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BACKGROUND: High levels of public awareness regarding the hazards of asbestos, rights to health, and benefits of an asbestos-free country can increase advocacy and political commitment to a total ban on asbestos. We aimed to investigate asbestos awareness and associated sociodemographic characteristics among the adult population of St. Kitts and Nevis. METHODS: In this cross-sectional study, 1009 participants completed an online questionnaire with questions about sociodemographic data and asbestos awareness. We applied multiple regression models to estimate associations between sociodemographic factors, levels of asbestos knowledge, and attitudes toward asbestos management. RESULTS: We found that 70% of residents of St. Kitts and Nevis considered asbestos exposure to be a general public concern and believed the government should prevent it. Of all participants, 54% were in favor of completely banning the use and importation of all asbestos products and materials; those with higher levels of asbestos knowledge were more likely to favor a total ban. Higher proportions and odds of favoring a total asbestos ban were also observed in participants aged ≥ 30 years, women, those with higher education, and those living in St. Kitts (vs. Nevis). CONCLUSIONS: These findings support implementing policies to regulate and outright ban the use of asbestos products and materials in St. Kitts and Nevis. This data can be used to develop tailored campaigns to improve asbestos knowledge among sociodemographic groups with lower asbestos awareness, such as in the wider Caribbean and other under-resourced countries.

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BACKGROUND: Healthcare workers are usually the first responders during outbreaks and are instrumental in educating the populace about the prevention of different diseases and illnesses. The aim of this study was to assess the association between healthcare workers' characteristics and knowledge, attitudes and practices toward Zika virus. METHODS: This was a cross-sectional study that collected data from healthcare workers at 3 medical facilities using a validated self-administered questionnaire between July 2017 - September 2017. Logistic regression models were used to examine the association between sociodemographic and knowledge, attitudes, and practices. RESULTS: A total of 190 healthcare workers were analyzed. Of these, 60, 72.6 and 64.7% had good knowledge, positive attitudes, and good practices toward Zika virus, respectively. Healthcare workers without a formal degree were less likely to have good knowledge of Zika virus (adjusted odds ratio (AOR) = 0:49; 95% confidence interval (CI) = 0.24-0.99) compared to those with a formal degree. Reduced odds for positive attitude towards Zika virus were observed in healthcare workers with low income as compared to those with high income (AOR = 0.31; 95% CI =0.13-0.75). Being younger than 40 years old was associated with poor Zika virus practices (AOR = 0:34; 95% CI = 0.15-0.79). CONCLUSIONS: Significant association between healthcare workers' sociodemographic characteristics and Zika virus knowledge, attitudes and practices were observed. Public health interventions that seek to increase Zika virus awareness should aim to train healthcare workers who are younger, without formal degree and those earning low income.

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Sustainable and reciprocal partnerships in pharmacy education and practice exist between schools and colleges of pharmacy in the United States and Caribbean countries and territories. This paper discusses the cultural considerations for such partnerships to flourish. First, general information on Caribbean countries and territories is covered. Next, the paper transitions into how to ensure culturally sensitive engagements when traveling to or hosting visitors from the Caribbean. This paper is intended to assist practitioners with integrating culturally sensitive considerations into the development of partnerships in this region.

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A pilot seroprevalence study was conducted to document exposure to selected pathogens in wild rats inhabiting the Caribbean island of St. Kitts. Serum samples collected from 22 captured wild rats (Rattus norvegicus and Rattus rattus) were tested for the presence of antibodies to various rodent pathogens using a rat MFI2 serology panel. The samples were positive for cilia-associated respiratory bacillus (13/22; 59.1%), Clostridium piliforme (4/22; 18.2%), Mycoplasma pulmonis (4/22; 18.2%), Pneumocystis carinii (1/22; 4.5%), mouse adenovirus type 2 (16/22; 72.7%), Kilham rat virus (15/22; 68.2%), reovirus type 3 (9/22; 40.9%), rat parvovirus (4/22; 18.2%), rat minute virus (4/22; 18.2%), rat theilovirus (2/22; 9.1%), and infectious diarrhea of infant rats strain of group B rotavirus (rat rotavirus) (1/22; 4.5%). This study provides the first evidence of exposure to various rodent pathogens in wild rats on the island of St. Kitts. Periodic pathogen surveillance in the wild rat population would be beneficial in assessing potential regional zoonotic risks as well as in enhancing the current knowledge when implementing routine animal health monitoring protocols in facilities with laboratory rodent colonies.

