WINDWARD ISLANDS RESEARCH & EDUCATION FOUNDATION
2009 Annual Report 16th Anniversary WINDREF Annual Report 2009 Mission Statement ounded in 1994, WINDREF seeks to advance health and F environmental development through multi-disciplinary research and education programs. WINDREF strives for program excellence by promoting collaborative relationships between internationally recognized scholars and regional scientists, and by adhering to the highest ethical and academic standards in the design and conduct of research. Goals
To provide a scientific resource center capable of coordinating international collaborative research of the highest caliber in the areas of medical and veterinary public health, anthropology, ecology, marine and terrestrial biology, and ethics.
To provide a first rate academic opportunity to scientists from the Caribbean and around the world offering unique research opportunities to enhance the knowledge and welfare of local and international communities.
To conduct applied scientific research for the benefit of community and health development at the local, national and international levels.
To share relevant scientific information with local and international communities.
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TABLE OF CONTENTS 1.0 Director’s Report: WINDREF Activities in 2009 (Calum N.L. Macpherson, PhD, DIC)...... 1 2.0 WINDREF Organization ...... 5 2.1 WINDREF Research Institute Board of Directors ...... 5 2.2 WINDREF St. Vincent and the Grenadines Board of Directors...... 5 2.3 WINDREF Research Institute Scientific Advisory Board...... 5 2.4 WINDREF Research Institute Administration ...... 5 2.5 WINDREF (USA)...... 5 2.6 WINDREF (UK)...... 5 2.7 WINDREF (UK) Board of Trustees ...... 6 2.8 WINDREF (UK) Administration...... 6 2.9 WINDREF Senior Research Fellows...... 6 2.10 WINDREF Research Fellows ...... 6 2.11 WINDREF Research Scientists ...... 7 3.0 Institutional Review Board (IRB) ...... 7 3.1 IRB Projects Reviewed ...... 8 4.0 Institutional Animal Care and Use Committee (IACUC)...... 8 5.0 Current Research Projects ...... 9 5.1 Streptococcal Project...... 9 5.2 Princess Alice Hospital Restoration in Grenada’s St. Andrews Parish ...... 10 5.3 Report on the CAD$1.6 Million Teasdale-Corti CEHP Grant ...... 11 5.4 Persistent Organic Pollutants ...... 13 5.5 Genetic Correlates of the Addictive Diseases: Cocaine, Alcohol and Marijuana Addiction – Grenada, W.I...... 13 5.6 Unexpected microbial diversity discovered in the Warm Spring in Grenada...... 14 5.7 Safe Paradise Beaches of Grenada...... 16 5.8 Marine Research Related Activities...... 18
ii WINDREF Annual Report 2009 5.9 “Soil Transmitted Helminths” and Streptococci infections among school going children between the ages of 5- 15 years old in the Parish of St. Andrew’s...... 20 5.10 Assessing Knowledge, Beliefs, and Behaviors of Medical Students in Grenada Regarding Sun Exposure and Sunscreen Use ...... 22 5.11 Basic Life Support Knowledge and Skill Retention in Pre-Clinical Undergraduate Medical Students...... 23 5.12 Occupational Health Problems among Nutmeg Production Workers in Grenada . 23 6.0 2009 Grants...... 24 7.0 Past, Present, and Future Research Projects ...... 25 7.1 Non-communicable Diseases...... 25 7.2 Infectious Diseases...... 26 7.3 Unique Projects...... 27 8.0 International Conferences Sponsored in Grenada ...... 28 9.0 Abstracts/Presentations at International Conferences Invited Plenary/Workshop/Roundtable/Professional Meetings/CME...... 29 10.0 Publications ...... 31 10.1 Books/Book Chapters...... 31 10.2 Journal Publications...... 31 11.0 Reviewers for Journals and Boards...... 35 12.0 Thesis Defenses ...... 35 13.0 Graduate Seminars...... 35 14.0 Contact Information...... 38
iii WINDREF Annual Report 2009 1.0 Highlights of the WINDREF Research Guyana’s Minister of Health, the Hon. Dr. Institute’s Activities Leslie Ramsammy, PhD, DSc (Hon), who is also a senior research fellow at WINDREF, 2009 was another productive year thanks to the input from all senior research fellows, research fellows, and research scientists. Thanks also to our collaborators for their valuable input. Our programs are carried out with the participation and collaboration of many different communities in many countries around the world and I thank them for this cooperation with our various programs. I would like to take the opportunity to welcome Neil Poulter, MD, as a new member of our UK Board of Trustees. Dr. Poulter is Dr. Leslie Ramsammy, Dr. Calum currently Professor of Macpherson, Dr. Sonia Chehill, Dr. Omur Preventive Cinar Elci, Dr. Satesh Bidaisee Cardiovascular Medicine and co- presented a seminar at WINDREF on Director of the September 3rd entitled “Caribbean Public International Centre for Health Agency”. As the current chair of the Circulatory Health at steering committee of the Caribbean Public Imperial College, Health Agency (CARPHA), Dr. Ramsammy London. He also serves explained the history and proposed the future as an Honorary Neil Poulter, MD role of the institution, which will be Consultant Physician constructed in Trinidad. Dr. Ramsammy, and Epidemiologist at the Peart-Rose formerly the 61st President of the World (hypertension) Clinic based at St Mary’s Health Assembly and President of the Pan Hospital, London, where he is actively American Health Organization, described the involved in the treatment of patients with agreement reached by the Ministers of Health hypertension and related problems. Some of of the CARICOM nations to create a self- his research activities include the optimal sufficient CARPHA by January 1, 2010. investigation and management of essential A Grant Agreement between The World hypertension and dyslipidaemia; the Bank, WINDREF, and the United Nations association between birth weight and University International Network on Water, hypertension; the cardiovascular effects of Environment and Health addressing exogenous oestrogen and progesterone; the Persistent Organic Pollutants (POPs) in the prevention of type 2 diabetes; and ethnic Caribbean Region has become effective as of differences in cardiovascular disease. Dr. June 24, 2009. Through the persistent efforts Poulter was one of the first 100 NIHR Senior of Dr. Martin Forde, Department of Public Investigators selected nationally in 2008. Health and Preventive Medicine (PHPM), Professor and Track Director for
1 WINDREF Annual Report 2009 Environmental and Occupational Health, the the incidence of both among school-going Caribbean Country Management Unit of The children (aged 5-15 years) in St. Andrew's World Bank has agreed to a US $275,000 Parish. The rural population of Grenada grant to monitor human exposure to POPs in suffers from the impact of rheumatic fever all 15 CARICOM nations including Grenada. infection and intestinal helminthic diseases The World Bank Grant is a critical extension that severely affect morbidity and quality of of a previously established research grant, life. No sustained effective intervention also obtained by Dr. Forde in collaboration with Dr. Eric Dewailly from Laval University and Dr. Neela Badrie from the University of the West Indies, from the Canadian International Development Research Center (IDRC) Teasdale Corti (T-C) grant initiative to carry out a multifaceted research and capacity building Dr. Martin Forde proposal entitled the (L-R) Amber Larsen, Calum Macpherson, Caribbean EcoHealth Karen Lawson, Trevor Noel, Isha English Program (CEHP). While the grant provided the funds to evaluate and determine the level strategies have been implemented. This of exposure to POPs of human beings, it was project involves the collection of prevalence limited to research in only four Caribbean data on these diseases, followed by states. It soon became clear that the study of implementation and intervention strategies POP concentrations, and short and long term including educating the population about effects on the human population, was needed these diseases and their prevention. This for the entire Caribbean region, thereby project will also involve a treatment/ requiring additional funding to expand the deworming of children participating in this research to include all 15 members of study. Education, surveillance, treatment of CARICOM. the subject population, and mass deworming have been shown to reduce the likelihood of Karen Lawson of the Bartholomew J. reinfection in many parts of the world. We Lawson Foundation for Children, in are hopeful that the mass deworming of partnership with REACH Grenada, has children and the educational component of awarded funding in the amount of US this project in St. Andrew’s Parish will $41,903 for the project titled “Neglected reduce the future transmission of intestinal Tropical Diseases (NTDs) and Rheumatic helminthes and reduce the incidence of Fever in St. Andrew’s Parish, Grenada: A rheumatic fever. project to prevent/eliminate helminthic and rheumatic fever infections among children, 5 In mid December, WINDREF entered into – 15 years of age”. Trevor Noël, is the a Memorandum of Agreement with the Principal Investigator and the goal of the United Nations Office for Project Services project is to establish the significance and (“UNOPS”) in connection with a project incidence of rheumatic fever infections and partially financed by the Global Environment intestinal helminthes, and reduce/eliminate Facility/Small Grants Programme (“GEF/
2 WINDREF Annual Report 2009 SGP”) in the amount of $50,000 capital and largest city, as well as attending a implemented by United Nations series of AMREF-hosted lectures and Development Program (UNDP) on behalf of seminars on tropical medicine, community the three GEF Implementing Agencies – and public health, and current methods to UNDP, United Nations Environment combat tropical diseases. The following week Program (UNEP) and the World Bank – and was spent in the nomadic communities of executed by UNOPS. Total project budget is Kajiado District with time at AMREF’s $100,000. These funds have been awarded Entasopia Integrated Health Program, as well for partial funding for the project titled as a two-night excursion to the Masai Mara “Implementing Renewable Energy and Game Reserve (one of the best and largest in Preventing Land Degradation: An Africa) to witness the indigenous wildlife Intervention in the Nutmeg Industry in abundance and experience the wildlife/ Grenada”, Muge Akpinar-Elci, MD, MPH as domestic animal/human interface. Principal Investigator. The purpose of this project is an intervention in the Nutmeg Industry in Grenada, which will focus on agroforestry, the introduction of renewable energy to the Nutmeg Industry in Grenada, and addressing the health condition of the workers. This project has been made possible through a successful collaboration with the Grenada Nutmeg Cooperative Association (GNCA) providing in-kind contribution in the amount of $5,000 and St. George’s University Department of Public Health and Preventive Medicine. Dr. Michael Smalley, Director General, AMREF, members of his administration, and Over the summer fifteen students from St the 2009 selective team George’s University School of Medicine Throughout the duration of the program, accompanied me to Africa to participate in SGU SOM students also benefited from the the first practical tropical medicine course cultural interchange with their Kenyan peers, held in collaboration with the African as they were joined in Kenya by five local Medical and Research Foundation (AMREF), medical students from Nairobi University. In one of Africa’s leading health development collaboration with the regional health organizations well known for its Flying authorities and Dr. John Nduba, Director of Doctors Service. The two-week Tropical AMREF’s Sexual Reproductive and Child Medicine Selective brought seven students Health program, an ultrasound clinic was from Grenada and eight students from the conducted on reproductive health as well as Keith B. Taylor Global Scholar’s program at for cystic hydatid disease. More than 250 Northumbria University in the United people were screened, including 49 pregnant Kingdom to rural and urban areas of Kenya, women. In the coming year, it is hoped that providing them with critical understanding of funds will be raised in order to provide an the economic and public health relevance of ultrasound scanner for the AMREF clinic. It tropical diseases in a developing country. The was a tremendous learning experience for our first week was spent visiting research students to see and hear first hand from the institutes and hospitals in Nairobi, Kenya’s AMREF experts, both in Nairobi and in the
3 WINDREF Annual Report 2009 field. Such a wealth of both practical and field experience that was shared had a profound effect on the students’ outlook on culture, health systems, and health care delivery options. In Kenya the whole program was coordinated by Ms. Victoria Kimotho, MPH and Ms. Nicky Blundel-Brown, AMREF Heritage Team. I thank the Director General Dr. Michael Smalley and his senior administrative staff at AMREF for their kind USDA/APHIS Workshop Participants: “The support of this selective. Identification of Coleopteran Pests of Economic Importance” Dr. Yvette Sheline, Professor of Psychiatry, Participants from 16 countries within the Radiology and Americas attended the Regional Workshop Neurology and Director on “The Identification of Coleopteran Pests of the Center for of Economic Importance” hosted at Depression, Stress and WINDREF 21st to 25th September. This was Neuroimaging, a Collaboration of United States Department Washington University of Agriculture (USDA), Ministry of Health, School of Medicine, Grenada, Department of Public Health and delivered the 10th Preventive Medicine, SGU and WINDREF. Yvette Sheline, MD Annual WINDREF To all who made 2009 a productive and Lecture on the evening of March 16th at Bell successful year, a big thank you. Lecture Hall on St. George’s University’s True Blue campus. She spoke on the topic: “Brain Imaging: New Insights into Submitted by Calum N.L. Macpherson Neuropsychiatric Disorders.” Dr. Sheline Director addressed the audience of SGU faculty, research scientists and students, emphasizing the use of neuroimaging in the diagnosis and treatment of Alzheimer’s disease. A recipient of many awards including the National Alliance for Research on Schizophrenia and Depressions (NARSAD) Young Investigator and Independent Investigator Awards and a NARSAD Klerman Award Honorable Mention, Dr. Sheline’s research studies have identified structural brain changes in MRI studies of depression, serotonin neurotransmitter changes on PET scans, and functional alterations in the emotional circuitry seen during MRI studies of depression.
