. The Adult Sickle Cell Quality of Life Measurement Information System indicated increased depression and loneliness in adults, with the lowest scores in the Emotional subscale. However, the Pediatric Quality of Life Inventory answered by caregivers of children with SCD showed the lowest scores in the Physical Functioning subscale. Further analysis using the Caregiver Burden Scale-Zarit Burden Interview revealed that 53.8% of caregivers of children with SCD indicated "little to no burden," which may reflect a difference in cultural expectations of a caregiver between high-income countries and Grenada. Finally, ~80% of respondents knew that SCD was a genetic condition; however, 61%-84% could not correctly indicate recurrence risks, demonstrating a need for additional education.

CONCLUSION

These data provide new insights regarding the experience of living with SCD in Grenada and support the need for further investigations into specific barriers to healthcare delivery, which could also improve education and well-being for those affected by SCD in Grenada and in the broader Caribbean community.

Family Influences on Caries in Grenada

If high-conflict family environments are cariogenic across cultures, and can be studied in cultures where both these environments and cariogenic dental practices are particularly prevalent, this would afford the opportunity to examine how these two pathways of risk might interact, laying the stage for culturally competent, integrated prevention efforts. The first investigation involved qualitative data about perceptions of oral health and family stressors in Grenadian families with school-aged children. The second study used a questionnaire and observational data to assess relations among oral health behaviors, relationship satisfaction, parenting, and child behavior; it also included a pilot study of Motivational Interviewing. Most of the themes discussed in focus groups suggested overlap between U.S. and Grenadian parents; possible culture-specific issues were high prevalence of single-parent homes, normativity of physical discipline, less preventive dental care, and more fatalistic view of oral health outcomes. Significant associations were found between parent and child oral health behaviors, between child externalizing and internalizing behaviors, and between family variables (e.g., relationship satisfaction, child behavior) and oral health behaviors (e.g., parent flossing, child brush time). The results strongly support the need for research on the relations between family functioning and oral health to be embedded within culture.

Gastrointestinal parasitic nematodes in pet red-footed tortoises (Chelonoidis carbonaria) from Grenada, West Indies

This study identifies the endoparasites in Red-footed tortoises (Chelonoidis carbonaria) during March 2018 to March 2019 from Grenada, West Indies. Fecal samples from a total of 103 tortoises were collected and examined by simple fecal floatation techniques for parasitic eggs and oocysts. Adult parasites found in the feces were examined under the microscope for identification based on their morphology. Fecal samples for this research were collected from four parishes; St. Andrew, St George, St. John and St. Patrick. The overall prevalence of intestinal parasites among tortoises was 14.6%.

The internal parasites consisted of nematodes belonging to three genera: Atractis, Labiduris and Proatractis. The most prevalent nematodes were Atractis spp. (86.7%), which included two species: A. thapari (7.7%) and A. marquezi (15.4%) followed by Labiduris gulosa (20%) and Proatractis parvicapiticaronata (13.3%). All nematodes of three genera found in red-footed tortoises in Grenada are reported for the first time. They are not zoonotic but are serious pathogens for tortoises.

More than just nestlings: incidence of subcutaneous Philornis (Diptera: Muscidae) nest flies in adult birds

Philornis flies Meinert (Diptera: Muscidae) have been documented parasitizing over 250 bird species, some of which are endemic species threatened with extinction. Philornis parasitism is hypothesized to affect nestlings disproportionately more than adult birds because limited mobility and exposed skin of nestlings increase their vulnerability to parasitism. We used a comprehensive literature review and our recent fieldwork in the Dominican Republic, Puerto Rico, and Grenada to challenge the idea that parasitism by subcutaneous Philornis species is a phenomenon primarily found in nestlings, a fact that has not been quantified to date. Of the 265 reviewed publications, 125 (49%) reported incidences of parasitism by subcutaneous Philornis, but only 12 included the sampling of adult breeding birds. Nine of these publications (75%) reported Philornis parasitism in adults of ten bird species. During fieldwork in the Dominican Republic, Puerto Rico, and Grenada, we documented 14 instances of parasitism of adult birds of seven avian species. From literature review and fieldwork, adults of at least fifteen bird species across 12 families and four orders of birds were parasitized by at least five Philornis species. In both the published literature and fieldwork, incidences of parasitism of adult birds occurred predominantly in females and was frequently associated with incubation. Although our findings indicate that Philornis parasitism of adult birds is more common than widely presumed, parasite prevalence is still greater in nestlings. In the future, we recommend surveys of adult birds to better understand host-Philornis relationships across life stages. This information may be essential for the development of effective control measures of Philornis to ensure the long-term protection of bird species of conservation concern.