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OBJECTIVES: For over two decades, feline trichomonosis caused by Tritrichomonas foetus has been recognized as a large-bowel protozoan disease of the domestic cat. It has a wide distribution, but no reports exist in the Caribbean. The objectives of this study were to detect the presence of T foetus and its prevalence in the domestic cat on St Kitts, West Indies. METHODS: A cross-sectional study was performed between September 2014 and December 2015. This study recruited 115 feral cats from a trap-neuter-return program and 37 owned cats treated as outpatients at the university veterinary clinic. Fresh feces were inoculated in InPouch culture medium, as per the manufacturer's instructions. In addition, PCR was performed using primers for T foetus. DNA extraction with amplification using primers of a Feliscatus NADH dehydrogenase subunit 6 was used as a housekeeping gene for quality control. RESULTS: Only two owned cats had reported diarrhea in the preceding 6 months. None of the 152 samples were positive on InPouch culture microscopic examination. Only 35/69 feral cat fecal DNA samples were positive for the housekeeping gene, of which none tested PCR positive for T foetus. CONCLUSIONS AND RELEVANCE: T foetus was not detected by culture and PCR in feral cats and owned cats on St Kitts. A high proportion of PCR inhibitors in the DNA samples using a commercial fecal DNA kit can lead to underestimating the prevalence, which should be taken into consideration when a survey on gastrointestinal pathogens depends exclusively on molecular detection.

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Herpestes auropunctatus, the small Indian mongoose, is an invasive omnivore introduced to the Caribbean, including the island of St. Kitts over 150 years ago. It has played a role in changing native fauna and can carry zoonotic pathogens of public health importance. The aim of the current study was to estimate the prevalence of parasites harbored by mongooses. In total, 87 mongooses trapped from April to July 2015 were examined for parasites using (1) hair plucks (N = 79), ear swabs (N = 79), and general coat and skin examination (N = 87) for mites, ticks, lice, and fleas; (2) dissection of the trachea, bronchi, and lungs for lungworms and flukes (N = 76); (3) a double centrifugation fecal flotation method for parasites of the gastrointestinal tract (N = 75); and (4) PCR of heart homogenates for Toxoplasma gondii (N = 60). The only ectoparasite seen was Ctenocephalides felis (79.3%; 69/87), with most mongooses having > 10 fleas (based on a subjective assessment) but insufficient numbers to result in signs of pruritus or anemia. On fecal flotation, coccidial oocysts were found with a prevalence of 69.3% (52/75). Neither T. gondii, lungworm, nor fluke infections were detected with the methods used. The high number of C. felis-infested mongooses and the infestation level of the individual mongooses suggest that they could serve as a reservoir for these potential vectors of pathogens. No evidence was found to support that mongooses are a component of T. gondii cycles on St. Kitts, although this finding needs to be confirmed with a larger sample size from other geographic locations.

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Trichomonosis is an endemic disease in cattle that are reared under extensive conditions and bred by natural mating. It causes profound economic losses to the producers by increasing calving interval, increasing embryo losses, and decreasing pregnancy rates. The aim of this study was to determine whether Tritrichomonas foetus infections were absent from cattle in St. Kitts. Using the modified hypergeometric method, preputial samples from bulls (n = 78) were tested using the InPouch™ culture for presence of T. foetus. Results highlighted an absence of trichomoniasis in bulls on St. Kitts with a 95% confidence.

