Rajeev Peeyush Nagassar

Background This study aimed to assess the association between hand hygiene compliance rates and the 5 moments of hand hygiene (HH) amongst healthcare workers, on various clinical wards, at a tertiary level hospital in east Trinidad and Tobago. Despite previous studies showing low HH compliance rates among some categories of staff, follow up data is...

Background Hand hygiene (HH) stands at the forefront of the defence against the spread of disease and Healthcare-Associated Infections (HAIs). Gaps may exist among the Knowledge, Attitudes and Practices (KAPs) of Healthcare Workers (HCWs). This study explores these gaps to understand the scope of the problem in East Trinidad. Method A cross-sectio...

Antimicrobial resistance (AMR) represents a major threat to health with significant global economic and safety implications. One of the major drives of this resistance is the misuse and overuse of antimicrobials. Background/Objectives: In this sense, WHO proposed to it members to estimate the antimicrobial consumption (AMC) at each country level, i...

Citation: Marin, G.H.; Giangreco, L.; Lichtenberger, P.; Dorati, C.; Mordujovich, P.; Rojas-Cortés, R.; Orjuela-Rodríguez, T.; Ramón-Pardo, P.; Castro, J.L.; Marin, D.; et al. Abstract: Antimicrobial resistance (AMR) represents a major threat to health with significant global economic and safety implications. One of the major drives of this resista...

Background The Coronavirus Disease of 2019 (COVID-19) pandemic highlighted the importance of hand hygiene (HH) in infection prevention and control. Knowledge, attitudes, and practices (KAPs) of HH in Trinidad and Tobago have been underexplored. This study examines the KAPs of HH among medical and non-medical students (years 1–3) post-pandemic. Meth...

Chronic bacterial prostatitis is generally difficult to treat. It may involve multiple courses of antibiotics and may be difficult to eradicate with high rates of recurrence. We present the case of a 33-year-old male patient with a previous history of renal tract calculi, stent insertions, and perinephric abscess with percutaneous drainage, which t...

Over the past decade, there has been an increasing number of case reports of bronchopulmonary infection due to Lophomonas spp. The Caribbean has not been included in any reports. We describe two cases of bronchopulmonary infection due to Lophomonas spp. We also describe successful treatment with metronidazole and an alternative, albendazole. We als...

Hand Hygiene Research Post Pandemic

The study emphasizes the vital role of hand hygiene (HH) in reducing healthcare-associated infections (HAIs), with a majority of respondents acknowledging its importance. Gender differences were observed, with females showing better knowledge, attitudes, and practices (KAP). Medical professionals demonstrated better adherence compared to non-medica...

The inappropriate consumption, use, and dispensing of antibiotics are problems faced globally, with a pattern of inappropriate consumption differing in higher-income countries due to the ease of accessibility of antibiotics. The main drivers of consumption and inappropriate use are the over-the-counter sales of antibiotics by pharmacies. Trinidad a...

An antimicrobial consumption (AMC) study was performed in Trinidad and Tobago at the Eastern Regional Health Authority (ERHA). A retrospective, cross-sectional survey was conducted from 1 November 2021 to 30 March 2022. Dosage and package types of amoxicillin, azithromycin, co-amoxiclav, cefuroxime, ciprofloxacin, levofloxacin, moxifloxacin, nitrof...

An antimicrobial consumption (AMC) study was performed in Trinidad and Tobago at the Eastern Regional Health Authority (ERHA). A retrospective, cross-sectional survey was conducted from 1 November 2021 to 30 March 2022. Dosage and package types of amoxicillin, azithromycin, co-amoxiclav, cefuroxime, ciprofloxacin, levofloxacin, moxifloxacin, nitrof...

Objective To understand the dispensing knowledge, attitudes and practices of pharmacists in the context of antibiotics registered under dichotomous laws in Trinidad and Tobago. Methods A cross-sectional study using an open-ended questionnaire gathered data from pharmacists recruited from the private and public sectors over 7 months. The Chi2 test...

Objective: To explore the association between the implementation of the WHO multimodal hand hygiene strategy and the hand hygiene (HH) compliance rates among healthcare staff of a public hospital in rural Trinidad and Tobago, in order to make practical recommendations for improvement of the hospital’s Infection Prevention and Control Programme. Des...

Objectives To assess physicians' knowledge, attitudes, and practices regarding the antibiotic management of uncomplicated UTIs in non-pregnant, pre-menopausal women and to determine physicians' antibiotic dispensing practices. Methods A cross-sectional study of physicians in private and public health facilities, treating uncomplicated UTIs across...

Objectives Antimicrobial resistance is a global problem. The extent of this problem in the Caribbean sub-region is not well characterised. Most reports are from a few countries within the Caribbean sub-region. The aim was to develop and refine an antimicrobial resistance surveillance system at the Caribbean Public Health Agency (CARPHA) for member...

Objectives The aim was to develop an antimicrobial surveillance system in Caribbean Public Health Agency (CARPHA) member states. The objectives were to: 1. establish a surveillance system for antimicrobial resistance (AMR) starting with key bacterial isolates such as Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus spp....