An analysis of time trends for canine heartworm disease in Grenada and its associated risk factors based on veterinary clinical pathology laboratory data base records between 2003 and 2015

Canine heartworm (CHW) disease is a common parasitic infection in dogs in the Caribbean islands. However, studies on temporal trends and risk factors are limited for this region. This study represents the time trends in laboratory prevalence and risk factors of canine heartworm infections between 2003 and 2015. In this case series, 662 cases of laboratory-diagnosed heartworm were compared to 662 dogs without a laboratory diagnosis of heartworm (controls). One hundred and seventy two frozen serum positive samples were later analyzed for heartworm antigens using Heska solo® Step CH, and all 172 cases of microfilariae were confirmed as Dirofilaria immitis. Annual prevalence, linear trends and odds ratios (OR) for CHW were estimated using EPIINFO version 7 at a significance level of α = 0.05. Logistic regression was used to assess the association of CHW with variables showing a statistically significant univariate relationship. Laboratory prevalence of CHW decreased from 72 cases per 1000 dogs per year in 2003 to 15 cases per 1000 dogs per year in 2015 [X² for linear trend = 151.8, p < 0.0001], with the occurrence of an epidemic of CHW between 2008 and 2010. The odds of CHW were higher among adult dogs [(OR) = 3.9 (95% CI, 2.9-7.0)] and geriatric dogs [OR = 2.1 (95% CI, 1.1-4.3)] compared to puppies. The odds of CHW were higher [OR = 1.3 (95% CI, 1.1-1.6)] among male dogs than female dogs, but the odds for CHW were lower among neutered dogs [OR = 0.4 (95% CI, 0.2 - 0.6)] compared to intact dogs. The odds of a dog being diagnosed with CHW were elevated [OR = 4.1 (95% CI, 3.2-5.2)] during the dry season compared to the rainy season. Our findings show that canine heartworm is extensive in laboratory submissions in Grenada. However, the laboratory prevalence of CHW decreased between 2003 and 2015, with an epidemic occurring between 2008 and 2010. Age of the dog, sex, neutered status, and seasonality of diagnosis were significantly associated CHW in Grenada.

Antimicrobial resistance patterns of commensal Escherichia coli isolated from feces of non-diarrheic dogs in Grenada, West Indies

Background and Aim:

There is currently no published information on the prevalence and antimicrobial susceptibility patterns of commensal Escherichia coli in dogs of Grenada origin. Monitoring antimicrobial resistance helps in the empirical selection of antibiotics. This study determined the occurrence of E. coli including the O157:H7 serotype in feces of non-diarrheic dogs of Grenada origin and the antibiotic resistance pattern of the E. coli isolates.

Materials and Methods:

Fecal samples from 142 of the 144 (98.6%) dogs were culture positive for E. coli. Selection of up to three colonies from each of the 142 E. coli-positive samples yielded a total of 402 E. coli isolates, which were analyzed for the presence of non-sorbitol fermenting colonies, and O157-agglutination.

Results:

Of the 402 E. coli isolates, 30 (7.5%) were non-sorbitol fermenters. However, none of the 402 isolates gave a positive reaction (O157:H7) to the E. coli O157:H7 latex kit. Antimicrobial susceptibility tests against 12 antibiotics revealed low resistance rates to all the tested antibiotics except for tetracycline (Te) (23.4%), cephalothin (CF) (13.2%), and ampicillin (AM) (7.7%). Thirty-nine out of the 402 (9.7%), E. coli isolates were resistant to two or more antibiotics of different classes.

Conclusion:

This is the first report of isolation and antimicrobial susceptibilities of commensal E. coli from non-diarrheic dogs in Grenada. Some of the isolates (39/402 isolates, 9.7%) were resistant to multiple antibiotics. This study showed that presently, dogs in Grenada should not be considered a reservoir for the E. coli O157:H7 serotype and for multiple antibiotic-resistant E. coli strains. Among the 402 E. coli isolates, the resistance rate to drugs other than Te, CF, and AM was very low.

Ectoparasites of brown rats (Rattus norvegicus) in Grenada, West Indies

Background and Aim:

Arthropod ectoparasites (mites, lice, ticks, and fleas) on common house rats or brown rats (Rattus norvegicus) are known to transmit zoonotic pathogens and diminish rat health. To the best of our knowledge, there is no published information regarding the prevalence of ectoparasites on R. norvegicus in Grenada. This study aimed to determine the prevalence and types of ectoparasites present on brown rats from Grenada.

Materials and Methods:

One hundred sixty-eight rats were collected live from the parishes of St. George and St. David, Grenada, from May to July 2017. Following euthanasia, external parasites were collected using fine combs, thumb forceps, and paper tape. Tape samples and free specimens were placed in containers with 70% ethanol. External parasites were evaluated using dissection microscopy.

Results:

Over 2000 ectoparasites were collected from 149 of the 168 trapped rats (88.7%). Ectoparasites identified included mesostigmatid mites (found on 84.6% of infested rats), fur mites in the families Atopomelidae and Listrophoridae (67.1%), Polyplax spp. lice (6.7%), fleas (3.4%), an unidentified larval tick (0.7%), and a mite in the family Myobiidae (0.7%). Infestation rates were higher in St. David Parish (86/89; 96.6%) than in St. George Parish (63/79; 79.7%) (p=0.001). When comparing sex and age, males had a marginal increase in infestation rate (83/89; 93.3%) compared to females (66/79; 83.5%) (p=0.054), and adults had an infestation rate of 90.7% (97/107) compared to juvenile rats who had a 66.7% (14/21) infestation rate.

