2005 Annual Report

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.

WINDREF’s primary goals include: • 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 PAGE

Table of Contents ...... i 1.0 Highlights from 2005: Director’s Report...... 1 1.1 WINDREF Humanitarian Program...... 3 2.1 WINDREF Research Institute Board of Directors...... 5 2.2 St. Vincent and the Grenadines Board of Directors ...... 5 2.3 Scientific Advisory Board...... 5 2.4 Research Fellows...... 5 2.4.1 Senior Research Fellows...... 5 2.4.2 Research Fellows...... 5 2.5 Research Scientists...... 6 2.6 WINDREF Research Institute Administration...... 6 3.0 WINDREF (USA)...... 6 4.0 WINDREF (UK)...... 6 4.1 WINDREF (UK) Board of Trustees ...... 6 4.2 WINDREF (UK) Administration...... 7 5.0 SGU Institutional Review Board (IRB) ...... 7 6.0 Current Research Projects...... 8 6.1 The Dengue Diagnostic Lab at WINDREF...... 8 6.2.1. Lymphatic Filariasis Elimination Program in Guyana...... 8 6.2.2. A Comparative Analysis of the Knowledge, Attitudes, Practices, Beliefs and Socio-economic Impact of Lymphatic Filariasis (LF) in Georgetown, Guyana...... 12 6.3. How Improving Living Conditions Affects Prevalence and Reinfection Rates of Intestinal Parasitoses; Focusing Especially on the Proper Disposal of Human Feces ...14 6.4. Characterization of Novel Bacterial Species and Genera ...... 16 6.5. Novel Antimicrobial Compounds from Tropical Marine Environments ...... 17 6.6. The Effect of Water Quality on the Students of St. George’s University ...... 18 6.7. Summer 2005 – Apres Tout Water Project ...... 20 6.8. New Species Isolated from the Bottom of the Sea, Grenada, West Indies ...... 22 6.9. The Antimicrobial Properties of the Nutmeg...... 27 6.10. Evaluating the Level of Perceived Fear and Desensitization towards HIV/AIDS in Botswana...... 29 6.11. Genetic Correlates of the Addictive Diseases: Cocaine, Alcohol and Marijuana Addiction – Grenada, W.I...... 32 6.12. An Investigation of Pediatric Botanical Medicine for Acute Respiratory Infections, with Emphasis on Streptococcus pneumonia and Streptococcus pyogenes ...... 34 6.13.1. Marine Protected Areas Realization in Grenada, Caribbean...... 35

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6.13.2. A Project Pre-proposal to the US National Fish and Wildlife Foundation (NFWF) for a Grenada-based Marine Protected Area Project...... 37 6.14. The Inplementation and Evaluation of the Grenada Return to Happiness Program ...... 40 6.15. The MIRT Research Group Uganda Study Results for the Summer Activities in 200543 6.16. Studies on the Role of Ultrasound in Evaluating the Need for an Echinoccus granulosus Control Program: Field Studies in Eastern Turkey ...... 46 7.0 Acknowledgements...... 48 7.1 Associated Faculty, Staff and Institutional Collaborators...... 48 8.0. Grants...... 49 9.0 Past, Present and Future Research Projects...... 50 9.1. Non-communicable Diseases...... 50 9.2. Infectious Diseases...... 51 9.3. Unique Projects...... 53 10.0. Conferences/Meetings/Workshops Sponsored in Grenada ...... 53 11.0 Abstracts/Presentations at International Conferences Invited Plenary/Workshop/Roundtable/Professional Meeting/CME ...... 53 12.0 Publications...... 54 13.0 Thesis Defenses...... 55 14.0. Seminars...... 55 15.0 Further Information...... 57

1.0. Highlights from 2005 Director’s Report University in the USA (genetic 2005 was a year we were able to correlation of addictive diseases). refocus our attention on the research Two new projects were started in programs, whilst the rebuilding activities Grenada in response to monitoring some following Hurricane Ivan of September of the effects of Hurricane Ivan. The first 7th 2004 continued. Collaborative was supported from a grant by the Pan research projects continued in Grenada American Health Organization (PAHO). (dengue, water quality testing, marine This study examined whether changes in biology, medicinal plants and the genetic the birthrate occurred following the loss correlation of addictive diseases). of electrical and cablevision services for Internationally projects continued in a number of months. The study is Guyana (lymphatic filariasis), the ongoing and details of the outcome will Dominican Republic (sanitation and be presented in next year’s annual intestinal parasitoses), Uganda (wildlife report. The second study was initiated zoonoses), Turkey and Romania (cystic through Dr. Kotelnikova’s Caribbean echinococcosis), and at Rockefeller Environmental Research Initiative

WINDREF Research Institute Annual Report 2005 1

Environmental Research (CERI) In 2005 WINDREF (UK) program. The aim was to improve the welcomed Baroness Howells of St. quality of drinking water for the village David, OBE, to their Board of Trustees. of Apres Tout in St. Andrew’s Parish Baroness Howells was the first black and in so doing reduce the incidence of woman to sit on the Greater London childhood diarrhea. An initial meeting Council’s Training Board; the first was held with the Minister of Health, the female member of the Court of Hon. Ann David-Antoine, and the Governors of the University of Environmental Health officer, Mr. Greenwich and was the Vice Chair at the Worme, NAWASA officials, the London Voluntary Services Council. stakeholders from Apres Tout and the Baroness Howells was born in Grenada funders (Just a Drop, a charitable trust in and was raised to the peerage as the UK) to plan the project. Baroness Howells of St David, of Charlton in the London Borough of Greenwich in 1999. She received her early education at St. Joseph's Convent in Grenada before moving to the South West London College and City College in Washington DC.

Participants who attended the Apres Tout Meeting. WINDREF, June 2005. th The 6 Annual WINDREF lecture was presented by Dr. Mary- Jeanne Kreek (below) a distinguished physician scientist who is the Professor and Head of the Laboratory for Addictive Diseases at Rockefeller University in New York. Her lecture was Baroness Howells of St. David, OBE entitled “Drug Abuse and Addictions: The WINDREF (USA) board of Some scientific approaches to a global directors welcomed Dr Karen Lawson to health problem”. the board. Dr Lawson brings a wealth of experience to the board. She also serves as the president of the Bartholomew J. Lawson Foundation for Children. WINDREF last a very valued senior research scientist, Dr. Mike Fisher, in 2005. Mike joined Merck in 1957 and worked with them until he had a stroke in early 2004. He was vice president of research and head of a lab of 60 research scientists. It was his scientific intellect and observational Professor Mary-Jeanne Kreek, MD scholarship which led to perhaps his most profound discovery of ivermectin. WINDREF Research Institute Annual Report 2005 2

all of these benefits may never have evolved for the organism has never again been found in its natural state in the wild. Mike was one of the most modest self effacing scientists, a real gentleman, and it was indeed a great honor to have known him. Mike passed away at his Bel Air plantation home on 20th April 2005. So many people and animals have benefited from Mike’s work, his legacy will not be forgotten. During 2005 a number of papers Dr. Mike Fisher, 1926 – 2005 were published in peer reviewed journals In the 1970’s Mike’s lab was and oral presentations were delivered at receiving thousands of soil and plant scientific meetings held in Italy, Turkey samples from all over the world which and the USA. I would like to thank all he was screening for their effects on a involved with our research carried out in number of organisms. One sample came WINDREF during the year. Funding for from a bunker from a golf course in WINDREF during the year came from a Japan that contained a fungus called number of sources, and I take this Streptomyces avermillis. This fungus opportunity to thank them all for their proved to be lethal to Mike’s lab mice, continued support of our activities. and when others may have discarded the Finally I thank everyone who compound, Mike persevered and tried participated in our research projects in ever minute doses of the substance. He 2005 in the many different countries we was amazed at how little compound worked in around the world completely removed nematodes from the mice …. and a new powerful drug against roundworm parasites was born. For his discovery Mike received the Thomas Edison award for creative discovery, and the veterinary and medical world received a compound that revolutionized the treatment and cure of a myriad of infectious diseases. Today as a result of the discovery of ivermectin over 35 million people no longer live under the threat of inevitably going blind Ms Hollie Schramm and Cal from onchocerciasis (river blindness), Macpherson working on an millions more have been spared the anesthetized young lion in Queen gross disfigurement from lymphatic Elizabeth National Park in Uganda, filariasis (elephantiasis and hydrocoele) June 2005. The project looked at and dogs and cats (heartworm), pigs, zoonotic infections in the predator cattle, sheep, goats and horses live a population in the Park. healthier life because of ivermectin. Shockingly, if the astute observation on Dr. C.N.L. Macpherson, PhD, DIC ivermectin had not been made by Mike, Director WINDREF Research Institute Annual Report 2005 3

1.1. WINDREF Humanitarian damage to their roof and wooden Program floors. WINDREF/SGU Relief Our initial program that began undertook the task of rebuilding the in 2004 continued into 2005. Several Caribbean Examination Council countries sent representatives to assess (CXC) wing of SJC, a priority to ensure the children would be able to take their exams in the summer. The CXC students at SJC, under the guidance of the Principal, Sister Maureen, were able to complete their exams following the repair process carried out by WINDREF/SGU students and members of the local community.

US Secretary of State Colin Powell’s plane with the St. George’s University in the background. the gravity of the situation. The information gathered was fed back to their respective leaders and people. This helped in maintaining continued donation support from overseas to the WINDREF/SGU Relief Fund. Donated funds assisted greatly WINDREF/SGU Relief relocating a in the refurbishment of two schools in SJC classroom into UNICEF tents Grenada. Two of the projects while the convent is repaired. completed at Presentation Brothers College were the repair of the Leonard The SJC students performed very well Dennehy Wing and the restocking of in the CXC examinations, achieving a the Science laboratory with all the 91.1% pass rate, one of the highest apparatus, instruments and chemicals. pass rates ever achieved. One of the SJC students won the La Grenade cup. An award given to the student with the highest grades in technical subjects.

SJ convent students and members of the SGU student body working together.

The completed CXC examination hall in St. Joseph’s Convent.

Another school, St. Joseph’s

Convent (SJC), suffered terrible WINDREF Research Institute Annual Report 2005 4

This assistance program was Some assistance was also given facilitated by WINDREF in by our alumni in the form of The SGU conjunction with the Department of Docs for Grenada program. These Medicine and was run over an eight SGU alumni provided a much week period.

appreciated support network for the Grenada, Carriacou and Petit existing physicians on the island. Martinique were hit by Hurricane These doctors provided supportive Emily a Category 1-2 Hurricane in roles in several different specialties. 2005. While the severity of Emily This program came to a close during paled in comparison to Hurricane Ivan, the first half of the year. it affected our re-roofing program, Following Hurricane Ivan, causing an increase in the demand for several students assisted in different building materials. The re-roofing capacities. Over the summer, four program continues albeit on a smaller students, two volunteer medical scale. students Carlos Rial and Michael Swan The next area of concentration from Imperial College, London, and for WINDREF will be the play ground two premed Texas A & M students on project. WINDREF/SGU Relief the Fogarty International grant for members had meetings with both the Minority Health and Health Disparities Minister of Health and the Minister of International Research Training Tourism to discuss the feasibility of (MIRT) program, Jeniece Carter and building playgrounds for the children Jenelle Rhinehart, worked in the health of Grenada. In 2006, we received sector, assisting in burden analysis written permission from both around the time of Hurricane Ivan. Ministries to secure funding for a major playground project. It is anticipated that this project will be funded by the Bartholomew J. Lawson Foundation for Children.

Submitted by Trevor Noel Assistant Director, WINDREF

Burden analysis team including UK medical student, Carlos Rial and two premed MIRT students, Jeniece Carter and Jenelle Rhinehart, with Dr. B Noel.

WINDREF Research Institute Annual Report 2005 5

2.1. WINDREF Research Institute 2.4. WINDREF Research Institute Board of Directors Research Fellows

In 2005 we welcomed Dr Karen The following investigators have Lawson to the Board. been appointed to the Windward Islands Research Institute as research fellows Dr. Keith B. Taylor, MD (President) • and are currently conducting • Dr. Calum N.L. Macpherson, PhD, collaborative research projects. DIC (Vice President) • Ms. Margaret Lambert, MA 2.4.1. Senior Research Fellows (Secretary / Treasurer) • Paul Fields, PhD, Brigham Young • Dr. Karen Lawson, PhD • Paul Garner, PhD, Liverpool School • Mr. Trevor P. Noel, MPH of Tropical Medicine (Assistant Director) • Mary Glenn, PhD, Humboldt State • Dr. Allen Pensick, PhD • Duane Gubler, ScD, Hawaii Uni

2.2. WINDREF St. Vincent and the • Ruth Milner, MSc, Vancouver Hosp. Grenadines Board of Directors • Stephen Morse, PhD, Columbia • Leslie Ramsammy, PhD, DSC (Hon) • Dr. Ed Johnson, MD, Director Minister of Health, Guyana • Sir Fredrick Ballantyne, MD, • Stanley Weiss, MD, UMDMJ Associate Director

2.3. WINDREF Research Institute Scientific Advisory Board

• Sir Frederick Ballantyne, MD • John R. David, MD • John J. Ferguson, MBChB, FRCGP • Malcolm Ferguson-Smith, MBChB, FRCP, FRCPath • Edmond Fischer, DSc • C. James Hospedales, MB, BS, MSc • Sir Malcolm MacNaughton, MD, Marios Loukas, MD, PhD, who LLD, FRCPG, FRAC recently joined the department of • Calum Macpherson, PhD, DIC anatomical sciences, was appointed as a research fellow in WINDREF. Dr. • Thomas W. Meade, CBE, DM, FRS Loukas has a keen interest in • Graham Serjeant, MD, FRCP, CMG continuing to develop anatomical • Sir Kenneth Stuart, MD, DSc (Hon) research at SGU and to try to attract • M.S. Swaminathan, DSc research funds to facilitate this goal. • Keith Taylor, DM, FRCP 2.4.2. Research Fellows • John B. Zabriskie, MD • Zuri Amuleru-Marshall, PhD • Glennis Andall, PhD WINDREF Research Institute Annual Report 2005 6

• Charles Avgeris, MSc 2.6. WINDREF Research Institute • Orazio Giliberti, MD Administration

• Richard Kabuusu, DVM, MPH Mrs. Isha English continued as • Svetlana Kotelnikova, PhD Administrative Assistant and Ms. Meg • Matthias Lorenz, PhD Conlon as Executive Secretary.

