Search Results (58)

Stroke is the second leading cause of death and disability in Latin America; however, few epidemiological studies have been conducted in South America. An observational study was conducted to analyze trends in stroke mortality in South American (SA) countries. Age-standardized mortality rates and proportional mortality due to stroke in the populations of SA countries between 1990 and 2019 were assessed by extracting data from the Global Burden of Disease 2019 study. Joinpoint regression models were employed to identify trends in the annual percentage change in mortality rates for each segment. Considering the data collected over the 30 years that were studied, the age-standardized stroke mortality trend decreased in Argentina (−1.6%), Uruguay (−0.6%), Brazil (−0.5%), Guyana (−0.5%), and Bolivia (−0.4%), while Venezuela (+1.6%) and Suriname (+1.0%) showed an increasing trend. The proportional stroke mortality trend decreased in Argentina (−1.7%), Paraguay (−0.9%), Uruguay (−0.7%), Guyana (−0.7%), Brazil (−0.5%), and Chile (−0.5%), whereas Bolivia (+1.0%), Suriname (+0.6%), and Peru (+0.4%) exhibited an increasing trend. The trends in stroke mortality between 1990 and 2019 demonstrated considerable variability. While most SA countries experienced significant decreases in stroke mortality trends, Venezuela and Suriname showed increases in age-standardized mortality rates, and Bolivia, Suriname, and Peru exhibited increases in proportional mortality rates. No decreasing stroke mortality trend was observed in the segment after the last joinpoint, highlighting the need for improvement in prevention and treatment. Full article

Exposure to mercury (Hg) and lead (Pb), in combination with liver and kidney impairment, may result in adverse birth outcomes. From 408 women in the age range of 16 to 46 years, living in rural and urban areas in the interior of Suriname, we looked at the association between adverse birth outcomes and exposure to Hg and Pb in combination with liver and kidney function. This group of women represented a subcohort of pregnant women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH)—Meki Tamara study. Liver function was assessed by measuring aspartate amino transferase (AST), alanine amino transferase (ALT), and gamma-glutamyl transferase (GGT). Kidney function was assessed by measuring creatinine, urea, and cystatin C. We defined preterm births as birth before 37 weeks of gestation, low birthweight as birthweight < 2500 g, and low Apgar score as a score < 7 at 5 min, and these were used as indicators for adverse birth outcomes. Small size for gestational age was defined as gestational age < −2SD weight for GA. We found significant statistical associations between biomarkers for liver and kidney functions and adverse birth outcomes Apgar score and gestational age. No significant association was found between heavy metals Hg and lead and adverse birth outcomes. Full article

Artisanal and small-scale gold mining (ASGM) has made several environmental impacts, resulting in the significant siltation of water bodies due to the deposition of sediments on riverbanks. Based on this perspective, this study aims to investigate the water bodies and regions most impacted by mining activities, especially in relation to the increase in the Total Suspended Solids (TSS) caused by ASGM, focusing on the territories of Suriname and French Guiana, over the period from 2017 to 2023, through the creation of an algorithm in Google Earth Engine. This research also aims to map and describe active mining in this region using the Classification and Regression Tree (CART) method, which achieved an overall accuracy of 82% and a kappa index of 0.77. The results reveal that from 2017 to 2024, there was an increase of 148.09 km² in mining, with an average increase in TSS of up to 167 mg/L in water bodies most affected by mining activities. Finally, the continued importance of using remote sensing technologies, such as GEE, together with innovative methodological approaches, to monitor and manage natural resources in a sustainable manner is highlighted. Full article

The early detection of sickle cell disease (SCD) is vital to reduce mortality among affected children. Suriname currently lacks a newborn screening programme (NSP) for SCD. We performed a pilot programme to evaluate the scalability of such an initiative. Dried blood spots were collected from five birth centres and subjected to electrophoresis analysis. The programme scalability was evaluated using the non-adoption, abandonment, scale-up, spread, and sustainability framework. Challenges across six domains (illness, technology, value proposition, adopter system, organisation, and societal system), were categorised hierarchically as simple 😊, complicated 😐, or complex 😢. It has been proven that implementing programmes with mainly complicated challenges is difficult and those in mainly complex areas may be unachievable. SCD was detected in 33 of 5185 (0.64%) successfully screened newborns. Most of the domains were classified as simple or complicated. Disease detection and technology suitability for screening in Suriname were confirmed, with favourable parental acceptance. Only minor routine adjustment was required from the medical staff for programme implementation. Complex challenges included a reliance on external suppliers for technical maintenance, ensuring timely access to specialised paediatric care for affected newborns, and securing sustainable financial funding. Scaling up is challenging but feasible, particularly with a targeted focus on identified complex challenges. Full article