Conclusion:

Brown rats in Grenada are heavily infested with ectoparasites, including known vectors of pathogens. Future studies will examine the prevalence of zoonotic pathogens in these arthropods.

Internal parasitic burdens in brown rats (Rattus norvegicus) from Grenada, West Indies

This study identified the endoparasites in Brown rat (Rattus norvegicus) during May to July 2017 in Grenada, West Indies. A total of 162 rats, 76 females and 86 males were trapped from St. George and St. David parishes in Grenada. The collected fecal samples were examined for parasitic eggs and/or oocysts using simple fecal flotation technique. Adult parasites found in the intestinal tract were examined for identification. The overall prevalence of intestinal parasites among rats was 79 %.

Ten helminth species were recovered, several of which were reported for the first time in rodents in Grenada. The internal parasites consist of seven nematodes (Angiostrongylus spp., Nippostrongylus braziliensis, Heterakis spumosa, Strongyloides ratti, Aspiculuris tetraptera, Syphacia spp. and Protospirura spp.), one cestode (Hymenolepsis diminuta), one acanthocephalan (Moniliformis moniliformis) and one protozoa species (Eimeria spp.). The most prevalent zoonotic species were Angiostrongylus spp. (35.2%), Hymenolepsis diminuta (7.4%) and Moniliformis moniliformis (3.1%). Several nonzoonotic endoparasites; which included Nippostrongylus braziliensis (50.6%), Heterakis spumosa (15.4%), Strongyloides ratti (43.2%), Aspiculuris tetraptera (2.5%), Syphacia spp. (1.9%), Protospirura spp. (1.2%) and Eimeria spp. (4.7%) were also identified. The most prevalent parasites were Nippostrongylus brasiliensis (50.6%), Strongyloides ratti (43.2%) and Angiostrongylus spp. (35.2%). Co-infections occurred with up to six species per rat showing different combinations of parasitic infections.

Identification of Helminth Parasites from Selar crumenophthalmus in Grenada, West Indies

HIGHLIGHTS

Helminths in Selar crumenophthalmus fish were identified by PCR. Two helminth taxa were identified: Anisakis typica and an unknown acanthocephalan. Neither taxon of helminth identified is zoonotic. To our knowledge, this is the first report of either type of helminth in fish in Grenada.

George Parish, Grenada

Blood-feeding patterns of mosquitoes affect the transmission and maintenance of arboviral diseases. In the Caribbean, Aedes aegypti (L.) and Culex quinquefasciatus Say mosquitoes are the dominant mosquito species in developed areas. However, no information is available on the bloodmeal hosts of these invasive vectors in Grenada, where arboviral pathogens such as dengue, chikungunya, and Zika viruses cause significant human suffering. To this end, Ae. aegypti and Cx. quinquefasciatus mosquitoes were investigated from five semirural locations near houses in St. George's Parish, from 2017 to 2018. Polymerase chain reaction was conducted on DNA extracted from individual blood-fed mosquitoes using vertebrate-specific cytochrome b primers. The 32 Ae. aegypti bloodmeals included humans (70%), mongooses (18%), domestic dogs (6%), a domestic cat (3%), and an unidentified bird (3%). Thirty-seven Cx. quinquefasciatus mosquitoes took bloodmeals from seven species of birds (51%), humans (27%), domestic cats (8%), iguanas (5%), a domestic dog (3%), a rat (3%), and a common opossum (3%). The high percentage of human bloodmeal hosts in our study, especially by the normally anthropophilic Ae. aegypti, is expected. The bloodmeal sources and the percentage of nonhuman bloodmeals (30%) taken by Ae. aegypti are comparable to other studies. The large range of hosts may be explained in part by the semirural nature of most local housing. Accordingly, this may contribute to an exchange of pathogens between domestic, peridomestic, and sylvatic transmission cycles.

in brown rats (Rattus norvegicus) from Grenada, West Indies

Background and Aim:

Leptospirosis is an emerging disease of animals and humans. Among rodents brown rats (Rattus norvegicus) are an important reservoir of bacteria Leptospira. There is a paucity of information on reservoirs of Leptospira in Grenada. This study was conducted to estimate the prevalence of antibodies against Leptospira spp. in brown rats in a densely human populated area of Grenada.

Materials and Methods:

Blood samples from 169 brown rats were collected and sera screened for antibodies against Leptospira spp. using enzyme-linked immunosorbent assay.

Results:

Among a total of 169 brown rats trapped in two parishes in Grenada, 77/169 (45.5%) were positive for Leptospira spp. antibodies. A significant difference in seropositive population of brown rats between two collection sites was observed. No differences were found between sex and age of seropositive rats.

Conclusion:

Due to the close contact of brown rats with humans in Grenada, rats should be considered a high-risk factor in transmission of Leptospira to humans. Appropriate preventive measures should be instituted to prevent the transmission of Leptospira infection to humans.

Increased taxation on cigarettes in Grenada: potential effects on consumption and revenue

Objective

To investigate the feasibility of addressing the public health concerns of tobacco consumption through increased taxation, while preserving or augmenting government revenues in Grenada.