• Marios Loukas, MD, PhD 3.0. WINDREF (USA) • Theresa McCann, MPH, PhD WINDREF (USA) was • Barrymore McBarnette, MD established to facilitate coordination of • Craig McCarty, PhD the USA activities and to administer • Clare Morrall, PhD charitable donations from the United • Shamdeo Persaud, MD, MPH States to the WINDREF Research • Shanti Singh, MD, MPH Institute. As a non-profit organization, its goal is to enhance the development of 2.5. WINDREF Research Institute WINDREF’s research and educational Research Scientists programs. The offices are located on Long Island in New York to provide Research Scientists appointed to administrative and logistical support for the Research Institute include: John the WINDREF Research Institute. Ms Adamski, Sadiq Al-Tamini, Sumita Candyce Armenti replaced Mrs. Melissa Asthana, Yitzhack Asulin, Bishara Conway-Nyhan as program coordinator Baddour, Jean-Pierre Barakat, Matthew in the New York Office. Beeson, Keith Bensen, Matthew Boles, Karen Brennan, William Brown, Ella 4.0. WINDREF (UK) Cameron, Nicholas Caputo, Jessica Clayton, Mmakgomo Coangae, Rae WINDREF (UK) was set-up in Connolly, Abraham El-Sedfy, Daniel Winchester, England in 1999 to promote Firer, Scott Forman, Vamsi Guntur, collaboration between WINDREF François Hallé, John Holleran, Anthony scientists and academic centers of Junck, Sebastian Kreitzschitz, Erik Lacy, research in the United Kingdom. It is Richard Lehman, Setshidi Makwinja, hoped that by reaching out to a larger Paul Mancuso, Baher Maximos, John scientific community, WINDREF will McCormack, David Melamed, Kirk broaden its research opportunities by Minkus, Jessica Morlok, Kevin Neill, forming collaborations with scientists Bayela Nfila, Yolanda Ng, Michael from the European community. Nillas, Steve Nimrod, Andre Panagos, Rakesh Patel, Barry Politi, Sandeep 4.1. WINDREF (UK) Board of Trustees Pulim, Sean Ramsammy, Tarek Refaie, Alan Rhoades, Laura Robinson, Karin A Board of Trustees was Schioler, Corey Schwartz, Christopher appointed in 1999 to oversee the Skaff, David Steinberg, Derrick activities of WINDREF (UK). In 2005 Tlhoiwe, Sarah Treter, Nghia Truong, we welcomed Baroness Howells of St James Tsai, Dan Twyan, Frank Van David to the Board. Natta, Ru-Amir Walker, Juliette Williams, David Winokur, Colleen • Lord Soulsby of Swaffham Prior, Wunderlich, Elliot Yung. PhD, DSc, DVM (Chairman) WINDREF Research Institute Annual Report 2005 7

• Sir Kenneth Calman, KCB, FRCSE • Jonathan Kibble, Professor, • Baroness Howells of St. David, OBE Associate Professor, Physiology, • Sir Kenneth Stuart, MD, DSc Effectiveness of Supplementary Instruction in Medical Physiology. • Richard Summerfield, MB, BChir, • Shohreh Sameni, MPH student, • Keith B. Taylor, DM, FRCP Public Health Impact of a Natural • Calum Macpherson, PhD, DIC Disaster on Birth Rates and (Ex Officio) Antenatal Facilities on a Small Island Nation. 4.2. WINDREF (UK) • Michelle Chen, MSc student, Administration Microbiology, Development of a Ms. Sue Huntington continues as Model System to Study Detachment Executive Secretary. Ms. Huntington of Biofilm in Urinary Catheters. provides the administrative support and • Ashley Crisp, MSc student, expertise that is central to WINDREF’s Microbiology, Nasal Carriage of (UK) fundraising, administrative and Staphylococcus aureus in Medical collaborative activities. Students. • Matthew Beeson, SOM/WINDREF student, Assessment of the Effect of 5.0. SGU IRB Treating E. coli Biofilms with Phage and Antibiotics Successively. The Institutional Review Board was • Reccia Charles, Assistant Professor, registered in the USA in March 2003 with School of Arts and Sciences, the the US Office of Human Rights Protection, Relationship between National Department of Human and Health Services Culture and Attitudes towards (DHHS). IRB members include members of Higher Education. the Grenadian community as well as SGU • Daniel Duffy, GRENED, Brandeis faculty and staff. In August 2005, the University undergraduate, Poverty officers of the IRB rotated, with Dr. Theresa and Entitlement in Grenada’s Relief McCann replacing Dr. Cheryl Cox and Rehabilitation Efforts following Macpherson as Chair. Hurricane Ivan. IRB forms and information may be found on www.sgu.edu - look for links on • William Brown, MD/MSc student, SOM page → MD Program, or use the WINDREF, How Improving Living Office of Research link on ‘My SGU’ page Conditions Affects Prevalence and (forms page). Proposals that meet the Reinfection Rates of Intestinal criteria for expedited review are usually Parasitoses, Focusing on Proper reviewed within approximately two weeks. Disposal of Human Feces. All applications must be submitted • Valentin Fuster, President, World electronically to the IRB Administrator. For Heart Federation, and Thomas more information, please contact Meg Pearson, Dean, Rochester University, Conlon: [email protected] or [email protected] Grenada Heart Project Rapid or phone (473) 444-4175 x 2221 Assessment Profile. The IRB approved the following • Valentin Fuster, President, WHF, projects in 2005: Grenada Heart Project. WINDREF Research Institute Annual Report 2005 8

• Lucia McLendon, SOM student, kit. The RT-PCR process identifies the Empowering Caribbean Women. specific serotype of dengue virus present • Shunling Tsang, SOM student, while the immunoassay seeks to detect Effects of Health Education on the presence of immunoglobulin Personal Hygiene and Sanitation indicative of primary or secondary Knowledge. infections with the dengue virus. In 2005, 20 samples were • Catherine Gribbin, SOM student, analyzed yielding three (3) positives: Prevalence of Diabetes and one (1) positive IgM to dengue virus, Hypertension in St. David’s Parish. indicative of a primary dengue infection • Lian Doble, MSc student, SOVM, and two (2) for Dengue- 3 virus. Prioritization of Disease Control for Dengue fever, which in most Urban and Per-urban Pig Production cases is self-limiting, sometimes leads to Systems, Kampala, Uganda. a more complicated or life-threatening • Edé Langevine, MSc student, forms; dengue shock syndrome or WINDREF, Comparative Analysis dengue hemorrhagic fever. of the Socio-economic Impact of The reduction in the number of Lymphatic Filariasis in Georgetown cases of dengue could be due to a Guyana. number of factors. One of the interventions that may play a part is the increase in vector control activity carried 6.0. Current Projects out by the Ministry of Health (cleaning drains, removing solid waste, cleaning The projects currently being brush, and fogging adult stegomya undertaken at WINDREF are briefly aegypti population formerly aedes reviewed below. aegypti). Another factor may be a reflection of the increase herd immunity to dengue-3 which was introduced in 6.1. The Dengue Diagnostic Lab 2001 and resulted in an epidemic. at WINDREF Dengue immunity is lifelong but restricted to each of the four serotypes. The Dengue Diagnostic Lab Immunity is for the exposure to the located at WINDREF continues to offer specific type and confers no cross its diagnostic services to the University protection to the other three serotypes Health Services and the Grenadian (Dengue-1/4). community. Submitted by The dengue virus belongs to the Grant Lambert genus Flavivirus, family Flaviviridae and is spread primarily by the Stegomya aegypti mosquito, which is ubiquitous 6.2.1. Lymphatic Filariasis throughout the Caribbean and the wider Elimination Program in tropics. Guyana

The samples are processed by INTRODUCTION RT-PCR (Reverse Transcriptase – The National Program for the Polymerase Chain Reaction) and a Elimination of Lymphatic Filariasis (LF) commercially available immunoassay WINDREF Research Institute Annual Report 2005 9 in Guyana entered its second year of establishment of a National Task Force implementation in 2005, following the for the Elimination of LF in Guyana launch of DEC fortified cooking salt as (NTF-LF) and a programme the major strategy for the interruption of management structure within the the transmission of Wucheria. bancrofti, Ministry of Health to implement the the lymph dwelling parasite which project and activities of the programme. causes filarial disease. The programme The NTF-LF consisted of a wide range experienced some technical difficulties of Government agencies, local about 4 months after the DEC-salt stakeholders, local and international launch with some change in color of the NGO’s, Universities (University of product, and then in September 2004, Guyana and St. George’s University) damage to the salt plant in Jamaica by and international organizations focused Hurricane Ivan caused another break in on health in Guyana. The Chief Medical supplies. Production resumed in June Officer chairs the National Task Force 2005 and the programme is now on track and the National Programme Manger and shows much promise in eliminating served as the secretary to body. LF from Guyana. FUNDING BACKGROUND The Ministry of Health provided Following the WHO resolution in initial start up funding for the program’s 1997 for the elimination of LF as a establishment through the Department of public health problem, the Government Disease Control. Funds were available to of Guyana embarked on the support staffing and over-head costs for establishment of the National Lymphatic the programme, but this was inadequate Filariasis Elimination Programme in for the full implementation of the 1999. Guyana was identified as one of national plan. A proposal was developed 80 countries worldwide, and one of only and major funding was secured for a seven in the Americas, to have reported period of two years from the Bill and continued transmission and resultant Melinda Gates Foundation to implement filarial disease over the last 20 years. the DEC-salt program. Resources from Initially the Ministry of Health was this grant administered by PAHO tasked with developing a draft national through the local PAHO office in plan for the elimination programme and Guyana were allocated mainly to the to recommend a program structure and social mobilization and social marketing funding source for the activities campaign of the programme. identified in the plan. A joint working Additionally, Emory LF Support Centre group was established with the MoH and and the CDC (USA) supported PAHO/WHO that produced the draft PAHO/WHO in establishing the DEC- plan in 2000. Following a series of salt production capacity and the DEC- national consultations and stakeholder salt quality control system. The WHO involvement the national plan was procured and shipped all the DEC active finalized. ingredient needed to fortify salt need by Guyana for at least three years. Through PROGRAM STRUCTURE a grant from the CDC Nutrition Project, The program was formally UNICEF was able to support the local established in 2001 with the salt importers in quality control and in WINDREF Research Institute Annual Report 2005 10 reducing the impact of the increases in shopkeepers and consumers that salt price associated with the packaging DEC/Iodised salt was slowly becoming and labelling of DEC/Iodised-salt. A “blue” once it was exposed to the moist grant was awarded to Windward Island air. This colour change was not Research and Education Foundation acceptable and as such the decision to from the Liverpool LF Support Centre in halt production and correct the difficulty 2002 for the development of human was recommended. It took the technical resource need to sustain and develop the team about 3 months to solve the Guyana programme. problem of the colour and for DEC/Iodised salt production to DEC SALT INTERVENTION recommence. By then the public interest In July of 2003, the first batch of was lost and market demand waned. DEC fortified salt was received in Hurricane Ivan in the summer of Guyana and a successful public lunch of 2004 caused some structural damage to the program took place. DEC/Iodised the salt plant in Jamaica, the only facility salt was well received by the Guyanese producing DEC/Iodised salt in public already sensitised by the ongoing commercial quantities. The facility social mobilization campaign. underwent extensive structural Additional targets for promotion modification for 9 months and resumed especially from the rural communities production in June 2005. During the were planned and active promotion at time of interrupted supplies, the schools and health facilities were sensitised public was left without the initiated. Since the intervention was well-promoted DEC/Iodised salt. applied through the commercial salt distribution system marketing 90 intervention were also developed and 80 implemented. 70 2003 60 2004 50 2005 40 On Market 30 20 10 0

r r p a p a Jun Se Dec M Jun Se Dec M Jun

Graph: DEC/Iodised Salt importation and market availability in Guyana (2003 – 2005)

The National programme, while working with its partners in resolving A packet of DEC salt salt issues, continued to implement other

The supply of DEC/Iodized salt aspects of the initiative such as training increased over the last four months of and the Morbidity Reduction Program. 2003 until some technical difficulties By June 2005 DEC-salt was re- with the salt production halted introduced onto the local market. Efforts importation. It was recognised by are now actively persuaded to enhance WINDREF Research Institute Annual Report 2005 11 the marketing and social mobilization in proposal focused on the survival of adult all the targeted regions. filarial worms (by the presence or absence of the filarial dance sign on SOCIAL MOBILIZATION ultrasonographic examination) in The aim of the social infected persons following DEC-salt mobilization component of the treatment, and hypothesises that the low programme is to increase the use of continuous dose of DEC supplied by DEC-salt throughout Guyana so that at DEC-fortified salt will not only suppress least 80% of the “at risk” population is Mf production by adult filarial worm but regularly taking meals with DEC-salt. will also ensure clearance of mature The approach shares vital information on adult worms capable of continuously filarial and the benefits of DEC-salt producing Mf. This is almost absolutely through trained volunteers with members necessary to ensure interruption of of the community predominantly on a transmission. “one on one” or group basis. The new The project will also examine the social marketing strategy focuses on a impact of additional recommended “door to door” approach in high burden intervention, e.g. the addition of areas and more general community albendazol to the mass treatment promoting in other areas. Targets for the regimen since albendazol is known “door to door” activities for the last macofilaricidal effect. Additionally the quarter of 2005 include the high newer recommendations for the use of prevalent areas in South and East the antibiotic doxycycline against the Georgetown where 3 large communities Wolbachia bacteria, which has a are covered, and in Linden and New symbiotic relationship with the adult Amsterdam. Additionally, market site filarial worms, may prove against the promotions are planned for large macrofilarial parasite. These additional shopping areas in Regions 4, 6, and 10. interventions can effectively reduce the DEC-salt is now supplied to all facilities chance of the re-establishment of LF preparing meals for groups of persons transmission, and by shortening the life such as hospitals and care homes. span of the adult worm, can reduce undesirable lymphedema and hydrocele. RESEARCH As a part of the WINDREF grant, the National Programme Manager, Dr. Shamdeo Persaud, was offered a fellowship to read for the Doctor of Philosophy (PhD) in infectious diseases control. The fellowship commenced in January of 2003, and following a period of four months of theoretical pre- research training, a proposal was developed to examine the outstanding question of the efficacy of DEC-salt in suppression of microfilaria (Mf) production long enough to ensure Dr. Shamdeo Persaud displays a interruption of transmission. The packet of DEC salt

WINDREF Research Institute Annual Report 2005 12

The proposal is now ready for fixed sites in Lodge and Tucbur. Two ethical review and for IRB approval by spot check sites will also be studied the University IRB. Additional training during this period to ascertain uptake of in the area of ultra-sonographic the intervention and its impact in the visualization of adult worms in the wider community. The first coverage known site in males was completed with survey for DEC/Iodised-salt is scheduled assistance from the Filaria Research for between March and June 2006. Centre in Recife in Brazil. The sample Several market type surveys are also consisting of males tested positive for W. planed and depending on resources, bancrofti antigen using ICT from these will be implemented in the second endemic lymphatic filarial areas in and third quarter of 2006. Guyana during the preparatory stages of the national programme already exists. Submitted by Dr. Shamdeo Persaud Once ethical approval is obtained, WINDREF Research Fellow participants of the study will be taken through an informed consent process and the double-blinded intervention study 6.2.2. A comparative analysis of the will begin. Knowledge, Attitudes, Practices, Beliefs and Socio- PLAN FOR 2006 economic impact of Lymphatic The Lymphatic Filariasis Filariasis (LF) in Georgetown, Elimination Programme targets 2006 for Guyana rapid up scaling of all activities including the production and importation Lymphatic Filariasis (LF) is a of DEC salt, social marketing, morbidity mosquito borne, parasitic, worm disease control, and monitoring and evaluation. that has been identified as one of the six The required amount of salt for diseases targeted for elimination. household use in Guyana is on average Wuchereria bancrofti which accounts for 1,200 tons annually. The programme 90% of all filariasis cases world-wide, hopes to increase from the 240 tons affects 107 million people. It is also the imported in 2005 to at least to 1,000 tons second leading cause of disability world- by the end of 2006. Social mobilization wide with chronic clinical manifestations will be ongoing with a focuses on hard (CCMs) such as elephantiasis, to reach communities and the regions lymphoedema and hydrocele. In with lower prevalence in the hinterland. childhood, there are more reports of The morbidity control lymphadenopathy than in any other component targets an increase of 50% category of development Therefore, this over the already 17 centres in operation allows for early, preliminary, diagnosis and that at least 2,000 persons with by the parents of an infected child. lymphedema know how to CARE for the The GPELF (Global Programme swollen legs. The establishment of at for the Elimination of LF) was started in least 6 support groups in high burden 1998 with the aim of eliminating LF by areas in addition to the one that is 2020. Studies have found that 90% of currently operational. the population in Guyana is at risk and The second sentinel site survey is as many as 30% of children are positive planed for February of 2006 in the two for the W. bancrofti worm antigen. The WINDREF Research Institute Annual Report 2005 13 concern is that if even a small proportion an economic burden to their families. of those children develop the chronic The individual, his or her household, the disease, it would be unacceptable. In community and the government all feel Guyana, the Ministry of Health (MoH), the economic impact of this disease. in collaboration with PAHO/WHO, The economic and social costs decided to address the transmission and have been documented in a number of morbidity issues associated with LF. The studies done in Africa and Asia, activities of the LFEP (LF Elimination however little information is available Programme – Guyana) included: about the impact of LF in the Caribbean mapping of LF infection using the ICT and in South America, and especially in card test which identifies those persons the context of a country that is using the carrying filarial worm antigen and DEC salt intervention strategy. There is stained blood smears which detect the also scant, documented information on presence of microfilariae in the blood the knowledge, attitudes and perceptions (microfilaremia), assessing morbidity of the persons who are chronically and developing a strategy of mass infected with LF. treatment to reduce the level of The purpose of the study is to microfilaremia and stop transmission. investigate the knowledge, attitudes, The DEC (Diethylcarbamazine) practices and beliefs of persons with and salt strategy was chosen, since it was without chronic clinical manifestations safe and effective, and it could be of LF, with respect to early diagnosis in incorporated into existing iodization and children, transmission and fluoridation programmes, making it self- prevention/control of LF, DEC salt use sustaining. This strategy would succeed and LFEP once an 80% national market penetration It will also provide baseline is achieved and sustained for one year. information as to whether having Since the launch of the chronic/overt LF has affected socio- programme in 2003, DEC salt use has economic status been irregular as the availability of the The hypothesis of this cross- product has been inconsistent. There sectional study is therefore that the were plans to have the salt provided in knowledge, attitudes, practices, beliefs January, 2005. However as a result of and socio-economic impact of LF is the severe flooding in January of 2005, significantly different for persons who attention was diverted to other health have chronic, clinical manifestations related, post flood clean up activities. (CCMs) than for those who do not have PAHO representatives did indicate that any CCMs the persons recruited would be targeting Two groups will be selected, poorer areas and would also be offering namely a case group and a comparison information about LF and DEC salt. group. Cases will be selected from The socio-economic burden of Filariasis Clinics in Georgetown, Linden the disease is tremendous because of the and East Coast Demerara, and they must accompanying disability and have overt/chronic clinical disfigurement. Some of the social issues manifestations of LF and must have had include stigma, sexual dysfunction and the condition for at least 1 year. The reduced marital prospects. Studies have participants from the comparison group shown that patients consider themselves will be selected from those persons WINDREF Research Institute Annual Report 2005 14 attending care sites/health centres in the will be documented evidence of the same areas. They will be matched impact with relevance to Guyana and its according to age, sex and race and must use of DEC salt. The study will also have no history of overt/chronic LF. provide information about the likely Comparison group may include effectiveness of the elimination strategy individuals who have acute LF or who It will also ensure that any are positive for the LF antigen. information concerning LF elimination A questionnaire and personal is given in such a way that persons with observations will be used to collect acute and chronic disease as well as the information. The first few questions of at-risk population are involved for the the questionnaire will address long term duration of the programme. demographics including gender, age, marital status and average income. Submitted by Edé Langevine Participants will also be asked about Research Scientist their perceptions and also specific examples of how their condition has affected them both socially and 6.3. How improving living economically. Some questions will focus conditions affects prevalence on the source and extent of interviewee’s and reinfection rates of knowledge of LF and the LF Elimination intestinal parasitoses; focusing Programme and DEC salt. Others will especially on proper disposal of deal with the attitudes, beliefs and human feces practices. There will be a section which will focus on the structure and external The aim of the study is to environment of the interviewee’s home. compare the efficacy of helminth control in populations of Haitian refugee children receiving the currently recommended WHO regimen of deworming medication versus populations of such children that have been provided with proper, in-house sanitation facilities. The relative efficacy of control is being measured by the two treatments’ individual abilities to prevent reinfection with the intestinal helminth Ascaris lumbricoides. This project was divided into several stages. During the summer of 2005, phase I of the study was completed. During this phase a fecal sample was obtained from each Edé Langevine (left) discusses participant and cross-sectional results with a medical student. prevalence rates of Ascariasis were