The suicide rates in Guyana, Suriname and Trinidad and Tobago are among the highest in the Americas, containing significant Indo-Caribbean populations that are suggested to be most vulnerable to suicide. This systematic review analyzes the existing literature and identifies knowledge gaps in risk and protective factors against suicide in these countries. The literature search conducted followed PRISMA guidelines using the PubMed and APA PsycInfo databases. The PRISMA flow diagram illustrated that eight scholarly papers were eligible for inclusion. Included literature examined stratified data focused on the aforementioned countries, as well as their Indo-Caribbean adolescent populations. Excluded literature did not mention suicidality, adolescents, Indo-Caribbeans, or the focal countries or was focused on the Jonestown mass murder–suicide event. The studies encompassed 6581 individuals. Identified risk factors include social stigma regarding suicide, mental health resource scarcity, and difficult socioeconomic conditions. The identified protective factors for youth include religious/spiritual practices and group activities. Limitations include database quantity, risk of publication bias, and the small sample for each study. A prevailing social stigma regarding suicide was identified. Greater research is needed relating to effects of suicide legislation, bereavement experiences, sociocultural contexts, geography, migration patterns, and culturally compatible interventions to aid future suicide prevention efforts. The protocol was registered with PROSPERO (CRD42023417494). Full article

Climate change mitigation, adaptation to intensifying hurricanes, and decarbonization challenges in developing countries emphasize the urgent need for resilient high-voltage grids to facilitate the expansion of renewables. This research explores the technical feasibility of extending the U.S.–Caribbean Super Grid to include the Virgin Islands, Guadeloupe, Martinique, Trinidad and Tobago, Guyana, Suriname, French Guyana, and the northeastern part of Brazil in South America. This proposed extension aims to capitalize on the recent introduction of a new generation of wind turbines certified for operation under strong hurricane forces. The research utilizes modeling and simulation techniques to evaluate the performance of the proposed extension. A method for modeling and estimating spatiotemporal wind power profiles is applied, and the results demonstrate a reduction in maximum wind power variability within the U.S.–Caribbean Super Grid. Depending on the hurricane trajectory, the variability is reduced from 56.6% to less than 43.2%. This reduction takes effect by distributing peak surplus wind power alongside the proposed U.S.–Caribbean–South America Super Grid (UCASG). The research concludes by acknowledging the merits and limitations of the study and discussing potential directions for future research in this field. Full article

Prior research has shown that climate literacy is sparse among low- and middle-income countries. Additionally, no standardized questionnaire exists for researchers to measure climate literacy among general populations, particularly with regards to climate change effects on vector-borne diseases (VBDs). We developed a comprehensive literacy scale to assess current knowledge, attitudes, and behaviors towards climate change and VBD dynamics among women enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort in Suriname. Items were generated by our research team and reviewed by a group of six external climate and health experts. After the expert review, a total of 31 climate change and 21 infectious disease items were retained. We estimated our sample size at a 10:1 ratio of participants to items for each scale. In total, 301 women were surveyed. We validated our scales through exploratory (n = 180) and confirmatory factor analyses (n = 121). An exploratory factor analysis for our general Climate Change Scale provided a four-construct solution of 11 items. Our chi-squared value (X² = 74.32; p = 0.136) indicated that four factors were sufficient. A confirmatory factor analysis reinforced our findings, providing a good model fit (X² = 39.03; p = 0.23; RMSEA = 0.015). Our Infectious Disease Scale gave a four-construct solution of nine items (X² = 153.86; p = 0.094). A confirmatory factor analysis confirmed these results, with a chi-squared value of 19.16 (p = 0.575) and an RMSEA of 0.00. This research is vitally important for furthering climate and health education, especially with increases in VBDs spread by Aedes mosquitoes in the Caribbean, South America, and parts of the southern United States. Full article