Methods

Purposive sampling methods were used to ensure data availability and geographical representativeness. Average price per 20-pack of the most-sold brands of cigarettes was calculated using data from three major supermarkets. The World Health Organization's Tax Simulation Model was used, with excise tax rates adjusted to effect 5%, 10%, and 15% consumption decreases.

Results

A 17% to 117% excise tax increase on the cost, insurance, and freight (CIF) value would achieve a 5% consumption decrease. Total government revenues would grow 8.7% and excise tax revenues would increase 11%. The average excise tax per 20-pack would move from EC$ 3.24 (2014 US$ 1.20) to EC$ 3.80 (US$ 1.41), while the average price per pack would increase to EC$ 9.21 (US$ 3.41) from EC$8.48 (US$ 3.14). In the 10% and 15% consumption reduction scenarios, excise taxes would have to be increased by 33% and 50% (to 133% and 150% of CIF, respectively), pushing the average excise tax per pack to EC$ 4.37 (US$ 1.62) and EC$ 4.90 (US$ 1.81), respectively.

Conclusion

In Grenada, consumption can be reduced alongside growth in government revenues, making available additional resources for health. This aligns with the literature, which indicates that taxation can be effective in pursuing the public health objective of reduced incidence of smoking-related illnesses via reduced consumption.

in asymptomatic small ruminants in Grenada, West Indies

Cryptosporidium spp. is a protozoan parasite that causes enteric infection in a wide range of hosts, including livestock and humans. The aim of this cross-sectional study was to estimate the prevalence of Cryptosporidium spp. in small ruminants in Grenada, West Indies. Fecal samples were collected from 100 sheep and 202 goats from 32 farms. The fecal samples were tested using an Enzyme-linked immunosorbent assay (ELISA) for qualitative detection of antigens in feces (Diagnostic Automation Inc., USA). The overall prevalence of Cryptosporidium spp. was 19.5% [95% confidence interval (CI): 15.4% to 24.4%] in both sheep and goats. The prevalence of Cryptosporidium spp. in sheep and goats was 14% (95% CI: 8.4% to 22.3%) and 22.3% (95% CI: 17.1% to 28.5%), respectively. There was no significant difference in the prevalence of Cryptosporidium spp. infection between sheep and goats (p = .42, Fisher's exact test) in Grenada. Of the 32 farms visited, 19 (59.4%) had at least one Cryptosporidium spp. positive animal.

in brown rats from Grenada, West Indies

Background and Aim

Leishmania spp. are known to cause disease in man and animals. Rats are considered important reservoir hosts and transmission takes place through the bite of female sand fly, Phlebotomus spp. To the best of our knowledge, there is no published information on Leishmania infection in rats in Grenada. This study was conducted to estimate the antibodies for visceralizing Leishmania spp. (VL) in rats (Rattus norvegicus) from Grenada.

Materials and Methods

A total of 146 brown rats (R. norvegicus) were trapped live from two parishes (St. George and St. David) in Grenada. Following anesthesia, blood was collected from the heart through thoracic puncture. The serum was collected after the centrifugation of blood. Serum was tested for antibodies to VL. with a commercially available immunochromatographic dipstick test which is licensed for use in animals and humans.

Results

The seroprevalence of antibodies against Leishmania spp. was found in 34 of 146 rats (23.3%; CI 95% from 16.70 to 30.99). No significant differences were found between sexes and young or adults. The prevalence between parishes (St. George and St. David) was also not significant.

Conclusion

The results show that rats (R. norvegicus) in Grenada are exposed to Leishmania spp. The rats could play an important role in the transmission of leishmaniasis to humans and other animals in Grenada.

Serological evidence of widespread exposure of Grenada fruit bats to chikungunya virus

Antibody detection against selected potentially zoonotic vector-borne alphaviruses and flaviviruses was conducted on sera from bats from all six parishes in Grenada, West Indies. Sera were tested for (i) antibodies to flaviviruses West Nile virus, St. Louis encephalitis virus, Ilhéus virus, Bussuquara virus (BSQV), Rio Bravo virus and all four serotypes of dengue virus (DENV) by plaque reduction neutralization test (PRNT); (ii) antibodies to alphaviruses western equine encephalitis virus, Venezuelan equine encephalitis virus and eastern equine encephalitis virus by epitope-blocking enzyme-linked immunosorbent assay (ELISA); and (iii) antibodies to the alphavirus chikungunya (CHIKV) by PRNT. Two species of fruit bats were sampled, Artibeus jamaicensis and Artibeus lituratus, all roosting in or within 1,000 m of human settlements. Fifteen (36%) of the 42 bats tested for neutralizing antibodies to CHIKV were positive. The CHIKV-seropositive bats lived in localities spanning five of the six parishes. All 43 bats tested for epitope-blocking ELISA antibody to the other alphaviruses were negative, except one positive for Venezuelan equine encephalitis virus. All 50 bats tested for neutralizing antibody to flaviviruses were negative, except one that had a BSQV PRNT80 titre of 20. The CHIKV serology results indicate that bats living close to and within human settlements were exposed to CHIKV in multiple locations. Importantly, bats for this study were trapped a year after the introduction and peak of the human CHIKV epidemic in Grenada. Thus, our data indicate that bats were exposed to CHIKV possibly during a time of marked decline in human cases.

