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Keenan J.,University of Alabama at Birmingham | Ervin G.,University of Alabama at Birmingham | Aung M.,Western Regional Health Authority | McGwin Jr. G.,University of Alabama at Birmingham | Jolly P.,University of Alabama at Birmingham
American Journal of Tropical Medicine and Hygiene

A retrospective, matched case-control study was conducted in Jamaica's Western Regional Health Authority (WRHA). Forty-three individuals developing clinical leptospirosis between January 2005 and December 2007 (i.e., cases) were age and neighborhood matched to 89 controls. Odds ratios (OR) and associated 95% confidence intervals (CIs) and the relative excess risk due to interaction (RERI) were calculated. Cases had increased odds of contact with rodents OR 3.52, goats OR 3.38, and being engaged in outdoor labor OR 5.30. Knowledge of leptospirosis and indoor work was protective, OR 0.39 and OR 0.16, respectively. Positive RERI values were noted for joint exposure to rodents and goats (RERI 5.54), outdoor labor and goats (RERI 6.97), and outdoor labor and rodents (RERI 30.59). Our results suggest a synergistic effect of occupational and environmental exposures on clinical human leptospirosis from the WRHA. Knowledge of the disease and its risk factors allows for protection from the disease. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene. Source

Monroe C.E.,University of Alabama at Birmingham | Affuso O.,University of Alabama at Birmingham | Martin M.Y.,University of Alabama at Birmingham | Aung M.,Western Regional Health Authority | And 2 more authors.
The West Indian medical journal

There is a paucity of studies on psychosocial disorders in clinic populations in Jamaica. Therefore, we sought to determine the prevalence and correlates of symptoms of depression and anxiety in a clinic population in western Jamaica. A total of 338 participants from four outpatient clinics of : A total of 338 participants from four outpatient clinics of the Western Regional Health Authority (WRHA) were screened for symptoms of depression and anxiety using questions from the Beck Depression Inventory-II and the Beck Anxiety Inventory. The Chi-square test was used to examine differences in symptoms of anxiety and depression by gender. Multivariate linear and logistic regression were used to examine the associations between symptoms and sociodemographic variables with significance set at p<0.05. Approximately 30% of participants had moderate or severe depression symptoms while 18.6% had moderate or severe anxiety symptoms. Participants aged 30-39 years were more likely than older participants to have moderate or severe anxiety symptoms (odds ratio [OR]: 2.0, 95% confidence interval [CI]: 1.39, 5.56). Women reported a statistically significant higher prevalence of anxiety symptoms (10.0% vs 7.1%, p = 0.003). There was also a statistically significant difference between anxiety means by gender. Furthermore, income was found to be a significant predictor of anxiety for women only (p = 0.0113). Married persons were more likely than those who had never married to have moderate or severe anxiety symptoms (OR: 2.57, 95% CI: 1.14, 5.76). Our findings suggest that the prevalence of depression may be higher than global estimates in similar outpatient settings. Screening and intervention efforts may need to focus on younger persons, women, and married persons. Source

Capanna C.,University of Alabama at Birmingham | Chujutalli R.,University of Alabama at Birmingham | Murray S.,Western Regional Health Authority | Lwin K.,Western Regional Health Authority | And 2 more authors.
Preventive Medicine Reports

To conduct and evaluate the impact of a theory-based health education intervention on awareness of prostate cancer and intention to screen among men in Western Jamaica and determine screening rates of men participating in the intervention at 6 months post-intervention. 454 men utilizing various clinics and hospitals in Western Jamaica completed an interviewer-administered pretest survey on general prostate cancer knowledge and intention to screen. Upon completing the pretest, participants observed a prostate cancer health education intervention and immediately completed a posttest survey. Statistically significant improvements in the percentage of correct responses between the pretest and posttest were evident (p < 0.05). Additionally, screening rates increased dramatically by 6 months post-intervention with over 33% of men receiving a prostate exam after participating in the educational intervention. The theory-based educational intervention increased participants' knowledge of prostate cancer, types of screening tests, frequency of screenings and risk factors and symptoms, and was effective in increasing screening rates among the men in Western Jamaica within 6 months post-intervention. This theory-based educational intervention may be replicated to promote awareness of prostate cancer and further increase screening rates in other areas of Jamaica and other developing countries. © 2015. Source

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