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Purpose of overview: The constant surge in accessing essential medicines creates a greater need for continuous monitoring of usage. The inability to source active pharmaceutical ingredients during the COVID-19 pandemic resulted in drug shortages that increased online requests for medications. E-commerce and social sites have opened the floodgate for the marketing of falsified, substandard, and unregistered pharmaceuticals, making them easily accessible to consumers with the click of a button. A high prevalence of such products with compromised quality highlights further the need for enhanced post-marketing vigilance of safety and quality within the pharmaceutical industry. This review aims to assess the extent to which pharmacovigilance (PV) systems in selected Caribbean countries conform to the minimum World Health Organization (WHO) requirements, highlight the importance of PV in ensuring the safer use of medicines across the Caribbean region, and identify opportunities and challenges in building comprehensive PV systems. Recent Findings: The review finds that while major advancements in PV and adverse drug reaction (ADR) monitoring have occurred in Europe and other parts of the Americas, little has been done in the Caribbean region. Only a few countries in the region are active members of the WHO's global PV network, and ADR reporting is minimal. The reason for low reporting includes a lack of awareness, commitment, and participation of healthcare professionals, manufacturers, authorized distributors, and the general consumers. Summary: Nearly all established national PV systems do not fully conform to the minimum PV requirements by the WHO. Legislation, regulatory framework, political commitment, adequate funding, strategies, and incentives to encourage reporting of ADRs are needed to build sustainable PV systems in the Caribbean.
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Minimally invasive surgery is rapidly expanding its role in almost all of the surgical sub-specialties. There is also a growing demand of this service as patients became more and more concerned about cosmesis in addition to their original surgery. Although its role in thyroid surgery has already been proven earlier; but it is not yet accepted as a routine approach amongst many thyroid surgeons. There is no reported case of laparoscopic thyroid surgery in the English literature from the Caribbean. We are reporting our first clinical experience in performing laparoscopic thyroid surgery in the Caribbean with a successful outcome.
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BACKGROUND: Access to contraceptive by minors (pre-adolescents and adolescents) has spurred policy and legislative debates, part of which is that in an effort to successfully meet government's objective of a healthy sexual lifestyle among minors. AIMS: THIS STUDY EXAMINED FACTORS AFFECTING SEXUAL REPRODUCTIVE HEALTH IN MINORS, NAMELY: access to contraceptive advice and treatment, pregnancy, number of sexual partners, sexually transmitted infections (STIs) and confidentiality. MATERIALS AND METHODS: This research involved quantitative and qualitative data. Two hundred and thirty eight sexually active cases were investigated in Jamaica by the researchers, during the period 2006-2007. The age group population was 9-11, 12-14, and 15-17. RESULTS: The study showed that access to contraceptive advice and treatment by minors was more favorable to males than females. The difference in access to contraceptive between male and female was statistically significant (x(2) = 20.16, p<0.05). Of the 80 male respondents, who are contraceptive users, 11 encountered challenges in legitimately accessing contraceptive methods, while 38 of the 40 female users also encountered challenges. This resulted in unintended pregnancies and impregnation (33.2%), as well as the contracting of STIs (21%). CONCLUSION: The findings of this study will be important in informing the development of reproductive health services and family life education programs for pre-adolescents and adolescents in Jamaica and other Caribbean countries.
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Introducción: Las infecciones de transmisión sexual, en especial a sífilis, se encuentran entre las principales causas de enfermedad en el mundo y en la mayoría de los países de la América Latina. Objetivo: realizar una exploración de la situación de la sífilis y la sífilis congénita en los países de laregión y disponer de una aproximación a la situación epidemiológica actual y sus tendencias. Métodos: se realizó un estudio de corte transversal y para la obtención de los datos se diseño una encuesta que fue validada en el mes de diciembre del 2007 y enviada posteriormente a los coordinadores de programas nacionales de 20 países de la región. El periodo de ejecución y llenado de la información transcurrió entre enero y febrero del 2008 y se solicitó información de los últimos cuatro años (periodo 2003 - 2007). Resultados: todos los países poseen servicios de Vigilancia Epidemiológica y en la mayoría de ellos la sífilis total y congénita son enfermedades de notificación obligatoria. Existen, al menos, 10 países cuyas tasas de incidencia de sífilis congénita están por encima de 0,5 X 1.000 Nacidos vivos a pesar de que la subnotificación de casos en la región es grande. Latinoamérica y Caribe notifican en el 2006 un pequeño porcentaje del total de los casos de sífilis y sífilis congénita que la OMS/OPS estima ocurren en el área y según la opinión de los jefes de programas y expertos nacionales la tendencia de estas infecciones en la mitad de los países de la región es al aumento o desconocida. Conclusión: La sífilis congénita continúa siendo un serio problema de salud en la región. La información disponible sobre sífilis en términos de incidencia, prevalencia, tendencias, prioridades de intervención, coberturas de atención a grupos vulnerables, disponibilidad de recursos humanos y materiales es insuficiente en muchos países. Se observa en la región la existencia de oportunidades para el desarrollo de trabajo colaborativo conjunto entre los países miembros.
Introduction: Sexually transmitted infections, especially syphilis, are found among the main causes for illnesses in the world and in the majority of Latin American countries. Objective: investigate the situation of syphilis and congenital syphilis in countries of the region and obtain an approximationof the current epidemiological situation and its tendencies. Methods: a study of transversal cut was performed and to obtain data a questionnaire was validated in the month of december of 2007 and later sent to the national program coordinators of 20 countries in the region. The implementation and information gathering period took place between January and February of 2008 and data regarding the last 4 years of the programs (from 2003 to 2007) was requested. Results: all countries have Epidemiological Surveillance services and, for the most part, total and congenital syphilis are illnesses of mandatory notification. There are at least 10 countries where congenital syphilis incidence rates are above 0,5 X 1.000 newborns, even when a high number of cases are not notified in the region. Latin America and the Caribbean notified in 2006 a percentage of total syphilis and congenital syphilis cases that is smaller than that estimated by the WHO/PAHO for the region. According to national experts and directors of national programs, the tendency of these infections in half of the countries of the region are either rising or is unknown. Conclusion: congenital syphilis continuesto be a serious health problem in the region. The available information about syphilis regarding its incidence, prevalence, tendencies, interventionpriorities, assistance to vulnerable groups, and availability of human and material resources is insufficient in many countries. There is opportunityto develop a collaborative work between member nations.