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2.0 WINDREF Organization Executive Secretary and Mrs. Rachel Paul 2.1 WINDREF Research Institute Board King as Secretary of Directors 2.5 WINDREF (USA) Lord Soulsby of Swaffham Prior, MRCVS, WINDREF (USA) was established as a DVSM, MA, C.Biol., F.I.Biol., DSc (Hon), 501 (c) 3 non-profit organization to facilitate (President) coordination of the USA activities and to Calum N.L. Macpherson, PhD, DIC, (Vice administer charitable donations from the President) United States. Its goal is to enhance the Margaret Lambert, MA, (Secretary/ development of WINDREF’s research and Treasurer) educational programs. The offices are located Mary Jeanne Kreek, MD, PharmD (Hon), on Long Island in the state of New York and PhD (Hon) provide administrative and logistical support. Karen Lawson, PhD Ms. Valerie Smith continued as program Trevor P. Noël, MPH coordinator in the New York Office. Allen Pensick, PhD 2.2 WINDREF St. Vincent and the Grenadines Board of Directors Ed Johnson, MD, Director Sir Fredrick Ballantyne, MD, Deputy Director 2.3 WINDREF Research Institute Scientific Advisory Board Sir Frederick Ballantyne, MD John R. David, MD John J. Ferguson, MBChB, FRCGP Dr. Charles Modica, Sir Kenneth Calman Malcolm Ferguson-Smith, MBChB, FRCP, 2.6 WINDREF (UK) FRCPath WINDREF (UK) was set-up as a Edmond Fischer, DSc charitable trust in Winchester, England in C. James Hospedales, MB, BS, MSc 1999 to promote collaboration between Sir Malcolm Macnaughton, MD, LLD, WINDREF scientists and academic centers FRCPG, FRAC of research in the United Kingdom. It is Calum Macpherson, PhD, DIC hoped that by reaching out to a larger Thomas W. Meade, CBE, DM, FRS scientific community, WINDREF will Graham Serjeant, MD, FRCP, CMG broaden its research opportunities by forming Sir Kenneth Stuart, MD, DSc (Hon) collaborations with scientists from the M.S. Swaminathan, DSc European community. A Board of Trustees John B. Zabriskie, MD was appointed in 1999 to oversee the activities of WINDREF (UK). A Program 2.4 WINDREF Research Institute Coordinator was appointed to provide the Administration administrative support and expertise that is Mrs. Isha English continued as central to WINDREF’s (UK) fundraising, Administrative Assistant, Ms. Meg Conlon as administrative and collaborative activities.
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2.7 WINDREF (UK) Board of Trustees of the Section of Lord Soulsby of Swaffham Prior, MRCVS, International DVSM, MA, C.Biol., F.I.Biol., DSc(Hon), Psychiatry at {Chairman) Dalhousie University Sir Kenneth Calman, KCB, FRCSE in Halifax, Nova Baroness Howells of St. David, OBE Scotia, Canada. She also holds the Mr. Patrick Orr position of Associate Sir Kenneth Stuart, MD, DSc Director, WHO Richard Summerfield, MB, BChir Collaborating Mental Neil Poulter, MD Health, Training and Margaret Lambert, MA (Ex Officio) Sonia Chehil, MD, Policy Development, Calum Macpherson, PhD, DIC (Ex Officio) FRCPC and is the Mental Health Technical Advisor for the Ministry of 2.8 WINDREF (UK) Administration Health in Guyana. Dr. Chehil’s international Ms. Sue Huntington continues as activities focus on the design and Executive Secretary. Ms. Huntington implementation of mental health competency provides the administrative support and based training programs for health human expertise that is central to WINDREF’S (UK) resources and the development of mental fundraising, administrative and collaborative health policy and plans in low and middle activities. income countries (LMIC). Both of these 2.9 WINDREF Senior Research Fellows activities aim to enhance existing mental health care competency and capacity in Paul Fields, PhD, Brigham Young University LMICs; to promote the human rights of the Paul Garner, MBBS, PhD, Liverpool School mentally ill; and to reduce the stigmatization of Tropical Medicine and discrimination against mental illness. Mary Glenn, PhD, Humboldt State University Victoria Kimotho, Duane Gubler, ScD, Hawaii University MPH has accepted an Ruth Milner, MSc, Vancouver Hospital appointment as a new Stephen Morse, PhD, Columbia University WINDREF Research Leslie Ramsammy, PhD, DSC (Hon) Fellow. Ms. Kimotho Minister of Health, Guyana was one of two Douglas Slater, MD, MPH, Minister of recipients of a Master Health, St. Vincent and the Grenadines of Public Health (MPH) scholarship Stanley Weiss, MD, UMDMJ Victoria Kimotho, MPH awarded by SGU to 2.10 WINDREF Research Fellows AMREF in 2007. Dr. The following investigators have been Kimotho has assumed a leadership role in appointed to WINDREF as Research Fellows advocacy as a Researcher in the Directorate and are currently conducting collaborative of Health Policy and Systems Research research projects. (HPSR) at the African Medical and Research Foundation (AMREF) Headquarters in Sonia Chehil, MD, FRCPC, has accepted an Nairobi, Kenya. appointment as a new WINDREF Research Fellow. Dr. Chehil is currently the Director
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Muge Akpinar-Elci, 2.11 WINDREF Research Scientists MD, MPH has Sadiq Al-Tamini, Jonathan Ashcroft, Sumita accepted an Asthana, Yitzhack Asulin, Bishara Baddour, appointment as a new Jean-Pierre Barakat, Matthew Beeson, Keith WINDREF Research Bensen, Matthew Boles, Karen Brennan, Fellow. Dr. Akpinar- William Brown, Matt Browne, Ella Cameron, Elci is currently an Nicholas Caputo, Jessica Clayton, Associate Professor at Mmakgomo Coangae, Rae Connolly, St George’s Abraham El-Sedfy, Daniel Firer, Scott Muge Akpinar-Elci,, MD, University School of MPH Forman, Vamsi Guntur, François Hallé, John Medicine, in the Holleran, Anthony Junck, Megan Kaminskyj, Department of Public Health and Preventive Sebastian Kreitzschitz, Erik Lacy, Richard Medicine and Environmental and Lehman, Setshidi Makwinja, Paul Mancuso, Occupational Health Track. Dr. Akpinar-Elci Baher Maximos, John McCormack, David has clinical and field research experience in Melamed, Kirk Minkus, Jerry Mitchell, occupational health and continues to conduct Jessica Morlok, Kevin Neill, Bayela Nfila, research in her current position at St. Yolanda Ng, Michael Nillas, Steve Nimrod, George’s University. Her areas of expertise Andre Panagos, Rakesh Patel, Barry Politi, include Occupational Health, Public Health, Sandeep Pulim, Sean Ramsammy, Justin Epidemiology, Occupational Respiratory Rebo, Tarek Refaie, Alan Rhoades, Laura Diseases, and Respiratory Research Methods. Robinson, Karin Schioler, Corey Schwartz, Other WINDREF Research Fellows include: Christopher Skaff, David Steinberg, Derrick Tlhoiwe, Sarah Treter, Nghia Truong, James John Adamski, MD, MSc, MPH Tsai, Dan Twyan, Frank Van Natta, Ru-Amir Zuri Amuleru-Marshall, PhD Walker, Juliette Williams, David Winokur, Glennis Andall, PhD Colleen Wunderlich, Elliot Yung. Charles Avgeris, MD, MSc Grant Burgess, PhD 3.0 Institutional Review Board (IRB) Dirk Burkhardt, MD The IRB is registered with the US Office Reccia Charles, PhD of Human Research Protection, Department Francis Fakoya, MBBS, PhD of Health and Human Services, and conforms Martin Forde, DSc to international standards. It meets four times Orazio Giliberti, MD a year, usually the 3rd Friday of February, Richard Kabuusu, DVM, MPH April, October and November. The deadline Svetlana Kotelnikova, PhD for the receipt of proposals to be reviewed is Matthias Lorenz, PhD two weeks before the meeting. Proposals that Marios Loukas, MD, PhD meet the criteria for Expedited Review are Theresa McCann, MPH, PhD reviewed within approximately two weeks by Barrymore McBarnette, MD the Executive Committee. Craig McCarty, PhD The IRB makes an independent Clare Morrall, PhD determination about whether to approve or Shamdeo Persaud, MD, MPH disapprove a protocol. Determinations are Bonnie Rusk, MSc based upon whether or not human subjects Samina Rutrecht, PhD are adequately protected from possible harms Shanti Singh, MD, MPH including violations of privacy and confidentiality. 7 WINDREF Annual Report 2009 Some research that involves human arising from the research should be shared subjects may be exempt from the regulations with the IRB/Office of Research, and copies requiring IRB review. Examples include of successfully published work should be educational testing and surveys that use no provided to the IRB/Office of Research. identifying information to link subjects to the data, and through which disclosure of data 3.1 IRB Projects Reviewed: would not reasonably place the subjects at 30 projects were submitted to the IRB in risk of civil or criminal liability, or be 2009, almost twice as much as any other otherwise damaging to the subject. Also year, reflecting the dramatic growth of considered for exemption is research that research at SGU. involves the use of existing data, documents, or specimens, where there is no identifying Of the projects reviewed by the IRB in information about participants. 2009, 17 projects were approved by expedited review, and two were formally Jurisdictional questions arise in that as exempted. The balance of the projects part of their Assurances with the US submitted were either still pending at the end authorities, institutions are required to protect of the year, or incomplete submissions. human subjects involved in research whether or not the research is conducted or supported by a US federal department or agency. IRB Applications Reviewed & Approved Many institutions’ human subjects policies 35 30 stipulate that even research that may be 25 exempt from review is to be reviewed by the 20 Reviewed IRB prior to classifying it as exempt. The 15 Approved 10
SGU IRB has adopted this policy with the applications of number 5 view of preventing the overload of the small 0 2003 2004 2005 2006 2007 2008 2009 pool of research participants available in year Grenada, and assuring there is administrative knowledge of research taking place within 4.0 Institutional Animal Care and Use SGU or Grenada before the work is Committee (IACUC) conducted and findings are disseminated. The use of animals for research or Beginning during the Fall of 2009, the teaching purposes must be pre-approved by IRB requires that a printed certificate of the SGU IACUC. The IACUC forms are completion of the on-line training course available on the Office of Research website, “Protecting Human Research Participants” is forms and policies page. provided to the IRB by all investigators at the time of submission of a research proposal to Submitted by Meg Conlon the IRB. The certification is valid for two IRB Administrator years. There is no charge for the course, Office of Research which is accessible on http:// phrp.nihtraining.com/users/login.php. In addition to annual summary reports, outcomes of research must be provided to the IRB/SGU Office of Research. Any publications or conference presentations
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5.0 Current Research Projects 5.1 Streptococcal Project Rheumatic Fever is as a result of exposure to Streptococcus pyogenes. The sequelae of this can lead to Rheumatic heart disease. Rheumatic heart disease is a debilitating condition that is usually brought on by stenosis of the mitral or aortic valves.