Background: Orthopedic surgery is a specialty at risk for medical malpractice claims. We aimed to assess the frequency of alleged malpractice cases related to orthopedic surgery in the Netherlands from the last 15 years. Methods: We systematically searched the database of the Dutch Medical Disciplinary Court for verdicts related to orthopedic surgery between January 2009 and July 2023 and extracted case data and data on allegations and outcomes. Results: We identified 158 verdicts (mean of 10.5 per year), of which 151 (96%) were filed against specialists and 7 (4%) against residents. Cases were most frequently classified as incorrect treatment/diagnosis (n = 107, 67.7%). Cases were related to the subspecialties of knee (n = 34, 21.5%), hip (n = 31, 19.6%), ankle (n = 25, 15.8%), spine (n = 22, 13.9%), and shoulder (n = 19, 12.0%). A total of 32 cases (20.3%) were judged as partially founded and 9 (6%) as founded. The Dutch Medical Disciplinary Court imposed 28 warnings, 10 reprimands, and 3 temporary suspensions. A total of 68 appeals were submitted, of which 95% were rejected for filing patients. In three instances, unfounded verdicts were changed to two warnings and a reprimand. In four appeals by an orthopedic surgeon, a warning and reprimand were dismissed, and two reprimands were changed to warnings. Conclusions: The amount of malpractice cases against orthopedic surgeons in the Netherlands is relatively low. The cases in our study may improve our understanding of allegations against physicians and improve the quality of patient care. Full article

Name change can only take place in the Netherlands under strict conditions and according to patronizing regulations. At the moment, an amendment of name law is being drafted that would give descendants of Dutch citizens whose ancestors lived in slavery an exemption. If they have a family name that their ancestors received upon their release, they may change it free of charge. It remains to be seen, however, whether the desire to adopt new names in keeping with a reclaimed African identity can also be granted. After all, that would conflict with the general regulations when creating a new name. The whole issue shows political opportunism. First, it would be useful to get a good picture of name adoption in light of surnaming in general. Is it right to consider the names in question as slave names? Are they really that bad? It is more likely that precisely the exceptional position now obtained leads to undesirable profiling. In fact, the only solution to embarrass no one is a wholesale revision of the name law that does away with outdated 19th century limitations. Why should anyone be unhappy with their name? Why should someone who insists on having a different name be prevented from doing so? This essay examines the announced change in the law against the background of surnaming in general and the acquisition of family names in Suriname and the Netherlands Antilles in particular. Full article

Employing Grey Relation Analysis (GRA) and Leximetrics, this study conducts a comparative analysis of sustainable food governance performance in the Organization of Islamic Cooperation countries (OIC). It assesses the alignment of their food security policies with sustainable development principles. Addressing a gap in the existing literature, the study aims to assess two separate components of food security governance, i.e., policy formulation and policy implementation. This is achieved by focusing on critical intrinsic factors like sustainable agriculture, sufficiency, resilience, and inclusivity, and sustainable finance which are often overlooked in policy formulation and evaluation. The findings reveal inadequate incorporation of sustainable finance, sustainable agriculture, circular food systems, and effective governance principles. Several countries lack concise policies (e.g., Iran, Turkmenistan, Suriname), relying on fragmented approaches, while others adopt regional food security strategies with observed differences in food governance versus policy alignment performance. The study enhances our understanding of food security governance and policy formulation and implementation, offering insights for advancing sustainability in the food security policies of the OIC. Full article

Introduction: French Guiana is a French territory bordering Brazil and Suriname where the COVID-19 pandemic has severely strained the French Guianese health system. The people working on illegal gold mining sites in French Guiana, also known as garimpeiros, are mainly of Brazilian origin. Their health conditions are precarious, they live under the radar of the surveillance system and therefore, assessment of their health is quite challenging.. The objective of this study was to describe their knowledge, attitudes and practices regarding COVID-19 and vaccination against this infection. Methods: We conducted an international multicenter cross-sectional survey between 1 March 2022 and 30 April 2022 in French Guiana and Suriname, using a structured questionnaire. Results: Eighty persons were included, 95.0% of whom were Brazilian. Most had good general knowledge of COVID-19. Antibiotic prophylaxis had been practiced by 10.0% of participants. Forty-three people thought they had been infected with COVID-19 (53.8%). Self-medication was frequent, often with antibiotics (32.6%, mostlychloroquine, ivermectin or azithromycin) and most had not consulted a physician for symptoms of COVID-19. A majority (62.5%) had received at least one dose of vaccine. Those who were ever tested for COVID-19 were the most likely to be vaccinated (PR = 1.98, p = 0.009). Conclusions: Garimpeiros have a good level of knowledge about COVID-19 but the high consumption of antibiotics raises concerns about the selection of resistant bacteria. The vaccination rate was higher than that of the Guianese population. The most vaccinated individuals were those who had already taken a COVID test suggesting that these individuals had more exposure to the disease, were more health conscious, or had easier access to health centers. Full article

