D Eldemire-Shearer

Unique Cryptosporidium Population in HIV-Infected Persons, Jamaica

A cryptosporidiosis survey showed the presence of Cryptosporidium hominis, C. parvum, C. canis, and C. felis in 25, 7, 1, and 1 HIV-positive persons from Jamaica, respectively; 1 person had both C. hominis and C. felis. Multilocus sequence typing indicated the presence of a homogeneous but geographically distinct C. hominis population in Jamaica.

Household food safety awareness of selected urban consumers in Jamaica.

Home interviews of 110 randomly selected householders representing three distinct socio-economic groups in North Central St Andrew, an urban community in Jamaica, were conducted during January-March 1999. Respondents were interviewed about their awareness of safe food handling, risk perception, food handling practices and attitude to food safety issues. The majority of respondents reported a fairly high knowledge of safe food handling practices; however, more than one-half were unfamiliar with the correct procedure for freezing and thawing of foods. Householders were very concerned about the food they purchased for preparation at home, displayed strong concerns about sanitation of food handling establishments, food handlers practices, and the appearance of foods purchased. The majority of respondents had never contacted their local Health Department or the Ministry of Health regarding food safety concerns. Diarrhea, stomach pain, vomiting and nausea were reported as the major symptoms of food-borne illness, while animal foods including dairy, beef, chicken, pork and fish/shellfish were implicated as the main source of food borne illnesses. There were no significant differences (P<0.5) observed between gender and socio-economic groups in the study, except for concern of the appearance of food and shopping options, respectively. These findings raise concerns about consumer food safety knowledge and practices in Jamaica. It is suggested that a national knowledge, awareness and practices survey should be conducted, followed by a properly designed food safety public education campaign, to enhance household food safety awareness in Jamaica.

Mental well-being of doctors and nurses in two hospitals in kingston, Jamaica

Hospital work involves some of the most stressful situations found in any workplace. Furthermore, hospital workers may be affected by non-work-related stress such as family responsibilities and financial difficulties, leading to impaired mental well-being and suboptimal performance. The aim of this study was to assess the level of general mental well-being among doctors and nurses from two hospitals in Kingston, Jamaica. A total of 212 doctors and nurses at the Kingston Public Hospital and the University Hospital of the West Indies were studied yielding a participation rate of 83.1%. A self-administered questionnaire was used to gather social and biomedical data and the General Health Questionnaire 30 (GHQ 30) used to determine general mental well-being. Probable caseness was defined as a GHQ 30 score > 5. Focus group discussions were also held with staff at both hospitals. A total of 27.4% of the study population met the GHQ-30 criteria (caseness) defining them as probable cases of mental distress. Cases and non-cases were not different in age, gender or hospital of employment. However, caseness was associated with years of professional experience, work-related and non-work-related stress, serious financial difficulties and fears of coming to work. Significant predictors of increased risk of caseness were fear of coming to work (OR 3.06; CI 1.40, 6.70); professional experience in excess of five-years and high non-work-related stress. High work-related stress was associated with reduced risk of being classified a case, suggesting that work may have been therapeutic. Focus group discussions suggested that non-work stress was related to financial difficulties, commuting and child care, especially among nurses. Intervention to improve general mental well-being should be targeted at new employees and should address child care, commuting and financial management.

‘Active ageing’: a qualitative study in six Caribbean countries

ABSTRACT The aim of this study was to document the perceptions of elders in six Caribbean countries about ‘active ageing’ and on the basis of their reports to make recommendations to improve their situation. Data were collected principally through 31 focus group discussions conducted in both urban and rural areas. Comparative analysis was carried out of the qualitative information, focusing on three components of ‘active ageing’: health and social services access and use, social support, and economic circumstances. Most of the participants were women, aged 60–79 years, of lower socio-economic status and from urban areas. Large disparities in the responses of Caribbean societies to population ageing were indicated, as well as unequal opportunities to obtain health care and social services, public transport, income and food by both socio-economic status and location. Home-care services are either insufficient or non-existent. Some elders receive social and financial support from relatives while others fear isolation and face deprivation. Social participation varies by place, physical condition, financial situation, association membership, and transport opportunities. Social protection benefits do not provide adequate income and some older people face food insecurity. It was concluded that a comprehensive and multi-sectoral approach using the ‘active ageing’ framework should be implemented to ensure a healthy ageing process.

Health literacy and health seeking behavior among older men in a middle-income nation

Health literacy is a measure of the patient’s ability to read, comprehend and act on medical instructions. This research article examines health literacy and health-seeking behaviors among elderly men in Jamaica, in order to inform health policy. This is a descriptive cross-sectional study. A 133-item questionnaire was administered to a random sample of 2,000 men, 55 years and older, in St Catherine, Jamaica. In this study, 56.9% of urban and 44.5% of rural residents were health literate. Only 34.0% of participants purchased medications prescribed by the medical doctor and 19.8% were currently smoking. Despite the reported good self-related health status (74.4%) and high cognitive functionality (94.1%) of the older men, only 7.9% sought medical care outside of experiencing illnesses. Thirty-seven percent of rural participants sought medical care when they were ill compared with 31.9% of their urban counterparts. Thirty-four percent of the participants took the medication as prescribed by the medical doctor; 43% self-reported being diagnosed with cancers such as prostate and colorectal in the last 6 months, 9.6% with hypertension, 5.3% with heart disease, 5.3% with benign prostatic hyperplasia, 5.3% with diabetes mellitus, and 3.8% with kidney/bladder problems. Approximately 14% and 24% of the participants indicated that they were unaware of the signs and symptoms of hypertension and diabetes mellitus, respectively. The elderly men displayed low health literacy and poor health-seeking behavior. These findings can be used to guide the formulation of health policies and intervention programs for elderly men in Jamaica.