Sister Donette Cunningham administering throat swab while Sister Roche organises patient files
The current study involved drawing blood samples and throat swabs. A total of 1,300 samples were collected. The school children were randomly selected and were between Sister Donnette Cunningham, Dr. Bharatti the ages of 5 – 15 years old. These samples Datta, Dr. William Moskowitz, Trevor Noël that were collected were analyzed. The blood samples were subjected to Anti streptolysin O titres tests and the throat swabs to cultural In St. Vincent and the Grenadines, ten isolation for beta hemolytic streptococci. All schools were selected for the streptococcal positive cases were treated at the Cardiology study. These schools had been included clinic or at decentralized clinics in the several years ago in an initial Echocardiogram study that used ECHO only community. without a provision for the Duckett Jones Positive beta hemolytic streptococci Criteria. This was carried out with the samples are currently stored in the assistance of Dr. William Moskowitz. Dr. William Moskowitz, is an active member in the Richmond-based International Hospital for Children, and a founder of the Mended Little Hearts, Virginia Chapter, a support group for families with children with congenital heart disease. The schools were Pageat Farm, Bequia, Mustique Government, Questelles, Chateaubelair, Sandy Bay, Georgetown, Stubbs Government, Mesopotamia, Stony Grounds and CW Prescodd. From an ethical perspective, the study was approved by the One of the students who participated in the Research Oversight Committee in St. Vincent study and the Grenadines. 9 WINDREF Annual Report 2009 We hope to have laminated posters placed in all schools and health centers over the coming year. The consensus among the collaborators is to continue the educational program for at least one full further school year. This program is using the model that was used initially in the Grenada streptococcal project. In Grenada, the educational program was run for 2 years and in the following third year we recorded no new cases of RF. The thoughts pertaining to the aspect of rescreening have Trevor Noël, Sister Feroza Roche, Sister varied. However, by consensus we hope to Donette Cunningham, Hage John possibly rescreen in the Fall of 2011. In the interim, we have noted the importance of WINDREF Institute in Grenada and will be educating the public through both the sent to Rockefeller University and the Ministries of Health and Education about the University of Minnesota for further use of health departments, penicillin, and subtyping. The sample collection component streptococcal/rheumatic fever follow-up. The of the study began in May 2009 and was data from the screening study is being completed in November 2009. The analyzed and a detailed report will be written educational component of the study was by March 2010. begun with initial sensitization of community health workers and educational workers. This study was carried out in collaboration with WINDREF, Rockefeller University, University of Minnesota and the Ministries of Health and Education, St. Vincent and the Grenadines, Richmond-based International Hospital for Children. Submitted by Trevor P. Noël, MPH Assistant Director, WINDREF 5.2 Princess Alice Hospital Restoration in St. Vincent and the Grenadines schoolchildren Grenada’s St. Andrews Parish with educational brochures Rotary International (3H grant), Rotary Club Grenada East, Grenada’s Ministry of The primary prevention (education) was Health, and the Windward Islands Research administered in a multimedia format. The and Education Foundation (WINDREF) have Powerpoint presentations were made to implemented the Princess Alice Hospital health care personnel and to all the school Restoration in Grenada’s St. Andrew’s principals from St. Vincent and the Parish. In October 2009, WINDREF and the Grenadines. In addition, 11,000 brochures Department of Public Health and Preventive were distributed to the schools and health Medicine of St. George’s University centers throughout St. Vincent and the undertook the Knowledge, Attitude, and Grenadines. This educational component Practice (KAP) baseline survey. The study continues. assessed utilization of health services 10 WINDREF Annual Report 2009 available and focused on selected diseases the participants. Nutrition knowledge is high, (diabetes, hypertension, sexually transmitted however education on alternative methods of diseases (STD) including HIV) that affect preparation and potions is needed. women and their families. All the key modes of transmission of HIV As part of the capacity building were identified by most of the participants. perspective of the project, 22 community However, 57 (9.8 %) out of 580 indicated volunteers, supported by Rotary Club kissing as a mode of transmission, and 63 Grenada East, Lorna Samuel and Patrick (10.9%) identified sex with a condom as a Bain, were trained as data collectors. 803 self mode of HIV transmission. administered questionnaires were distributed The participants were not well informed to women between the ages of 15 to 64 who or aware of the services offered at Princess reside in St. Andrew’s Parish and 580 Alice Hospital or the role of Princess Alice (72.2%) responses were received. The Hospital within the health system. The findings of the study were presented to equipment that is to be provided by the SGU’s research committee and community project may not be utilized if the women feel members from St. Andrew’s Parish in uncomfortable with the service providers and January 2009. if the staff numbers continue to be 147 (25.3%) respondents reported insufficient. utilization of private clinics and 99 (17.1%) Knowledge levels on diseases that affect reported using Princess Alice Hospital in the women and their families is high but this last month. 35 (6%) use their local health does not translate into practice. We observed centre or medical station. 168 (51.2%) there is need to transfer skills to ensure reported spending between 37.7 USD – 188.7 practice of safe sex, increased physical USD (100-500 EC$) of their income on activity, and healthy eating. health. Submitted by Victoria Kimotho, MPH Women who had children who reported Research Fellow being sick in the last 1 month are 13.4 times more likely to use health facilities in case of 5.3 Report on the CAD$1.6 Million sickness as compared to women who do not Teasdale-Corti Caribbean EcoHealth have children and reported being sick in the Programme (CEHP) Grant: January last 1 month [OR (95% CI) = 13.4 (8.3, to November 2009 21.8)]. The four-year CAN$1.6 million dollar 181 (47.3%) respondents recommended Global Health Research Initiative’s that Princess Alice, which is closer than St Caribbean EcoHealth Programme (CEHP) George’s General Hospital, should provide grant has successfully completed a second youth friendly reproductive health services. year of ambitious research programs in the Among the 510 participants, 245 (48%) Caribbean. The programme, which is reported they do physical activities, while designed to fill important gaps in regional 213 (41.8%) indicated sometimes, and 52 knowledge related to the environment and (10.2%) indicated that they do not exercise or public health, is currently executed by several do physical activities. Canadian, Caribbean, and international Oil down, which is the national dish and project partners. Core research partners rich in oils and carbohydrates, was selected include the Caribbean Epidemiology Centre as food of choice for lunch by 205 (35.3%) of (CAREC), the Caribbean Environmental
11 WINDREF Annual Report 2009 Health Institute (CEHI), the Public Health Agency of Canada (PHAC), the Pan- American Health Organization (PAHO), and several universities: Laval University (Canada), St. George’s University (Grenada), the University of the West Indies (UWI) (Trinidad and Barbados), and Ross University, Dominica. The main objectives of the programme are to conduct research in health and the environment and to build capacity for research in health and the environment in the CARICOM region. Attachment for Ross University medical students at AML – Chemistry in Dominica
to 10 months to maximize its impact within the Caribbean region, and (2) within each island, not only support CEHP’s ongoing research activities, but also assist the governments of the host countries with their priority environmental health research initiatives.
Atlantis Mobile Laboratory, St. George’s University, Grand Anse Campus
The centerpiece of several key CEHP research projects is the multi-million dollar mobile laboratory, the Atlantis Mobile Laboratory (AML), which is ideally outfitted for the research and capacity building element of CEHP. The AML was developed by Laval University and has been used extensively for research and capacity building in the far Northern regions of Technicians conducting Rain Water Quality Canada. Laval University has released AML Monitoring on the South Coast of Dominica to CEHP for the full four years of the grant. From July 2008, the AML was based at St. In 2009, the CEHP’s main research and George’s University Grand Anse Campus in capacity building programs included the Grenada, and as of February 2009, it has following: (1) a Burden of Illness (BOI) been based in Dominica where it is now co- study led by CAREC in collaboration with hosted by Ross University and the Ministry the Food Safety Division of PAHO and of Health. In March 2010, the AML is PHAC; (2) a microbial contamination of scheduled to be shipped to Barbados where it rainwater cisterns sub-project led by CEHI will be stationed for 8 to 10 months. The and supported by other program partners protocol with regards to the stationing and such as CAREC and Laval University; (3) a use of the AML is to (1) move the lab every 8 distance education module in food hygiene 12 WINDREF Annual Report 2009 and food safety developed by UWI’s St. expanding coverage within the Caribbean Augustine Campus in conjunction with region. As part of this study, maternal blood PAHO as part of its suite of graduate samples are being collected and analyzed for programs; and (4) monitoring of human these compounds using internationally exposure to Persistent Organic Pollutants recognized methodologies that have been (POPs), Pesticides, Heavy Metals and used in circumpolar countries, to better Zoonoses in the CARICOM region. understand and focus public health responses to the exposure of populations to POPs, The research on POPs and zoonotic infectious diseases in CARICOM populations heavy metals and zoonoses. will contribute to international efforts to implement the Stockholm Convention on Persistent Organic Pollutants by providing, for the first time, a comprehensive analysis of the POPs and zoonoses of particular concern in the CARICOM region. Submitted by Martin St. Clair Forde, ScD, P. Eng 5.4 Persistent Organic Pollutants As a result of the importance of the CEHP study and the emphasis placed on POPs Participants from 8 Caribbean islands at the internationally, the scope of the CEHP October 2009 Dominica POPs Training research study has been expanded from Session initially four islands (St. Lucia, Grenada, St. After a successful training session in Vincent and the Grenadines, and Barbados) 2008, for research assistants in 4 islands, to all 15 CARICOM Member States. This blood samples have been collected and was made possible by receipt of a grant of partial analyses conducted for Grenada, St. USD $250,000 from the World Bank- Vincent and the Grenadines, and Dominica, Canadian POPs Fund. Additionally, the and is currently ongoing in Barbados and St. French West Indies and Bermuda have Lucia. A second training session was held in committed to be included in the study further Dominica in October 2009 for 20 research assistants from eight additional Caribbean States and sampling will commence in the near future. Submitted by Martin St. Clair Forde, ScD, P. Eng 5.5 Genetic Correlates of the Addictive Diseases: Cocaine, Alcohol and Marijuana Addiction – Grenada, W.I. In Grenada, blood samples are taken from either normal volunteers, drug-free former Discussion on field strategy for POPs sampling cocaine users, drug-free former marijuana with counterpart Dominican nurses at AML users, drug-free former alcohol users, or
13 WINDREF Annual Report 2009 current illicit drug and alcohol users. To The Kreek Lab collaborates with assess the levels and types of addiction, a WINDREF in Grenada in an effort to gain a standard scale – developed by the Kreek Lab better understanding of the biology of – is used for each patient, called the KMSK addictive diseases, particularly the genetic scale. The KMSK scale is a brief survey that basis of addiction. Grenada provides a unique is 90-100% effective in screening for alcohol, study sample as heroin and other such opiates marijuana, cocaine and heroin addiction. This have yet to enter the country. In most scale is used for all patients studied in the countries, opiate and cocaine addiction is Kreek Lab. The patients are also asked about rampant and sometimes may go hand in hand. their family origin, as this information may Thus, the Grenada study acts as a control for play a role in further genetic studies done by any heroin cocaine addiction comorbidity the Kreek Lab. observed in previous genetic studies of addicts. Whole blood samples taken from subjects in Grenada are shipped to the Kreek Lab at Rockefeller University for DNA isolation. The DNA is further analyzed by lab members who look for any polymorphisms – variations in DNA – that may occur in specific regions of the DNA: mu and kappa opioid receptor genes being two of the many. Projects of a similar nature are being run in several other areas of the world, including Kathleen Collier, RN, MPH Student at SGU Stockholm, Lund, and Uppsala in Sweden, Oslo in Norway, Tel Aviv in Israel, and Las Our original research nurse, Nestar Vegas in Nevada, Oakland in California, New Edwards, continues in the position of Chief York City in New York, USA. Nursing Officer for Grenada. Nurse Beverly Mends, RN, has been joined by Nurse Submitted by Trevor P. Noël, MPH Kathleen Collier, RN. Kathleen Collier is Assistant Director, WINDREF currently an MPH student at St. George’s University. They are entrusted with the process of receiving a signed informed 5.6 Unexpected microbial diversity consent form and drawing the bloods and discovered in the Warm Spring in administering the Family Origin Grenada Questionnaire and the KMSK scale to the Microorganisms populate every habitable participants. environment on Earth and, through their To date 51 subjects have completed the full metabolic activity, affect the chemistry and questionnaires and blood draws in Grenada. physical properties of their surroundings. Our control subject selection is ongoing and They have done this for billions of years. we have completed 85 control samples. The Over the past decade, genetic, biochemical, samples and KMSK and family origin and genomic approaches have allowed us to questionnaires that are administered are sent document the diversity of microbial life in to Rockefeller University (New York) where geologic systems without cultivation, as well they are analyzed. as to begin to elucidate their function.
