Tracy Evans-Gilbert

The University of the West Indies and Cornwall Regional Hospital

Background: Psychosocial factors interact with adolescent development and affect the ability of HIV-infected adolescents to cope with and adhere to treatment. Aim: To evaluate psychosocial outcomes in perinatally HIV-infected adolescents (PHIVAs) in Western Jamaica after psychosocial intervention. Methods: The Bright Futures Paediatric Symptom Ch...

Chikungunya (CHIKV), Zika (ZIKV), and Dengue viruses (DENV) exhibit similar ecological, evolutionary, and epidemiological patterns but have different pathophysiological mechanisms of disease manifestations. Clinical presentations overlap and can be asymptomatic. Differences occur in the severity of clinical presentations with the highest mortality...

The Global Vaccine Action Plan 2011–2020 called for all countries to establish a National Immunization Technical Advisory Group (NITAG) by 2020. The Caribbean, with its unique geographical context of 22 countries/territories, had limited technical expertise to establish individual NITAGs in small countries. The Caribbean Immunization Technical Advi...

This study aims to assess coronavirus disease 2019 (COVID-19) surveillance methods, health resources, vaccination coverage and income stratification and quantify burdens of disease and death in children and adolescents in the Caribbean. The investigation was a descriptive, cross-sectional study that included 15 Caribbean countries/territories and u...

Background: The objectives are to determine the incidence of malnutrition and anemia and evaluate the association between nutritional status and COVID-19-related clinical outcomes in children hospitalized for COVID-19. Methods: This multi-island inpatient survey presents data from nine hospitals in three Caribbean islands on children from birth to...

Objective. To assess the legislative frameworks concerning childhood vaccination in the English- and Dutch-speaking Caribbean and propose a model legislative framework for Caribbean countries. Methods. This study included a survey of 22 countries and territories in the Caribbean regarding legal vaccination mandates for school entry, budget allocati...

The objective of this study is to characterize clinical manifestations of vulnerable subpopulations and quantify the use of health resources among subpopulations of COVID 19 infected children and adolescents

Background: Acute ischemic stroke is an infrequent occurrence in children with coronavirus disease 2019 (COVID-19). Adults are more likely to have comorbidities, cardiovascular events or multisystem involvement during hospitalizations,. We describe a case of ischemic stroke in a healthy infant Case Presentation Summary: A healthy breastfed 8-week-...

Background: COVID 19 is known to have a spectrum of hematopoietic events including severe pro-inflammatory states associated with a unique coagulopathy or thrombocytopenia. We describe novel severe pancytopenia with marked rebound thrombocytosis and spontaneous recovery in a previously healthy teenage girl diagnosed with SARS-CoV2 infection. Case P...

Background: There is limited evidence among children regarding the association between malnutrition and COVID-19 disease severity. We evaluated the impact of malnutrition on clinical outcomes in hospitalized COVID-19-infected children. Methods: This multi-island inpatient survey presents data from nine hospitals in three Caribbean islands in child...

Similarities in clinical, laboratory, and cytokine responses have been demonstrated in Dengue Fever and COVID-19 diseases. This study aims to determine a geographical correlation between COVID 19 mortality and the prevalence of dengue fever. This is a geographical ecological study among 16 Caribbean islands. Using secondary online data sources, we...

Objective: To review the legal frameworks for vaccination in the Caribbean sub-region. Methods: Legislation concerning the vaccination of children among 22 countries and territories in the Caribbean sub-region was reviewed. Data were collected using a standardized questionnaire on immunization which included information regarding legislation (such...

Objective: To evaluate the clinical outcomes of children with COVID-19. Methods: This is a retrospective study of children aged 0–17 years at a tertiary care institution conducted from April 2020 to February 2021. Children managed remotely, seen in the emergency room or admitted with a positive PCR test for SARSCOV2 were included. Demographic and c...

The first case of COVID-19 reported in Latin America occurred in São Paolo, Brazil, on February 25, 2020, in a 61-year-old man who had recently returned from the Lombardy region in Italy. The first cases in the Caribbean region were reported on March 1 in St Martin in a couple who returned from France and in the Dominican Republic in a 61-year-old...

Evidence-based interventions are urgently needed to successfully achieve the elimination of mother to child transmission of HIV. This study aimed to evaluate the impact of a default tracking programme on the outcomes of infants exposed to HIV. We conducted a longitudinal cohort study of mothers infected with HIV. We established a default tracking p...

Background: Ingestion of marijuana in children presents primarily with encephalopathy and potentially, in severe cases, seizures. There is a growing body of evidence supporting the benefit of medical marijuana as an anticonvulsant treatment for intractable seizures. However, there are limited data regarding its proconvulsant effects after ingestion...

In Jamaica, outbreaks of 3 different arboviral illnesses occurred in 2012, 2014 and 2016 with Dengue, Chikungunya and Zika viruses respectively. Vertical transmission of all 3 viruses has been well described but there is a paucity of data comparing outcomes in the same population. It is known that stillbirths and fetal losses are associated with De...

Early initiation of HAART preserves the robust immune system of perinatally HIV infected children and limits viral reservoir size. Our aim was to study the current immune and virological status of perinatally infected adolescents who returned after defaulting care. A retrospective analysis was conducted on laboratory outcomes stratified by defaulte...

Chikungunya is a mosquito-borne infectious disease that has emerged as a global pathogen. The virus can pass vertically from mother to child especially during the perinatal period, with an intrapartum vertical transmission rate of 50%. Approximately half of the neonates infected with chikungunya present with severe symptoms and infrequently death....

Background: Limited studies describe the growing population of PHIVA in resource limited settings. We examined outcomes of a cohort of PHIVA and evaluate factors associated with viral suppression. Methods: Adolescents 10-19 years diagnosed from 2004 to 2014 were enrolled from adult and pediatric clinics in Western Jamaica. Demographic, clinical an...