Hypertension and Diabetes Prevalence in Older Persons in Jamaica, 2012.

The Jamaican population is experiencing both a demographic and epidemiological transition. This 2012 study of 2943 community dwelling persons over sixty years of age sought to determine the prevalence of hypertension and diabetes and how it has increased since the earlier 1989 study. Hypertension was the most prevalent non-communicable disease with 61.4% and had increased from 41.4% since 1989. It increased with age and was more common in females than males. Diabetes, at 26.3%, was the third most prevalent; it had increased by 157.1% since 1989. While the majority of affected persons were on medication, control of both diseases was less than adequate. Obesity was associated with both diseases. The paper discusses the implications for healthcare systems.

Sociodemographic factors associated with depressive symptoms among elderly persons from two communities in Kingston, Jamaica

OBJECTIVE To explore possible associations of age, gender, socio-economic status, educational level and level of cognitive functioning with depressive symptoms in a community sample of elderly persons. METHOD Two hundred elderly persons from two communities in Kingston, Jamaica, were randomly selected for participation in the study. They or their caregivers provided sociodemographic information and participants also completed the Zung Self-rating Depression Scale (ZSDS) and the Mini Mental Status Examination (MMSE). Variables of interest were entered in a multiple variable regression model using ZSDS score as the outcome variable. RESULTS Predictors of depression were older age (B = 0.26, se = 0.08, p < 0.01), female gender (B = 3.98, se = 1.44, p < 0.01), low socio-economic status (B = 5.14, se = 1.50, p = 0.01) and low level of cognitive function (B = -0.38, se = 0.18, p < 0.05). No statistically significant association was found between educational attainment and depressive symptoms. CONCLUSION The findings highlight the need for further exploration of the extent to which the associations identified are relevant for the overall population of elderly persons as well as the potential value of targeted preventive and treatment interventions.

Public and private health care utilization differences between socioeconomic strata in Jamaica

Objective: To assess trends in the use of private and public health care services among Jamaicans over a 15-year period (1991–2007). Design and methods: Statistics on the use of health care services were taken from the Jamaica Survey of Living Conditions (JSLC) for the 15-year period 1993 to 2007. Use of hospital services were represented in income quintiles and compared for private and public facilities. The difference in percentage use between public and private was compared by quintiles over the period and the variability in those differentials assessed. Results: This study highlights the increasing use of private services by increasing wealth, exaggerated for the wealthiest quintile. There is a widening of the differences in utilization between public and private centers as income level increases (P < 0.001). Conclusions: Internal and external economic conditions influence the use of private and public health care services in Jamaica. Although the relative increase in the cost (to the user) of public health care is more than that for private health care, the actual cost to use the public health care system is still significantly cheaper than using the private system. Lower income health care users tend to take the lesser cost option.

Ageing in place: implications of morbidity patterns among older persons--findings from a cross-sectional study in a developing country (Jamaica).

Aim:  This paper describes morbidity patterns among older people, relevant health‐care resources in a localised population in a developing country (Jamaica) and implications for ageing in place in the community.

Re-testing theories on the correlations of health status, life satisfaction and happiness

Background: Empirical evidences have shown that happiness, life satisfaction and health status are strongly correlated with each other. In Jamaica, we continue to collect data on health status to guide policies and intervention programs, but are these wise? Aims: The current study aims to fill the gap in the literature by examining life satisfaction, health status, and happiness in order to ascertain whether they are equivalent concepts in Jamaica as well as the coverage of the estimates. Materials and Methods: The current study used a cross-sectional survey of 2000 men 55 years and older from the parish of St. Catherine in 2007 which is it also generalizable to the island. A132-item questionnaire was used to collect the data. The instrument was sub-divided into general demographic profile of the sample; past and Current Good Health Status; health-seeking behavior; retirement status; social and functional status. Ordinal logistic regression techniques were utilized to examine determinants of happiness, life satisfaction and health status. Results: Happiness was correlated with life satisfaction - Pseudo r-squared = 0.311, -2LL = 810.36, χ2 = 161.60, P < 0.0001. Life satisfaction was determined by happiness - Pseudo r-squared = 0.321, -2LL = 1069.30, χ2 = 178.53, P < 0.0001. H ealth status was correlated with health status age, income, education and area of residence - Pseudo r-squared = 0.313, -2LL = 810.36, χ2 = 161.60, P < 0.0001. Conclusion: The current study refuted the empirical finding that self-reported happiness depends on perceived health status for older men in Jamaica.