14 WINDREF Annual Report 2009 Thermophilic microbial inhabitants of The aim of the previous studies was to active seafloor and continental hot springs characterize the springs (Kotelnikova 2003; populate the deepest branches of the Kotelnikova et al., 2006, Kotelnikova et al., universal phylogenetic tree, making 2007; Naraine et al., 2007), to compare it to hydrothermal ecosystems the most ancient other geothermal sites and iron-rich continuously inhabited ecosystems on Earth. environments (Hallbeck et al., 2007), to study rates of light iron oxidation in the springs (Kotelnikova et al., 2007), and to attempt to isolate iron oxidizing (Samuel et al.,2007) as well as manganese-oxidising bacteria (Walker and Caines, 2007). We discovered the archaeal and bacterial diversity in unique warm iron springs in Grenada by using fluorescent microscopic and molecular techniques (Naraine et al., 2008). These efforts have the potential to reveal how ecosystems originate, the extent of the biosphere diversity, and the driving forces of evolution.
Dr.Kotelnikova and her student Ravindra Recently, a combination of in vitro Naraine after oral presentation “New activity studies, with in situ 16S rDNA microbial community as a source of organisms analysis and confocal FISH quantification, for energy sequestration systems based on were used to determine the microbial solar energy and iron.” at FEMS 2009 in diversity within an iron spring on the island Gothenburg, Sweden. of Grenada. The spring contained 16S rRNA genes of The iron warm spring in Grenada 18 novel microorganisms. Ten of the 16S represents an environment where subsurface rDNA sequences detected were distantly ground water meets surface-associated related (93%-97%) to known microaerophilic oxidized molecules, and where subsurface iron oxidizers (Siderooxidans, Gallionella, microorganisms meet those on the surface. Mariprofundus). Might it be a site like this where life originated? In accordance with our results, Others represented methanogenic the system is highly selective for a few archaeon 98% similar to Methanobacterium organisms adapted to the oligotrophic and subterraneum which was isolated as an mineral-rich water. Geochemical eurythermic strain (3.6 and 45C) from consequences of hot water-rock interactions granitic aquifers of 420 m below the surface in deep subsurface areas render these (Kotelnikova et al., 1997), bacteria involved environments habitable and supply a diverse in nitrogen cycle and chemoorganotrophy, array of energy sources. Clues to the five Cyanobacteria, and two eukaryotic strategies for how life thrives in these diatom species. dynamic ecosystems are beginning to be The microbial oxidation in antibiotic elucidated through a confluence of added in vitro microcosms contributed to biogeochemistry, microbiology, ecology, 55% of the total ferric iron produced at 34ºC molecular biology, and metagenomics. and was 2.2 times faster than abiotic
15 WINDREF Annual Report 2009 oxidation rate (p<0.05). The microcosm was ideas for incorporating bioinformatics into composed of Gram-negative Bacteria (ca. their courses. St. George's School of 42%) and Archaea (ca. 2%). The domain Medicine was chosen because Dr. ratios were similar both in antibiotic free Kotelnikova’s application demonstrated the cultures and in original biofilms (Archaea ca. potential to enrich the curriculum with 64%). sequence-based research. We believe that our approach has the potential to contribute to a The result of this study represents the first new model for undergraduate and graduate cultured iron-oxidising organisms at 34ºC (<94% Gallionella) and indicates the research. presence of three populations of related iron Submitted by S. Kotelnikova and R. Naraine oxidizers that are efficient at iron oxidation under circumneutral, microaerophilic and 5.7 Safe Paradise Beaches of Grenada warm conditions. Such microorganisms may The quality of recreational water is be of use in the fields of carbon important for population health and well sequestration, biofuel production, being. There has been no information bioremediation, and water treatment. available before the Environmental Testing With the expansion of culture-independent Unit (ETU) was established at the analyses of microbial communities, it will be Department of Microbiology of St. George’s possible to quantify gene activity at the species level. Genome-enabled biogeochemical modeling may provide an opportunity to determine how communities function, and how they shape and are shaped by their environments. Therefore we have submitted the proposal “Genome annotation in marine microorganisms and metagenomic libraries as a part of an undergraduate curriculum.” to the Department of Energy (DOE) Joint Genome Institute (JGI). The Education Department at the DOE JGI has selected St George’s University to collaborate with DOE JGI in the Undergraduate Research Program in Microbial Genome Annotation. The meeting/ workshop for the collaborators will be held January 28-29, 2010 at the DOE’s Joint Genome Institute in Walnut Creek, California. DOE had a higher than expected response rate to the call for applications, making the selection process extremely difficult. They have chosen 20 team members from the full Figure 1: Mr. Victor Amadi and Mrs. Avi range of undergraduate institutions, from a Bahadoor-Yetman observing the growth of variety of departments, and with varying indicator organisms.
16 WINDREF Annual Report 2009 University by the faculty, staff, and indicators from the above-mentioned bays administration to address the monitoring of that will be tested for antibiotic susceptibility coastal environments in Grenada. The ETU to access potential risks of antibiotic- monitored a number of coastal areas on a resistance gene transfer in the coastal water weekly basis including Grand Anse Beach, (Amadi and Kotelnikova, 2008). Prickley Bay in L’Anse Aux Epines, True The assessment and implementation of Blue Bay and Black Sand Beach since 2003 EPA recreational water quality standards is (Kotelnikova, 2004). The methodology used the responsibility of the individual for the determination of the contamination level of the recreational water was adapted (Cenci et al., 1993; Pepper et al., 1995; Fujioka, 2002), developed and described (Kotelnikova, 2004); and it is currently used by the ETU members Dr. David Lennon, Beulah Patterson, Brent Nelson, Grace Dolphin, Victor Amadi, Aví Bahadoor- Yetman and Dr. Svetlana Kotelnikova (Figures 1 and 2). Our previous studies showed that fecal coliform indicators and opportunistic pathogens were present in the coastal waters of Grenada (Davis and Kotelnikova, 2003, Davis and Kotelnikova, 2004, Kotelnikova et al., 2004; Nimrod et al, 2005). The inappropriate deposition of sewage has led to the introduction of drug- resistant organisms into coastal waters
Figure 3: Percentage of E.fecalis contaminated sample periods per year for period between 2006 and 2009 in four coastal area in Southern Grenada
community (Bartram & Rees, 2000; Fujioka, 2002). The standard defines a maximum of 35 cells of Enterococcus fecalis per 100 ml and 200 cells of fecal coliforms per 100 ml (Clark, 1997; EPA; 2009). The percentage of Figure 2: Brent Nelson, Victor Amadi, Grace sampling occasions when numbers of Dolphin-Bond, Beulah Patterson, and Avi indicators exceeded the EPA limits for Bahadoor-Yetman Enterococcus fecalis are represented in Figure 3, while the data for E. coli are shown (Huycke, 1998; Qureshi and Qureshi, 2002) in Figure 4. and St. George’s Bay was shown to be a source of antibiotic resistant pathogens (Patel The data on bacterial contamination in and Kotelnikova, 2007; Patel, 2007). coastal waters showed that Grand Anse Currently we isolated a number of bacterial Beach in South St. George, resulted in the
17 WINDREF Annual Report 2009 least percent of contaminated sampling Chao, 2005; Chao et al., 2005). occasions over the years of monitoring. Thus, the monitored beaches may be Values ranged from 3-17% while Black Sand claimed clean and reflective of EPA Beach and True Blue Bay presented highest requirements in 66-93% (EPA, 2009) of numbers ranging from 18-82% of sampling occasions as of 2009. True Blue contaminated occasions. It is interesting that Flag Campaigns may be applied to most of the compliance gradually improved after the the frequently visited hotels and marinas of establishment of the ETU monitoring, thus Grenada, to engage local business resources along with the St. George’s University monitoring efforts. While the annual trends during the observed period reflected a decrease in levels of both fecal coliforms and enterococcal contamination in most of the studied marine recreational environments in Grenada, one factor is important and should not be overlooked. Increase in population, sea vessels, urban runoff, and human waste pollution have to be considered. Therefore environmental education targeting local communities, yachting visitors, businessmen and waste management groups may contribute to further improvements. An investment in treatment plants / facilities and environmental monitoring will also help to control the coastal environment in our tropical paradise. Figure 4: The temporal variability of indicator organisms E.coli in the Coastal environments Submitted by Svetlana V. Kotelnikova of St. George’s, Grenada that exceeds the EPA Victor A. Amadi Standard. Aví A.T. Bahadoor -Yetman indicating a positive effect of water 5.8 Marine Research Related Activities monitoring for the management of run-offs in Mr. Steve Nimrod and Dr. Clare Morrall spite of the increasing SGU student continue their work with Marine Protected population. Our previous research has also Area (MPA) development in Grenada. In shown that the numbers of coliform April 2009 Mr. Nimrod was voted in as Chair indicators observed during the period of the MPA Co-management committee. between 2003 and 2005 did not translate into Recent progress of the committee includes any increase of GI infections in the non- developing job descriptions and a training immune compromised population of SGU programme for MPA wardens, working with students (Davis and Kotelnikova, 2004, the Fisheries Division to repair and install Nimrod et al, 2005). However, the presence mooring buoys for the Moliniere MPA, and of indicators in water used for domestic overseeing the purchase of a small boat for purposes affected even non-immune the MPA warden’s patrols. compromised populations (Kotelnikova and
18 WINDREF Annual Report 2009 Early in the fall of 2009 Mr. Nimrod, Atmospheric Administration (NOAA). The SGU, Mr. Jerry Mitchell, SAS student and development of a full proposal has been former MPA Manager, and Dr. Morrall approved for submission. worked closely with Dr. Dominique Roby, Two undergraduate students have consultant. Dr. Roby is a consultant for the completed research projects in the fall USAID-funded Caribbean Open Trade semester of 2009. Mr. Jerry Mitchell and Ms. Support Program and is writing a Sharmaine Shallow have been investigating management plan for the Moliniere MPA. seagrass communities around the coasts of Dr. Morrall wrote a supporting document Grenada under the direction of Dr. Easter- for a grant submission made by the Caribbean Marine Protected Area Management network and forum (CaMPAM) for ‘Reducing Marine Litter in the Wider Caribbean’ in May 2009. The funding proposal was successful, and it is anticipated that WINDREF will sign a Memorandum of Agreement in the amount of US $20,000 for a project aimed at alleviation of marine litter in the near future. Two SAS graduates will be employed to execute this project which will involve community education and improved disposal of litter.
Ms. Shallow and Mr. Mitchell collecting data Pilcher, Mr. Nimrod and Dr. Morrall. Ms. Shallow’s research paper is titled Ms. Shallow and Mr. Mitchell collecting data ‘Investigating the Distribution, growth and expansion of the invasive seagrass Halophilia stipulacea in Grenada, West Indies. Mr. Dr. Morrall and Mr. Nimrod supported the Mitchell’s paper is entitled ‘A comparative development of a pre-proposal by the study of seagrass meadow structure in Sustainable Grenadines Project for a project Grenada: South coast versus southwest titled: Strengthening Reef Management in the coast’. The student’s research findings will South Eastern Caribbean. The pre-proposal be submitted for publication early in 2010, was submitted to the Coral Reef and it is hoped that the students will also Conservation Programme through the present their findings at a scientific National Fish and Wildlife Foundation (NFWF) and the National Ocean and conference.
19 WINDREF Annual Report 2009 Dr. Ernesto Weil from the University of Dr Morrall and Mr. Nimrod continue to Puerto Rico, one of the world’s most eminent work closely with The Nature Conservancy coral disease experts supported by David in a range of their Eastern Caribbean Anderson, conducted coral disease surveys in initiatives. Grenada in September 2009. This was Dr. Faculty from the Life Sciences Weil's fourth research trip to Grenada. Department are grateful for the strong Dr. Morrall assisted and supported Mr. working relationship established with the Craig Berg, Milwaukee County Zoological Grenada Fisheries Division and for the quick Gardens, and Ms. Billie Harrison, Racine turn around on research clearance requests. Zoological Gardens, during their May field Submitted by Dr. Clare Morrall research visit to Grenada. Mr. Berg and Ms. Harrison are Herpetologists, and their interest 5.9 “Soil Transmitted Helminths” and is in frogs and snakes. During night research Streptococci infections among school expeditions, a range of frog species were going children between the ages of 5- surveyed and swabbed. Frog swabs were 15 years old in the Parish of St. analyzed via PCR in Dominica and the Andrew’s. deadly Chytrid disease was identified in frogs from a number of sites. The Marine Station live marine specimen collection has attracted visits from future SAS students from the Grand Anse Playscheme and the Montessori school. Groups of around 15 children ranging in ages between 3 and 15 thoroughly enjoyed their visits and their interactions with a range of marine creatures. Mr. Bawo Teddy Ikolo and Mr. Nimrod have been instrumental in making this a successful community outreach activity. Photograph of some students during the informed consent distribution process at St. Dr. Morrall coordinated Grenada’s Mary’s R.C with Deputy Principal and component of the Ocean Conservancies teachers. Annette Kabuusu (MPH practicum International Coastal Cleanup. Cleanups by student) and Trevor Noël. schools, businesses and community groups took place over two months from September This research project is being conducted 2009. Over 350 volunteers took part in in St. Andrew’s parish, Grenada. The study cleanup activities and specific data on over focuses on the Incidence of Neglected 6,000 lbs of garbage were collected. Mr. Tropical Diseases with a specific emphasis Steve Nimrod oversaw a cleanup at Flamingo on the “Soil Transmitted Helminths” with the Bay within the Moliniere MPA. Data aim to tackle the three main helminths, collected during the cleanup has been hookworms (Ancylostoma duodenale, submitted for inclusion in the Ocean Necator americanus), Roundworms (Ascaris Conservancy International Report. In lumbricoides) and Whipworms (Trichuris addition, the Grenada data will be presented trichiura) and the Incidence of Streptococci to the Ministry of the Environment and the infections among school going children Ministry of Tourism.
