W Indian Med J
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The prevalence of nocturnal enuresis has been investigated in 477 children (243 boys, 234 girls) attending government Basic Schools in Kingston, Jamaica. Enuresis, defined as wet at least 2 nights a week, occurred in 62%, 48%, 42% and 40% at 2, 3, 4 and 5 years of age, respectively. Enuresis, defined as wet at least one night a month, occurred in 68%, 58%, 53% and 52%, respectively. ⋯ Children with a family history of enuresis (first degree relatives wet beyond 8 years of age) were more likely to be enuretic than those with no family history, the difference reaching statistical significance for girls (less than 0.001) and for the sexes combined (p less than 0.001) but not for boys alone (p = 0.06). The prevalence of nocturnal enuresis in Jamaican children is higher than reported for Black children elsewhere, which in turn is higher than in their White counterparts. Cultural attitudes to bedwetting contribute to this variation and have implications for choice of therapy, both in Jamaica and elsewhere.
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The developments in the field of childhood disability in the English-speaking Caribbean are reviewed with recent information on prevalence, needs in services, early intervention and low cost, community-based services. These developments make the possibility of providing coverage in services much more optimistic than it was 10 years ago. Needs in training, research and dissemination of information to appropriate agencies and organisations are suggested.
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This article highlights an outbreak of food poisoning, the result of ingestion of Ciguatoxin-infected fish in a community. The case presentations of the patients involved are used to illustrate the clinical aspects of Ciguatoxin poisoning. The public health aspects of this incident and their relevance to disease surveillance are then discussed. Information of significance to general medical practice in relation to this particular type of fish poisoning, the effect of which could prove fatal in some cases, is also discussed.
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The Casualty Department of the University Hospital of the West Indies (UHWI) has evolved in an ad hoc manner over the last decade, and questions regarding its appropriateness and effectiveness as an Emergency Department persist. This study of 100 systematically-selected patients attempts to assess time utilization during transit, as dictated by the present system of patient management. Time to first contact averaged 2 hr 38 min (158 min). ⋯ Actual contact time with casualty officers averaged only 8.3 min. Referrals to specialist services constituted 11% of the sample, and overall mean waiting time for specialists was 2 hr 16 min (136 min) with a mean contact time of 48 min. Given that the mean total time of 3 hr 46 min is not inordinately long in a public health system such as ours, the recommendation is being made for a modified coding and triage system to reduce time to first contact for more urgent cases.