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BACKGROUND: Toxoplasma gondii is a worldwide protozoan parasite of felids which can infect almost all warm-blooded animals, including humans. Free-roaming chickens are good indicators of environmental contamination with T. gondii oocysts because they feed from the ground. Previous research has demonstrated a high seroprevalence of T. gondii in domestic animals on St. Kitts but little is known about the genotypes circulating in the environment. METHODS: Hearts and brains from 81 free-roaming chickens in St. Kitts were digested and inoculated into 243 Swiss Webster mice in a bioassay. DNA was extracted from digested chicken tissues and the brains of all mice, and screened for T. gondii. Positive samples were genotyped using restriction fragment length polymorphism. Chicken sera were also screened for T. gondii antibodies using a modified agglutination test (MAT). RESULTS: Overall, 41% (33 out of 81) of chickens were positive for T. gondii either by serology and/or by PCR. Antibodies to T. gondii were detected by MAT in 32% (26 out of 81) of chickens, and T. gondii DNA was detected in mouse brains representing 26% (21 out of 81) of chickens. Genotyping of 21 DNA isolates, using polymorphisms at 10 loci, including SAG1, SAG2 (5'-3' SAG2 and alt.SAG2), SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico, revealed that 7 were ToxoDB genotype #141, 6 were #1 (Type II), 3 were #13, 3 were #265, one was #264 and one was #2 (Type III). Genotypes #13 and #141 appear to be more virulent. CONCLUSIONS: The results of this study highlight the greater genetic diversity of T. gondii circulating in the Caribbean region, with potentially different degrees of virulence to humans.

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Salmonellae are Gram-negative zoonotic bacteria that are frequently part of the normal reptilian gastrointestinal flora. The main objective of this project was to estimate the prevalence of non-typhoidal Salmonella enterica in the nesting and foraging populations of sea turtles on St. Kitts and in sand from known nesting beaches. Results suggest a higher prevalence of Salmonella in nesting leatherback sea turtles compared with foraging green and hawksbill sea turtles. Salmonella was cultured from 2/9 and identified by molecular diagnostic methods in 3/9 leatherback sea turtle samples. Salmonella DNA was detected in one hawksbill turtle, but viable isolates were not recovered from any hawksbill sea turtles. No Salmonella was detected in green sea turtles. In samples collected from nesting beaches, Salmonella was only recovered from a single dry sand sample. All recovered isolates were positive for the wzx gene, consistent with the O:7 serogroup. Further serotyping characterized serovars Montevideo and Newport present in cloacal and sand samples. Repetitive-element palindromic PCR (rep-PCR) fingerprint analysis and pulsed-field gel electrophoresis of the 2014 isolates from turtles and sand as well as archived Salmonella isolates recovered from leatherback sea turtles in 2012 and 2013, identified two distinct genotypes and four different pulsotypes, respectively. The genotyping and serotyping were directly correlated. To determine the persistence of representative strains of each serotype/genotype in these environments, laboratory-controlled microcosm studies were performed in water and sand (dry and wet) incubated at 25 or 35°C. Isolates persisted for at least 32 days in most microcosms, although there were significant decreases in culturable bacteria in several microcosms, with the greatest reduction in dry sand incubated at 35°C. This information provides a better understanding of the epizootiology of Salmonella in free-ranging marine reptiles and the potential public health risks associated with human interactions with these animals in the Caribbean.

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Leishmaniasis caused by Leishmania infantum is an emerging/re-emerging zoonosis with dogs as the main reservoir. The first autochthonous case of canine leishmaniasis in St. Kitts was diagnosed, and had cutaneous involvement. This discovery expands the distribution of leishmaniasis to include this insular country in the West Indies and dictates further characterization of the disease in this region.