20 WINDREF Annual Report 2009 To date all fourteen (14) Primary schools in the parish of St. Andrew’s have been included in the study. The schools included are Belair Government, St.Matthew’s Roman Catholic (R.C.), St. Michael’s R.C, Holy Cross R.C., Holy Innocent Anglican, St. Giles Anglican, St. Mary’s R.C., Telescope Government, Paraclete Government, St. Andrew’s R.C., St. Andrew’s Methodist, Tivoli R.C., St. Andrew’s Anglican and Crochu R.C. Eleven hundred informed consents have Students at Tivoli R.C. conducting correct hand washing and drinking practices. been distributed to the schools mentioned above. Within each school the distribution was random with the names being selected between the ages of 5- 15 years old in the using a random number generator. The Parish of St. Andrew’s. current participation number is 85%. Our The protocol for this study was passed and hope is to draw samples from seven hundred approved through St. George’s University and fifty (750) children. The fecal, throat and IRB and subsequently passed and approved blood samples will be observed in the by the Research Oversight Committee at both laboratory for helminthes (fecal) and the Ministry of Education and Ministry of Streptococci (throat and blood samples). In Health level. addition to this testing, there will be an educational component that will provide the primary prevention through multi media mass education.
Children actively involved in the “Healthy Body, Healthy Minds” concept.
Funding has been received for medication that can be administered on a mass scale if the incidence of helminthes and Streptococci Current educational material available at the merits such action. The sampling process is community level. set to begin in March 2010.
21 WINDREF Annual Report 2009 Funding provided by the Bartholomew J. groups engaged in dangerous behavior Lawson Foundation for Children in related to sun exposure, the high risk group partnership with REACH Grenada. was of greater concern, with 16.1% spending greater than 3 hours in the sun per day and Submitted by Trevor P. Noël, MPH 49.4% “rarely” or “never” using sunscreen Assistant Director, WINDREF while outdoors or on campus. Furthermore, 5.10 Assessing Knowledge, Beliefs, and the 43.7% of the high-risk group students did Behaviors of Medical Students in not use an adequate SPF factor product when Grenada Regarding Sun Exposure outdoors. and Sunscreen Use Additional analyses are ongoing. In The “Sun Health” study began in early comparing the group of students that reported 2009 with a survey-based cross sectional safe sun practices by use of sunscreen study design, involving St. George’s “always” or “most of the time”, and the University School of Medicine (SOM) group of students that “never” used students in Grenada during the 2009 winter- sunscreen, it appears there may be significant spring semester. The objectives of this study differences between the two groups. Student were to assess the knowledge, beliefs and behaviors related to sun practice appear behaviors of medical students in Grenada linked to locations where students were regarding sun exposure (both intentional educated prior to their enrollment at SGU. “sunbathing” and unintentional “campus life Preliminary findings suggest public health and outdoor recreation”) and sunscreen use. campaigns regarding sun exposure and The research team involved in this study sunscreen use may be warranted for students included medical students and faculty. in Grenada and the rest of the Caribbean. Ethical approval was obtained via IRB Many students who participated in the review. Students were recruited from all research expressed interest in knowing the terms of SOM classes and SOM student clubs results of the study, so investigators plan to to take part in an online survey, which was provide summarized feedback upon open for five weeks during the term. No completion of data analysis. Comments from identifying information was obtained but study participants suggest skin health and sun extensive data were collected, with a total of exposure were issues of importance to 514 responses submitted online by the time students. The authors also intend to publish data collection stopped in April 2009. Several in peer reviewed journals to disseminate the local businesses donated items and discount findings more widely. Expect to hear more coupons as a way to thank survey participants about the “Sun Health” study in the coming for their time. year. Preliminary data analysis comparing high- risk skin type participants to low-risk skin Submitted by O Visnjevac, F Ma, type participants suggest that overall I Etelzon, B Srvantstian, TJ McCann knowledge of safe sun practice was generally high, with no statistical difference between the two groups. It is important to note that, of the students included in the sample, a significant proportion (16.9%) fit criteria for
skin that was highly susceptible to photodamage and skin cancer. Although both
22 WINDREF Annual Report 2009 5.11 Basic Life Support Knowledge and knowledge for both groups fell below AHA Skill Retention in Pre-Clinical standardized guidelines. Given the Undergraduate Medical Students importance of BLS in an acute emergency, we recommend more frequent review of BLS The objective of this study was to assess protocol by medical students than the Basic Life Support (BLS) and existing two year certification interval. In Cardiopulmonary Resuscitation (CPR) addition, BLS training should add emphasis written knowledge and practical skill on skills which degrade between 9-18 retention in pre-clinical undergraduate months; specifically, effective ventilation and medical students. Current practice is for health care professionals to recertify their delivery of CPR for a prolonged duration. BLS training every two years. Our goal was Submitted by JK Ramjist, A Fernandes, to better understand if more frequent BLS AK Scott, TJ McCann revision is required than the standard two year period and which skills degrade more 5.12 Occupational Health Problems among quickly over time. The research was Nutmeg Production Workers in undertaken on two groups of 50 medical Grenada students, who were 9 and 18 months post- The nutmeg industry is one of the most training. Students’ knowledge of significant contributors towards the local resuscitation was assessed by a written economy in Grenada, serving directly and multiple choice test, and their resuscitation indirectly as a source of employment and skills evaluated using training manikins by support for a significant portion of the local BLS instructors according to the 2005 population. During Hurricane Ivan, Grenada American Heart Association (AHA) protocol. lost 90% of the nutmeg trees (WINDREF When comparing total number of errors, Research Institute Annual Report, 2004). participants 9 months post-training had on Linked to the devastation of hurricane Ivan in average 4.67 errors (SD= ±2.955; 95% CI= 2004, only one nutmeg production plant, in 3.830-5.510), while participants 18 months Gouyave, remained active. The Gouyave post-training had on average 6.71 errors plant uses an old and ineffective technology (SD=±2.528; 95% CI=5.992-7.428). Upon that limits the economic benefits and evaluation of individual skills within the increases the environmental and occupational AHA protocol, there were 20-30% more health risks for workers. The plant processing students within 9 months of training who technology has not been updated for many provided adequate ventilation and continuous years. In October 2008, the Department of cycles of CPR when compared to those 18 Public Health and Preventive Medicine months post-training (P<0.05). When (DPHPM) at St. George’s University School comparing the written evaluation of of Medicine, the Grenada Cooperative participants, 44% of students 9 months post- Nutmeg Association (GCNA), and training scored 80% or greater, while only WINDREF started to collaborate on the 22% of students 18 months post-training project titled “Occupational Health Problems scored greater than 80% (P<0.05). among Nutmeg Production Workers”. The goal of this project was to investigate the The 9 months post-training group out- possible occupational health problems among performed the 18 months post-training group nutmeg production workers in the Gouyave on the written BLS knowledge assessment Nutmeg Processing Plant. The baseline data and had fewer errors on the practical collection was finished in May 2009. In this assessment. However, overall BLS skill and cross-sectional study, trained interviewers 23 WINDREF Annual Report 2009 administered a validated questionnaire, respectively. The prevalence of symptoms including sections for demographics, was high and, regardless of their tasks, occupational history, respiratory, occupational exposure patterns were similar dermatologic, and musculo-skeletal for all workers. There was also no observed symptoms, physician-diagnosed diseases, and significant relationship between symptoms smoking status. and occupational variables, including duration, work intensity and task. Workers also had a high prevalence of musculoskeletal symptoms. This requires planning of a population-based study to investigate environmental and occupational risk factors and health outcomes. Preparation for the second phase of the study on this population is in process. Submitted by M. Akpinar-Elci MD, MPH, S. Bidaisee DVM, MSPH, S. Peters MPH, O.C. Elci MD, PhD, FRSPH Dr. Satesh Bidaisee, Mr. Frank, Gouyave Plant Tour Cordinator, Dr. Akpinar-Elci, Dr. 6.0 2009 Grants Elci, Mr. Narine, acting Manager, Gouyave We would like to thank all of the donors nutmeg processing plant who have made WINDREF’s work possible SGU’s Institutional Review Board in 2009 approved the study procedures, and all The Bartholomew J. Lawson Foundation for participants provided a signed informed Children, in partnership with Reach Grenada, consent form. A total of 87 workers, out of for the St. Andrew’s Parish Helminths and 93 completed the questionnaire, which Rheumatic Fever Project corresponded to a participation rate of 93.6%. Workers were mostly female (77.0%), single Dr. Mary-Jeanne Kreek, Kreek Laboratory, (single female 77.6%), and nonsmoker Rockefeller University, NY, for the support (83.9%), with a mean age of 47.2±11.4 years. of the “Genetic Correlation of Addictive 56% of the workers are involved in the Diseases” project cracking and sorting of nutmegs that The Lounsbery Foundation, for their produces a high dust exposure. The most continued support of the Streptococcal common lower respiratory symptom was dry Program (St. Vincent and the Grenadines) cough (49.4%), and 28.7% reported wheezing. The workers, who had wheezing The Nature Conservancy, for their continued or dry cough symptoms, reported their support of the Marine Protected Areas symptoms mostly consistent with their work Program, Grenada (64.0% of wheezing and 46.5% of dry cough Rotary International, for support of the symptoms). There was 14.9% physician “Baseline Survey – Princess Alice Hospital diagnosed asthma. The most common rhinitis Programs, St. Andrew’s, Grenada” symptom was sneezing (67.8%), and stuffy St. George’s University, for ongoing support, nose (49.4%). Work-related upper airways including the Small Research Grant Initiative symptoms such as sneezing, runny nose, which has helped some WINDREF scientists itchy nose, and stuffy nose symptoms, were 57.6%, 31.6%, 29.4%, and 37.2% 24 WINDREF Annual Report 2009 The Teasdale-Corti Foundation for the grant Alcohol consumption in Grenada supporting the Caribbean EcoHealth The incidence