This study will be significant to determined in two groups of school aged both Governmental and non children; one cohort which has recently governmental institutions since there been provided with in-house toilets by WINDREF Research Institute Annual Report 2005 15 an independent, privately-funded odds ratio showed that children without organization, the other cohort lacking in-house toilets were nine times more such in-house sanitation facilities. At the likely to be infected with Ascaris close of phase I, all the participants were lumbricoides than those with toilets in dewormed with a single dose of their homes. The group with toilets in Albendazole, as per the their homes showed a 76% disease recommendations of the WHO. protection compared to those without During the summer of 2006 the toilets. This means that those children second and final phase of the study will with toilets in their homes have a 76% be completed. In this phase all reduced risk of infection with the participants will again provide a stool pathogen. The phase I data was also able sample which will be analyzed for to show that 61 cases of Ascariasis have evidence of infection with Ascaris been prevented in the 135 children that lumbricoides. benefit from in-house sanitation facilities. Consequently, with a Number Needed to Treat of 2.2, we see that for approximately every two children that receive adequate sanitation facilities one case of Ascariasis is prevented. Once the reinfection data is obtained from phase II of the study, and the identification of the cost of treatment per person per month that is associated with providing in-house sanitation facilities, practical recommendations can be made as to how limited resources can A study participant turns in his stool be most efficiently used to combat the sample. global problem of infection with intestinal helminths. Each newly reported case will be regarded as a reinfection with the pathogen and will contribute to the overall rate of reinfection for the group to which that participant belongs. Once all the samples have been analyzed, the overall rates of reinfection in the two groups will be compared and appropriate conclusions will be drawn regarding the two treatments and relative efficacies of controlling intestinal helminth infections. Research scientist Will Brown in the The results from phase I of the laboratory in the Dominican Republic. study showed a cross-sectional prevalence of Ascariasis of only 15% in Submitted by William C. Brown III those children with in-house sanitation Research Scientist facilities and 58% in those that lacked such facilities. The calculation of an WINDREF Research Institute Annual Report 2005 16

6.4. Characterization of novel The optical density was measured with a bacterial species and genera spectrophotometer at 590nm approximately every 2 hours, and growth My PhD research deals with curves were made based both on optical novel microorganisms I isolated from density and CFU. my MSc research. It is necessary to Table 2. Optimum temperature comparison of sequence the DNA and determine the isolates P2-2, P3-2, P4-4, and P5-2 with their optimum growth conditions as part of closest relates species. the classification of a novel species or Strain Optimum Closest related Optimum temperature species temperature genera of bacteria. The bacteria I (oC) (16SrRNA,FAME)* (oC) isolated produced substances that P2-2 24-45 Desemzia incerta 37-40 inhibited biofilm formation (up to (n.d., 0.367)** 84.5%, p=0.024) and eukaryotic fouling P3-2 37 Aerococcus viridans 35 (0.91%, 0.523) (up to 45.4%, p=.009) in situ. P4-4 24 Psychrobacter 25-30 To confirm previous results from immobilis 16S rRNA gene sequencing or fatty acid (5.15%, 0.554)** P5-2 24 Staphylococcus 25 analysis (FA), the isolates were sent for warneri additional sequencing. Table I lists the (0.00%, n.d.) results are listed in Table 1 and the As expected, the optimum isolates now have results from both 16S salinities differed from the distantly rRNA sequencing and FA. related species, indicating that they may Table 1. Optimum salinity comparison of isolates be novel genera, however, the optimum P2-2, P3-2, P4-4, and P5-2 with their closest temperature ranges were similar. relates species. Strain Optimum Closest related Optimum As expected, the temperatures salinity species salinity ranges were similar between isolates (% NaCl) (16SrRNA,FAME)* (% NaCl) whose closest related species indicated a P2-2 1-10 Desemzia incerta 2-3.75 close match however, their optimum (n.d., 0.367)** P3-2 4 Aerococcus viridans 0 salinities differed. Since these (0.91%, 0.523) microorganisms were isolated from the P4-4 5-15 Psychrobacter 2-3 marine environment they may be immobilis (5.15%, 0.554)** atypical halophilic strains.

P5-2 4 Staphylococcus (0) warneri (0.00%, n.d.) *= 16S rRNA gene sequencing (of 500 bp) percent difference greater than 5% indicates the isolate is not in the database. FA similarity index value of 1.000 = exact match, 0.600 = good species match, between 0.400 and 0.600 = isolate is not in database. **= indicates distantly related and possibly novel genera. Parenthesis indicates result for Staphylococcus aureus.

To determine the optimum Dr. Kotelnikova with pre-med temperature and salinity for the isolates, research assistants Kabelo Thusang they were grown at different and Tommy Palai, who assisted with temperatures in the Artificial Sea Water the project. broth, ranging from 10-45oC, and salinities, ranging from 0-15 g/L NaCl. Submitted by Cynthia Bruno, MSc WINDREF Research Institute Annual Report 2005 17

6.5. Novel Antimicrobial and biochemistry through the use of API Compounds from Tropical test strips. Marine Environments Results Background Fifty sea rocks from five Recent surveys on nosocomial distinctly different locations around the infections by CDC and WHO indicate southwestern coast of the island nation that bacterial resistance to contemporary of Grenada were sampled. From these, antibiotics is rising at an alarming rate. 141 strains were isolated and This study sought to find new avenues characterized morphologically. Fifteen for the derivation of novel antibiotics. of the 141 isolates showed antimicrobial We screened for antimicrobials derived activity, and 8 of these 15 (11%) showed from microorganisms living in biofilms activity greater than that of Penicillin on tropical marine abiotic surfaces. Our (the positive control). The data collected main goal was to answer the question of on these eight were then subjected to a whether or not there are microorganisms paired t-Test with 5% ά level. Of these inhabiting biofilms of sea rocks sampled eight, four showed inhibition of one or from the coastal floors around Grenada more of the pathogens that was that produce antimicrobial compounds. statistically significant (p<0.05). Four of We hypothesized that there must be these isolates, PB 4-31, PB 5-21, DB 9- novel bacteria producing antimicrobial 33, DB 2-31, were found to either substances waiting to be discovered. significantly inhibit number of pathogens (p<0.05) stronger than Methods penicillin. Strain PB 7-11 and TB 4-32 Samples were collected off the inhibited S. aureus but weaker than shores of Grenada at five locations via penicillin. Strain PB 6-33 inhibited S. Scuba diving and cultured in reduced aureus stronger than penicillin.

salinity artificial sea water agar Pathogen S. E. E. K. E. (salinity=36 ppt) in the microbiology aureus faecalis cloacae pneumonia coli Marine labs at St. George’s University. 141 isolate TB 4-32 0.16 - - - - marine isolates were cultured. These TB 5-22 - 0.01* 0.04* 0.01* 0.09 marine isolates were screened for DB 2-31 - - - - 0.01* DB 9-33 - - - - 0.04* antimicrobial activity against pathogens PB 7-11 0.36 - - - - DB 6-33 0.05* - 0.46 - 0.42 frequent in nosocomial infections PB 5-21 - - 0.08* Staphylococcus aureus (ATCC BAA- PB 4-31 - - - - 0.015*

44), Enterococcus faecalis (ATCC Table 1 shows which marine isolates 700802), Enterobacter cloacae (ATCC significantly inhibited (bolded*) the 39979), Klebsiella pneumoniae (ATCC pathogen it was tested against. 700603), Escherichia coli (ATCC BAA- 196), and Streptococcus pneumoniae Physiological characterization (ATCC 51936) with high rates of indicated that the organisms were antibiotic resistance, via a modified halophilic and related to Vibrio, Serratia Kirby-Bauer assay. 141 isolates were and Marinococcus. All isolates stored in characterized by colony morphology, 5% glycerol at -80°C in a culture color, and Gram stain. Those that were collection in the Microbiology Culture Collection at St. George’s University. shown to produce active antimicrobials were also characterized by physiology WINDREF Research Institute Annual Report 2005 18

Conclusion 6.6. The Effect of Water Quality on Antibiotic resistance is a rapidly the Students of St. George’s growing problem in healthcare systems University throughout the world. The attention it has been receiving has not satisfied those Water quality is of paramount experts in the field who are trying to concern to the prevalence and incidence address this problem. This study was of gastrointestinal diseases in the human started in response to that problem. In population. Microbial contamination is addition, it was hoped that this study the most common and widespread health would raise awareness of the problem, as risk associated with poor water quality. well as expand the field of marine The students on the True Blue Campus microbiology further into marine- at St. George’s University may be derived medicines. exposed to two sources of water; pipe This project has provided a borne and sea water from the valuable contribution to the field of surrounding beaches. Diarrheal disease marine microbiology, suggesting that is the most common presentation of antimicrobials can be derived from the gastrointestinal disease that is caused by biofilms of microorganisms that inhabit the water borne pathogens (WHO 2004). sea rocks. Further investigation into this The microbial quality of the water topic must be carried out so that the full should be assessed periodically, to potential of these substances for ensure acceptable levels of combating increasing bacterial resistance microorganisms for safety purposes. can be revealed. An estimated 2,038 Americans became ill from 17 outbreaks associated with drinking water during 1997–1998, according to the Centers for Disease Control and Prevention’s most recent survey of water-related outbreaks. During the same period, more than 2,000 people became ill from 32 outbreaks associated with recreational waters — beaches, lakes, and rivers. Most (29) were caused by infectious bacteria, viruses or protozoa (American Society Nick Caputo and the poster “Novel for Microbiology, 2002). antimicrobial producing organisms For microbial water quality, from tropical marine environments” verification includes microbiological presented at the “Microbes in the testing. The analysis of faecal indicator Changing World” conference in San organisms and specific pathogen Francisco, California, 23-28 July 2005. densities is routine. This should be done immediately after treatment of the water. Submitted by Nicholas D. Caputo, Water that is not properly treated before Research Scientist disposal into the sea, also affects the and Svetlana Kotelnikova, PhD quality of the water for recreational swimming. This will increase the likelihood of persons acquiring

WINDREF Research Institute Annual Report 2005 19

WINDREF Research Institute Annual Report 2005 19 pathogens in the seawater that may cause drank water from the tap without gastrointestinal disease (WHO 2000) boiling. T-test showed no statistical Verification of the water for differences in frequencies of diarrhea in microbial quality involves testing for students that drank water from the Escherichia coli as an indicator of faecal fountains and that purchased the bottled pollution. This organism should not be water, 40.35 and 41.54%, respectively. present in drinking water. Bacteria are Tap-drinkers did not have any higher not only known to cause disease when incidence of diarrhea, 40%. Comparison they enter a human body through food, of frequency of diarrhea in students surface water may also be an important which were drinking water from the source of bacterial infection. studied sources and non-drinking water

Diarrhea is the passage of loose from the sources did not show any or liquid stools more frequently than is significant difference (Figure 3) which normal for the individual. It is primarily means the studied sources of the a symptom of gastrointestinal infection. drinking water did not affect the Depending on the type of infection, the incidence of diarrhea in the studied diarrhea may be watery (for example in population. The results indicated that the cholera) or passed with blood (in presence of non-faecal coliforms in the dysentery for example). Diarrhea due to drinking water during the studied period infection may last a few days, or several translated into the absence of drinking weeks, as in persistent diarrhea (WHO water-dependent diarrhea. However, the 2000). Symptoms of diarrhea include results are not conclusive because of the frequent watery motions, loss of small studied population (80 students); appetite, stomach pains and dehydration. beside there are a number of factors that There are a variety of factors that might have contributed to the incidents contribute to gastrointestinal disease as a such as using the tap water for dishing, result of poor water quality. It is with food preparation, water off the campus, this information that the project seeks to and examination anxiety. classify the present quality of water with Figure 3. Effect of drinking water respect to the microbial load and sources on the incidence of diarrhea in evaluate the relationship between the SGU students (80), spring 2005. microbial load present in drinking water and recreational water in Grand Anse and True Blue Black Sand Beaches, and the occurrences of gastrointestinal outbreaks in the SGU student population. To achieve the aim, 80 SGU students accommodated on True Blue Campus were interviewed during spring term 2005 using a closed end questionnaire to enable quantitative statistical analysis. Our results demonstrated that 71% of the students

drank from water fountains, 60% purchased bottled water and only 18% WINDREF Research Institute Annual Report 2005 20

The next question was if recreational stress. When analyzing our results the swimming in a variety of beaches could reader should keep in mind that the contribute to the observed frequencies of studied population consisted of young diarrheas. Only 71% of the students people which are not non-immune- were swimming sometimes, while 29% compromised. never swam. Most of the swimmers used Our results indicated that the Grand Anse (60%), 5% used True Blue quality of drinking and swimming water Bay and 6% used Black Sand Beach. It in and around the SGU campuses have was noted that only 30% of the students not affected the gastrointestinal health of who swam had from one to four diarrhea the SGU student population. episodes during last two month before the question was administered while non-swimmers had 40% of diarrhea incidents (Figure 4). Figure 4 shows distribution of swimmers and percent of diarrhea between the varieties of studied beaches and compared to the respective values for non-swimmers. Frequencies

Figure 4. Effect of recreational water on the incidence of diarrheas in SGU Students who contributed to the students, spring 2005. project. Second from left, Michael Klug, Marisa Nimrod, Mehram

0 Massumi.

0 Submitted By Marisa Nimrod, 0 Michael Klug, Jessica Kramer, 0 Mehram Massumi, Dawn Adams 0 and Svetlana Kotelnikova, PhD 0 0 non- True BSB Grand swimers Blue Anse 6.7. Summer 2005 - Apres Tout Water Project

Water is fundamental to life and having a clean source for drinking is of Enterococcal pollutions of the beach crucial to the public health of a water during January-May of 2005 did 2 community. However, when there are not correlate (r =0.32) with the instances of contaminated water or lack frequencies of diarrhea incidents in the of suitable water for consumption, health swimmers. The results indicated that the consequences can be dramatic. The costs opportunistic microbial pathogens and of such consequences can be direct indicators observed in the recreational monetary costs of care, loss of water did not translate into any increase productivity, disability, and death. of diarrheas due to swimming. Vice The Apres Tout water project versa, the recreational swimming could was initiated in May of 2005 and is a have contributed to relaxation from the WINDREF Research Institute Annual Report 2005 21 collaboration between Just a Drop subsequent to it, for comparative charitable foundation, the National purposes. The quality of the spring water Water and Sewage Authority of Grenada was compared to the tap and dam water. (NAWASA), the Windward Islands The spring water contained rich Research and Education Foundation microflora, however it was free of the (WINDREF), and the Environmental indicator organism. Fifty percent of Testing Unit at the Microbiology samples collected from the dam between Department at SGU. This project has its May and July 2005 contained Echerichia main objective the provision of safe coli at numbers too many to count, drinking water for the community of which indicated pollution with intestinal Apres Tout, Grenada. This community microflora of warm-blooded animals. has been identified as having water The land around the drinking water dam quality issues, even before Hurricane is currently used as a pasture for Ivan, by the Caribbean Environmental animals, which explains the results. The Research Initiative (CERI) group of tap water showed countable coliforms WINDREF, supervised by Dr. (5-250 cells/ml) including E. coli, Kotelnikova. This goal will be achieved Klebsiella oxitoca, and Klebsiella through the building of a new pneumonia. Sixty-seven percent of purification system. It will be maintained interviewed inhabitants used the tap through monitoring of the local water water for drinking without boiling, fifty supply and education of the community percent of the people with very low on drinking water safety. incomes have to buy bottled drinking water or bring drinking water from the spring. The potential for illness was demonstrated in the water supply; it translated into the epidemiological data gathered. The data gathered showed that rates of diarrhea or gastroenteritis among the community of Apres Tout were significantly higher (incident of 15.4%) than average in Grenada as a whole (0.65%). The number of diarrhea cases Newly built water treatment system in per 200 inhabitants correlated (r2=0.90) Apres Tout, November 2005. with numbers of indicator organisms per ml in the tap water (Figure 1). Between NAWASA plans to build a sand 7 and 8% of the interviewed had filtration system to replace the existing problems with skin disorders and structure. In conjunction with vomiting. Sixty percent of children of NAWASA’s plans, bacteriological tests school and under school age experienced were carried out via the membrane filter colds. In summary, the tests showed that technique by students working in SGU the water supply being piped into the Microbiology labs in September, community was of low quality. The full October, and November 2004 and report was submitted to the Grenada February, May, June and July 2005. This Ministry of Health, Social Security, the was undertaken to monitor the quality of Environment and Ecclesiastic Relations. water prior to the intervention and WINDREF Research Institute Annual Report 2005 22

The monitoring was performed 6.8. New Species Isolated from the by PUBH-890 candidate Mr. Thirath Bottom of the Sea, Grenada, Chau and Life Science candidate Mrs. West Indies Shakeera James, using the facilities of the Environmental Testing Unit in the Antibiotic resistance in bacteria Department of Microbiology. The has become a serious problem. Thus the activity was funded by the charitable search for new antibiotics is an organization “Just a Drop”, UK via important endeavor and very much WINDREF, Grenada. needed. Nicholas Caputo originally Further work on this project will conceived a project entitled ‘Novel include the monitoring of the water Antimicrobial Producing supply to ensure its safety after the new Microorganisms from Tropical Marine filtration system is implemented. Surfaces’. He hypothesized that due to Additionally, further epidemiologic the evolutionary pressure of competition, investigations are warranted since some as well as the variety of life in tropical of the bacteria can cause illnesses ecosystems, biofilms from marine outside of the gastro-intestinal system. environments will possess novel micro- Furthermore, education on the drinking organisms from which secondary water safety is needed in the community. metabolites may be derived and purified for anti-microbial use. He had taken samples from various deep sea bottom biofilms around Grenada (Figure 1).