Lessons learned: Evaluating the program fidelity of UNWomen Partnership for Peace domestic violence diversion program in the Eastern Caribbean

To date, there have been a plethora of punitive and diversion programs to address domestic violence around the world. However, the evaluative scholarship of such programs overwhelmingly reflects studies in developed countries while barely showcasing the realities of addressing domestic violence in developing countries. This paper features a multi-year (2008-2011) evaluation study that measured the fidelity of the United Nations Partnership for Peace (PfP) domestic violence diversion program in the Eastern Caribbean country of Grenada. Our findings illuminate organic engagement strategies that were built within existing multi-sectoral partnerships that included magistrate court judges, law enforcement officials, and social service agencies. Furthermore, we documented how the locally-devised implementation strategies ensured the program's fidelity within a resource-limited context. This paper contributes to the global evaluative scholarship, highlighting the lessons learned about implementing culturally-adapted and theoretically-driven domestic violence diversion within a developing country.

Gastrointestinal parasites in small ruminants from Grenada, West Indies: A coprological survey and a review of necropsy cases

Gastrointestinal parasites are important in small ruminant farming because they can impact negatively on the productivity of animals. The objectives of the present study were to estimate the prevalence of gastrointestinal parasites and to assess mortality attributable to gastrointestinal parasite infection in sheep and goats. We collected fecal samples from 114 sheep and 292 goats from 34 farms for coprological examination. In addition, we evaluated necropsy records for sheep and goats that were submitted from 2002 to 2016 to the pathology diagnostic laboratory in the School of Veterinary Medicine at St. George's University, Grenada. Out of 406 small ruminant (292 goat and 114 sheep) fecal samples examined, 385 were positive for gastrointestinal parasites, giving an overall prevalence of 95% (95% confidence interval (CI) 92% to 97%). All the 34 farms visited were found to have positive animals to at least one type of gastrointestinal parasite; 100% herd prevalence (95% CI: 88% to 100%). Among the 292 goat fecal samples examined, 285 were positive for gastrointestinal parasites (98%; 95% CI: 95% to 99%) whereas the proportion of positive fecal samples in sheep was 88% (95% CI: 80% to 93%). There was a significant difference in prevalence of gastrointestinal parasites between sheep and goats (p = .0002). The proportion of infection with coccidia in goats and sheep was 76% and 75%, respectively. For helminthes, the proportions were as follows: Moniezia spp., 14% in goats and 4% in sheep; Strongyloides spp., 36% in goats and 21% in sheep; strongyle type eggs 89% in goats and 66% in sheep. Mixed infections in both sheep and goats were more common (92%) than single ones (8%). Out of 220 necropsy records evaluated, 29% of mortality was due to Haemonchus contortus infection. Moniezia spp and Oesophagostomum spp. were also commonly found.

Giardiasis: Serum antibodies and coproantigens in brown rats (Rattus norvegicus) from Grenada, West Indies

Aim:

Giardia is a serious zoonotic parasite, which causes diarrheal disease in humans and animals including rodents. The purpose of this study was to estimate the prevalence of Giardia spp. in brown rats (Rattus norvegicus) in Grenada.

Materials and Methods:

Intestinal contents from 99 and serum samples from 169 brown rats (R. norvegicus) from Grenada were collected. These samples were examined for the Giardia coproantigens using Cryptosporidium/Giardia Quik Chek assay (Tech lab^® Inc., USA), and the serum was screened through an enzyme-linked immunosorbent assay (ELISA) test kit for Giardia antibody (anti-GD) ELISA kit (MyBioSource, San Diego, CA, USA).

Result:

Giardia coproantigens were positive in 17.17% (95% confidence interval [CI]; 10.33-26.06%) rats, whereas 55% (95% CI: 47.20-62.68) were positive with serum antibodies (anti-GD) to Giardia.

Conclusion:

The prevalence of Giardia spp. in brown rats in Grenada was moderate based on the presence of coproantigens in the intestinal contents and antibody in serum. The findings of Giardia infections and prevalence in brown rats will help veterinarians and physicians to better plan diagnostic and preventative strategies. This is the first report of prevalence of Giardia in brown rats in Grenada.