and mortality of cancer in Programme (CEHP) Grenada over the ten year period: 1990-1999 The World Bank (for the Canadian POPs The prevalence of abnormal haemoglobin Trust Fund) for the Caribbean Persistent traits in Grenadian secondary school Organic Pollutants (POPs) Study adolescents Global Environment Facility (GEF) for Knowledge, attitudes, beliefs and practices of support of the Nutmeg factory project. sickle cell anemia in Grenadian primary and 7.0 Past, Present, and Future Research secondary school children Projects Decompression sickness among the 7.1 Past, Present, and Future Research indigenous fishing population in Grenada: Projects: Non-communicable Diseases Assessing the burden of disease Angiotensin converting enzyme and WINDREF / SGU Hurricane Relief angiotensinogen gene polymorphisms in the Spice Research Program Grenadian population: relation to hypertension Sulfate-reducing bacteria in oxidized freshwater of tropical mangroves Development of a decision rule for screening Obstructive Sleep Apnea and its Novel antibiotics from tropical marine epidemologic relevance to the people of environments: drug development in Grenada Grenada Study of the mutacin C-7A Prevalence and associated risk factors of Gram-negative bacteria isolated from aquatic hypertension in a sample population of native environments of Grenada (61.4°W, 12.0°N), Caribbean’s in Grenada, West Indies West Indies Assessing the prevalence of diabetic Identification of bacteria producing complications by examining type I and type antibiotics isolated from deep marine II adult diabetics for signs of retinopathy, biofilms of Grenada neuropathy, nephropathy and dermatological SGU Environmental Testing Unit (ETU) changes associated with poor glucose control within the native Caribbean population of Post-hurricane water surveillance in Grenada problematic areas of Grenada Hypertension management and control in two Evaluation of the relocation potential for Caribbean countries villagers residing in Queen Elizabeth National Park, Uganda Assessment of the effectiveness of broad- spectrum treatment to children with Study of the calls of the spotted hyena at protozoan and nemathelminthic parasitic feeding infections on diarrhea and school attendance Survey on the attitude of villagers in Queen The effects of iron-deficiency anemia on Elizabeth National Park, Uganda towards the cognition and behavior in infants threat of lions, leopards and hyenas Diurnal variation of urinary endothelin-I and Epidemiology of human injuries resulting blood pressure: related hypertension from wildlife in ten villages within Queen Elizabeth National Park, Uganda 25 WINDREF Annual Report 2009 Rural Ugandan village perspective on lion, The seroprevalence of Toxoplasma gondii in leopard and hyena conservation a population of pregnant women and cats in Epidemiology of human injuries by wildlife Grenada, West Indies in six villages within Queen Elizabeth The efficiency of diagnosing women of National Park, Uganda Toxoplasma gondii using PCR techniques in Prevalence of Campylobacter fetus comparison with ELISA subspecies venerealis and other Dengue virus in Grenada: seroprevalence and microorganisms in the reproductive tracts of associated risk factors cattle from the southern region of Santo A current appraisal of dengue virus in Domingo, Dominican Republic Grenada – serotype analysis and vector Antimicrobial properties of skin secretions assessment from Eleutherodactylus johnstonei on A site receptivity study determining the bacteriological isolates threat of reintroduction of malaria into Examination and analysis of prostate cancer Grenada through the study of Anopheline in Grenada spp. mosquito vectors A Church-based intervention to improve Chlamydial infection among STD clinic hypertension prevention and control among attenders in Grenada women in Grenada Fever in Grenada Occupational Health Problems among Mosquitoes and tourism in Grenada Nutmeg Factories Workers, SGU Small Research Grant Initiative Effectiveness of a formula feeding/weaning intervention program in preventing 7.2 Past, Present, and Future Research transmission of HTLV-1 from seropositive Projects: Infectious Diseases mothers to newborns in Grenada Investigation of the prevalence of SIV in the A multi-center longitudinal research study of mona monkey (Cercopithcus mona) in the behavioral significance of the prevalence Grenada of HIV-1 infection in pregnant women and Seroprevalence of HIV-I and HIV-II in their babies on the islands of Grenada and St. pregnant women in Grenada, W.I. – their Vincent knowledge of AIDS and their exposure A multi-center longitudinal research study of hazards to the virus the ethical analysis of informed consent of A cross sectional study of the current status the prevalence of HIV-1 infection in pregnant of Schistosoma mansoni in St. Lucia by field women and their babies on the islands of surveys and supplementary data collection Grenada and St. Vincent Identification and characterization of Determining the role of IL-15 in mediating hantaviruses among the mammal population function of viral-specific CD8+ T cells in the of Grenada myelopathogenesis of HTLV-1: symptomatic versus asymptomatic patients HIV/AIDS health education and evaluation program in Grenada Intestinal protozoan infections in 6-12 year old children in Grenada
26 WINDREF Annual Report 2009 Intestinal helminth infections in 6-12 year old ELISA antibody titres against group A children in Grenada streptococcal M protein moiety and cell wall N-Acetyl-D-Glucosamine in Grenadian The prevalence of intestinal parasites in Rheumatic Fever patients school children in rural Guyana Evaluating the effectiveness of educational The prevalence of filariasis and its effects on methods in the prevention of Rheumatic Fever children aged 8-14 in the central corentyne and knowledge, awareness and practices region of rural Guyana Prevalence of intestinal helminth infections in The prevalence of streptococcal infection in school children aged 5 – 15 years in Grenada, rural Grenadian school children Carriacou and Petit Martinique Cystic echinococcosis in Morocco and Studies examining the elimination of Uganda lymphatic filariasis as a public health problem Elimination of Lymphatic Filariasis in in Guyana Guyana Program Seroprevalence of heartworm infection in Neglected Tropical Diseases and dogs in Grenada Rheumatic Fever in St. Andrew’s Parish, Grenada: A project to prevent/eliminate Dengue in Grenada helminthic and rheumatic fever infections Assessing the potential risk factors of dengue among children (5-15 years of age) and dengue hemorrhagic fever in the tri-island state of Grenada, Carriacou and Petit 7.3 Past, Present, and Future Research Martinique Projects: Unique Projects A comparative study to find out if there is an Characterization of five amphibians association between sexual practices and inhabiting Grenada and subsequent isolation knowledge in adult populations of Botswana and antimicrobial assay of potential and Grenada with the prevalence of HIV/ antibiotics derived from their skin AIDS Mona monkey studies in West Africa HIV/AIDS in rural Botswana differentiating Investigation of medicinal plants in Grenada between informing and educating Use of medicinal plants in Grenada Evaluating the level of perceived fear and desensitization towards HIV/AIDS in Medicinal drugs from the sea: what do Botswana Grenada’s waters have to offer? Rheumatic Fever in Grenada Beekeeping in Grenada: effects of the mite Varroa jacobsoni and its control Streptococcal program in St. Vincent Effects of Grenadian medicinal plants on Isolating T cells from Rheumatic Fever endemic microbial causes of diarrhoeal positive blood: immunofluorescent assay of T diseases lymphocytes via fluorescently labeled monoclonal antibodies The neurobiological basis of hypoglycemia- associated autonomic failure Possible genetic predisposition to Rheumatic Fever: demonstrating the inheritance fashion of non-HLA B lymphocyte alloantigen D8/17, a marker for Rheumatic Fever
27 WINDREF Annual Report 2009 Stimulation of angiotensin 4 in cardiac Physiological characterization of novel fibroblasts activates matrix metalloproteinases marine bacterial species isolated off Grenada through MAP kinases pathways: A model for Characterization of marine sponge-associated astrocytes bacteria and cytotoxic activity of sponge REM sleep and memory extracts towards human cancer cells End of life care in Grenada Examining HIV/AIDS provider stigma: assessing regional concerns in the islands of Novel antibiotics from tropical marine the Eastern Caribbean environments Knowledge, attitudes and practice survey for Genetic correlates of the addictive diseases: cocaine, alcohol, and marijuana addiction– women (baseline survey) Grenada Caribbean EcoHealth Programme: public An investigation of pediatric botanical and environmental health interactions in medicine for acute respiratory infections food and water-borne illnesses (CEHP) Efficacy of phage therapy using an in vitro Persistent Organic Pollutants biofilm wound model system Implementing Renewable Energy and Degradation of 7 keto cholesterol by Preventing Land Degradation: An Intervention in the Nutmeg Industry in Xenohydrolases Grenada Ecological survival properties of pelagic and benthic indicator microorganisms from the St. Effects of prenatal ethanol exposure on the role of matrix-metalloproteinase mediated John’s river outflow in Grenada neural crest cells in an avian model The public health importance of dogs, Grand Assessing Medical Students’ Behavior, Anse, Grenada Perception, and Knowledge of UV Greater occipital nerve zones for treatment of Exposure and Sunscreen Application in the occipital neuralgia Caribbean (Grenada) Photovoltaic power generation program Basic Life Support Knowledge and Skill Review of current biomedical waste Retention in Pre-Clinical Undergraduate management practices in the Organization of Medical Students Eastern Caribbean States (OECS) Countries 8.0 International Conferences Sponsored in Microbial diversity in the iron-oxidizing Grenada biofilms of soda springs in Grenada “The Identification of Coleopteran Pests of Circadian cycle of iron-oxidation in warm Economic Importance” hosted at WINDREF soda springs in St. Andrew’s, Grenada, West for the 21 - 25 September. A Collaboration of Indies USDA, Ministry of Health, APHIS, Grenada, Department of Public Health and Preventive Do the microorganisms in the soda spring Medicine, SGU and WINDREF. water derive energy from the oxidation of manganese? Novel marine bacteria and their antagonistic properties against medically relevant biofilms