Participants of the project: S. Figure 1. One of the typical isolation Kotelnikova, Mr. Josef Johnson, Mr. sites. Coral reef covered bottom of the Charles Daniel (Just a Drop), Trevor sea at the 15 m depth. Noel, Andre Worme, Annette Gerlach, Thirath Chau and Shakeera James. He had then cultured them in the microbiology labs at St. George’s Submitted by Thirath Chau, University. The compounds produced by Shakeera James and these marine isolates were extracted and Svetlana Kotelnikova, PhD tested against pathogens of known drug resistance via Kirby-Bauer assays and the fast agar slab test. Among the 141 pure cultures isolated from the deep marine biofilms and screened for

WINDREF Research Institute Annual Report 2005 23

antimicrobials against above- size of individual cells as well as their mentioned pathogens, fifteen of the cell wall characteristics. Motility was isolates (~11%) were found to have observed by looking at the live isolate antimicrobial activity. Eight of the through a microscope. For biochemical fifteen met a set of standards as characterization, we used API® strip compared to the positive control, tests, CTA tests and MacConkey tests. penicillin. The data collected on these Finally we identified the optimal eight were then subjected to a number salinities for bacterial growth. All 50 of statistical procedures. Four of the characters were used for numerical isolates were found to significantly comparison with the closest relatives inhibit one or more of the pathogens. identified with the molecular Unfortunately he was unable to techniques. The results are described complete his project due to the below. unexpected arrival of Hurricane Ivan. Later, seven of the most active Dissimilarities between TB 4-32 and antibiotic-producers were analysed Rahnella aquatilis using fatty acid methyl esterase Strain TB 4-32 showed the analysis (FAME) and sequencing their same results for cell morphology, gram 16S rRNA gene. The results were staining, motility and growth for the compared to the FAME and GeneBank rest of biochemical tests and traits as databases and the most closely related R. aquatilis. Rahnella aquatilis is the organisms were identified. 16S rRNA only species of genus Rahnella, in the gene based phylogenetic trees were Enterobacteriacae family. It is a rare produced (Figure 2). The project was enteric, gram-negative, small, rod- continued due to efforts of PMED 390 shaped bacterium. It is facultative undergraduate students (Figure 5) anaerobic and its natural habitat is supervised by Dr. Kotelnikova, water. R. aquatilis and TB 4-32 director of CERI. showed number of differences: TB 4- 32 is halotolerant, gram-negative rod, oxidase-positive and catalase-negative, ferments/oxidises inositol and produces yellow pigment, whereas R. aquatilis does not. In total, we were able to identify at least nine Figure 2. Phylogenetic tree constructed phenotypical differences between the based on 16S rRNA gene comparison of strain and the most closely related strain PB 7-11 with the GeneBank. Our reference organism, R aquatilis, in strain is designed as C16843 PB7. accordance with the 16rRNA gene

Since the purpose of this study sequencing, comparison and was to characterize phenotypes of the dissimilarity of 0.19% and FAME seven strains by comparing them to (DI=0.760) which indicates that strain their closest known related species, 50 TB 4-32 most probably represents a new species of genus Rachnella. different tests were performed for the phenotypic characterization and Dissimilarities between DB 9-33 and identification of the isolates. In terms Serratia marcescens of gross morphology, the shapes, sizes, Strain DB 9-33 was a member and colors of the colonies formed were of genus Serratia in accordance with observed. In terms of microscopic the molecular indicators, 16rRNA gene characteristics, Gram-staining was sequencing, comparison and used to determine the shape and the dissimilarity of 0.19% from S. WINDREF Research Institute Annual Report 2005 24 marcescens and FAME (DI=0.581) S. were able to identify seven odorifera. DB 9-33 showed the same phenotypical differences between the results for cell morphology, strain and the most closely related pigmentation at 37C, gram staining, reference organisms in accordance lack of swarming motility, motility and with the 16rRNA gene sequencing, growth the rest of biochemical tests comparison and dissimilarity of 0.19% and traits. Our study demonstrated at from S. marcescens and FAME least seven phenotypic differences (DI=0.581) S. odorifera which between the strain DB 9-33 and S. indicates that strain DB 2-31 most marcescens. S. marcescens was probably represents a new species of positive for both acetyl-methyl- genus Serratia. carbinol production (Vogel Proskaur test) and beta-galactosidase, whereas Dissimilarities between PB 5-21 and V. DB 9-33 was negative for the same campbellii tests. DB 9-33 was positive for There were a number of fermentation of D-lactose, produced characteristics that were dissimilar for indol from L-tryptophan, however it strain PB 5-21 and V. campbellii. did not produce the red pigment, However, there is a clear difference in likely, prodigiosin, on RSASWA at colour: while V. campbellii is 30°C, was halotolerant and had high colourless, strain PB 5-21 growth rate between 9 to 160 g/l of demonstrated dark yellow mucus on NaCl. Based on molecular and both types of media, TSA (Tryptose phenotypic features the strain qualified Soya Agar) and RSASWA (Reduced to be considered a new halotolerant Salinity Artificial Sea Water Agar). species of genus Serratia. Strain PB 5-21 showed swarming and metabolized sucrose and rhaffinose, Dissimilarities between DB 2-31 and while V. campbellii did not. The Serratia marcescens optimal salinity for Strain PB 5-21 is DB 2-31 produced a compound within a fairly wide range (345-1034 with colicin properties (active mM), while V. campbellii prefers a selectively on E. coli. S. marcescens is slightly higher salinity of 280 mM. known to produce two types of Strain PB 5-21 did not metabolize bacteriocins A and/or B that are mannose, citrate and amygdaline, selectively active against E. coli K-12. while V. campbellii did. For example S. odorifera did not produce any of the the PB 5-21 strain did not have an bacteriocins. DB 2-31 showed the active ornithine decarboxylase while same results as compared to Serratia this enzyme is supposed be active in V. marcescens for cell morphology, campbellii. On the other hand, the pigmentation, gram staining, motility strain under study metabolizes both and growth the rest of biochemical sorbitol and inositol, but we were tests and traits, however DB 2-31 did unable to use this data since we have not produce the red pigment, likely, nothing with which to compare it. prodigiosin, on RSASWA at 30C, did Cell morphology and gram not reduce nitrate, and it showed staining, swarming motility, Growth at negative reaction in the test for 30 and 35 C, and the rest of tryptophan deaminase, was biochemical tests and traits are halotolerant and grew at 9 to 100 g/l of identical between PB 5-21 and V. NaCl, oxidized arabinose, mellibiose campbellii. and produced gas from glucose, while We were able to identify at S. marcescens did not. In total, we least nine phenotypical differences WINDREF Research Institute Annual Report 2005 25 between the strain PB 5-21 and the which indicates that strain DB 6-33 most closely related reference most probably represents a new species organisms, V. campbelii, in accordance of genus Vibrio. with the 16rRNA gene comparison and dissimilarity of 0.84% and V.fluvialis Similarities between PB 4-31 and V. in accordance with FAME (DI=0.789) alginolyticus. which indicates that strain PB 5-21 There are a few very most probably represents a new species differences between PB 4-31 and V. of genus Vibrio. alginolyticus in the colouration of the colonies: the opaque yellow mucus Dissimilarities between DB 6-33, V. produced by PB 4-31 when grown on harveyi and V. campbellii TSA and the blue spreading on the There are at least nine RSASWA differentiates it from the differences between the two colourless V. alginolyticus. Also PB 4- organisms. Strain DB 6-33 developed 31 was tolerating a higher bright yellow mucus swarming concentration of NaCl (Figure 3) and it spreading colonies on TSA, while V. was not able to oxidize citrate while V. campbellii was colourless and did not alginolyticus was able to. Every other show swarming motility. The upper characteristic is identical between the limit of the salinity range for strain DB two organisms. We were able to 6-33 is much higher (2586 mM) than identify at least three phenotypical the upper limit of 320 mM preferred by differences between the strain and the V. campbellii, making the strain in the most closely related reference study much more halophilic. organism, V .alginolyticus, in Strain DB 6-33 metabolized accordance with the 16rRNA gene sucrose alike V. harveyi, while V. sequencing, comparison and campbellii did not. Unlike V. dissimilarity of 0.37% from V. campbellii, DB 6-33 did not produce alginolyticus and FAME (DI=0.709, V. acetone (VP test), did not metabolise fluvialis) which indicates that strain PB starch, tryptophan or citrate but did 7-11 most probably represents a new acidify rhaffinose, metabolize beta- species of genus Vibrio. galactosidase (ONPG) and fermented rhamnose. The strain DB 6-33 was Effect of salinity to the growth rate of the more similar to V. campbellii because strain PB 4-31 it did not oxidize mellibiose while V. 300 harveyi did oxidize mellibiose. 250 Cell morphology and gram 200 staining, swarming motility, growth at 150 100 Growth rate Growth

30 and 35 C, and the rest of 50 biochemical tests and traits were 0 identical between DB 6-33, V. harveyi 0 50 100 150 200 Salinity, g/l and V. campbellii. We were able to identify at Figure 3. Effect of salinity to growth of least nine phenotypical differences the strain PB 4-31. between the strain and the most closely related reference organisms, V. Dissimilarities between PB 7-11 and V. campbelii, in accordance with the alginolyticus 16rRNA gene comparison and There are three differences dissimilarity of 0.93% and V .harveyi, between the two. The green-yellow in accordance with FAME (DI=0.969) mucus that PB 7-11 produced WINDREF Research Institute Annual Report 2005 26 differentiates it from V. alginolyticus have been shown to be low. DNA- when grown on TSA medium. The DNA hybridization would provide the upper limit of the optimal salinity final confirmation of relatedness of the range for PB 7-11 (2586 mM) is just isolates to their counterparts. under the 2070 mM preferred by V. The importance of our findings alginolyticus. V. alginolyticus also is evident based on known metabolizes gelatin and citrate, while pathogenicity of the close relatives of PB 7-11 does not. our isolates. V. harveyi have been We were able to identify at reported to cause devastating least three phenotypical differences pathological effects upon marine between the strain and the most closely invertebrates, prawn hatcheries in the related reference organism, V Philippines, Thailand, Indonesia and .alginolyticus, in accordance with the northern Queensland, the spiny lobster 16rRNA gene sequencing, comparison in India and the pearl oyster in Western and dissimilarity of 1.63% (Figure 2) Australia. The disease, termed and FAME (DI=0.829, V. natiegenes) vibriosis, has a high mortality rate and which indicates that strain PB 7-11 causes significant financial loss to most probably represents a new species marine aquacultures of shrimp of genus Vibrio. larviculture facilities. It is a proven After conducting the pathogen for shrimp and cultured red experiment, by performing phenotypic drum. V. fluvialis, is one of the major characterization of the strains and components of the microbiota of comparing them to their closest known several bivalve species such as relatives, we can conclude that sodium mussels, clams and oysters. However, was required for growth and stimulated it was first isolated in Bangladesh, the growth of PB 5-21, DB 6-33, PB 4- from human faeces. V. alginolyticus 31 and PB 7-11 (Figure 4), that was has been associated with several typical for Vibrio and Photobacterium. diseases of marine animals, including 16S rRNA gene and fatty acid methyl fish, shellfish and echinoids, causing ester (FAME) comparison showed that important economic losses. V. our strains were related to Vibrio and campbellii is a known pathogen for the Photobacterium, however the salinity marine invertebrates such as the optima and ranges of our isolates were Atlantic Blue Crab, shrimp, coral and higher than for any member of the others. It was first isolated from genera. seawater in Hawaii. The genes of V. While all of the seven strains campbellii and S. marcescens were showed phenotypic characteristics associated with white pox disease of confirming the molecular identification coral reefs at Key West, Florida. The at genus level, they showed a number disease was also observed around of phenotypic differences which Grenada. S. marcescens is an indicated that these strains qualified for opportunistic pathogen; it tends to new taxa classification. However, we affect hospitalized patients where it would encourage further studies on the colonizes the urinary and respiratory subject since we truly believe that tracts causing nosocomial infections. there is potential for new antimicrobial Some new research has even found compounds to be produced by these strains of S. marcescens that can organisms. We found that 16S rRNA biodegrade petroleum products. gene and FAME data provided reliable indication of relatedness, however, the differentiation power of these methods WINDREF Research Institute Annual Report 2005 27

alcohol-free, non-drowsy Vicks cough syrup. Easy Breather Tissue, developed by Robinson-Health Care in Britain, which helped clear congestion, was developed using the oil as an active ingredient. Again in 1991, a Undergraduate students who pain relieving ointment named contributed to the project: Eugeniya Ramedica Herbal Wonder Balm was Varicheva, Stacey Trim (non- marketed in the US by Ramedica participant), Bhavna Bhimarasetty, International Corp. Grenadian bush Judith Birungi. doctors recommend the use of ground nutmeg against diarrhea. Nutmeg oil is Submitted by Eugeniya Varicheva, composed of trimyristin (84%), Bhavna Bhimarasetty, Judith Birungi triglycerids of oleic acids (3.5%), and Svetlana Kotelnikova resinous material (2.3%), glycerid of linilenic acid (0.6%), formic, and acetic acids. Myristic acid, a 6.9. The Antimicrobial Properties carboxylic acid, is one by-product of of the Nutmeg trimyristin. Aminated form of myristic acid is structural analog of dopamine It is known that nutmeg has and may interfere with membranes. At antimicrobial properties, as this was high concentration myristicin is known observed against E. coli. Organic to cause nausea, hallucinogens, extracts of ground nutmeg inhibited epilepsy, convulsions, tachycardia, growth of S. sonnei, S. typhimurium psychosis, strong neurotoxic effects and E. coli (Kotelnikova, S, and brain damage, coma and death. WINDREF Annual Report 2003). 30- (Figure 1). This component has 55% of the seed consists of oils of important biological properties. which 45-60% consists of solid matter including cellulose materials. The two types of oils contained therein are the essential oil, which accounts for about 5-15% of the seed, and the fixed oil, which makes up approximately 24- 40% of the seed. Nutmeg oil is prominently used in the pharmaceutical industry. Historically, nutmeg has been used as a form of medicine to treat many illnesses ranging from those affecting the nervous system to the digestive system. Today, nutmeg oil is prominently used in the pharmaceutical industry, with many companies incorporating nutmeg essential oil in their products. For instance, in 1992, according to published information by Product Alert, nutmeg oil was the major Figure 1. Nutmeg flush, mace, seed (by ingredient in Procter and Gamble’s Kotelnikova, S.) and formula of myristicine WINDREF Research Institute Annual Report 2005 28