Background: Adolescents with chronic diseases require youth directed services. In Jamaica, children are transferred at age 12 years to adult care in the public hospitals. We compare the outcomes of perinatally HIV infected adolescents (PHIVA) who were transferred to adult care with those in pediatric care. Methods: Adolescents aged 10-19 years fro...

Eosinophilic meningitis caused by Angiostrongylus cantonensis is an endemic and emerging disease that affects adults and children in Jamaica. Most cases resolve without sequelae, but young children are at high risk of neurological damage and death. Treatment with corticosteroids and albendazole is considered safe for adults and children, but protoc...

This case report highlights the course of two healthy unrelated children with an encephalopathy characterised by dyskinesia, seizures, hemiparesis and behavioural change associated with recent human parvovirus B19 infection. The cases are compared with a previously described case of childhood chorea encephalopathy associated with human parvovirus B...

With the increasing incidence of paediatric asthma, there has been a corresponding increase in the physical, emotional and financial burden. This has led to a greater interest in determining the impact of asthma and its treatment on many aspects of patient functioning and wellbeing. To assess the usefulness of the Asthma Clinic established in Jamai...

The objectives of our study were to describe the epidemiology of child-health indicator diseases in western Jamaica, examine differences in indicator diseases between sex and age, and generate hypotheses about causes of disease burden. International Classification of Disease, 10th Revision, coded discharge diagnoses were collected from consecutive...

Paediatric and Perinatal HIV/AIDS remain significant health challenges in the Caribbean where the HIV seroprevalence is second only to Sub-Saharan Africa. We describe a collaborative approach to the prevention, treatment and care ofHIVin pregnant women, infants and children in Jamaica. A team of academic and government healthcare personnel collabor...

Paediatric HIV/AIDS remains a significant challenge in developing countries. We describe the effectiveness of interventions in HIV-infected children attending Paediatric Infectious Diseases Clinics in Jamaica. One hundred and ninety-seven HIV-infected children were followed prospectively in multicentre ambulatory clinics between September 1, 2002 a...

We aimed to describe the adherence patterns to antiretroviral therapy (ART) in a cohort of HIV-infected children. Between the periods May to October 2005, 63 HIV-infected children and their caregivers recruited consecutively at four Paediatric Infectious Disease Clinics in Greater Kingston and St. Catherine, Jamaica, were interviewed. Adherence was...

HIV has been a leading cause of death in Jamaican children aged < or = five years. Antiretroviral drugs (ARVs) are increasingly available in Jamaica through the Global Fund. Adverse effects of ARVs are a major cause for non-adherence to medications. Knowledge of the use and side effects of these drugs are crucial in the management of HIV-infected c...

Documentation regarding the renal complications of paediatric HIV infection from developing countries is scarce. In the era prior to highly active antiretroviral therapy (HAART), HIV-infected children in Jamaica who developed HIV-associated nephropathy (HIVAN) progressed to end stage renal disease (ESRD) and death within a few months of diagnosis....

Paediatric HIV is a leading cause of morbidity and mortality worldwide. We describe HIV-related mortality in a cohort of HIV-infected Jamaican children and identified factors which influenced survival. A retrospective descriptive study was conducted for the period March 2003 - December 2005 at Cornwall Regional Hospital, Montego Bay, Jamaica. We su...

Objectives: We compared methods of monitoring for adherence in a cohort of HIV infected children receiving HAART Methods: An observational prospective study was conducted on HIV infected children on HAART at Cornwall Regional Hospital in western Jamaica between 2004-2006.We assessed factors influencing compliance using linear regression . We compa...

In the face of the continuing pandemic of HIV/AIDS, the burden of the disease is now largest in the resource-poor developing world. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has listed the adult prevalence rate for the Caribbean as second only to Sub-Saharan Africa. To document the socio-demographic characteristics of paediatric and p...

In a few Caribbean islands, prevention of mother-to-child transmission (pMTCT) of HIV with zidovudine prophylaxis has reduced transmission rates from 27 - 44% to 5.5 - 9 %. To highlight the uptake of interventions, preliminary outcomes and challenges in caring for HIV-exposed infants in a pMTCT HIVprogramme in a resource-limited setting. A cohort o...

To document the frequency of Centers for Disease Control and Prevention (CDC)-defined clinical conditions, opportunistic and co-infections among children with HIV/AIDS. This prospective, observational study reports the findings of 110 HIV-infected children followed in multicentre ambulatory clinics during September 1, 2002, to August 31, 2003, from...

The study describes a cohort of HIV-infected Jamaican children receiving antiretroviral therapy (ART) and reports the outcome. An observational prospective study was conducted on HIV-infected Jamaican children receiving anti retroviral drug therapy (ART). The outcome measures, weight, height, hospital admissions and length of stay were compared at...

The aim of this study is to describe the investigation and management of outbreaks of acute tuberculosis, varicella zoster virus and scabies in a residential facility for children with HIV/AIDS. A review of the results and management for diagnosed cases of acute TB (four between 2001 and 2002) as well as varicella zoster virus (15) and scabies (14)...

Reported sexual assault in Jamaica is highest among children and adolescents. The risk of HIV transmission after sexual assault, although small, may be significant in certain circumstances, and it is therefore reasonable that post-exposure prophylaxis should be offered. These HIV transmission rates are similar to those of healthcare workers after o...

The continuing worldwide epidemic of adult HIV/AIDS has led to an increase in the number of HIV-positive children mainly through perinatal transmission. Although national data are available, there is no published report of the epidemiology of HIV/AIDS in children in Jamaica. A multicentre retrospective analysis of 183 HIV seropositive children admi...