28 WINDREF Annual Report 2009 9.0 Abstracts/Presentations at Prevention Committee Meeting and International Conferences Invited Conference, 24–27 November 2009, Grenada Plenary/Workshop/Roundtable/ Professional Meetings/CME Forde, Martin, “Assessment, Monitoring and Management of Persistent Organic Akpinar-Elci, M., “Occupational Health Pollutants (POP)” and “Persistent Toxic Problems among Nutmeg Factories Substances (PTS) in the Coastal Ecosystems Workers,” CDC/ The National Institute for of the Wider Caribbean Region”, presented at Occupational Safety and Health, 17 The Caribbean Ecoheatlh Programme: November, 2009, Morgantown, West Overview, Status and the Next Phase, 23-24 Virginia, USA January 2009, Reef Yucatan Hotel, Merida, Akpinar-Elci, M., Weikart D.K., Mexico. Abrokwah M.E., Elci O.C., “Are we Forde, Martin, Facilitated two-day missing an important clue? “United Airways workshop to finalize Biomedical Waste Disease” among Farmers,” International Management Policy for Grenada at the American Thoracic Society Congress, May, Biomedical Waste Management Policy 2009, San Diego, California, USA Workshop, 6-7 January 2009, Grenada Charles, Reccia, “Testing the Influence of Forde M., Forde SCF., “Disaster National Business Culture and Context on Preparedness and Response Plan For HIV/ Motivation in Grenada, St. Lucia and St. AIDS Interventions In Emergencies In Vincent”. Paper presentation: Caribbean Grenada”, The United Nations Trust Fund for Studies Association XXXIV Annual Human Security (UNTFHS) Project, May Conference: Centering the Caribbean in 2009. Caribbean Studies, 1-5 June 2009, Kingston, Jamaica Forde, M., Forde, SCF. “Disaster Preparedness and Response Plan MANUAL Charles, Reccia, “Do National Culture and For HIV/AIDS Interventions In Emergencies Performance Goal Orientation Influence In Grenada,” The United Nations Trust Fund Motivation? Exploring the Relationship of for Human Security (UNTFHS) Project, May National Culture and Performance Goal 2009. Orientation on Motivation in the Caribbean Islands of Grenada, St. Lucia and St. Forde, M. (Editor), “Biomedical Waste Vincent”. Paper presentation: Academy of Management Policy for Grenada”, Ministry International Business 51st Annual of Health, Government of Grenada, January Conference: Is the World Flat or Spiky? 14, 2009 Implications for Global Strategies, 27-30 Glasgow, L., Owen, G., May-Hardford, J., June 2009, San Diego, California, USA Antoine, S., Forde, M., Perez, E., Indar, L. Easter-Pilcher, A., Zieger, U., “Bird Strike “Preliminary analysis of burden of diarrheal Task Force” comprised of SGU, Grenada illness studies in St. Lucia and Grenada,” Airport Authority, Air Jamaica, with the task presented at the Caribbean Health Research of delineating bird activities and associated Council 54th Annual Council and Scientific potential hazards to incoming and outgoing Meetings, 22-25 April, 2009, Sandals Grande aircraft at Maurice Bishop International St. Lucian Beach Resort, St. Lucia Airport, Grenada. Presented at International Kimotho, V., “Strengthening Leadership and Civil Aviation Organization Seventh CAR/ Management for Results,” key note speaker, SAM Regional Bird/Wildlife Hazard East Central and Southern Africa Health
29 WINDREF Annual Report 2009 Community – (ECSA –HC), “Improving Morrall, C., Coastal Zone Management Unit access to Quality Health Care to achieve the SGU student internship opportunities Millennium Development Goals”, 14th -18th September 2009, Arusha, Tanzania Morrall, C., presentation on a range of environmental issues to a group of Young Kotelnikova, S., Naraine, R., Jagevall, S., Leaders from Westerhall Secondary School Pedersen, K., “New Microbial Community as and the Anglican High School, April 2009, a Source of Organisms for Energy Grenada Sequestration Systems Based on Solar Energy and Iron,” Oral presentation and abstract, Morrall, C., Easter Pilcher, A., Protected FEMS 2009, 28 June - 2 July, P. 103, Area planning workshop, April 2009, Gothenburg, Sweden Grenada. Kotelnikova, S., Bruno, C., “Novel Marine Morrall, C., Easter-Pilcher, A., Wionkler, Bacteria and their Antagonistic Properties N., one day workshop to refine and amend Against Medically Relevant Biofilms,” environmental legislation for Grenada: the Abstract, KENES for FEMS 2009 Congress, Grenada Environment and Biodiversity 28 June - 2 July 2009, P. 104, Gothenburg, Coordination Act and the Grenada Natural Sweden and Cultural Heritage Act. Macpherson, Calum, PAHO Meeting for Morrall, C., Mitchell, J., workshop on setting research agenda for Schistosomiasis, Grenadines Marine Resource Space-use 20-25 October 2009, Asuncion, Paraguay Information System (MarSIS) conducted by CERMES, November, 2009, Grenada Morrall, C., MPA Management training workshop, National Ocean and Atmospheric Nimrod, S., Mitchell, J., Mr. Nimrod Administration, fall 2009, Barcelona. Support Resilience and Climate Change Workshop, provided by David and Lucile Packard June, 2009, Bonaire Foundation
Morrall, C., International Union for the
Conservation of Nature (IUCN) Conservation Congress, fall 2009, Barcelona Morrall, C., workshop on Land Based Sources of Pollution, Ministry of Environment, Spring 2009, Grenada Morrall, C., Executive Board Meetings of the Association of Marine Laboratories of the Caribbean (AMLC), May 2009, Roseau, Dominica Morrall, C., 34th Scientific Meeting of the
AMLC, May 2009, Roseau, Dominica Morrall, C., Coastal Environment Resource Management Unit (CERMES), October 2009,
University of the West Indies, Cave Hill Campus, Barbados
30 WINDREF Annual Report 2009
10.0 Publications Apaydin, N., Loukas, M., Tubbs, S.R., Bozkurt, M., Esmer, A.F. “The course of the 10.1 Publications - Books/ Book Chapters inferior gluteal nerve and surgical landmarks Loukas, M., Colborn, G.L., Abrahams, P., for its localization during posterior Carmichael, S. “Grays’ Anatomy for approaches to hip.” Surgical and Radiologic Students Review Book” Elsevier, 2009. Anatomy (2009) 31(6):415-8. Apayadin, N., Tubbs, R.S., Loukas, M., Duparc, F. “Review of the surgical anatomy of the zxillary nerve and the anatomic basis of its iatrogenic and traumatic injury.” Surgical Radiologic Anatomy (2009) Chikweto, A., Bhaiyat, M.I., Macpherson, C.N.L., DeAllie, C., Pinckney, R.D., Richards, C. and Sharma, R.N. “Existence of Angiostrongylus cantonensis in rats (Rattus norvegicus) in Grenada, West Indies.” Veterinary Parasitology, (2009) 162: 160–162
Marios Loukas, MD, PhD and William Chikweto, A., Bhaiyat, M.I., Sharma, R., Schmitt editor/publisher in Elsevier deAllie, C., McNeil, P.E. “Angiomatous lesions of the skin of dogs in Grenada.” 10.2 Publications - Journal Journal of Commonwealth Veterinary Association, (2009) 25:29-31 Anderson, R.H. and Loukas, M. “Introduction to the Special Issue on Cardiac Dubey, J.P., Lappin, M.R., Kwok, O.C.H., Anatomy and Development.” Clinical Mofya, S, Chikweto, A., Baffa, A., Doherty, Anatomy (2009) 22:2-3 D., Shakier, J., Macpherson, C.N.L. and Sharma, R.N. “Seroprevalence of Anderson, R.H., and Loukas, M. “The Toxoplasma gondii and concurrent Bartonella importance of attitudinally appropriate spp., feline immunodeficiency virus, and description of cardiac anatomy.” Clinical feline leukemia infections in cats from Anatomy (2009) 22:47-51 Grenada, West Indies.” Journal of Anderson, R.H., Smerup, M., Sanchez- Parasitology (2009). (EPub Apr 22) Quintana, D., Loukas, M., Lunkenheimer, Elci O.C., Akpinar-Elci, M. “Occupational P.P. “The three-dimensional arrangement of exposures and laryngeal cancer among the myocytes in the ventricular walls.” nonsmoking, nondrinking men.” International Clinical Anatomy (2009) 22(1)64-76 Journal of Occupational and Environmental Apaydin N, Bozkurt M, Loukas M, Vefali Health. Oct 2009; 15 (4); 370-373 H, Tubbs RS, Esmer AF. “Relationships of Gielecki, J., Zurada, A., Nowak, H.K.D, the sural nerve with the calcaneal tendon: an Loukas, M., “Morphometric and volumetric anatomical study with surgical and clinical analysis of the middle cerebral artery in implications.” Surgical and Radiologic human fetuses.” Acta Neurobiologiae Anatomy (2009) 31:775-780 Experimentalis (2009) 69:129-137.
31 WINDREF Annual Report 2009 Karatas, A., Apaydin, N., Uz, A., Tubbs, Loukas, M., Saad, Y., Tubbs, R.S., Shoja, S.R., Loukas, M., Gezen, F. “Regional M.M. “The heart and cardiovascular system anatomic structures of the elbow that may in the Qur’an and Hadeeth.” Int J Cardiol potentially compress the ulnar nerve.” J (2009) Shoulder Elbow Surg (2009) 18(4):627-631 Loukas, M., Shea, M., Shea, C., Lutter- Louis, R.G. Jr, Loukas, M., Wartmann, Hoppenheim, M., Zand, P., Tubbs, R.S., C.T., Tubbs, R.S., Apaydin, N., Gupta, Cohen-Gadol, A.A. “Jean Baptiste Paulin A.A., Spentzouris, G., Ysique J.R. “Clinical Trolard (1842-1910): his life and Anatomy of the mastoid and occipital contributions to neuroanatomy.” J Neurosurg emissary veins in large series.” Surgical and Loukas, M., Tubbs, R.S. “Musculus Radiologic Anatomy (2009) 31:139-144. Dorsoepitrochlearis.” Clinical Anatomy Loukas, M., Bilinsky, S., Bilinsky, E., El- (2009) 22:782 Sedfy, A., Anderson, R.H. “Cardiac Veins: Loukas, M., Tubbs, R.S., Louis, R.G., Jr., A Review of the Literature.” Clinical Apaydin, N., Bartczak, A., Huseng, V., Anatomy (2009) 22:129-145 Alsaiegh, N., Fudalej, M. “An endoscopic Loukas, M., Bilinsky, S., Bilinsky, E., and anatomical approach to the septal Matusz, P., Anderson, R.H. “The clinical papillary muscle of the conus.” Surgical and anatomy of the coronary collateral Radiologic Anatomy (2009) 31:701-706 circulation.” Clinical Anatomy (2009) Loukas, M., Tubbs, R.S., Louis, R.G., Jr, 22:146-160 Wartmann, C.T., Apaydin, N. “The Loukas, M., Darius, R.G., Strike, Tubbs, Princeps Pollicis Artery Arising from the R.S., Tarneja, N., Shoja, M.M. “An Superficial Palmar Arch: Case Report and interrupted inferior vena cava in a situs Review of the Literature.” Singapore inversus. Case report and review of the Medical Journal (2009) 50:e391-392 literature.” Folia Morpfologica (2009) Loukas, M., Wartmann, C.T., Tubbs, R.S., 68:184-187. Apaydin, N., Louis, R.G. Jr, Black, B., Loukas, M., Grabska, J., Tubbs, S., Jordan, R. “The Clinical Anatomy of the Wartmann, C.T., Apaydin, N., Jordan, R. Sinutubular Junction.” Anatomical Science “Mapping the axillary nerve within the International (2009) 84:27-33 deltoid muscle.” Surgical and Radiologic McIntosh K.H., Moore J.B., Elci O.C., Anatomy (2009) 31:43-47 “Predisposing factors related to adolescent Loukas, M., Groat, C., Khangura, R., sexuality among students in rural and urban Owens, D.G., Anderson, R.H. “The Normal school-based health centers in eastern North and abnormal anatomy of the coronary Carolina.” Journal of Public Health arteries.” Clinical Anatomy (2009) 22:114- Management and Practice. 2009, 15: E16-22 128 Ngatia, P. & Kimotho, V., “Retention of Loukas, M., Noordeh, N., Tubbs, R.S., clinical officers in southern Sudan: a tracer Jordan, R. “A previously unreported study of Maridi National Health Training variation of the Axillary Arch muscle.” Institute (NHTI) Graduates”, Medicine & Singapore Medical Journal (2009) 50:e88-90 Health 2010, (2009) pp. 42-44