Elemicin is another important extracted as 20 weight percent into component of nutmeg oil. Nutmeg 70% alcohol while nutmeg oil was essential oil (Myristica fragrans) and extracted by steam distillation of the its composition were reported by nutmeg seeds Then sterile disks were Masada. The major components by soaked with filter sterilized extracts of GC/MS were identified as α-pinene oil, waste and ground nutmeg in (26.7%), β-pinene (20.7%), sabinene separate sterile Petri dishes. The (14.5%), limonene (9.4%) and bacteria were inoculated onto sterile terpinen-4-ol (4.4%) in nutmeg NA. Penicillin disks were dispensed essential oil. 33 and 37 constituents into one sector labelled as positive have been identified representing control in each dish. The solvent (70% 99.9% and 99.3% of the total mace and alcohol) was used as negative control. nutmeg essential oils, respectively. A Each of the soaked disks was placed in Major component was terpinen-4-ol their respective sectors at least 10mm (20.0% and 31.3%), respectively in from the edge of the plate. The mace and nutmeg essential oils. inhibition zones were measured in all Antifungal properties of mace and seed repeats during two independent oil was demonstrated on Aspergillus experiments. Average data are flavus, A. niger, Candida albicans, presented in Table 1. Microsporum canis, Pseudallescheria The experimental data (Figure boydii, Trichopyton mentagrophytes. 3) concluded that the oil shows the It is not known, however, most potent inhibition towards the whether the nutmeg oil is more various pathogenic bacteria and yeast efficient at inhibiting the pathogenic Table 1. Antimicrobial and antifungal bacteria and fungi than the other effects of different nutmeg parts to components (i.e. ground and nutmeg microbial pathogens waste). The goal of this study, Pathogen Oil, Seed Waste conducted by students of Research instant extract, extract, Methods course SAS-390, was to extract 20w% 20w% K.Pneumoniae 11 ± 1.8 ± 0 explore which of the nutmeg parts has 1.35 0.58 the most potent anti-microbial S.Typhinium 6 ± 1.15 1±1.67 2.7 ± properties and to research aspects of 0.58 E.Faecalis 8 ± 1.57 3.83 ± 4.5 ± new anti-microbials. To test the anti- 2.89 0.29 microbial/ antifungal effects, the S.Sonnei 5 ± 2.00 0 1.3 ± 0.5 different parts of the Nutmeg plant E.Coli 7.8 ± 1.5 1.7 ± 5.8 were extracted and tested using the 6.21 ±2.18 E.Cloacae 8.7 ± 0 1 ± 1.7 modified Kirby-Bauer method on pure 5.51 cultures of reference strains of the P.Aeruginosa 17 ± 5.67 ± 6 ± 2.6 following pathogenic microorganisms: 4.62 0.58 C.Albicans 4.8 ± 0.67 ± 0 Klebsiella pneumoniae ATCC 13883, 0.67 1.15 Shigella sonnei ATCC 25931, • Average Inhibition Zone is presented as Escherichia coli ATCC 25922, the difference between experiment and Enterobacter cloacae ATCC 23355, negative control and Standard Deviation Pseudomonas aeruginosa ATCC of Nutmeg Components on each 27853, Enterococcus faecalis ATCC Microbe. *The unit of the Inhibition 19433, Salmonella typhimurium ATCC Zone is in mm. 14028, and Candida albicans SGUCC • Minimal inhibiting concentrations were 23 (Table 1). Two different measured as the last dilution of an components of nutmeg (ground extract (20% w) inhibiting visible nutmeg and nutmeg waste) were growth of a pathogen. The results are presented in Table 2. WINDREF Research Institute Annual Report 2005 29

Table 2. MIC of nutmeg oil for remains unknown, it may be due to the different microbial pathogens lysis of membrane or interfering with Pathogen Oil, instant extract, microbial signalling. The similarity of MIC myristicin (Figure 1) to dopamine K.Pneumoniae 10-5 alludes that it may be mimicking the S.Typhinium n.d. microbial signalling molecule as well. E.Faecalis n.d. Since oil is immiscible with water, it is S.Sonnei 10-5 hydrophobic, it adheres easily to the E.Coli 10-10 hydrophobic part of the bacterial E.Cloacae 10-2 phospholipids membrane of the Gram- P.Aeruginosa 10-9 negative and Gram-positive cell walls. C.Albicans 10-3 This provides a much easier transference of anti-microbial Inhibition of Pathogens by Nutmeg chemicals from the nutmeg oil to the 20 microbe, as compared to the nutmeg 15 wast e waste or ground nutmeg. The 10 5 seed mechanism is recommended for future 0 oil research.

Figure 3. Effect of different parts of nutmeg plant on pathogenic microorganisms compared to ground (p<0.01) and waste nutmeg (p<0.04). All of the pathogens tested were significantly Field trip of SGU students Rex inhibited by the essential oil, however Omabu and Daniel Rochard with Dr. P. aureginosa and E. faecalis were Mathias Lorenz to collect samples of shown to be the most sensitive. P. nutmeg. aureginosa and E. faecalis are involved in most of the clinically Submitted by Rochard Daniel, important and nosocomial biofilm- Smith Jaime and associated infections. Resistance of Svetlana Kotelnikova, PhD pathogens to anti-microbial drugs is rising faster then new drugs are developed. Biofilms are hundreds of 6.10. Evaluating the level of times more resistant to antibiotics perceived fear and compared to the planktonic cell. desensitization towards Therefore the discovered effect of HIV/AIDS in Botswana different components of nutmeg to microbial pathogens has a promising At present Botswana ranks as future, especially for external one of the hardest hit countries by the application as an anti-biofilm-forming pandemic in the world. The country is agent. Toxicity of diluted oil should be home to only 1.6 million people, of studied before it may be used against whom 350,000 are living with diarrheal symptoms. The mechanism HIV/AIDS and 33 000 are said to have of inhibition of oil on microbes lost their lives to the disease. This WINDREF Research Institute Annual Report 2005 30 gives Botswana an adult HIV able to establish a comprehensive prevalence rate of 37.3% (Anon, approach, including prevention, 2004a). The HIV/AIDS prevalence treatment and care as part of a national rates among 15-19 and 20-24-year old response to the pandemic. In addition, respectively estimates at 22.8% and the Botswana government has made 38.6%. Moreover the prevalence rate is tremendous success in distributing the highest among 25-29 year olds, interventions to the population at large. estimated at 49.7% in 2003 (Anon, Despite the fact that Botswana 2004b). Thus the HIV/AIDS pandemic has advanced in making HIV/AIDS forms a serious threat to the prevention and treatment accessible reproductive and economically nationwide, many of the statistic productive population of this country. indicators show a low rate of At present, there are 120 000 AIDS participation by Batswana in these orphans in need of proper care and an interventions. Moreover, Batswana’s estimated 25 000 children under the behavior towards HIV/AIDS is still of age 15 living with HIV/AIDS in major concern. Although various Botswana (Anon, 2004a). This is a initiatives to change behavior have major cause of concern, especially been put in place, behavioral elements given the fact that Botswana already such as attitudes towards sex, alcohol has an undersized population consumption, misconceptions, beliefs, (Stephenson, 2000). and other traditions and customs that To date, even after multiple are vital to HIV/AIDS prevention, strategies to curbing the pandemic, the have shown little change. Stigma and HIV/AIDS situation in Botswana discrimination, which have fuelled remains an urgent matter, which, silence and denial, still remain as without an alternative form of action, major barriers to HIV/AIDS will continue to devastate the society. prevention in this country. However, as highlighted above, the Botswana government has made key adjustments to rectify these many obstacles to the prevention and treatment of HIV/AIDS. Unfortunately, these programmes have achieved very little success, a fact verified by the small number of Batswana utilizing these interventions, and the country’s devastating HIV/AIDS environment. The question now is: why are Batswana not taking advantage of the free services that the Botswana government has been Figure 1: Map of Botswana providing to them? After a slow start, the In trying to explain the misfit Botswana government has shown signs between availability of HIV/AIDS of progress in terms of preventative preventative intervention in Botswana and treatment measures against and the low responsive behavior to HIV/AIDS. The government’s these interventions among Batswana, commitment to curb this pandemic has we hypothesized the following: grown stronger over the past few years. Batswana are living in fear of The Republic of Botswana has been HIV/AIDS, hence are controlling the

WINDREF Research Institute Annual Report 2005 31 threat posed by HIV/AIDS by The second hypothesis argues defensively avoiding HIV/AIDS related that due to the prolonged exposure to the issues. This section of the study will be HIV/AIDS environment, Batswana have guided by the extended parallel process been desensitized towards HIV/AIDS model (EPPM)., which incorporates and thus are less responsive to issues some of the original explanation from: regarding HIV/AIDS. Practically Drive Model (McGuire, 1968, 1969); everyone has been affected by the Parallel Process Model (Leventhal, HIV/AIDS pandemic. HIV/AIDS is all 1970, 1971); Protection Motivation around us, bombarding us on every Theory (Rogers, 1975, 1983) and thus level. It is so widespread and pervasive named Extended Parallel Process Model that we rarely give it a second thought. (Witte, 1992). The EPPM also adapts the Unfortunately, the vast amount of Fear Appeals theory, which Witte information on the subject of HIV/AIDS defined as persuasive messages that in Botswana has failed to bring about the scare an audience into adopting a appropriate behavioral changes needed recommended response by describing by the society to survive this crisis. the consequences that will occur if they do not take action (Witte, 1992).

Figure 3: An illustration of Figure 2: The Extended Parallel Process desensitization towards HIV/AIDS Model (EPPM) It is difficult to explain why so Based on the above theory, we much preventative information and hypothesized that Batswana are living in exposure on HIV/AIDS has not resulted fear of HIV/AIDS, hence are controlling in the appropriate behavioral changes. the threat posed by HIV/AIDS by One hypothesis involves the concept of defensively avoiding HIV/AIDS related “desensitization”. People hear reports on issues. The rationale underlying our this topic on a daily basis, thinking is that people in Botswana have recommendations/interventions are been conditioned to fear HIV/AIDS, pitched them non-stop, however, hence are controlling their fear instead of statistics on AIDS related death and controlling the danger of HIV/AIDS. number of new HIV infection do not That is, they believe they are at risk of seem to change. As researchers we HIV/AIDS (high perceived threat), hypothesized that people are now however, they also believe there is desensitized towards the topic of nothing they can do about it (low self- HIV/AIDS, hence are less responsive to efficacy), therefore they are controlling HIV/AIDS recommendations. This their fear of AIDS, thus putting hypothesis is supported by Batswana’s themselves at even greater risk by low response rates to the many avoiding issues regarding HIV/AIDS. interventions that have been distributed WINDREF Research Institute Annual Report 2005 32 all over Botswana and provided to them 6.11. Genetic Correlates of the free of charge. Addictive Diseases: Cocaine, The goal of this study is to Alcohol and Marijuana investigate why a small number of Addiction - Grenada, W.I. people in Botswana are enrolled or using the HIV/AIDS intervention provided to Following several setbacks them. The study will be divided into five caused by hurricane Ivan, the study on sections. The first section begins with a Genetic Correlates of addictive diseases, brief discussion of the effects of the cocaine, marijuana and alcohol began on HIV/AIDS pandemic. It includes a the 13th April 2005. Nurse Nestar global picture of the pandemic, the Edwards and most recently Nurse current HIV/AIDS situation in sub- Beverly Mends have been entrusted with Saharan Africa and a brief rundown of the process of receiving a signed the HIV/AIDS situation in southern informed consent form and drawing the Africa. This section will also give us a bloods and administering the Family summary on the challenges faced to date Origin Questionnaire and the KMSK with regards to the pandemic, with scale to the participants. emphasis on availability and access to HIV/AIDS prevention and treatment interventions. The second section provides background information on Botswana and discuses the current HIV/AIDS situation in Botswana and how Botswana has responded to the pandemic, including some of the challenges it still faces to date. This will then be followed by a critical discussion on the theories and literature relevant to this study in section three. The relationship between fear and human behavior will be explored. This section The newest addition to our also looks at the desensitization theory. collaborative team, Nurse Beverley The aim of the study is to come Mends, Research Nurse, Rathdune up with recommendations regarding fear Clinic, Mt. Gay Hospital. of HIV/AIDS and sensitivity towards HIV/AIDS related issues based on the This process has proven at times results. Analysis of the results will also to be quite testing. One of the problems provide a better insight into the current we faced with this process was the HIV/AIDS situation in Botswana. This participant may complete the should be helpful in formulating future questionnaire but change their mind strategies to encourage Batswana to about allowing the drawing of blood, or utilize the HIV/AIDS prevention allowing the draw of blood and refusing intervention provided. to answer the questions posed in the family origin form or the KMSK Submitted by Bayela Nfila questionnaire. Research Scientist In Grenada, blood samples are taken from either normal volunteers, WINDREF Research Institute Annual Report 2005 33 drug-free former cocaine users, drug- study acts as a control for any heroin- free former marijuana users, drug-free cocaine addiction comorbidity observed former alcohol users, or current drug and in previous genetic studies of addicts. alcohol users. To assess the levels and Whole blood samples taken from types of addiction, a standard scale – subjects in Grenada are shipped to the developed by the Kreek Lab – is used for Kreek Lab at Rockefeller University for each patient, called the KMSK scale. DNA isolation. The DNA is further The KMSK scale is a brief analyzed by lab members who look for survey that is 90-100% effective in any polymorphisms – variations in DNA screening for alcohol, marijuana, cocaine – that may occur in specific regions of and heroin addiction. This scale is used the DNA: mu and kappa opioid receptor for all patients studied in the Kreek Lab. genes being two of the many. The patients are also asked about their family origin, as this information may play a role in further genetic studies done by the Kreek Lab. To date 20 subjects have completed the full questionnaires and blood draws in Grenada. The samples and KMSK and family origin questionnaires that are administered are Nurse Mends administering the sent to Rockefeller University (New KMSK scale and blood draw on a participant. York) where they are analyzed.

Projects of a similar nature are being run in several other areas of the world, Stockholm, Lund, and Uppsala in Sweden, Oslo in Norway, Tel Aviv in Israel, and Las Vegas in Nevada and Oakland in California, in the USA.

Mary Jeanne Kreek (centre front) with the laboratory team from Kreek Lab at Rockefeller University, New York.

The Kreek Lab collaborates with WINDREF in Grenada in an effort to gain a better understanding of the The collaborative team includes biology of addictive diseases, members from WINDREF, Rockefeller particularly the genetic basis of University (New York), Mt. Gay addiction. Grenada provides a unique Hospital (Grenada), Ministry of study sample as heroin and other such Education (Grenada) and Ministry of opiates have yet to enter the country. In Health ( Grenada). most countries, opiate and cocaine addiction is rampant and sometimes may go hand in hand. Thus, the Grenada Submitted by Trevor Paul Noel Assistant Director, WINDREF WINDREF Research Institute Annual Report 2005 34

6.12. An Investigation of Pediatric against bacterial strains S. pneumonia Botanical Medicine for Acute and S. pyogenes. Respiratory Infections, with The majority of ethnobotanical emphasis on Streptococcus interviews have been conducted in pneumonia and Streptococcus Grenada, while Carriacou and Petit pyogenes Martinique remain for data collection. Below is a list of the potential plant Ethnobotanical investigations species that will be utilized during the have provided great insight into the laboratory phase. The particular species, medical community. Cultural influences medicinal use, and approximate dosage as well as application of bioactive (in lay terms relayed by the traditional phytochemicals for medical purposes healers) are indicated. Along with the have advanced the degree of medicine. identification of medicinal plants Throughout history as well global, commonly used, the cultural and anthropologists, botanists and the ceremonial aspects will also be culmination of these fields, exemplified. ethnobotanists, have explored the vast Plant Species Common Name and diverse application of our native Coleus spp. Big Thyme pharmacopeias, the green pharmacy. Cordia curasavia Black sage In particular, the Caribbean Kalanchoe pinnatum Wonder of the world offers a unique and powerful source for (Bryophyllum) medical application of plants. These Lantana camara Sugardish habitants of these Caribbean islands Lippia alba Santa maria have utilized bush teas for hundred of Neuroloma lobata Zeba pique years. Ethnobotanical investigations on Momordica charantia Coolie pawpaw the island of Grenada have opened the Laboratory assays will include a door to connecting the cultural number of experiments to help isolate influences of tropical herbs along with the active compounds in order to the healing properties for remedies. adequately test them contra the focused There exists a true harmony between the bacteria. The MIC (minimum inhibitory natural environment and the utility of concentration) as well as the MBC such resources. (minimum bactericidal concentration) This study investigates the tests will initially be used for medicinal plants recommended by preliminary experiments. The above experienced traditional healers for species have illustrated bioactive children with acute respiratory properties against other organisms, infections. Eighteen traditional healers however this study will focus entirely on from Grenada, and several from the the two mentioned above. There is neighboring islands of Carriacou and excitement in the medical and scientific Petit Martinique, will help target the community to discover new alternatives plants applicable for this study. for health as well as combat the The proper investigation for this increasing resistance to pharmaceutical type of research requires a dichotomous drugs. The Tri-Island State should be approach encompassing ethnobotanical prosperous for knowledge in regards to investigation and in vitro antimicrobial future advances. experimentation of the plant extracts WINDREF Research Institute Annual Report 2005 35

twelve months. To assist with the running of the project, Dr. Morrall hired a former student and volunteer Stephen Nimrod, B.Sc. (Hons.) as Project Manager. Mr Nimrod started a B.Sc. Degree in Marine Biology at St. George’s University in 1999 and later transferred to University of Plymouth in the United Kingdom where he completed his B.Sc. degree in Marine Biology.

