Santo Domingo.- This Tuesday morning, Minister of Public Health, Víctor Elías Atallah Lajam, reassured the public by stating that the health sector remains calm, as there is no significant overload of dengue cases in the country.

Atallah announced the commencement of the first national dengue day, marking the launch of a preemptive campaign to mitigate the potential outbreak. He emphasized the government’s proactive stance in averting a crisis that could potentially mirror the severe outbreaks experienced in other countries across the Americas.

The Pan American Health Organization (PAHO) had previously issued a warning in March, predicting the worst dengue season in history for the American continent. This alarming prognosis is largely attributed to the global rise in temperatures and extreme weather events.

PAHO Director, Jarbas Barbosa, highlighted the gravity of the situation, citing that last year witnessed 4.5 million dengue cases, with the current year already tallying 3.5 million cases. This surge indicates the likelihood of the worst dengue season on record for the Americas. Barbosa stressed the imperative for countries experiencing heightened transmission rates to intensify preventive efforts to curb the disease’s spread.

During a virtual press conference, Barbosa presented the latest data on dengue, revealing that as of March 16, the American continent had reported over 3.5 million cases and more than 1,000 deaths attributed to the disease.

The announcement came at a ceremony to celebrate the World Health Organisation’s (WHO) recognition of the Best-dos Santos Public Health Laboratory as a National Influenza Centre and a member of the WHO Global Influenza Surveillance and Response System (GISRS).

Mottley emphasised the inevitability of another pandemic and the need to learn from the COVID-19 experience.

“Pandemics are usually a cycle of panic and neglect and it is up to us as a government and as an institution, or as institutions like PAHO and WHO, to ensure that that panic and neglect is removed from our experience in preparation for the next pandemic and we, as a government, are choosing to walk the walk and not just talk the talk,” she said.

The prime minister highlighted the country’s recent investments in public health infrastructure, including the Best-dos Santos Lab and the upcoming Barbados Living Lab, which will provide enhanced research capabilities in various areas.

“The continued investment in the Barbados Living Lab, which carries us outside of the narrow confines of only monitoring and diagnosis, but looking also at research, is important to us because we do not believe that our people are just drawers of water and hewers of wood, but our people have the capacity also to be at the cutting edge of the research capabilities that we need in this world to make lives better,” she said.

Mottley also revealed ongoing conversations with pharmaceutical producers to build a regulatory framework for the industry, with the aim of positioning Barbados as more than just a “fill and finish” hub, but a key player in pharmaceutical research and development.

These efforts, according to the PM, are not only aimed at pandemic preparedness but also at preventing brain drain by creating local employment opportunities in the growing healthcare and pharmaceutical sectors.

She said: “This country cannot continue to invest hundreds of millions of dollars in ensuring that our citizens can be the best that they can be by studying at the University of the West Indies and then not have opportunities for them to remain in the land of their birth, simply because we do not have the opportunities for them to work.

“The Best-dos Santos Lab immediately presented an opportunity for us to create employment for dozens of persons who have contributed to their own development by making the effort of studying and providing themselves with the skills, only then to be topped up by the international partnerships that we have.”

Prime Minister Mottley added: “We have to continue to see this as an area not just of social stability that is necessary for public health excellence, but also as an investment opportunity so that regulation can become part and parcel of Barbados’ competitive advantage over other countries in the region and the hemisphere.” (SM)

The post ‘Getting ready’ appeared first on Barbados Today.

A simple blood test every five years is sufficient to screen low risk men for prostate cancer, new research has shown.

The PSA blood test checks the level of prostate-specific antigen, a marker for prostate cancer. In Europe, only Lithuania routinely screens men for prostate cancer based on their PSA levels, as the test has historically been seen as insufficiently reliable.

The German study, presented at the European Association of Urology (EAU) Congress in Paris today [April 6, 2024], involved over 12,500 men aged between 45-50 taking part in the ongoing PROBASE trial, which is testing different prostate cancer screening protocols.

The research has also been accepted for publication in European Urology.

PROBASE is recruiting men aged 45 and splitting them into three groups based on their initial PSA test. Men with a PSA level of under 1.5 nanograms per millilitre (ng/ml) are deemed low risk and followed up with a second test after five years. Men with a PSA level between 1.5-3 ng/ml are deemed intermediate risk and followed up in two years. Those with a PSA level over 3 ng/ml are seen as high risk and given an MRI scan and biopsy.

Of over 20,000 men recruited to the trial and deemed low risk, 12,517 have now had their second PSA test at age 50. The researchers found that only 1.2% of these (146 in total) had high levels of PSA (over 3 ng/ml) and were referred for an MRI and biopsy. Only 16 of these men were subsequently found to have cancer – just 0.13% of the total cohort.

The EAU recommends that men should be offered a risk-adapted strategy (based on initial PSA level), with follow-up intervals of 2 years for those initially at risk, in which they include men with PSA over 1 ng/ml. The new findings suggest that the screening interval for those at low risk could be much longer with minimal additional risk.