32 WINDREF Annual Report 2009 Rutrecht, S., Brown, M. “Differential Tubbs, R.S., Apaydin, N., Uz, A., Shoja, virulence in a multiple-host parasite of M.M., Slappey, J.B., Comert, A., Acar, bumble bees: resolving the paradox of H.I., Tekdemir, I., Loukas, M. “The clinical parasite survival?” Oikos (2009) 118:941-949 anatomy of the ligament of Barkow at the proximal tibiofibular joint.” Surgical and Schioler, K.L. and Macpherson, C.L. “Dengue Transmission in the Small-island Radiologic Anatomy (2009) 31:161-163 Setting: Investigations from the Caribbean Tubbs, R.S., Apadin, N., Uz, A., Sullivan, Island of Grenada” Annals of Tropical A., Loukas, M., Shoja, M.M., Cohen-Gadol, Medicine and Parasitology, (2009) 81: 280- A.A. “The Clinical Anatomy of the Lateral 286 Intermuscular Septum of the Arm.” J Service, M.W. and Macpherson, C.N.L. Neurosurgical (2009) 111:336-339 “George Stanley Nelson.” Annals of Tropical Tubbs, R.S., Bailey, M., Barrow, W.C., Medicine and Parasitology, (2009) 103: 369- Loukas, M., Shoja, M.M., Oakes, W.J. 37 “Morphometric Analysis of the Craniocervical Juncture in Children with Chiari I Shoja, M.M., Tubbs, R.S., Loukas, M., Malformation and Concomitant Khalili, M., Alakbarli, F., Cohen-Gadol, “ Syringobulbia.” Childs Nervous System A.A. Vasovagal syncope in the Canon of Avicenna: the first mention of carotid artery (2009) 25:689-692. hypersensitivity.” International Journal of Tubbs, R.S., El-Zammar, D., Loukas, M., Cardiology (2009) 134:297-301 Comert, A., Cohen-Gadol, A.A. “Intradural cervical root adjacent interconnections in the Shoja, M.M., Tubbs, R.S., Loukas, M., normal, prefixed and postfixed brachial Shokouhi, G., Ardalan, M.R. “Facial Nerve plexus.” Journal Neurosurgery Spine (2009) Palsy and its Management in the Kitab al- Hawi of Rhazes (865-925 AD)” Neurosurgery 11:413-416. (2009) 64:1188-1190 Tubbs, R.S., El-Zammar, D., Rogers, M.E., Kelly, D.R., Lott, R., Chua, G.D., Shoja, Shoja, M.M., Tubbs, R.S., Ghabili, K., M.M., Loukas, M., Oakes, W.J., Cohen- Loukas, M., Oakes, W.J., Cohen-Gadol, Gadol, A.A. “The existence of hypoglossal A.A. “Johan Georg Raeder (1889-1959) and root ganglion cells in adult humans: potential paratrigeminal sympathetic pareseis.” Childs clinical implications” Surgical and Radiologic Nerv Syst (2009). Anatomy (2009) 31:173-176 Shoja, M.M., Tubbs, R.S., Shokouhi, G., Tubbs, R.S., Loukas, M. “Hic Locus Est Ubi Loukas, M. “Wang Qingren and the 19th Mortui Viveuntes Docent.” Clinical Anatomy. century Chinese doctrine of the bloodless (2009) 22:942 heart.” (2009) Int J Cardiol Tubbs, R.S., Loukas, M., Hill, M., Shoja, Stefanoudaki, E., Williams, M., M.M., Cohen-Gadol, A.A. “Richard Lower Chartzoulakis, K. & Harwood, J.L. “Olive (1631-1691): Acknowledging his notable oil quality parameters after orchard irrigation contributions to the exploration of the nervous with saline water.” Journal of Agriculture and system.” Journal of Neurosurgery (2009) Food Chemistry (2009) 57 (4) 1421-1425 111:1096-1101
33 WINDREF Annual Report 2009 Tubbs, R.S., Loukas, M., Kato, D., Tubbs, R.S., Miller, J., Loukas, M., Shoja, Ardalan, M.R., Shoja, M.M. “The History of M.M., Shokouhi, G., Oakes, W.J. “Anatomy Anatomy in Japan” Clinical Anatomy (2009) and Surgical Landmarks for the Perineal 22:425-435. Branch of the Posterior Femoral Cutaneous Nerve: Implications in Perineal Pain Tubbs, R.S., Loukas, M., Shoja, M. “The Syndromes” Journal of Neurosurgery (2009) verterbral nerve” Surgical and Radiologic 111:332-335 Anatomy. (2009) 31:823-824. Tubbs, R.S., Tubbs, R.S., Loukas, M., Shoja, M.M. Shah, N.A., Sullivan, B.P., “Letter to the editor, Persitent falcine sinus in Marchase, N.D., Cömert, A., Acar, H.I., children.” World Journal of Pediatrics. (2009) Tekdemir, I., Loukas, M., Shoja, M.M. “The Costoclavicular Ligament Revisited: A 3:243 Functional and Anatomical Study” Romanian Tubbs, R.S., Loukas, M., Shoja, M.M., Journal of Embryology and Morphology Cohen-Gadol, A.A. “Wilhelm His (1831- (2009) 50:475-479. 1904) and his contributions to neuroanatomy.” Childs Nerv Syst (2009) Tubbs, R.S., Shoja, M.M., Loukas, M., Ardalan, M.R. “Pierre Dionis and His 25:1613-1615. Anatome de homme.” Singapoore Medical Tubbs, R.S., Loukas, M., Shoja, M.M., Journal (2009) 50:447-449. Shokouhi, G., Wellons, J.C., Oakes, W.J., Cohen-Gadol, A.A. “The contralateral long Tubbs, R.S., Shoja, M.M., Loukas, M. thoracic nerve as a donor for upper brachial “Acrel’s Ganglion” Clinical Anatomy (2009) plexus neurotization procedures: Cadaveric 22:420. feasibility study.” Journal of Neurosurgery Wartmann, C.T., Loukas, M., Tubbs, R.S. (2009) 110:749-753 “Letter to the editor, on Arcuate Line.” Anatomical Science International (2009) Tubbs, R.S., Loukas, M., Yalcin, B., Shoja, M. Cohen-Gadol, A.A. “Classification and 84:266-267. clinical anatomy of the first spinal nerve: Wartmann, C.T., Loukas, M., Tubbs, R.S. Surgical implication.” Journal of “Letter to the editor, zygomaticofacial, Neurosurgery Spine (2009) 10:390-394 zygomaticorbital, zygomaticotemporal Tubbs, R.S., McDaniel, J.G., Burns, A.M., nerves.” Clinical Anatomy (2009) 22:637-638 Kumbla, A., Cossey, T.D., Apaydin, N., Williams, N., Forde M. “Ergonomics and Comert, A., Acar, H.I., Tekdemir, I., Shoja, Obesity”, Applied Ergonomics, (2009) 40, M.M., Loukas, M. “Anatomy of the 148–149. Reflected Ligament of the Inguinal Region” Yalçın, B., Hurmeric, V., Loukas, M., Romanian Journal of Embryology and Tubbs, R.S., Ozan, H. “Variations of the Morphology. (2009) 50:689-691 Levator Palpebrae Superioris Muscle” Tubbs, R.S., Menendez, J., Loukas, M., Clinical and Experimental Ophtalmology Shoja, M.M., Shokouhi, G., Cohen-Gadol, (2009) 37:407-411 A., Oakes, W.J. “The Petrosal Nerves”: Clinical Anatomy (2009) 22:537-544
34 WINDREF Annual Report 2009
11.0 Reviewer for Journals and Boards Trends in Parasitology, Veterinary Record. Dr. Francis Fakoya: Journal of Anatomical Dr. Clare Morrall: Revisita de Biologia Sciences Tropical (the International Journal of Tropical Dr. Muge Akpinar-Elci: American Journal Biology and Conservation). of Respiratory and Critical Medicine, The 12.0 Thesis Defenses Archives of Environmental and Occupational No research scientist thesis defenses were Health, Chest. conducted this year. Dr. Martin Forde: Environmental Monitoring and Assessment. 13.0 Graduate Seminars Dr. Svetlana Kotelnikova: Earth-Science Victoria Kimotho, MPH, “Knowledge, Attitude and Practice (KAP); A Baseline Reviews, Elsevier. Health Survey for Women in the St. Andrew’s Dr. Marios Loukas: Surgical and Radiologic Parish, Grenada”. 11 February 2009. Anatomy, Clinical Anatomy, Neuroanatomy, European Journal of Surgical Research, Muge Akpinar-Elci, MD, MPH, “The Journal of Brachial Plexus and Peripheral Occupational Health Controversy around Nerve Injury, Journal of Anatomy, Pain America’s Favorite Snack: Popcorn”. 25 Practice, Medical Science Monitor, Indian February 2009 Journal of Plastic surgery, American Journal Satesh Bidaisee DVM, MSPH, “Emerging of the Medical Sciences, Clinical Infectious Diseases, A One Health, One Rehabilitative Tissue Engineering Research, Medicine Approach”, 4 March 2009. Life Sciences, Anatomy, International Journal Alan Wabrek, MD, MPH, DrPH, “The Ten of Experimental and Clinical Anatomy, Most Important Public Health Achievements Current Urology, World Journal of Surgery, of the 21st Century”. 11 March 2009. Clinical Medicine Case Reports, World Journal of Emergency Medicine, Acta Yvette I. Sheline, MD, Stress and Neurochirurgica, Turkiye Klinikleri Journal of Neuroimaging at WUSM. “Current Research Medical Sciences, Turkiye Klinikleri, Journal in the Area of Depression”, 18 March 2009. of Ophthalmology, Journal Biomedicine Cox-Ganser, PhD, “Studies of Building- International, Journal of Clinical Medicine related Asthma and Respiratory Symptoms in and Research, Anatomical Record, Relation to Dampness and Microbial International Journal of Cardiology, Journal of Contamination of the Indoor Environment”. Neurosciences in Rural Practice, Anatomy 25 March 2009. Research International Cecilia Hegamin-Younger, MPH, PhD, Dr. Calum Macpherson: Acta Tropica, “Enhancing the Success of At-Risk Students: Annals of Tropical Medicine and Preliminary Findings.” 8 April 2009. Parasitology, BMC Infectious Diseases, Locksley L. McV. Messam, DVM., PhD, “A Emerging Infectious Diseases, Epidemiology Few Simple but Important Issues to and Infection, Gastroenterology, International Remember When Using Diagnostic Tests”. 15 Journal for Parasitology, Journal of the April 2009. Caribbean Veterinary Medical Association, Lancet, Parasitology International, Small MPH Students from the Department of Animal Practice, Transactions of the Royal Public Health and Preventative Medicine, Society of Tropical Medicine and Hygiene, “Our Practicum Experiences”. 29 April 2009.
35 WINDREF Annual Report 2009 Zane Shaeffer, MPH, Term 2 MD Student, Satesh Bidaisee, DVM, MSPH, “Vector “Pre Hospital Stroke Care: A Feasibility Borne Diseases: A One Health, One Medicine Study in Utah”, 6 May 2009. Approach – Focusing on Malaria and Dengue Professor Jennifer Ames, Associate Dean of Fever”, 23 September 2009. Research “Towards Collaborative Research Calum N.L. Macpherson, PhD, DIC, between Northumbria University and SGU”; MEVPC, “Collaborating with the Flying 11 May 2009. Doctors: The Summer 2009 Kenya Selective”. Dr. Andrew Collins, “The Disaster and 30 September 2009 Development Centre at Northumbria”. 11 Rolf E. Larsen, DVM, PhD, Dipl. ACT, May 2009. “Artificial Insemination in the American Victor Amadi, MSc, “Termites, a Source of Alligator”, 14 October 2009 Methane Production”, 13 May 2009. Brenda Kirkby, PhD, “The Right to Die: The Legality of Euthanasia, Assisted Suicide Sandra Augusto, David Carlton, Shivaughn Forsyth, Alexander Juusela, Annet and ‘Pulling the Plug’”, 28 October 2009 Kabuusu, Robert Kruse, Jenna Luker, Joanne Rayner, PhD, “The Microbiology of Anushka Mahal, Winifred Razack, Robert the ‘Food of the Gods’”, 4 November 2009 Reichmann, Natalie Shabahzi, Lindsey Alejandro Martinez, “Oral Rabies Trutter. “From the Classroom to the Field”, Vaccination in Wild Carnivores in the US”. 20 May 2009. 11 November 2009 Mary Glenn, PhD, “Mona Monkeys in Cindi Hillemeyer, “Chronic Wasting Disease Grenada”. 27th May 2009. in Wild Ruminants of North America”, 11 Christine Royal, “The Prevalence of November 2009. Overweight Adolescents in Secondary Sarah Mihalek, "The Human Elephant Schools from Two Parishes in Grenada, West Conflict in Africa", 18 November 2009 Indies”. 3 June 2009. Rebekah Riedel, "Viability of Community Lindonne Glasgow, “The Burden of Based Conservation in Sub-Saharan Africa”, Gastrointestinal Illness in Grenada”, 23 June 18 November 2009 2009. David Lennon, PhD, “Obsolete Scientific William P. Boyan, MD, MDA, LLC, Dogmas Pt 1: Koch's Postulates” , 25 “Clinical Perspectives on Geriatrics and November 2009 Palliation”, 26 August 2009. Fred Jordan, MD, “Mass Disasters, The Elizabeth Louie, MD, “Autism and Ethical Role of the Medical Examiner.” 2 December Dilemnas”, 2 September 2009. 2009 Alan Wabrek, MD, MPH, DrPH and Mrs. Lynn Wabrek, MEd, MPH, “Sex and You”, 9 September2009. Alan Wabrek, MD, MPH, DrPH and Mrs. Lynn Wabrek, MEd, MPH, “Sex and You”. 16 September 2009.
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14.0 Contact Information Administrative Assistant, WINDREF (USA) Director, WINDREF (Grenada) Ms. Valerie Smith Dr. Calum N.L. Macpherson 1 East Main Street, Suite 228 P.O. Box 7, St. George’s Bay Shore, New York, 11706 Grenada, West Indies United States of America Tel: 1 (473) 444-3068 Tel: 1 (800) 899-6337 Fax: 1 (473) 444-3041 Fax: 1 (631) 665-2796 E-mail: [email protected] E-mail: [email protected] Assistant Director, WINDREF (Grenada) Mr. Trevor Noël Exec. Secretary, WINDREF (UK) Mrs. Sue Huntington P.O. Box 7, St. George’s Kingdon’s Yard, Parchment Street Grenada, West Indies Winchester, Hampshire, SO 23 8AT Tel: 1 (473) 444-3997 United Kingdom Fax: 1 (473) 444-3041 Tel: 01962 850650 E-mail: [email protected] Fax: 01962 850567 Admin. Assistant, WINDREF (Grenada) E-mail: [email protected] Mrs. Isha English P.O. Box 7, St. George’s Caribbean EcoHealth Programme (CEHP) Dr. Martin Forde Grenada, West Indies P.O. Box 7, St. George’s Tel: 1 (473) 444-3997 Grenada, West Indies Fax: 1 (473) 444-3041 Tel: 1 (473) 439-2000 x.2349 E-mail: [email protected] Email: [email protected], martin- Secretary, WINDREF (Grenada) [email protected] Mrs. Rachel Paul-King P.O. Box 7, St. George’s Caribbean Environmental Health Initiative Grenada, West Indies (CERI) Dr. Svetlana Kotelnikova Tel: 1 (473) 444-4175 x 2555 P.O. Box 7, St. George’s Fax: 1 (473) 444-3041 Grenada, West Indies E-mail: [email protected] Tel: 1 (473) 444-4175 ext. 2465 SGU IRB & WINDREF (Grenada) Fax: 1 (473) 439-1845 Ms. Meg Conlon E-mail: [email protected] P.O. Box 7, St. George’s Grenada, West Indies Tel: 1 (473) 444-4175 x 2221 Fax: 1 (473) 439-4388 E-mail: [email protected]
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