OBJECTIVE To describe the epidemiology of sharp injuries, in healthcare workers, at the Sangre Grande Hospital (SGH) in Trinidad. A secondary analysis of non-sharp injuries was also done. Sharp injuries predispose staff to blood borne infections and thus are occupational infection prevention and control matters. Sharp injuries were observed to be a...

Background The Centres for Disease Control and Prevention (CDC) and World Health Organization (WHO) list extended spectrum beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae as serious threats and priority pathogens. This study identified phenotypic resistance patterns to these pathogens in east Trinidad, West Indies. We als...

Background

Objectives To verify the utility, cost and feasibility of various methods for Group (Gp) B Streptococcus (GBS) identification; To elucidate the prevalence and resistance patterns of GBS in a clinic population. Design and Methods Isolates were collected from pregnant patients by culturing lower vaginal swabs (LVS) and rectal swabs (RS) from May to S...

The Dialysis Unit at the Sangre Grande Hospital has 11 chairs which are utilized 3 time per day from 6 am to 6 pm. However, the need for additional dialysis time and facilities is ever increasing. This is due to the fact that there are many patients awaiting dialysis, are being facilitated at private dialysis centers and there is a growing number o...

Objective: To describe the resistance patterns of key pathogens in the Caribbean. Methods: The Caribbean Public Health Agency’s (CARPHA) laboratory provided automated identification and susceptibility testing on the Vitek 2 Compact, of clinically relevant isolates provided by CARPHA Member States (CMS) laboratories. These were submitted following a...

This study focuses on the cost effectiveness and cost benefit of screening, identification and susceptibility testing using carrot broth and various growth media and definitive identification techniques in the Obstetric clinic at the Sangre Grande Hospital, Trinidad. It also looks at the prevalence of Group B Streptococcus in the clinic. Reliable...

http://www.caribbeanmedicaljournal.org/2020/06/17/a-pilot-study-to-delineate-factors-contributing-to-multi-drug-resistant-organism-mdro-outbreak-and-control-at-the-sangre-grande-hospital/

http://www.caribbeanmedicaljournal.org/2020/05/09/recommendations-for-antibiotic-prescriptions-for-upper-respiratory-symptoms-in-children-in-trinidad-and-tobago-grade-adolopment-approach/

BACKGROUND The Sangre Grande Hospital (SGH) experienced several Multi Drug Resistant Organism (MDRO) outbreaks for 2015. In this regard, a study was conducted to understand factors contributing to MDRO acquisition and control, for policy and implementation of prevention and control measures. METHODOLOGY A Case-Control Study Design was chosen to exe...

Background: In Trinidad and Tobago, 22,329 and 18,594 cases of acute respiratory infections (ARI) in children less than 5 years were recorded for 2016 and 2017 respectively. Often, antimicrobials are over prescribed without proof of bacterial infection. Recommendations for management of ARIs are needed. Methods: The GRADE-ADOLOPMENT approach was us...

Objectives To assess the compliance of hand hygiene (HH) practices of staff and determine the impact of multimodal interventions to improve hand hygiene practices. Methods A prospective study was conducted to determine the hand hygiene (HH) practices of staff according to the World Health Organization’s “5 moments of HH”. During random visits to t...

Introduction: Consistent practice of hand hygiene (HH) has been shown to reduce the incidence and spread of hospital acquired infections. The objectives of this study were to determine the level of compliance and possible factors affecting compliance with HH practices among HCWs at a teaching hospital in Kingston, Jamaica. Methodology: A prospec...

Objective: To determine the association between health insurance/health benefit and medication adherence amongst adult diabetic patients in Kingston, Jamaica. Methods: This was a cross-sectional study. Target population was diabetics who attended the diabetic outpatient clinics in health centres in Kingston. Two health centres were selectively c...

A previously healthy 27-year-old Jamaican man presented to the University Hospital of the West Indies with recurrent joint pain, remitting and relapsing fever, and shortness of breath. He was subsequently found to have Abiotrophia defectiva endocarditis. This was the first time this organism had been isolated at our institution. Despite culture dir...

Background: VITEK 2 Compact (VTC), VITEK 2 60 (VT60) and API20E/NE (all bioMérieux) use biochemicals for bacterial identification (ID), while the VITEK MS (VMS) uses matrix-assisted laser desorption/ionization-time of flight mass spectrometry. This pilot compared the accuracy, cost and time to ID of these methods.� Methods: A total of 80 Gram-negat...

Dengue fever is an important public health problem in Jamaica and has various serious manifestations, which if not identified and treated at the appropriate time can lead to dire consequences. Bacterial co-infections have been seen in clinical practice but may be thought of as simply coincidental. This review highlights the importance of bacteria i...

The authors report a fatal case of Corynebacterium sp. endocarditis. Corynebacterium spp. are non-sporulating, pleomorphic Gram-positive bacilli. In particular the authors have identified a species of Corynebacterium very closely related to C striatum. This is C simulans. The authors were able to identify the genus and species using various phenoty...

Domestic violence is a medical and social issue that often leads to negative consequences for society. This paper examines the association between the prevalence of domestic violence in relation to the different socio-economic classes in Central Trinidad. The paper also explores the major perceived causes of physical abuse in Central Trinidad. Part...