Rohan Maharaj

University of the West Indies, St. Augustine | UWI · Department of Para-Clinical Sciences

Objective: Sugar-sweetened beverages (SSB) are implicated in the increasing risk of diabetes in the Caribbean. Few studies have examined associations between SSB consumption and diabetes in the Caribbean. Design: SSB was measured as teaspoon/day using questions from the National Cancer Institute Dietary Screener Questionnaire about intake of sod...

Improving public health initiative requires an accurate anthropometric index that is better suited to a specific community. In this study, the anthropometric grouping index is proposed as a more efficient and discriminatory alternative to the popular BMI for the Eastern Caribbean population. A completely distribution-free cluster analysis was perfo...

Background: The aim of this study was to measure the patient’s perception of patient centeredness in their consultations for non-communicable diseases (NCDs). We also measured consultation length and patient enablement. Method: A cross-sectional study was conducted over 2 months at four primary care clinics at the St. Joseph cluster of the North Ce...

Introduction Studies conducted in the US and other high-income countries show that the local food environment influences dietary intakes that are protective for cardiovascular health. However, few studies have examined this relationship in the Caribbean. This study aimed to determine whether perceptions of the local food environment were associated...

Aims To determine the level of glycemic control and cardiovascular (CVD) risk among adults with diabetes in the Eastern Caribbean. Methods Baseline data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study (ECS) were used for the analysis. ECS participants were 40 years of age and older, residing in the US Virgin Islan...

Little has been published regarding postgraduate assessments during the COVID-19 pandemic. There is an urgent need to graduate well-trained specialists including family physicians who play a key role in patient care. The successes and challenges encountered in mounting qualifying 2020 Family Medicine examinations during the COVID-19 pandemic at the...

Background Accurately defining obesity using anthropometric measures that best capture obesity-related risk is important for identifying high risk groups for intervention. The purpose of this study is to compare the association of different anthropometric measures of obesity with 10-year cardiovascular disease (CVD) risk in adults in the Eastern Ca...

Background: Metformin is the drug of first choice in people newly diagnosed with type 2 diabetes. Most patients respond to metformin monotherapy, but many others remain uncontrolled even at maximal doses. Although non-adherence is a major contributor to non-response, genetic polymorphisms of organic cation transporters play an important role in cl...

Background: Palliative care is in its infancy in most of the developing world. We set out to explore the lived experiences of families and caregivers of recently deceased cancer patients in Trinidad and Tobago and to determine the unmet needs of the patients and what recommendations could be derived to improve the current services. Methods: A ph...

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region. Objective: This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean. Design: The Eastern Caribbean Health Outcome...

Objective: To describe the rationale and design of a prospective study of ambulatory blood pressure measurement (ABPM) combined with measurement of contextual factors to identify hypertensive phenotypes in a Caribbean population with high rates of HTN and cardiovascular disease. Design: Prospective, multi-center sub-study. Setting: Eastern Car...

Background Over 60% of households (HHs) in Trinidad and Tobago (T&T) consume alcohol. These HHs were more likely to report illnesses, relationship problems, and behavioral problems with children. This study set out to determine what proportion of HHs were willing to support changes in specific policies, laws and regulations in a national alcohol ca...

Purpose: The Caribbean population faces a growing burden of multiple non-communicable chronic diseases (NCDs). Breast cancer is the leading cause of cancer death for women in the Caribbean. Given the substantial burden of NCDs across the region, cancer prevention and control strategies may need to be specifically tailored for people with multiple...

Objective Prior studies have suggested that weight misperception – underestimating one's actual weight – may be associated with reduced engagement in weight loss programs, decreasing the success of initiatives to address obesity and obesity‐related diseases. The purpose of this study was to examine the factors associated with weight misperception a...

Background To determine the patterns of alcohol use among households in Trinidad and Tobago (T&T) and to estimate the association between alcohol use and negative psychological, social, or physical events experienced by the household. MethodsA convenience sample of 1837 households across T&T. We identified bivariate correlates of alcohol use, and h...

Lessons learned: Despite intermittent setbacks the FM programme in the ESC has grown due to: (1) The presence of an umbrella institution in the UWI. (2) The role of the Caribbean College of Family Physicians providing a unifying force of advocacy and cooperation. (3) Collaboration of staff across four sites despite large distances, differing depar...

Background To describe the prevalence of missing teeth, use of bridges and dentures and unmet dental needs among those aged 60 years and above. The associations of these conditions with socio-demographics, type 2 diabetes mellitus and depression were also studied. The work was carried out in 7 Latin American and Caribbean (LAC) cities in 1999-2000....

Background: Patients with normal weight obesity (NWO) have a normal body mass index (BMI) but elevated body fat percentage (BF%), thereby increasing their risk of cardiovascular and metabolic disorders. The purpose of this research was to determine the prevalence of NWO and its associated factors in a sample of young adults in Trinidad and Tobago...

Aim: To determine the sensitivity and specificity of the Reichert™ Tono-Pen AVIA® when used by novice medical students in an ethnically diverse population in Trinidad. Subjects and method: Participants were residents of Trinidad between the ages of 20 and 90 years attending the Ophthalmology Clinic at the Eric Williams Medical Sciences Complex (...

Dissolution testing is used to evaluate the performance of pharmaceutical products. This study compared the dissolution profiles of seven immediate-release metformin 500-mg formulations, including two products with the trade name Glucophage, in simulated intestinal fluid (SIF) at pH 6.8 buffer without enzymes. Other characteristics investigated wer...