Lead researcher, Professor Peter Albers, from the Department of Urology at Heinrich-Heine University Düsseldorf, explained: “By raising the bar for low risk from 1 ng/ml to 1.5, we enabled 20% more men within our cohort to have a longer gap between tests and very few contracted cancer in that time. With nearly 14 million men aged between 45-50 in Europe, the numbers affected by such a change would be significant. Our study is still underway, and we may find that an even longer screening interval, of seven, eight or even ten years, is possible without additional risk.”

Prostate cancer screening has historically been a controversial subject, with concerns raised both around false positives leading to unnecessary invasive treatments and false negatives leading to cancers being missed. This is gradually changing due to MRI scans which can avoid unnecessary biopsies and the use of ‘active surveillance’, where men with early-stage cancer are monitored and only undergo treatment if their disease progresses.

Prostate cancer screening guidelines contradictory and unclear

Current guidelines and policies from European governments and health bodies remain contradictory and unclear, leading to high levels of opportunistic testing and inequality of access to early diagnosis, according to further research presented at the EAU Congress. The study reviewed early detection policies across the European Union and carried out focus groups with urologists to identify how guidelines were interpreted in clinical practice.

Dr Katharina Beyer, from the Department of Urology at the Erasmus MC Cancer Institute in Rotterdam, Netherlands carried out the research. She said: “Some country’s guidelines are actively against screening, others are non-committal and a few, such as Lithuania, have some form of screening. But in many countries, if you ask for a test, you can get one, sometimes free and sometimes not. This means that well-educated men, who know about PSA tests are more likely to be screened and get an early diagnosis, while others with less knowledge are at a disadvantage.”

This is also the situation in the UK, according to Professor Phillip Cornford, from Liverpool University Hospitals NHS Trust, who chairs the EAU Prostate Cancer Guidelines Committee.

Professor Cornford said: “The NICE guidelines here in the UK are incongruous. They say there’s no evidence that PSA screening is worthwhile, but at the same time say any man can ask for a PSA test if they want it. The result is that well-educated, driven men ask and others, including many Afro-Caribbean men who are actually at higher risk, don’t ask and so prostate cancers get missed.

“There is clearly a need for more organised prostate cancer screening and last November, the UK government and the charity, Prostate UK, announced a £42m research programme to look at this. The details of that should soon be made public. Each country will need to design a screening programme that fits their health system and the resources they have available. But there is still plenty we can learn from other countries and the work underway in the EU. New findings, such as those from the PROBASE trial, can help us design an appropriate screening programme both in the UK and elsewhere.”

Reference:

Five-year interval is safe for prostate cancer screening, research shows, European Association of Urology, Meeting: EAU24 European Association of Urology Congress.

In an age dominated by screens and sedentary lifestyles, the call for physical activity has never been more urgent, especially for our school-age children. The mental, physical and cognitive benefits of physical activity have been unequivocally proven. Yet there remains a glaring deficit in physical activity opportunities within schools, particularly in regions like the Caribbean, including Jamaica, where the burden of non-communicable diseases (NCDs) looms large over public health systems. If implemented as intended, the proposed Jamaica School Nutrition Policy could help to facilitate more physical activity opportunities for generations to come.

For school-age children, regular physical activity is crucial for their growth and development. It not only helps them maintain a healthy weight but also fosters stronger bones and muscles, improves cardiovascular health, and boosts mood and cognitive function. Too much sedentary behaviour – or periods of sitting or lying down with little to no movement- can also increase the risk of obesity and affect sleep duration. Active children are more likely to develop lifelong habits of physical activity, reducing their risk of developing NCDs later in life. 

Beyond the benefits, states also have an obligation to provide children with access to the highest attainable standard of health which includes opportunities to be active and to engage in play, as they are signatories to the Convention on the Rights of the Child (CRC). Yet, according to recent statistics, a significant percentage of school-age children in the region do not meet the recommended levels of physical activity as almost two thirds are insufficiently physically active, over 40% are sedentary, and over 20% are physically inactive, more frequent among girls than boys. Factors such as limited access to sports facilities, lack of physical education classes, and sedentary lifestyles exacerbated by excessive screen time contribute to this concerning trend. Thus, it is imperative that they are provided with multiple, diverse opportunities to be active. For instance, skipping, dancing, or cycling are examples of aerobic exercises. Playing on playground equipment is an example of a muscle-building activity; and engaging in sports like basketball or running and hopscotch are examples of bone-strengthening exercises.

