RESUMO
OBJECTIVE: To determine the status of existing violence and injury prevention (VIP) efforts and surveillance systems in the Caribbean. SUBJECTS AND METHODS: The Caribbean Public Health Agency undertook a survey to gather evidence of VIP in 24 member Countries. The survey was administered to national epidemiologists and non-communicable disease focal points in October 2015 using an online tool, Survey Monkey. Questions were asked about the availability in each country of VIP representative surveys, policies,action plans, laws, victim support services and surveillance systems.RESULTS: Nineteen (79%) countries completed the VIP survey. Only three (16%) countries confirmed having undertaken a nationally representative survey. Twelve (63%) had not developed a national policy and 14 (74%) had not implemented an action plan on VIP. Each country reported the existence of VIP laws and offered victim support services, though average enforcement ranged from 4079%. Nine (47%) countries indicated using an injury registry and 15 (79%) reported collecting injury data within patient records, mainly from public hospitals. All 19 countries confirmed that records of reported violent incidents were maintained by the police. Unique identifiers were generally lacking in registries and police systems. Only four (44%) countries with registries, ten (67%) countries with inpatient injury data and 12 (63%) countries with police records indicated sharing data with other organizations. CONCLUSION: Each country reported some level of injury surveillance system; however, such systems should be harmonized to produce more complete baseline data. The use of unique identifiers is required to reduce duplication and effectively link surveillance systems.
Assuntos
Humanos , Violência , Vigilância em Desastres , Região do CaribeRESUMO
OBJECTIVE: This study examined cancer-related mortality rates among the 21 Caribbean countries that submitted mortality data to the Caribbean Public Health Agency. METHODS: We calculated proportions and age-standardized mortality rates (ASMR) by cancer site and gender for each country using the most recent five years of mortality data available from 2003 to 2013. Calculations were completed using SEER*Stat software and the world (Segi 1960) standard million population. RESULTS: Age-standardized mortality rates for all cancers combined ranged from 46.1 to 139.3 per 100 000. Among males, prostate cancer was the most common cause of cancer deaths in all countries, accounting for 18.447.4% of cancer deaths, and an ASMR of 15.1 to 74.1 per 100000. Lung cancer (4.634.0 per 100 000) was the second or third leading cause of cancer deaths among males in most countries. Among females, breast cancer was the most common cause of cancer deaths in 16 of 18 countries(with > 6 reported cases), accounting for 16.130% of cancer deaths and an ASMR of 10.0 to 27.3 per 100 000. The ASMR of cervical cancer was higher than the world average (6.8 per 100 000) in 11 countries, and accounted for 4.518.2% of cancer deaths. CONCLUSION: There is great variability in cancer-specific mortality rates within the Caribbean region; however, prostate and breast cancers are consistently the leading causes of cancer-related deaths among males and females, respectively. Lung and cervical cancerscancers for which World Health Organization best buy interventions existare also important causes of mortality in many countries.
Assuntos
Humanos , Neoplasias/mortalidade , Região do CaribeRESUMO
In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.
Assuntos
Ginecologia , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento , Teste de Papanicolaou , Médicos de Família , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal , Adulto , Idoso , Competência Clínica , Feminino , Humanos , Consentimento Livre e Esclarecido , Masculino , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Inquéritos e Questionários , Trinidad e Tobago , Neoplasias do Colo do Útero/virologiaRESUMO
Tobago, until lately, was considered a society with a low prevalence of cigarette smoking. Recent surveys, however, showed an increasing smoking prevalence among school children. To assess whether teachers in Tobago can be credible role models for their pupils, we carried out a cross-sectional survey on their smoking-related attitudes and behaviour in 2002. We distributed anonymous, structured questionnaires to teachers of all 52 primary and secondary schools in the island and conducted structured observations in schools. Of 579 teachers present during the survey, 559 (97%) returned a completed questionnaire; 8.6% of the male and 2.4% of the female teachers reported to be current cigarette smokers; slightly higher proportions had ever been daily smokers. Teachers were well aware of the harmful effects of smoking. Significantly more non-smokers than current smokers were in favour of strict school smoking regulations. The vast majority of the teachers perceived anti-smoking education as their duty. None of the schools had dedicated smoking rooms for teachers, and we found no cigarette butts in or around teachers' rooms. In Tobago, teachers have a lower reported prevalence of cigarette smoking than their pupils. Thus, most teachers can be credible role models with regard to smoking prevention and should be encouraged to become more active in school-based preventive activities.
Assuntos
Docentes , Fumar/epidemiologia , Adolescente , Adulto , Idoso , Atitude , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Trinidad e Tobago/epidemiologiaRESUMO
Tobago, until lately, was considered a society with a low prevalence of cigarette smoking. Recent surveys, however, showed an increasing smoking prevalence among school children. To assess whether teachers in Tobago can be credible role models for their pupils, we carried out a cross-sectional survey on their smoking-related attitudes and behaviour in 2002. We distributed anonymous, structured questionnaires to teachers of all 52 primary and secondary schools in the island and conducted structured observations in schools. Of 579 teachers present during the survey, 559 (97) returned a completed questionnaire; 8.6 of the male and 2.4 of the female teachers reported to be current cigarette smokers; slightly higher proportions had ever been daily smokers. Teachers were well aware of the harmful effects of smoking. Significantly more non-smokers than current smokers were in favour of strict school smoking regulations. The vast majority of the teachers perceived anti-smoking education as their duty. None of the schools had dedicated smoking rooms for teachers, and we found no cigarette butts in or around teachers' rooms. In Tobago, teachers have a lower reported prevalence of cigarette smoking than their pupils. Thus, most teachers can be credible role models with regard to smoking prevention and should be encouraged to become more active in school-based preventive activities