Sarcocystis cymruensis: discovery in Western Hemisphere in the Brown rat (Rattus norvegicus) from Grenada, West Indies: redescription, molecular characterization, and transmission to IFN-γ gene knockout mice via sporocysts from experimentally infected domestic cat (Felis catus)

Rodents are intermediate hosts for many species of Sarcocystis. Little is known of Sarcocystis cymruensis that uses the Brown rat (Rattus norvegicus) as intermediate hosts and the domestic cat (Felis catus) as experimental definitive host. Here, we identified and described Sarcocystis cymruensis in naturally infected R. norvegicus from Grenada, West Indies. Rats (n = 167) were trapped in various locations in two parishes (St. George and St. David). Microscopic, thin (< 1 μm) walled, slender sarcocysts were found in 11 of 156 (7.0%) rats skeletal muscles by squash examination. A laboratory-raised cat fed naturally infected rat tissues excreted sporocysts that were infectious for interferon gamma gene knockout (KO) mice, but not to Swiss Webster outbred albino mice. All inoculated mice remained asymptomatic, and microscopic S. cymruensis-like sarcocysts were found in the muscles of KO mice euthanized on day 70, 116, and 189 post inoculation (p.i.). Sarcocysts from infected KO mice were infective for cats at day 116 but not at 70 days p.i. By transmission electron microscopy, the sarcocyst wall was "type 1a." Detailed morphological description of the cyst wall, metrocytes, and bradyzoites is given for the first time. Additionally, molecular data on S. cymruensis are presented also for the first time. Molecular characterization of sarcocysts 18S rDNA and 28S rDNA, ITS-1, and cox1 loci showed the highest similarity with S. rodentifelis and S. muris. In conclusion, the present study described the natural infection of S. cymruensis in Brown rat for the first time in a Caribbean country and provided its molecular characteristics.

Outcomes of a Falls Prevention Education Program Among Older Adults in Grenada

In Latin America and the Caribbean, there is a scarcity of data on falls, the leading cause of death as a result of unintentional injuries, among older adults aged 65+ years of age. By 2050, 80 % of the 2 billion older adults worldwide are expected to be living in this region; therefore, it is imperative that this issue receive urgent attention from community health practitioners, health educators and policy makers. Guided by Pillar 1-awareness of the WHO fall prevention model for community-dwelling older adults, the purpose of this paper was to describe the feasibility of implementing a falls prevention awareness educational initiative in the Eastern Caribbean Island of Grenada. Sixty-two older adults, average age 67, participated in a falls awareness workshop. An anonymous pre-workshop falls assessment checklist was distributed to establish baseline information followed by an interactive workshop. Eight fall risks were identified and 52 % of the participants reported a history of falls. Based on the group's eagerness to participate, we are encouraged that falls prevention intervention initiatives are feasible among others of similar characteristics in Grenada and plan to implement Pillar II-objective falls assessment and Pillar III-on-going interventions.

The Identification of Risk Factors for Chronic Chikungunya Arthralgia in Grenada, West Indies: A Cross-Sectional Cohort Study

Background

Chikungunya virus (CHIKV) is a re-emerging arboviral pathogen. In 2014, an explosive CHIKV outbreak occurred in Grenada, West Indies, infecting approximately 60% of the population. In approximately 50% of cases, CHIKV infection transitions to painful arthralgia that can persist for years. Elucidation of the risk factors for chronic disease is imperative to the development of effective risk management strategies and specific therapeutics.

Methods

We conducted a cross-sectional study of 240 people who were tested for CHIKV during the outbreak. We administered questionnaires to examine demographic, behavioral, psychological, social, and environmental factors to identify associations with chronic disease. Physical examinations were performed and persistent symptoms were recorded.

Results

Ethnicity and socioeconomic status were not associated with risk of chronic joint pain. Female sex increased risk, and age was demonstrated to be predictive of chronic CHIKV sequelae. Mosquito avoidance behaviors did not reduce risk. Patients suffering joint pains, generalized body ache, and weakness in the extremities during acute infection were more likely to develop chronic arthralgia, and an increased duration of acute disease also increased risk.

Conclusions

These data demonstrate that chronic CHIKV affects people across the ethnic and socioeconomic spectrum, and it is not reduced by vector avoidance activity. Increased duration of acute symptoms, in particular acute joint pain, was strongly correlated with the risk of persistent arthralgia, thus effective clinical management of acute CHIKV disease could reduce burden of chronic CHIKV.

Prevalence of sickle cell disease among Grenadian newborns

Objective To establish the birth prevalence of sickle cell disease in Grenada, with a view to assess the requirement for a population-based neonatal screening programme. Methods A two-year pilot neonatal screening programme, involving the Ministry of Health of Grenada, the Sickle Cell Association of Grenada, and the diagnostic laboratory of hemoglobinopathies of the University Hospital of Guadeloupe, was implemented in 2014-2015 under the auspices of the Caribbean Network of Researchers on Sickle Cell Disease and Thalassemia. Results Analysis of 1914 samples processed identified the following abnormal phenotypes: 10 FS, 2 FSC, 183 FAS, 63 FAC. These data indicate β^s and β^c allele frequencies of 0.054 and 0.018, respectively. Conclusion Neonatal screening conducted in the framework of this Caribbean cooperation can allow rapid detection and earlier management of affected children.

Twenty-first century cancer patterns in small island nations: Grenada and the English-speaking Caribbean

PURPOSE

Grenada is a small island nation of 105,000 in the Caribbean with one single general hospital and pathology laboratory. This study assesses cancer incidence on the island based on existing pathology reports, and compares the cancer mortality burden between Grenada and other Caribbean nations.