Utilising wildlife as natural resources has a long history and wide appeal for many nations, while seeking international wildlife that is sustainably managed is the primary responsibility of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). However, data-driven trade reviews are required, utilising CITES data to increase our understanding of the trade and facilitate evidence-based conservation planning. This study presents the first trade review for Toucans utilising CITES import reported data. The total number of Toucans exported was over 22,000, which subsequently generated a retail ‘real price’ value of nearly US $72 million. The countries accounting for the majority of Toucan exports were Guyana (39%), Suriname (33%) and Nicaragua (14%), while the main importing country was The Netherlands (nearly 25%). Toucan species traded were Ramphastos vitellinus (accounting for 21.5%), Ramphastos toco (19%) and Ramphastos tucanus (17%), making the top three while trade was recorded in 10 species. However, successfully identifying economic values for 15 species highlights that trade exists within non-CITES listed Toucan species too. Therefore, the levels of trade in non-CITES-listed Toucan species need urgent attention, as do the non-detrimental findings that underpin the CITES quotas set for each species, given the species’ importance ecologically. Full article

The primary aim of this prospective study was to examine the single and combined effect of prenatal exposure to perceived stress, probable depression, and lead on toddlers’ neurodevelopment using the Bayley Scales of Infant and Toddler Development, third edition. Data from 363 mother-toddler pairs enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health prospective cohort study were analyzed. A prenatal lead exposure of ≥3.5 µg/dL was associated with significantly lower receptive (p = 0.008) and expressive (p = 0.006) communication scaled scores. Moderate and severe maternal prenatal probable depression scores were associated with significantly lower fine (p = 0.009) and gross (p = 0.009) motor scaled scores. However, a maternal report of prenatal stress was not associated with neurodevelopmental outcomes. After adjusting for maternal demographics, prenatal stress and lead exposure, prenatal probable depression remained predictive of the toddlers’ gross motor scaled scores (β −0.13, 95% CI [−0.24–−0.02]). Similarly, when adjusting for demographics, prenatal stress and probable depression, prenatal lead exposure remained a significant predictor of their receptive communication scaled scores (β −0.26, 95% CI [−0.49–−0.02]). An analysis testing combined exposure to perceived stress, probable depression, and lead exposure, measured using a cumulative risk index, significantly predicted the child fine motor scaled scores after adjusting for other covariates (β −0.74, 95% CI: [−1.41–−0.01]). Full article

Prenatal exposure to pesticides and the association with adverse health outcomes have been examined in several studies. However, the characterization of pesticide exposure among Surinamese women during pregnancy has not been assessed. As part of the Caribbean Consortium of Research in Environmental and Occupational Health research program, 214 urine samples were collected from pregnant women living in three regions in Suriname with different agricultural practices: capital Paramaribo, the rice producing district Nickerie, and the tropical rainforest, the Interior. We used isotope dilution tandem mass spectrometry to quantify urinary concentrations of biomarkers of three pesticide classes, including phenoxy acid herbicides and organophosphate and pyrethroid insecticides, all of which are commonly used in agricultural and residential settings in Suriname. We observed that participants residing in Nickerie had the highest urinary metabolite concentrations of 2,4-dichlorophenoxyacetic acid and pyrethroids compared to those from Paramaribo or the Interior. Paramaribo had the highest concentrations of organophosphate metabolites, specifically dialkyl phosphate metabolites. Para-nitrophenol was detected in samples from Paramaribo and the Interior. Samples from Nickerie had higher median urinary pesticide concentrations of 2,4-dichlorophenoxyacetic acid (1.06 μg/L), and the following metabolites, 3,5,6-trichloro-2-pyridinol (1.26 μg/L), 2-isopropyl-4-methyl-6-hydroxypyrimidine (0.60 μg/L), and 3-phenoxybenzoic acid (1.34 μg/L), possibly due to residential use and heavy rice production. Full article

Exposure to mercury (Hg) and lead (Pb) may have an effect on pregnant women. We assessed the effect of exposure to mercury and lead on liver and kidney functions in a subcohort of pregnant women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH)—Meki Tamara, study. From 400 women aged 16–46 living in rural, urban, and interior regions of Suriname, we measured blood mercury and blood lead levels. Creatinine, urea, and cystatin C were measured to assess kidney function, and aspartate amino transferase (AST), alanine amino transferase (ALT), and gamma-glutamyl transferase (GGT) were measured to assess liver function. Education, region, and ethnicity showed significant differences for both blood mercury and lead levels, which all had p-values < 0.001. Creatinine and urea were elevated with higher mercury blood levels. Our findings also suggest a relationship between high mercury blood levels and potential harmful effects on liver and kidney function. Full article