Schools continue to be a critical environment for facilitating healthy habits. Children spend more time in school than in any other setting.  Thus there is a need for sustained and strategic physical activity interventions within the school setting. The Ministry of Health and Wellness (MOHW) deserves credit for actively promoting the increased level of physical activity through initiatives like Jamaica Moves in School, which started in 2018. One of the three components of the project, which is a collaboration between the Ministry and the Ministry of Education and Youth (MOEY) is to increase physical activity. In addition, a number of initiatives have been carried out under this programme, including the Jamaica School Ambassador programme, which selects teachers and students to support the message of fostering a healthier school environment, and National School Moves Day, which is scheduled for April 26 and encourages schools across the island to participate in one hour of physical activity for the day. 

However, there is more that can be done to facilitate a comprehensive approach to physical activity, elements of which are proposed in the National School Nutrition Policy Green Paper. The last available version of the policy includes the need to provide:

• Physical activities for children from early childhood to grade 13
• Three five-minute physical activity breaks per day
• A minimum of one hour of physical activity per week
• Physical education in schools as guided by the curriculum
• A safe, secure, and suitable play area for all students
• Access to safe and age-appropriate physical activity facilities and equipment  

Beyond these factors, the World Health Organisation (WHO) encourages member states to adopt a whole-of-school approach to promoting physical activity which includes active classrooms (movement during class), quality physical education, facilitation of physical activity opportunities before and after school, at playtime and active transportation.

The need to urgently prioritize proactive public health interventions, such as the School Nutrition Policies is critical given its wider impact on the public health system. NCDs such as diabetes, hypertension, and obesity are on the rise, placing an immense burden on healthcare resources and diminishing the quality of life for affected individuals. In Jamaica alone, NCDs account for a substantial portion of the country’s healthcare expenditure, diverting funds away from other crucial areas of health promotion and care.

In 2025, the Fourth High-level Meeting on NCDs will be held where heads of governments will assess the progress on 9 voluntary global targets for the prevention and control of NCDs, including physical activity. It is not too late for Jamaica and the wider Caribbean to shine in prioritizing strong comprehensive policy action as recommended by the Caribbean Moves which was recently endorsed by CARICOM, and the 2023 Bridgetown Declaration on NCDs and Mental Health. 

To address this pressing issue, action must be taken now, and it starts with prioritizing physical activity within schools. First and foremost, the government must urgently implement the proposed School Nutrition policy and consider collaboration between schools, communities, and healthcare providers to promote and sustain physical activity in and beyond the school setting.

In addition, priority should be given to:

•  Building Awareness: Continue with efforts such as Jamaica Moves as a physical activity awareness and promotion mechanism so that all, including teachers and parents should be educated about the benefits of physical activity to support and encourage children in their pursuits. As guided by the WHO and PAHO, the campaign to enhance awareness should also highlight the social, economic, and environmental co-benefits of physical activity. For example, facilitation of active transportation such as walking and cycling can reduce carbon emissions and help to mitigate climate change.  
• Active Environments: The government should be commended for its intention to establish parks across the island. Ensure that these are also safe and accessible spaces for children to engage in physical activity outside of school hours. 
• Continuous Monitoring and Evaluation: Regular monitoring and evaluation of physical activity programs and policies within schools are essential to assess their effectiveness and make necessary adjustments to ensure long-term success.

Finally, adults, including teachers, parents, and community leaders, should serve as positive role models by prioritizing their own physical activity and demonstrating its importance through their actions.

The time to act is now. By prioritizing physical activity within schools and communities, we can empower our children to lead healthier lives, reduce the burden of NCDs on our public health system, and pave the way for a brighter and more active future. 

We join our voices with other advocates in asking: Why delay the implementation of a policy crucial for the current and future health and wellness of the nation’s children?

Offniel Lamont is the Physiotherapist at the G.C. Foster College of Physical Education and Sport. He holds a Masters degree from University College London (UCL) in Sports Medicine, Exercise, and Health whose focus area is leveraging exercise as a powerful tool in the prevention and treatment of sports injuries and NCDs. Lamont’s commitment also extends to empowering Caribbean youth as a dedicated advocate within the Healthy Caribbean Coalition.

Danielle Walwyn is the Advocacy Officer for the Healthy Caribbean Coalition’s Childhood Obesity Prevention and Healthy Food Policy Programme. She holds a Masters degree from Queen’s University (Canada) with a specialization in Health Promotion and a focus on physical activity. 

The post Are We Subjecting Our Children To Poor Health Outcomes? appeared first on Healthy Caribbean Coalition.

“The ministries of Health, Mental Health, Wellness, and Religious Affairs announce the resumption of visits to Mt Gay Hospital effective Saturday, 6 April 2024”

View the full post Resumption of visits to Mt Gay Hospital on NOW Grenada.

President Irfaan Ali on Friday announced that government was willing to “bring in” doctors to address a backlog of cases in the public health sector if those already in the system would be unable to do so. “If we have a backlog in a specific area, which are these areas and which areas will require ...

View the full post National Primary School Nutrition Quiz Finals 2024 on NOW Grenada.

World Health Day: PAHO reaffirms its commitment to the right to health for all people

Cristina Mitchell

5 Apr 2024