METHODS

Age-adjusted overall and site-specific cancer "incidence" rates (based on pathology reports) and mortality rates were calculated and compared for 2000-2009. Next, mortality rates for a more recent period, 2007-2013, were calculated for Grenada and a pool of English-speaking, majority African-ancestry Caribbean island nations. Lastly, for direct mortality comparisons by cancer site, mortality rate ratios were computed using negative binomial regression modeling.

RESULTS

The pathology reports alone do not suffice to calculate national incidence rates but cancer mortality rates are rapidly increasing in Grenada. The leading causes of cancer mortality were prostate and lung cancers among men, and breast and cervical cancers among women. Overall cancer mortality is significantly higher for both male and female Grenadians than their Caribbean counterparts: RR 1.43 (95% CI 1.32-1.55) and RR 1.26 (95% CI 1.15-1.38), respectively. High prostate and non-Hodgkin's lymphoma rates are concerning.

CONCLUSIONS

Given the small existing cancer infrastructure, excessive mortality in Grenada compared to its neighbors may be disproportionately more attributable to low survival than a high cancer risk. Global solutions will be required to meet the cancer control needs of geographically isolated small nations such as Grenada.

Campylobacter Species Isolated from Pigs in Grenada Exhibited Novel Clones: Genotypes and Antimicrobial Resistance Profiles of Sequence Types

Infections caused by Campylobacter species pose a severe threat to public health worldwide. However, in Grenada, the occurrence and characteristics of Campylobacter in food animals, including pigs, remain mostly unknown. In this study, we identified the sequence types (STs) of Campylobacter from young healthy pigs in Grenada and compared the results with previous studies in Grenada and other countries. Antimicrobial resistance patterns and diversity of the Campylobacter clones were evaluated. Ninety-nine Campylobacter isolates (97 Campylobacter coli and 2 Campylobacter jejuni) were analyzed by multilocus sequence typing. Eighteen previously reported STs and 13 novel STs were identified. Of the 18 previously reported STs, eight STs (ST-854, -887, -1068, -1096, -1445, -1446, 1556, and -1579) have been associated with human gastroenteritis in different geographical regions. Among these 18 previously reported STs, ST-1428, -1096, -1450, and -1058 predominated and accounted for 18.2%, 14.1%, 11.1%, and 8.1% of all isolates, respectively. Of the 13 novel STs, ST-7675 predominated and accounted for 20% (4 of 20 isolates), followed by ST-7678, -7682, and -7691, each accounting for 10% (2 of 20 isolates). Antimicrobial resistance testing using Epsilometer test revealed a low resistance rate (1-3%) of all C. coli/jejuni STs to all antimicrobials except for tetracycline (1-10.1%). Some of the C. coli STs (13 STs, 24/99 isolates, 24.2%) were resistant to multiple antimicrobials. This is the first report on antimicrobial resistance and multidrug resistance patterns associated with Campylobacter STs recovered from swine in Grenada. This study showed that pigs in Grenada are not major reservoirs for STs of C. coli and C. jejuni that are associated with human gastroenteritis worldwide.

Natural exposure of bats in Grenada to rabies virus

Introduction: Grenada is a rabies endemic country, where terrestrial rabies is maintained in the small Indian mongoose (Herpestes auropunctatus). The role of bats in the epidemiology of rabies in Grenada is unknown. A 1974 report described one rabies virus positive Jamaican fruit bat (Artibeus jamaicensis), and a high seroprevalence in this species. In the current study, the natural exposure to rabies virus in Grenadian bats was re-evaluated. It is postulated that bats serve as a natural rabies reservoir, probably circulating a bat-specific rabies virus variant. Material and methods: Bats were trapped in 2015 in all six parishes of Grenada using mist- and hand nets. For the detection of rabies virus in brain tissue, the direct fluorescent antibody test (dFAT) and the reverse transcription polymerase chain reaction (RT-PCR) were used. Serum neutralizing antibodies were determined using the fluorescent antibody virus neutralization test (FAVN). Results and discussion: Brain tissue and sera from 111 insectivorous and frugivorous bats belonging to four species were tested (52 Artibeus jamaicensis, two Artibeus lituratus, 33 Glossophaga longirostris, 24 Molossus molossus). Rabies virus antigen and genomic RNA were not detected in brain tissues. Rabies virus neutralizing antibodies were detected in the sera of eight A. jamaicensis in four of the six parishes. Bats in Grenada continue to show natural exposure to rabies virus. As rabies virus was not isolated in this study, serology alone is not sufficient to determine the strain of rabies virus circulating in A. jamaicensis bats in Grenada. Conclusion: Artibeus jamaicensis appears to play a role as a reservoir bat species, which is of public health concern in Grenada. Dispersion of bats to neighboring islands is possible and serological bat surveys should be initiated in these neighboring states, especially in those areas that are free of rabies in terrestrial mammals.

Seroprevalence of antibodies to astrovirus in chickens in Grenada, West Indies

Aim:

Chicken astroviruses (CAstV) are known to cause mild gastroenteritis, growth depression, and even mortality in poultry, especially in chickens, turkeys, and ducks. To the best our knowledge, there is no published information on CAstV in Grenada. This study was conducted to determine the prevalence of astrovirus in chickens in Grenada.