Momordica charantia (Coolie pawpaw) has been used globally for alleviating symptoms of diabetes, colds and flu’s.

Submitted by Daniel J. Firer Project manager Mr. Stephen Nimrod

MD/MSc Student Following the passage of Hurricane Ivan in 2004, concerns were raised by local dive operators and other 6.13.1. Marine Protected Areas key stakeholders regarding damages to Realization in Grenada, the marine environment, particularly that Caribbean the coral reefs, may have suffered. This prompted swift action and Dr. Morrall In September 2005, the United was instrumental in organizing a team of States National Fish and Wildlife volunteers to conduct a post hurricane Foundation announced that Dr. Clare marine assessment. This initial marine Morrall had been awarded a grant to assessment served as the basis for the support development of coral reef project proposal for which funding was conservation in Grenada. requested. Implementation and Dr. Morrall, an Associate Professor in completion of the funded project will the School of Arts and Sciences, allow the marine environment in Director of Marine Programs at St. Grenada to get the much needed George’s University and WINDREF attention it deserves. Research Fellow, applied for, a grant of After close observation and US$25, 000 through WINDREF. When evaluation of the effectiveness of the the grant is received it will fund a project current Marine Protected Area (MPA) entitled ‘Marine Protected Area management plan, it became apparent to Realization in Grenada, Caribbean,’ Dr. Morrall and Mr. Nimrod that which will be conducted over a period of realization of Grenada’s MPA is needed WINDREF Research Institute Annual Report 2005 36

in order to advance coral reef protection established and internationally accepted for the ecological and economic benefit ‘Atlantic and Gulf Rapid Reef of Grenada. Taking this into Assessment’ (AGRRA) methodology. consideration, the project is geared This research will involve the collection towards the implementation of coral reef and characterization of benthic and fish protection, using a partnership approach population data, thus establishing a to develop an adaptive management plan baseline database for the Moliniere and coral reef monitoring program at the MPA. Community involvement will be designated MPA in Grenada. an integral component of the project, and as such, a team of volunteers will be trained in SCUBA and (AGRRA) methodology and will assist with the data collection during this research. Results from coral reefs surveys conducted will be summarised in the form of a poster and scientific paper. This will be presented at the Gulf and Caribbean Fisheries Institute (GCFI) annual meeting in Belize in November 2006 by Dr. Morrall and Mr. Nimrod.

Volunteers for post hurricane marine assessment 2004.

Mr. Nimrod, who will be based at WINDREF, and Dr. Morrall, will be working closely with the Grenada Fisheries Division, the body responsible for MPA’s in Grenada, and other stakeholders to enhance management capacity of the Moliniere MPA. In an effort to develop an effective management plan for Grenada’s MPA, The WINDREF/SGU collaborators will review the current management plan Stephen Nimrod with volunteer Katie Bryant after a reef survey. with fisheries personnel and key stakeholders. Following this review we The research team will assess the will visit the Soufriere Marine knowledge of key stakeholders and other Management Authority (SMMA) in St. users of the marine environment, as it Lucia, a successful case study of MPA relates to the importance of, and threats management, to study daily operations to, coral reefs and other related marine and management strategies. ecosystems. They will also sensitize Coral reef systems within the through educational outreach programs, Moliniere MPA on the west coast of stakeholders and the public as to the Grenada will be surveyed along with a importance of MPAs as they relate to similar reference site using the well coral reef conservation and protection. WINDREF Research Institute Annual Report 2005 37

The project will be guided by the expertise of Dr. Michael Risk from McMaster University, Dr. Craig Dahlgren from Perry Institute for Marine Science, Bahamas, and the Nature Conservancy (TNC).

Key stakeholders at the TNC management and planning workshop in Carriacou, 2005.

We are keen to work with the Grenadian people over the next twelve months. We look forward to making a Dr. Phillip Kramer from the significant contribution to marine Nature Conservancy conservation in Grenada and the demonstrating AGGRA survey Caribbean as a whole. method.

The Nature Conservancy, an Submitted by Stephen Nimrod international conservation organization, and Dr. Clare Morrall. has been working in Grenada since 2001 through the USAID funded ‘Grenadian Parks in Peril’ Program, which has the 6.13.2. A project pre-proposal to the main goal of strengthening the US National Fish and Wildlife conservation effectiveness of the marine Foundation (NFWF) for a protected area system in Grenada and St. Grenada-based Marine Vincent and the Grenadines. Moreover, Protected Area project Grenada is a signatory nation on the Convention on Biological Diversity and The US based Conservation as such is committed to establishing organization ‘The Nature Conservancy’ effectively managed marine protected (TNC) and Dr. Michael Risk, a coral areas by 2012. To help achieve this reef expert currently based in Canada, target, TNC is providing support in the both gave assistance with this proposal. areas of conservation planning and A full proposal was requested by NFWF management, institutional capacity and finally in August we received the building, and environmental education. eagerly anticipated and joyous news that We have already attended one in a series our project funding had been approved! of conservation management and Former SGU Marine Biology student planning workshops held in Carriacou. Mr. Steve Nimrod and recent graduate of The workshop was facilitated by TNC in the University of Plymouth has been collaboration with the Caribbean hired as project manager for this project. Regional Environment Program (CREP) Steve is based at WINDREF and is Sandy Island/Oyster Bed Marine Park. currently working on building and strengthening ties with the Grenada WINDREF Research Institute Annual Report 2005 38

Fisheries Division, the Grenada Scuba week-long training workshop on the Diving Association and other partners Atlantic and Gulf Rapid Reef who will play key roles in the Marine Assessment (AGRRA) survey technique. Protected Area (MPA) project. Again Mr. Jerry Mitchell from Grenada This year has been busy with Fisheries and Dr. Morrall attended along workshops. The Nature Conservancy with reef survey volunteer and local dive (TNC) continue to support capacity store manager Mr. Frank Collymoore. building in Grenada for protected area The workshop was based at the Bellairs development through their ‘Parks in Research Institute of McGill University Peril Project’. We have been fortunate to in Barbados and was run by a team of have been among the Grenada AGRRA experts including one of the representatives supported by TNC at a Grand-Daddies of coral reef ecology, Dr. variety of training workshops. Robert Ginsberg from the University of In May 2005, four Grenada Miami, and Dr Judith Lang. The week representatives from attended a week- was intensive but highly rewarding with long ‘Caribbean Workshop on Marine long dive sessions (despite quite foul Protected Area Effectiveness and weather!) and classroom sessions Adaptive Management’ in St. Croix. Mr. running late into the evenings. Paul Phillip and Mr. Jerry Mitchell from the Grenada Fisheries Division, Mr. Martin Barriteau, Project Manager for the Carriacou Sandy Island and Oyster Bed Marine Protected Area project, and Dr. Morrall attended and worked together for the week. The workshop participants were from a wide variety of Caribbean islands and much was learnt from information exchange as well as at the formal workshop sessions. AGRRA Training Team- including,

from far left: Dr Robert Ginsberg and Dr. Judith Lang. Front row left to right: Clare Morrall, Frank Collymoore and Jerry Michell.

This fall semester we have been in Carriacou on two occasions. In September Dr. Morrall participated in a week-long reef survey training and data collection trip along with Mr. Paul The Grenada team in St. Croix. Left Phillip, Mr. Jerry Mitchell and a number to right: Paul Phillip, Martin of Carriacou based representatives. The Barriteau, Clare Morrall, Raquel training was run by Dr. Phillip Kramer Seybert (TNC), James Byrne (TNC) and Mr. James Byrne, both from the and Jerry Mitchell. Nature Conservancy. After a couple of days in the classroom, we spent the rest In June, TNC supported three of the week offshore barely surfacing Grenada representatives to attend a between survey dives! An enormous WINDREF Research Institute Annual Report 2005 39 amount of reef data was collected, conducting coral disease surveys around including data from badly hurricane Grenada in October. Dr. Weil has World damaged shallow reefs off the south Bank funding to complete disease coast of Carriacou and the deeper but surveys at sites spanning the globe. Dr. close to pristine reefs surrounding the Weil completed surveys in Grenada in rocky outcrops known as the Sisters. In 2001 and plans to return again in a October Dr. Morrall made another trip to couple of years to reassess the condition Carriacou, this time accompanied by Mr. of Grenada’s reefs. Our MSc. student Steve Nimrod and MSc. student Mrs. Lisa McCartney and Mr. Steve Nimrod Lisa McCartney, to attend a two day assisted the scientists in the field and MPA management meeting. The gained valuable experience from their meeting was attended by a variety of hands-on help with the survey work. stakeholders including fishermen, water Permanent survey sites were established taxi drivers and hoteliers. The same at two reef sites. It is hoped that thermal meeting format will be used for the loggers will be installed at these sites in NFWF funded Grenada MPA project. the near future. This year’s high sea In June Dr. Morrall attended the surface temperatures have resulted in an Association of Marine Laboratories of intensive and widespread coral bleaching the Caribbean (AMLC) Executive Board event throughout the Caribbean and Meetings and Scientific Meeting in Grenada’s reefs have been badly Curacao in the Netherland Antilles. The affected. It is hoped that the sea AMLC are interested in holding their temperatures will reduce speedily to 2009 scientific meeting in Grenada, and allow the coral’s to recover. During his we very much hope that this will be stay Dr. Weil gave a dynamic and possible. interesting seminar at WINDREF on In early November we attended a Coral Reef Diseases which was well one day ‘Sea Turtle Action Planning attended by students and representatives Meeting’ held in St. George’s. The from local dive stores. meeting was run by Ms. Rebecca King Finally, through our work with and Mr. Carl Lloyd from the local local NGO ‘Conservation Grenada Inc.’ Marine Conservation organization Dr. Morrall took responsibility as the ‘Ocean Spirits’ and was supported by Grenada co-coordinator for The Ocean turtle expert Dr. Karen Eckert from the Conservancy International Coastal Wider Caribbean Sea Turtle Cleanup in September. Six teams of Conservation Network (WIDECAST) volunteers cleaned up a variety of based at Duke University, and Mr. coastal and underwater sites around Crafton Isaac from the Grenada Grenada. A total of 534 trash bags were Fisheries Division. The meeting was filled, representing a weight of around very well attended and was highly 8,300 lb! Dr. Martin Forde from the informative. It is hoped that progress can department of Public Health and be made soon to better protect Grenada’s Preventative Medicine organized his sea turtles from a range of deleterious Environmental Health class to take part human activities. in the cleanup and were based in the Visiting scientists Dr. Ernesto Grand Anse Beach area. Other SGU Weil and Dr. Aldo Crocker from the representatives took part in the cleanup, University of Puerto Rico spent a week contributing to the success of the event. WINDREF Research Institute Annual Report 2005 40

The cleanup effort was well supported 6.14. The Implementation and by local businesses. Data from the Evaluation of the Grenada Grenada cleanup will be published in an Return to Happiness Program Ocean Conservancy report and the will also be sent to the Ministry of Health and the Environment, the Grenada Solid Waste Authority and the Ministry of Tourism. We hope to get greater support both from the St. George’s University population and the Grenada population for the 2006 Coastal Cleanup.

Return to Happiness Logo

The Return to Happiness program is a psycho-affective recovery program for children who have experienced the trauma of armed conflict or natural disasters. It has been implemented in many nations, including Figure three. Conference Bay cleanup Mozambique, Columbia, Honduras, El bagged up! Salvador, East Timor, Ecuador, Venezuela, Nicaragua, Belize, Peru, Paraguay, and most recently, Grenada. The program employs the strategies of play therapy and creative arts to encourage children to express their concerns, fears, anxieties, and other emotions related to their experiences during and following a disaster. Adolescent and young adult volunteers work with children ages 6-12 in small groups, using program materials, such as Figure four. Carenage underwater puppets, cloth dolls, wooden toys, arts cleanup results! and crafts, plays and storybooks.

Responding to the trauma Submitted by Dr. Clare Morrall, associated with experiencing Hurricane WINDREF Research Fellow, Ivan, a category 3 hurricane that passed Chair of Life Sciences, through Grenada on September 7, 2004, SGU/SVM Marine Development UNICEF recognized the immediate need Program Director to address issues of child protection and

recovery. In cooperation with the

government of Grenada, UNICEF implemented the Return to Happiness

WINDREF Research Institute Annual Report 2005 41

WINDREF Research Institute Annual Report 2005 41 program in eight sites, serving a structured opportunity to process approximately four hundred of his/her experience of Hurricane Ivan and Grenada’s children. Following this the crises associated with its aftermath. project, it was decided by the Ministry of The expectation was that this would Education and UNICEF that all of enable these children to recover from Grenada’s children should benefit from a any acute emotional trauma and return to program designed to address their a state of confidence, security and hope. unique psychosocial recovery needs. The strategies employed included extensive inter-agency collaboration, community empowerment, materials adaptation and development, volunteer recruitment and training, multiple simultaneous implementations at sites across the island, and systematic data collection for the program evaluation. There was very effective collaboration between the UNICEF Regional Office, SGU Psychological Relief Team: Dr. the Ministry of Education, the Terry Ruthrauff, Dr. Omowale Department of Youth in the Prime Amuleru-Marshall, Dr. Zuri Amuleru- Minister’s Office, the schools, St. Marshall, Ms. Novia John, Ms. Nadine George’s University – Psychological Baksh. Relief Team and Health Promotion The St. George’s University Research Center in the Department of Psychological Relief Team, under the Public Health and Preventive Medicine, leadership of Dr. Zuri Amuleru- and the participating NGOs – the Marshall, Professor of Behavioral Grenada Red Cross, GRENCODA, the Sciences, planned this nationwide Agency for Rural Transformation implementation, as well as its (ART), and NCH Action for Children.

evaluation. The members of the team are Dr. Omowale Amuleru-Marshall, Chair and Professor, Department of Public Health and Preventive Medicine; Dr. Terry Ruthrauff, Acting Director, Counseling Services, Ms. Novia John, Assistant Registrar; and Ms. Nadine Baksh, Assistant Registrar. The evaluation was administered by the Locally Produced Toys for Kits.

Health Promotion Research Center in the Department of Public Health and CULTURAL ADAPTATION Preventive Medicine. A proposal was OF THE PROGRAM submitted and approved for full funding The original RTH kits were by UNICEF, Caribbean Area Office. adapted to fit the Caribbean context. The goal of the Return to This adaptation included the local Happiness demonstration in Grenada development of a new logo, new stories was to provide each primary school and plays, the production of new child, between the ages of 6 and 12, with puppets, dolls and toys, and the WINDREF Research Institute Annual Report 2005 42 identification of appropriate songs and period at each school. A daily snack games. prepared by a local vendor was provided for participants, and on the 11th day, a program celebration was held. The program was implemented in six sequential phases from January 2005 to June 2005. Each phase included full program implementation for 6 to 11 schools. The total participation of schools, volunteers, and students is quite impressive: • 51 schools • 588 community volunteers (21% Storytelling Students with Volunteer. served in more than 1 phase) • 7,239 primary school children An international renowned Grenadian artist/author, Richardo Keens- EVALUATION Douglas, assisted with many of these The evaluation effort was adaptations, and also permitted the use managed by the Health Promotion of some of his books and songs in the Research Center in the Department of program. A total of 100 backpacks were Public Health and Preventive Medicine produced locally for the program. at St. George’s University. The

Department accepted the evaluation of the Return to Happiness program as a project within its Center and provided leadership, secretarial assistance, office resources, as well as fully equipped office space for the data entry clerks as in-kind contributions to the project. The St. George’s University Psychological Creative Arts students with Dr. Relief Team provided periodic Amuleru-Marshall. consultation to the evaluation team. The evaluation plan included both process and outcome components, IMPLEMENTATION requiring extensive continuous data This was a massive undertaking, collection and analysis. The outcome which involved every public primary evaluation design is a pre-post school in Grenada, Carriacou, and Petite comparison group design involving the Martinique. The onsite program participants in phases 4 and 5. This activities were housed, for the most part, design controls for a number of potential in school facilities, immediately after threats to the validity of the study, normal school hours. Volunteers from including maturation, history, regression, the school communities were recruited and testing. It does not control for by the NGOs and trained by program selection however, because the two staff to use the materials and strategies groups are not randomly selected or when working with the participating assigned. There were four schools in children over the 10-day implementation WINDREF Research Institute Annual Report 2005 43 phase 4 and four schools in phase 5. understanding between the two While the program did not achieve all of institutions in June 2004, facilitates the its outcome objectives, it was found to long term planning of combined research be effective, at a statistically significant activities. The current research plan were level, in reducing one of the most salient developed closely with Dr. Ludwig features of distress – anxiety. Clearly, Sieffert of the Department of Wildlife decreasing children’s levels of anxiety is Medicine at Makerere and focused on an important contribution to their Cystic Hydatid Disease. In the summer psycho-emotional recovery from the of 2005, given the larger than usual experience of trauma. number of students who were able to The evaluation has provided travel to Uganda, it was felt prudent to useful information to program sponsors expand the research activities along the and planners regarding the fidelity of the lines set by UWA. We summarize here program’s implementation, as well as the the research activities conducted. program’s effectiveness in achieving its goal of children’s psychoaffective recovery from the experience of Hurricane Ivan. As usual, there are many recommendations for improvement; however, the Return to Happiness Program as implemented in Grenada, was found to be very promising.