Introduction Baseline indices for the Government of Trinidad and Tobago’s national strategic plan for HIV/AIDS were required for routine monitoring and evaluation. As such a national Knowledge, Attitude, Practice and Belief survey (KAPB) on HIV/AIDS was conducted by The University of the West Indies in collaboration with the National AIDS Coordinat...

Global Health Leadership and NCDs in the Caribbean.

Previous studies have demonstrated poor metabolic and blood pressure control in the diabetic population in Trinidad. The aim of this study is to compare baseline and follow-up metabolic parameters and blood pressures taken within a 16-month period to ascertain if there have been improvements. A retrospective chart review was conducted of diabetic p...

Available from: http://nhfshare.heartforum.org.uk/RMAssets/ncdlinks/HCC_ALCOHOLMINISTEROFHEALTH_CaucusMeeting28Sept.pdf

The objective was to examine the cervical screening programme at selected health centres in the Eastern Regional Health Authority (ERHA), Trinidad and Tobago, specifically regarding Pap smear coverage, frequency distribution of abnormal smears and the adequacy of follow-up of abnormal smears, according to the Caribbean Frameworks for Developing Nat...

Background: Our previous work has shown that type 2 diabetes mellitus is a problem in the school-aged population of Trinidad, West Indies. The current study evaluated the prevalence in this population of selected risk factors for diabetes, viz: obesity, family history of diabetes and acanthosis nigricans. Objective: To assess the prevalence of t...

The objective of the present study was to determine the knowledge and practices among Trinidad and Tobago school-attending adolescents towards energy drinks (ED), alcohol combined with energy drinks (AwED), weight-altering supplements (WAS) and vitamin/mineral supplements (VMS) and their experience of adverse effects associated with such use. A cro...

Alcohol Policy in the English Speaking Caribbean

Introduction: Intra-lesional glucocorticosteroid (GCS) injections are used widely for painful musculoskeletal conditions in general practice. Case: A 26 year old female, was given an intra-lesional injection of 24 mg methyl prednisolone acetate (MPA) with 15 mg lidocaine for treatment of DeQuervain's tenosynovitis. She was six weeks postpartum a...

Background: The provision of written asthma action plans (WAAPs) is regarded by regional and international guidelines as an essential component of patient education and self-management. However, the evidence for this practice in children is deficient. Aim: To evaluate the effectiveness of adding a personalized WAAP in the treatment of children w...

Diabetes, hypertension and heart disease inflict a heavy health burden on the Caribbean Republic of Trinidad and Tobago. This study assessed the prevalence of self- reported diabetes, hypertension and heart disease in lower socioeconomically placed individuals accessing welfare grants. Data collected between July 2008 and June 2009 were analyzed fr...

Objectives Somatoform disorders are common in international primary care settings, but have been little studied in the developing world. The objective of this study was to determine the prevalence of severe undifferentiated somatoform disorder, and its relationship to depression and anxiety, among patients attending walk-in clinics in Trinidad. Met...

Although the epidemic of diabetes in adults is well established and documented, information on the epidemiology of type 2 diabetes mellitus (T2DM) in children and adolescents in Trinidad and Tobago is limited. Anecdotal reports suggest an increase in children and especially adolescents with T2DM amongst clinic attendees. To assess the prevalence of...

Objectives: Current treatment strategies for painful diabetic neuropathy (PDN) include oral medications, which are costly and may have adverse effects. Topical therapies have been used for PDN with some benefit. Nutmeg has certain properties that may be effective in ameliorating neuropathic pain. The purpose of this study was to determine whether...

Appendix. There were five forms used in this study for recording patient information based on their current Stage of Change with respect to diet, exercise and medication use. These forms were used as checklists for the physician to ensure all the sections of the consultation were attended to during the visit. An Example of these forms is included h...

To improve glycaemic control among Type 2 diabetics using patient-physician consultations guided by the Stages of Change (SOC) model. A randomised trial was conducted. After ensuring concealment of allocation, Type 2 diabetics were randomly assigned to receive the intervention or the control. The intervention consisted of identifying each patient's...

The authors offer their views whether or not Trinidad & Tobago should introduce Highly Active Antiretroviral Therapy (HAART) in the primary health care system. They comment on the use of HAART for treating HIV infections. They discuss the lack of continuity of care by primary care physicians on HIV patients.

To determine the prevalence of abuse by their partners and its association with mental disorders among female patients at walk-in clinics in Trinidad. Female participants from 16 randomly selected walk-in clinics, previously stratified to represent all administrative regions and urban and rural settings, who were 18 years or older, were surveyed du...

Table S1. Summary Table of papers on Adolescent Health in the Caribbean.

The aim of this paper was to review and summarize research on prevalence of health risk behaviours, their outcomes as well as risk and protective factors among adolescents in the English-speaking Caribbean. Searching of online databases and the World Wide Web as well as hand searching of the West Indian Medical Journal were conducted. Papers on res...

To determine the prevalence of depression and psychosocial factors associated with depression in secondary school students in Trinidad This was a cross-sectional study of a stratified random sample of public secondary schools utilizing a modified pre-tested self-administered Beck Depression Inventory (BDI) to detect depression in students aged 13-1...

Depression is the most common mental disorder; in an ambulatory-care setting 5 to 10% of patients meet the criteria for major depression. Despite extensive documentation in primary care internationally, Trinidadian studies published on depression have been primarily hospital-based and focussed on suicide. The objectives of this study were to determ...