Materials and Methods:

Blood samples from 366 indigenous chickens and 92 commercial chicken layers were collected from all parishes of the island and tested for antibodies against CAstV using commercial enzyme-linked immunosorbent assay.

Results:

The seroprevalence of antibodies against astrovirus was 57.6% (95%, Confidence interval [CI]: 47.4-67.2) in commercial layers and 61.5% (95%, CI: 56.4-66.3) in indigenous chickens. The results show the presence of infection throughout the island.

Conclusion:

The results show the infection with CAstV in approximately half of the chicken population in Grenada. This is the first report on the prevalence of CAstV in chickens in Grenada and the Caribbean region.

Exposing the culture of silence: Inhibiting factors in the prevention, treatment, and mitigation of sexual abuse in the Eastern Caribbean

This article features a study that explored the presence of adverse childhood experiences (ACEs), including childhood sexual abuse and neglect, among women associated with Partnership for Peace (PfP), the first and only culturally adapted domestic violence diversion program for men in the Eastern Caribbean. Within a multiyear evaluative study that assessed the impact of the PfP intervention in reducing domestic violence in Grenada in the West Indies, life-history interviews were collected from a subsample of women (N=9) associated with men enrolled in the PfP program between 2009 and 2011. We found that the exposure to sexual abuse and neglect during childhood was evident in the histories of the women. Most perpetrators were trusted family or community members who suffered from a common set of behavioral patterns, most prominently alcohol use. Our findings reflect an evidence-based connection, as one causative factor, of a culture of silence that is related to child sexual abuse and its management. The apparent lasting effects of these traumatic childhood exposures reflect cycles of abuse in the life histories collected during the domestic violence evaluation study. Our study identified three key structural deficiencies (insufficient research, ineffective policy, and lack of public-health interventions) and one embedded cultural norm (the culture of silence) that together "inhibit current attempts to address ACEs as a means of curbing domestic violence in the Caribbean."

The Issue of Leptospirosis in Grenada

The aim of this study was to conduct a literature and secondary data review regarding leptospirosis and its impact in Grenada. The data analysed consisted of a published secondary source of animal investigations. The results of this investigation suggested that the burden of this disease is quite substantial and significant for the population of Grenada, as well as its global visitors. An examination into the literature related to public health policies and practices that could be suited to a developing nation like Grenada was then conducted. Recommendations were made regarding these analysed public health programmes revolving around surveillance, vector control, sanitation and education.

in small Indian mongooses (Herpestes auropunctatus) in Grenada, West Indies

Intestinal samples from 156 small Indian mongooses (Herpestes auropunctatus) collected island-wide in Grenada from April 2011 to March 2013 were examined for the presence of Salmonella enterica spp. Nineteen (12%) mongooses were culture-positive for S. enterica spp. of which five serotypes were identified. Salmonella javiana and S. Montevideo were the most commonly isolated serotypes. The other serotypes isolated were S. Rubislaw, S. Panama and S. Arechavaleta. All isolates were susceptible to amoxicillin-clavulanic acid, ampicillin, cefotaxime, ceftazidime, ciprofloxacin, enrofloxacin, gentamicin, nalidixic acid, imipenem and trimethoprim-sulfamethoxazole. One isolate (S. Montevideo) showed resistance to tetracycline and intermediate resistance to streptomycin. The five isolated Salmonella serotypes are potential human pathogens suggesting that the mongoose may play a role in the epidemiology of human salmonellosis in Grenada.

Adolescent pregnancy in Grenada

A retrospective review of adolescent deliveries (maternal age range: 12-19 years) at the maternity unit of the main General Hospital, Grenada, was undertaken for the years 1987 and 1988 using the delivery room register and hospital medical records. These mothers were compared with women who delivered during the same period but were aged between 20 and 30 years. Of the 3203 deliveries which occurred during the study period, 613 (20%) involved adolescents, giving a prevalence rate of one in five pregnancies. chi 2 and Fisher's exact test analyses revealed that pregnancies occurring in younger adolescents (age less than 16 years, n = 58) carried an increased risk of preterm labour, operative delivery, prematurity, small-for gestational age infants, asphyxia and perinatal mortality when compared with the 'optimum reproductive age group'. Older adolescents (16-19 years, n = 555) had a higher risk of pregnancy induced hypertension but otherwise compared well with the optimal reproductive age group. Adolescent pregnancy is very prevalent in Grenada and the reproductive outcome for young adolescents < 16 years of age is relatively poor.

Shifts in Grenadian migration: an historical perspective

Migration from Grenada has been varied and large over the past century, reaching levels which even resulted in negative population growth. This article focuses on changes in Grenadian migration over the past 80 years, with emphasis on the Grenada Revolution, 1979-1983. After the 1979 revolution there were some changes in the attitudes of Grenadians to migration, although many of the expected socioeconomic and demographic features of migration were still present. Migration may be seen as a means of circumventing low wages and limited opportunities, as a culturally specific pattern of behavior, or as a combination of economic, political and cultural factors. After reviewing the pattern of Grenadian migration over the past 80 years, some of the causes of and attitudes to migration are examined, and the meaning of migration for Grenadians is discussed.