Submitted by Dr. Zuri Amuleru – Marshall, PhD Professor of Behavioral Sciences, SGU and Research Fellow, WINDREF A Park Ranger watches out for other members of the anesthetized lion’s 6.15. The MIRT Research Group pride who scattered when the Uganda study results for the individual was tranquilized. Data on summer activities in 2005 infectious diseases in the large predators was collected. The Uganda Wildlife Authority’s (UWA) research plan for 2003 to 2008 All research projects were carried highlights the priority of investigating out in the Queen Elizabeth National Park wildlife diseases and human wildlife (QENP) in western Uganda. Projects conflicts in all game conservation areas were divided into three main areas based and national parks. Specifically of on the UWA priority list, vis; large interest were studies to investigate the predator viral project; livestock/wildlife epidemiology of common livestock brucellosis project, and a tick project to zoonotic diseases. The ongoing examine potential zoonotic diseases; collaboration between St. George’s wild animal/ human conflicts and University, WINDREF and Makerere solutions with regard to elephants; a new University, which culminated in the study was initiated to carry out a census signing of a memorandum of of the chimpanzee population in the Kyambura Gorge was started at the WINDREF Research Institute Annual Report 2005 44 request of the chief game warden. Each be due to the virus not having been of the 10 students on the team prepared a introduced to date into QENP. The management by objectives form, which negative FeLV results is consistent with facilitated the priority purchases for each the absence of this virus elsewhere in of the projects. All materials, reagents, Africa in wild lion populations. Further and test kits were purchased in the US studies on these viruses within the lion and shipped with the students to Uganda. and leopard population in QENP are Unused supplies were left in the lab at required. Such studies done in Mweya. Implementation of the projects conjunction with other work, particularly was conducted using established with community education and protocols. The data was left with Dr appreciation of the importance of these Sieffert. species for tourism, could yield important new data which would help to further help the survival of these species within the park.

Dr Sieffert explains the darting technique to the MIRT students.

A total of six lions (2 males and Ms Hollie Schram placing the leopard 4 females) and one male leopard aged in the shade to recover from the between 2 – 7 years were anesthetized in anesthetic. the Park and samples were collected from the same. All of the large Blood and fecal samples were carnivores tested negative for Feline collected from 48 healthy and 2 ill thrift Leukemia Virus (FeLV) and canine cattle in the villages of Kahendero and parvovirus but positive for Feline Katwe which lie inside the boundaries of Immunodeficiency Virus (FIV). The fact QENP. In the blood smears of the 2 sick that all tested positive for FIV antibodies cows sampled at Kahendero Thelileria may be due to the close contact between sp. and Anaplasma marginale was the lion population, such as grooming found. At Katwe 20 blood and fecal and possible fighting which will readily samples were taken. In the fecal samples facilitate transmission of the virus. The taken from both Kahendero and Katwe present depressed numbers of predators mixed infections with Bunostomum, (the lion population is currently Eimeria, Monezia, and Strongyle species estimated to be 65 individuals) means were found. The milk ring test for that transmission opportunities will be brucellosis was positive in a number of more frequent and it is likely that all cattle and this is likely to be an may be exposed to the virus. The important zoonoses in the area. absence of FeLV seen in this study may WINDREF Research Institute Annual Report 2005 45

Speciation of ticks requires but not as common is Mauritius thorn specialist analysis and the results are not bush (Caesalpinia decapetala) planted yet available. as a fence. Both methods, such as trenches and Mauritius thorn fences, are paid for by UWA and villagers carry out the initial labor, for which they are paid, and maintenance for which they are not paid. The digging of a 5ftx7ft trench costs around 3,000 Uganda shillings (approximately US $1.63) per meter, while planting thorn scrub costs 3,000 shillings per kilogram of seed, which can be spread up to one kilometer. Before the implementation of large-scale elephant deterrent measures local farmers commonly spent nights in Elephants require large areas to move guarding huts located within the fields. in creating increasing conflicts with the expanding human population.

Elephant numbers in QENP have risen to almost 2,500 individuals and large numbers of elephants were seen. Raided farms were found to be used for both sustenance and income and ranged from 0.5 to 2 acres in size (estimate). Elephants consumed beans, tomatoes, mango, papaya, maize, banana, and sorghum. Communities most often chose to use deterrent methods that covered A trench dug between farmland and large areas and protected many QENP to keep elephants from entering individual farms. Long trenches fields in Kyambura, Uganda. covering up to 10km were dug in Kyambura, Kikarara and Kahihi to keep They used fire and noise to deter elephants away from crops and crop-raiding elephants but were not Muhokya is currently requesting UWA often successful. Although both to help in construction of one for their Mauritius thorn fences and trenches village. Many factors account for which have been effective to deter elephants deterrent methods are used. The village there are disadvantages. Both must be of Katwe, for example, did not often use maintained. The trench in Kikarara, for deterrent methods other than noise, due example, was not weeded or kept at the to the position of the town on a hill correct depth to effectively deter allowing villagers to see elephants elephants. Villagers in Kyambura approaching the village. Katwe is not claimed that the trench limited access to officially allowed to grow crops so is not drinking water and that elephants walked actively assisted by UWA. One method to the end of the trench causing a that is effective in deterring elephants WINDREF Research Institute Annual Report 2005 46 disproportionate amount of damage to warden of QENP, head of community farms in that location. relations, Gertrude. Thank you Josephine The local communities work Afema, Joel Zewa, MZ and Dr. Ludwig together with UWA to determine which Sieffert for facilitating the fieldwork. elephant deterrent measures are best for Thanks to our sponsors, Fogarty each situation. Villagers are made aware International, for the grant made to of the benefit of elephants to tourism and Texas A and M and its facilitation to the the environment. Windward Island Research and Education Foundation at St. George’s University. Finally thanks to Dr. Sis, the PI, Dr. Calum Macpherson for field co- ordination and to Dr. Richard Kabuusu for his help.

Deans Macpherson, Sis from WINDREF and St. George’s University with Dean Kabaasa from the School of Veterinary Medicine, Makerere, University, Uganda with the MIRT Dr. Sieffert and Dr. Joel Ziwa and project students following their members of the MIRT team in QENP, presentations in WINDREF. June 2005.

The chimp study provided few Submitted by results as time did not permit the Dr Cal Macpherson, Sarah Scott rigorous study required to fully assess and the MIRT students the chimpanzee numbers in Kyambura Gorge. We would like to thank UWA for 6.16. Studies on the role of permission to conduct the above studies ultrasound in evaluating the and for facilitating their implementation need for an Echinoccus in QENP. Although given the time frame granulosus control program: available, the studies were not Field studies in Eastern Turkey exhaustive and do not provide enough information for an evidence based Cystic echinococcosis (CE) is a approach to their resolution, it is our major economic and public health hope that the little information obtained problem in Turkey. The parasite mainly will add to the information collected circulates in a sheep intermediate host over the years as a whole. We also thank dog definitive host life cycle and humans the head of WORM, Dr. Michael become infected indirectly through Ochaido Thank you to the chief game environmental contamination with WINDREF Research Institute Annual Report 2005 47

Echinococcus eggs. The vast majority of from the Mosque by the local Imam who the Turkish population is Muslim whose also re-iterated the terms of participation religious teachings preclude close in the study … that the screening was associations with dogs. Dogs are free, what diseases were to be looked regarded as being very useful as guards for, what procedures would be carried and in most areas they are kept for this out on the volunteer participants purpose. This study was carried out at (questionnaire, ultrasound screening and the request of the Turkish president of blood samples from positive cases and a the CE association, Dr. Nazmiye few controls) and that the results would Altintas, Professor of Parasitology from be instant. Only those who wanted to be Izmir University in Western Turkey. screened need participate in the study. Because of the importance of CE in Experience in other parts of the world Turkey, mass community based has shown that the level of participation ultrasound screening programs are is extremely high and the data obtained planned to identify more accurately the is a very accurate refection of the true public health importance of the disease disease status in a community. throughout the country. Based on surgical records collected from regional hospitals the rural area around Kars, in Eastern Turkey, was selected for the initial survey (map).

Participants in the ultrasound screening program first complete a questionnaire which helps to collect data on risk factors and also serves as Map of Turkey showing the city of Kars an educational tool for the (arrowed) in Eastern Turkey. The study participating population. was conducted in small rural villages surrounding this historic city between The screening program started September 26th – October 1st 2005. with the children, then the women and finally the men of each village. Schools The villages to study were were selected as the screening venue as previsited a few weeks earlier by a local they had multiple rooms and were veterinarian and an associate professor at invariably located near the center of the the University of Kars. Dates for the village. Questionnaires were completed survey were set and a team of using faculty and graduate students. physicians, veterinarians, scientists and Ultrasound examinations were carried students set off daily to the out by CNLM behind a screen and predetermined sites. Informed consent positive cases were confidentially was counseled during the early visits. counseled. Positive VDU images were The arrival of our team was announced WINDREF Research Institute Annual Report 2005 48 recorded digitally. Blood samples were Agriculture and the National Parks and taken from all suspected CE patients. Protected Areas Department, Ministry of Tourism and the Forestry Department for their help and cooperation with the research projects. We would also like to thank Senator Ann David-Antoine, the Minister of Health, Dr. Bert Brathwaite, Chief Medical Officer, for their considerable input during 2005.

7.1. Associated faculty, staff and institutional collaborators The ultrasound team arrives at a village school in preparation for the Collaborator Projects screening. Ms. Josephine Afema...... Uganda Of the 2001 people screened by Mr. Dave Alexander ... Addictive Diseases us, 5 (0.24%) were found to have CE Dr. B. Amelingmeier .Intestinal Helminths lesions, all located in the liver. One of Dr. J Amelingmeier Intestinal Helminths the lesions was classified as CE Type Dr. T. Andrews ...... Novel Antimicrobial 1, one was CE Type 4 and the other Aquanauts ...... Novel Antimicrobial three were cystic lesions. In addition to Dr. Bert Brathwaite..... Addictive Diseases the CE lesions, two patients had Ms. Cynthia Bruno.... Novel Antimicrobial marked punctuate calcified lesions of Mr. Nicholas Caputo...... New Species unknown etiology. The prevalence Dr. Tom Champney .. Novel Antimicrobial found was much lower than expected, Min. Clarice Charles...... All Projects given the risk factors prevailing in the Dr. Wendy Crawford ...... CERI area. These included a large dog Mr. Charles Daniel...... Apres Toute population usually kept close to the Sen. Ann David-Antoine ...... All Projects house, feeding hydatid cysts, when Ms. Grace Dolphin...... CERI found, to dogs, poor hygiene and large Nurse Nestar Edwards Addictive Diseases numbers of sheep. The reasons for the Dr. Paul Fields ...... All Projects low prevalence will be investigated Mr. Peter Giesler...... Novel Antimicrobial further by the local veterinarians at Ms. Suzanne Hall...... Novel Antimicrobial Kars University. Sister Sharon Harris.... Addictive Diseases Welles Henderson..... Novel Antimicrobial Submitted by Dr. David Johnson .... Novel Antimicrobial Cal Macpherson, PhD, DIC Ms. Fiona Jeffrey...... Apres Toute Director, WINDREF Dr. Richard Kabuusu ...... Uganda Dr. Mary Jeanne KreekAddictive Diseases Mr. Grant Lambert.... Novel Antimicrobial 7.0. Acknowledgements Dr. David Lennon ...... Micro Projects Mr. Tarami Long ...... Intestinal Helminths WINDREF works in close Dr. Matthias Lorenz...... Nutmeg collaboration with a number of local Dr. C.N.L. Macpherson ...... All Projects and internationally based institutions Dr. Fran McGill ...... Relief and individuals. In Grenada, we would Dr. Eugeny Martin.... Novel Antimicrobial like to thank the Ministry of Health, Ms. Trisha Martin ..... Novel Antimicrobial Ministry of Education, Ministry of Ms. Rebecca Melfi.....Intestinal Helminths WINDREF Research Institute Annual Report 2005 49

Nurse Beverly Mends .Addictive Diseases during the summer of 2005 Microbiology Division...... CERI studying wildlife and the Ministry of Education .Addictive Diseases population living in and around Ministry of Health...... All Projects Queen Elizabeth National Park in Dr. Winston Mitchell ...... Relief Western Uganda, as well as for a Dr. David Molyneux...... LF student who conducted research in Mr. Mandlenkosi Mthunzi Classification of species the Dominican Republic. Ms. Ruella Munro ...... Nutmeg • Hill’s Pet Nutrition, makers of The Mr. Trevor Noel...... CERI Science Diet, for donations of pet Mr. Tom Nutley...... Apres Toute food and products. Dr. Michael Ochaido...... Uganda Mr. Rex Omabu ...... Nutmeg • The Iams Company for donations Ms. Beula Patterson ...... CERI of pet food and products. Mr. Tommy Pelai...... Classification of species • The Liverpool Support Center for Dr. Allen Pensick...... All Projects their continued support of the Mr. Arthur Pierre ...... Addictive Diseases Lymphatic Filariasis Elimination Dr. Ateef Qureshi...... Novel Antimicrobial Project in Guyana. Dr. Leslie Ramsammy ...... LF • Dr. Mary-Jeanne Kreek, Dr. Joanna Rayner.....Novel Antimicrobial Rockefeller University, NY, for the Mr. Thorne Roberts.....Addictive Diseases support of the substance abuse Dr. Mirta Roses ...... Return to Happiness project. Dr. Zara Ross ...... Novel Antimicrobial Dr. Ludwig Sieffert...... Uganda • Minority Health and Health Dr. Ray Sis...... Uganda Disparities International Research Mr. Kabelo Thusang Classification of species Training (MHIRT), US National Mr. Baogo Tapela ...... Classification of species Institutes of Health, for training of Dr. Keith Taylor...... All Projects students in Grenada, Uganda, and the Mr. Terrance Walters..Addictive Diseases Dominican Republic. Ms. Heidi Wiegandt.. Intestinal Helminths • Pan American Health Organization Mr. Joel Zewa ...... Uganda (PAHO) for the support of the project “The Public Health Impact of a Natural Disaster on Birth 8.0. Grants Rates and Antenatal Facilities in a Small Island Nation”. We would like to thank all of • Purina Petcare for donations of pet the donors who have made food and products. WINDREF’s work possible in 2005. These include: • SGU Docs for Grenada who donated time, resources, and • The Bartholomew J. Lawson medical and other services to the Foundation for Children for the General Hospital and clinics. rebuilding of secondary schools and refurbishing of laboratory • UNICEF for the support of the equipment in Grenada. Return to Happiness Program. • Mary Glenn and the Humboldt • A very special thanks to all who State University Grenada Disaster provided support, time, and energy Relief Fund for Grenadians. to the WINDREF / SGU Hurricane Relief Project (Humanitarian • Fogarty International provided Project). support for ten veterinary students

from SGU who spent ten weeks

WINDREF Research Institute Annual Report 2005 50

control within the native Caribbean population of Grenada • Hypertension management and control in two Caribbean countries • Assessment of the effectiveness of broad-spectrum treatment to children with protozoan and nemathelminthic parasitic infections on diarrhea and school attendance An arthroscope was donated to WINDREF by the alumni of the • The effects of iron-deficiency University College of Cork, Ireland, anemia on cognition and behavior in and Dr. William McAveney from the infants Virginia Rotary Club. Dr. Cal • Diurnal variation of urinary Macpherson handed over the endothelin-I and blood pressure: equipment to Dr. Douglas Noel, the related hypertension head of the Department of • Alcohol consumption in Grenada Orthopedics at the General Hospital. • The incidence and mortality of cancer in Grenada over the ten year 9.0. Past, present and future period: 1990-1999 research projects (present • The prevalence of abnormal research projects bolded) haemoglobin traits in Grenadian secondary school adolescents 9.1. Non-communicable diseases • Knowledge, attitudes, beliefs and practices of Sickle Cell Anemia in • Angiotensin converting enzyme and Grenadian Primary and Secondary angiotensinogen gene polymorphisms school children in the Grenadian population: relation to hypertension • Decompression sickness among the indigenous fishing population in • Development of a decision rule for Grenada: Assessing the burden of screening Obstructive Sleep Apnea disease and its epidemologic relevance to the people of Grenada • WINDREF / SGU Hurricane • Prevalence and associated risk Relief factors of hypertension in a sample • Spice Research Program population of native Caribbean’s in • Sulfate-Reducing Bacteria in Grenada, West Indies Oxidized Freshwater of Tropical • Assessing the prevalence of diabetic Mangroves complications by examining type I • Novel Antibiotics from Tropical and type II adult diabetics for signs Marine Environments: Drug of retinopathy, neuropathy, Development in Grenada nephropathy and dermatological changes associated with poor glucose • Study of the Mutacin C-7A