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OBJECTIVE: The aim of the present study was to investigate the occurrence of keratinophilic fungi including dermatophytes on feathers of domestic and wild birds in the islands of St Kitts and Nevis. METHOD: During 2010-2011, samples of feathers from ninety-four birds were examined by hair-baiting technique in Petri-dishes containing sterilized soil. Fungal growths appearing on the feathers and the hair-baits were microscopically examined and the cultures obtained were identified on the basis of their microscopic and colonial morphology. RESULTS: Chrysosporium constituted the majority (86.9%) of the 72 isolates of keratinophilic fungi, represented by mainly C tropicum and C indicum. Sepedonium spp isolates were recovered from nine of the feather samples; two of these were identified as Sepedonium chrysospermum, and the other two as S ampullosporum. CONCLUSION: Recovery of four isolates of the dermatophyte, Microsporum gypseum complex (two each of M gyspeum and M fulvum) from feathers of birds is a finding of public health significance.

OBJETIVO: El objetivo del presente estudio fue investigar la presencia de hongos queratinofílicos, incluyendo dermatofitos, en las plumas de aves domésticas y silvestres en las islas de St Kitts y Nieves. MÉTODOS: Durante 2010-2011, se examinaron muestras de plumas de noventa y cuatro aves, utilizando la técnica de anzuelo queratínico (técnica de Vanbreuseghem) en placas de Petri con tierra esterilizada. Los crecimientos fúngicos que aparecieron sobre las plumas y los anzuelos de queratina de pelos (hair baits) fueron examinados bajo el microscopio, y los cultivos obtenidos fueron identificados sobre la base de su morfología microscópica y colonial. RESULTADOS: Chrysosporium constituyó la mayor parte (86.9%) de los 72 aislados de hongos queratinofílicos, representados principalmente por el C tropicum y el C indicum. Aislados de Sepedonium spp fueron obtenidos de nueve muestras de plumas. Dos de ellos fueron identificados como Sepedonium chrysospermum y los otros dos como S ampullosporum. CONCLUSIÓN: La recuperación de cuatro aislados del complejo M gypseum dermatofito (formado por dos M gyspeum y dos M fulvum respectivamente) de las plumas de aves, es un hallazgo de importancia para la salud pública.

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ABSTRACT OBJECTIVE: Previous mosquito surveys performed in the Federation of St Kitts and Nevis identified Anopheles albimanus in Nevis but there is no recorded occurrence of this mosquito in St Kitts. To determine the presence of this and other species in St Kitts and Nevis, a mosquito survey was conducted. METHODS: Surveys were performed in two phases - the dry season (March 16-23, 2010, in St Kitts), and the rainy season (October 18-25, 2010) in St Kitts and Nevis. BG SentinelTM mosquito traps baited with BG Lure® and CO2 were set in a variety of habitats (urban, rural, semi-urban, dry forest and mangrove). Identification was performed using morphological keys. RESULTS: The most abundant species during both phases were Culex quinquefasciatus, Aedes taeniorhynchus and Aedes aegypti. A new record for St Kitts was Anopheles albimanus which was trapped during the rainy season near a mangrove site. CONCLUSION: This is the first time a potential malaria vector has been identified in St Kitts.

OBJETIVO: Las encuestas previas sobre mosquitos realizadas en la Federación de Saint Kitts y Nevis identificaron al Anopheles albimanus en Nevis, pero no hay registro de este mosquito en Saint Kitts. El objetivo de esta investigación fue determinar la presencia de esta u otra especie de mosquito en Saint Kitts. MÉTODOS: Se realizaron encuestas en dos fases - la estación seca (16-23 de marzo de 2010, en Saint Kitts), y la estación lluviosa (18-25 de octubre de 2010) en Saint Kitts y Nevis. Trampas BG SentinelTM para mosquitos preparadas con BG Lure® y CO2 se colocaron en diversos habitats (urbano, rural, semi-urbano, bosque seco y manglar). La identificación fue realizada usando claves morfológicas. RESULTADOS: Las especies más abundantes durante ambas fases fueron Culex quinquefasciatus, Aedes taeniorhynchus y Aedes aegypti. Un nuevo registro para Saint Kitts fue Anopheles albimanus, atrapado durante la estación de lluvias cerca de un manglar. CONCLUSIÓN: Esta es la primera vez que se identifica un vector potencial de la malaria en Saint Kitts.

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