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• Gram-negative bacteria isolated from • Seroprevalence of HIV-I and HIV-II aquatic environments of Grenada in pregnant women in Grenada, W.I. (61.4°W, 12.0°N), West Indies Their knowledge of AIDS and their • Identification of bacteria exposure hazards to the virus producing antibiotics isolated from • A cross sectional study of the current deep marine biofilms of Grenada status of Schistosoma mansoni in St. • SGU Environmental Testing Unit Lucia by field surveys and (ETU) supplementary data collection • Post-hurricane water surveillance • Identification and characterization of in problematic areas of Grenada hantaviruses among the mammal population of Grenada • Evaluation of the relocation potential for villagers residing in Queen • HIV/AIDS health education and Elizabeth National Park, Uganda evaluation program in Grenada • Study of the Calls of the Spotted • The seroprevalence of Toxoplasma Hyena at Feeding gondii in a population of pregnant women and cats in Grenada, West • Survey on the attitude of villagers in Indies Queen Elizabeth National Park, Uganda towards the threat of lions, • The efficiency of diagnosing women leopards and hyenas of Toxoplasma gondii using PCR techniques in comparison with • Epidemiology of Human Injuries ELISA Resulting From Wildlife in Ten Villages within Queen Elizabeth • Dengue virus in Grenada: National Park, Uganda seroprevalence and associated risk factors • Rural Ugandan Village Perspective on Lion, Leopard and Hyena • A current appraisal of dengue virus Conservation in Grenada - serotype analysis and vector assessment • Epidemiology of Human Injuries by Wildlife in Six Villages within • A site receptivity study determining Queen Elizabeth National Park, the threat of reintroduction of Uganda malaria into Grenada through the study of Anopheline spp. mosquito • Prevalence of Campylobacter fetus vectors subspecies venerealis and other Microorganisms in the Reproductive • Chlamydial infection among STD Tracts of Cattle from the Southern clinic attenders in Grenada Region of Santo Domingo, • Fever in Grenada Dominican Republic • Mosquitoes and Tourism in Grenada

9.2. Infectious diseases • Effectiveness of a formula feeding/weaning intervention • Investigation of the prevalence of program in preventing transmission SIV in the mona monkey of HTLV-1 from seropositive (Cercopithcus mona) in Grenada mothers to newborns in Grenada

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• A multi-center longitudinal research • A comparative study to find out if study of the behavioral significance there is an association between of the prevalence of HIV-1 infection sexual practices and knowledge in in pregnant women and their babies adult populations of Botswana and on the islands of Grenada and St. Grenada with the prevalence of Vincent HIV/AIDS • A multi-center longitudinal research • HIV/AIDS in rural Botswana study of the ethical analysis of differentiating between informing informed consent of the prevalence and educating of HIV-1 infection in pregnant • Evaluating the level of perceived women and their babies on the fear and desensitization towards islands of Grenada and St. Vincent HIV/AIDS in Botswana • Determining the role of IL-15 in • Rheumatic Fever in Grenada mediating function of viral-specific CD8+ T cells in the • Isolating T cells from Rheumatic myelopathogenesis of HTLV-1: Fever positive blood: Symptomatic versus asymptomatic Immunofluorescent assay of T patients lymphocytes via fluorescently labeled monoclonal antibodies • Intestinal protozoan infections in 6- 12 year old children in Grenada • Possible genetic predisposition to Rheumatic Fever: Demonstrating the • Intestinal helminth infections in 6-12 inheritance fashion of non-HLA B year old children in Grenada lymphocyte alloantigen D8/17, a • The prevalence of intestinal parasites marker for Rheumatic Fever in school children in rural Guyana • ELISA antibody titres against group • The prevalence of filariasis and its A streptococcal M protein moiety effects on children aged 8-14 in the and cell wall N-Acetyl-D- central corentyne region of rural Glucosamine in Grenadian Guyana Rheumatic Fever patients • The prevalence of streptococcal • Evaluating the effectiveness of infection in school children aged 5 – educational methods in the 15 years in Grenada, Carriacou and prevention of Rheumatic Fever and Petit Martinique Knowledge, Awareness and • Studies examining the elimination of Practices lymphatic filariasis as a public health • Prevalence of intestinal helminth problem in Guyana infections in rural Grenadian school • Seroprevalence of heartworm children infection in dogs in Grenada. • Cystic echinococcosis in Morocco • Dengue in Grenada and Uganda • Assessing the potential risk factors • Elimination of Lymphatic of dengue and dengue hemorrhagic Filariasis in Guyana Program fever in the tri-island state of Grenada, Carriacou and Petit Martinique

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9.3. Unique projects 10.0. Conferences, meetings, workshops sponsored in 2005 • Characterization of five amphibians inhabiting Grenada and subsequent Workshop on the improvement of isolation and antimicrobial assay of Apres Tout water quality. A potential antibiotics derived from collaboration between Ministry of their skin Health, National Water and Sewerage • Mona Monkey studies in West Authority (NAWASA), WINDREF and Africa SGU.

• Investigation of medicinal plants in Grenada 11.0. Abstracts, Presentations at • Use of medicinal plants in Grenada International Conferences, Invited Plenary / Workshop / • Medicinal drugs from the sea. What Roundtable / Professional do Grenada’s waters have to offer?

• Beekeeping in Grenada: Effects of Abell, N., Rutledge, S.E., McCann, the mite Varroa jacobsoni and its T.J., Padmore, J. Intervening in control HIV/AIDS Provider Stigma: Assessing • Effects of Grenadian Medicinal Regional Concerns in the West Indies. Plants on Endemic Microbial causes The University of the West Indies rd of Diarrhoeal Diseases HIV/AIDS Response Programme, the 3 Annual Scientific and Business • The neurobiological basis of Conference, Barbados, 5-8 May 2005. hypoglycemia-associated autonomic failure Brunetti, E., Macpherson, C.N.L. and • Stimulation of angiotensin 4 in Richter, J. Short Course on Abdominal cardiac fibroblasts activates matrix Ultrasound in Tropical Medicine, Pavia metalloproteinases through MAP University, Pavia, Italy, 28 March - 1 kinases pathways: A model for April 2005. astrocytes Caputo, N. and Kotelnikova S. Novel • REM sleep and memory antimicrobial producing organisms from • End of life care in Grenada tropical marine environments, Poster • Novel antibiotics from tropical presentation at Microbes in the marine environments Changing World, San Francisco, California, July 2005. • Genetic Correlates of the Addictive Diseases: Cocaine, Gribbin, C.W., McLendon, L., Tsang, Alcohol, and Marijuana S., Lee, P.J., McCann, T.J. Diabetes Addiction– Grenada type II and hypertension prevalence, • An Investigation of Pediatric education, complications and disease Botanical Medicine for Acute management within a rural community Respiratory Infections of the island of Grenada. Invited poster presentation at the Annual American Public Health Association’s 133rd

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Annual Meeting, Philadelphia, 10-14 natural disaster. Invited oral presentation December 2005. at the American Public Health Association’s 133rd Annual Meeting, Kachani, M., Alioua, F., Benazzouz, Philadelphia, 10-14 December 2005. M., Bouslikhane, M. and Macpherson, C.N.L. Benefits of Physician- Sharma, R.N., Dubey, J.P., Bhaiyat, Veterinarian Collaboration in the M.I., De Allie, C., Macpherson, Control of Zoonoses – The Hydatid C.N.L., Sreekumar, C., Vienna, Disease Control Program in Morocco. M.C.B., Shen, S.K., Kwok, O.C.H. and Oral paper at WAAVP, Christchurch, Lehmann, T. Seroprevalence and New Zealand, 25 October 2005. isolation of Toxoplasma gondii in free ranging chickens in Grenada, Oral Lee, P.J., Tsang, S., Gribbin, C.W., presentation at 8th Biennial Conference McLendon, L., McCann, T.J. of the Society for Tropical Veterinary Response to post-disaster health needs Medicine: Impact of Emerging Zoonotic through community-based initiatives in Diseases on Animal Health, 26 June Grenada. Invited poster presentation at 2005, Hanoi, Vietnam. the American Public Health Association’s 133rd Annual Meeting, Tsang, S., Lee, P.J., McLendon, L., Philadelphia, 10-14 December 2005. Gribbin, C.W., McCann, T.J. Effects of health education on personal hygiene Macpherson, C.N.L. The role of and sanitation knowledge in post- ultrasound in Echinococcus control disaster rural Grenada. Invited poster programs: diagnosis, treatment, presentation at the American Public surveillance and education, Plenary Health Association’s 133rd Annual paper 14th Annual Parasitology Meeting, Philadelphia, 10-14 December Congress, Izmir, Turkey, 23 Sept 2005. 2005.

Macpherson, C.N.L. The role of academic institutions in the lymphatic 12.0. Publications filariasis elimination program in the Americas, 6th Regional PAHO meeting, Asulin, Y., McCann, T.J., McCarty, on the program for the elimination of C.W., Hage, R.W., Rooney, P. J., lymphatic filariasis, Costa Rica. Macpherson C.N. L. (2004). Cancer Incidence and Mortality in Grenada: Macpherson, C.N.L. The use of 1990-2000. West Indian Medical ultrasound in the epidemiology of Journal 2004; 53 (6):368-373. parasitic disease, Invited symposium paper, American Society of Tropical Dubey, J.R., Bhaiyat, M.I., de Allie, Medicine and Hygiene, Washington, 12 C., Macpherson, C.N.L., Sharma, December 2005. R.N., Sreekumar C., Vianna, M.C., Shen, S.K., Kwok, O.C., Miska, K.B., McLendon, L., Gribbin, C.W., Tsang, Hill, D.E., Lehmann, T. (2005). S., Lee, P.J., McCann, T.J. Power of Isolation, tissue distribution, and the tool in the hand of the woman: molecular characterization of empowering Caribbean women after a Toxoplasma gondii from chickens in

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Grenada, West Indies. Journal of Caputo, Nicholas. (2005) Novel Parasitology, 91: 557-560. antimicrobial producing micro- organisms from tropical marine surfaces. Loukas, M., Louis, R.G., Kapos, T., Kwiatkowska, M. (2005). A case of a Forman, Scott. (2005) Decompression bilateral accessory digastric muscle, illness among the indigenous fishing Folia Morfologica (War) 2005, 64; 3: population of Grenadian waters: 233-236. assessing the prevalence, perceptions and burden of disease. Macpherson, C.N.L. (2005). Human behaviour and the epidemiology of parasitic zoonoses. International Journal 14.0. Seminars of Parasitology, 35, 1319 – 1331. ™ Novel Antibiotics from Tropical Noel, T.P., Zabriskie, J., Macpherson, Marine Surfaces. Nicholas Caputo. rd C.N.L. and Perrotte, G. (2005). Beta 23 February 2005. hemolytic streptococci in school children 5-15 years of age with an ™ The mutacin C-7A, a novel antimicrobial peptide. François emphasis on rheumatic fever, in the tri- nd island state of Grenada. West Indian Hallé. 2 March 2005. Medical Journal, 54, 22 – 27. ™ Reproductive Health, International Research and Ethics. Dr. Ruth Panagos, A., Lacy, E.R., Gubler, D.J. th and Macpherson, C.N.L. (2005). Macklin 16 February 2005. Dengue in Grenada. Pan American ™ Investigation of pediatric botanical Journal of Public Health,17: 225-229. medicine. Daniel Firer. 9th March

2005.

13.0. Thesis Defenses ™ The role of ultrasound in the epidemiology of parasitic disease. Cameron, Ella. (2005) Cystic Dr. Cal Macpherson. 16th March Echinococcus in Morocco: A 2005. comparative regional analysis.

™ An assessment of the effect of reacting E.coli biofilms with phage and antibiotics successively. Mathew Beeson. 23rd March 2005.

™ Diethylcarbamezine, hygiene and skin care to improve quality of life of lymphoedema patients in Guyana. Dr. Karen Cummings. 30th March Mrs. Ella Cameron MSc following 2005. her successful defense with her supervisory committee, Dr. Paul ™ Nasal carriage of staphylococcus Garner, Dr. Cal Macpherson and Dr. aureus in medical students at SGU. Zuri Amuleru-Marshall. Ashley Crisp. 6th April 2005.

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™ A comparison of two different areas filariasis in Georgetown, Guyana. in Georgetown, Guyana as it relates Edé Langevine. 5th October 2005. to KAP and prevalence of lymphatic filariasis. Edé Langevine. 13th April ™ Predator Presentation from Queen 2005. Elizabeth National Park, Uganda. Emily Hays, Hollie Schram, ™ Sickle Cell. Dr. Graham Sergeant. Christina Fernandez, Shannon Shaw 20th April 2005. and Sara Koehn. 12th October 2005.

™ Development of a biofilm model ™ Brucellosis in cattle in Queen system. Michelle Chen. 27th April Elizabeth National Park, Uganda. 2005. Samantha Zaplinski and Jill Caldwell. 19th October 2005. ™ Antagonistic properties of reef fish microflora. Cynthia Bruno. 4th May ™ Elephant crop raiding deterrent 2005. methods in Queen Elizabeth National Park, Uganda. Sarah Scott and Adam ™ Helminthiasis in Haitian Refugees. Calcutt. 19th October 2005. William Brown. 11th May 2005. ™ Chimps in Queen Elizabeth National ™ Zen of Botox. Dr. David Lennon. Park. Stacie Gallenstein. 19th th 18 May 2005. October 2005.

™ Prions and prion diseases in the ™ Helminthiasis in Haitian refugees: st USA. Dr. Paul Smith. 31 August Phase I results. William Brown. 26th 2005. October 2005.

™ Ethnobotany: Is it relevant to clinical ™ The history of methicillin resistant th medicine? Daniel Firer. 7 Staphylococcus aureus. Ashley Crisp September 2005. – Cubbage. 2nd November 2005.

™ HIV, Gender and ethics. Dr. Cheryl ™ Hospital Infections. Michelle Chen. th Cox – Macpherson. 14 September 9th November 2005. 2005. ™ Elephant crop raiding deterrent ™ Evaluating the level of perceived methods in Queen Elizabeth National fear and desentization towards Park, Uganda. Sarah Scott. 16th HIV/AIDS in Botswana, Southern November 2005. Africa. Bayela Nfila. 21st September 2005. ™ Antagonistic properties of reef fish microflora. Cynthia Bruno. 23rd ™ A new production extraction and November 2005. purification technique for mutacin C7A. François Hallé. 28th September ™ History of Bacteriophage Research 2005. 1936 – 2005. Matthew Beeson. 30th November 2005. ™ A comparative analysis of the socio- economic impact of lymphatic

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15.0. Further information

For further information please contact:

Dr. Calum Macpherson Ms. Candyce Armenti Director, Administrative Assistant WINDREF (Grenada) WINDREF (USA) P.O. Box 7, St. George’s 1 East Main Street, Suite 154 Grenada, West Indies Bay Shore, New York, 11706 Tel: 1 (473) 444-3068 United States of America Fax: 1 (473) 444-3041 Tel: 1 (800) 899-6337 E-mail: [email protected] Fax: 1 (631) 665-2796 E-mail: [email protected] Mr. Trevor Noel Assistant Director Mrs. Sue Huntington WINDREF (Grenada) Executive Secretary P.O. Box 7, St. George’s WINDREF (UK) Grenada, West Indies Kingdon’s Yard, Parchment Street Tel: 1 (473) 444-3997 Winchester, Hampshire, SO 23 8AT Fax: 1 (473) 444-3041 United Kingdom E-mail: [email protected] Tel: 01962 850650 Fax: 01962 850567 Mrs. Isha English E-mail: [email protected] Administrative Assistant WINDREF (Grenada) Dr. Svetlana Kotelnikova P.O. Box 7, St. George’s Director Grenada, West Indies CERI Tel: 1 (473) 444-3997 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 Fax: 1 (473) 439-1845 Ms. Meg Conlon E-mail: [email protected] Executive Secretary WINDREF (Grenada) 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]