Development of a Pilot Literacy Scale to Assess Knowledge, Attitudes, and Behaviors towards Climate Change and Infectious Disease Dynamics in Suriname

Prior research has shown that climate literacy is sparse among low- and middle-income countries. Additionally, no standardized questionnaire exists for researchers to measure climate literacy among general populations, particularly with regards to climate change effects on vector-borne diseases (VBDs). We developed a comprehensive literacy scale to assess current knowledge, attitudes, and behaviors towards climate change and VBD dynamics among women enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort in Suriname. Items were generated by our research team and reviewed by a group of six external climate and health experts. After the expert review, a total of 31 climate change and 21 infectious disease items were retained. We estimated our sample size at a 10:1 ratio of participants to items for each scale. In total, 301 women were surveyed. We validated our scales through exploratory (n = 180) and confirmatory factor analyses (n = 121). An exploratory factor analysis for our general Climate Change Scale provided a four-construct solution of 11 items. Our chi-squared value (X2 = 74.32; p = 0.136) indicated that four factors were sufficient. A confirmatory factor analysis reinforced our findings, providing a good model fit (X2 = 39.03; p = 0.23; RMSEA = 0.015). Our Infectious Disease Scale gave a four-construct solution of nine items (X2 = 153.86; p = 0.094). A confirmatory factor analysis confirmed these results, with a chi-squared value of 19.16 (p = 0.575) and an RMSEA of 0.00. This research is vitally important for furthering climate and health education, especially with increases in VBDs spread by Aedes mosquitoes in the Caribbean, South America, and parts of the southern United States

HIV-1 Genetic Diversity and Drug Resistance Mutations Among Treatment-Naive Adult Patients in Suriname

International audienceThe molecular epidemiologic profile of HIV-1 in Suriname was determined through protease (PR) and reverse transcriptase (RT) sequences obtained from HIV-1 strains collected from 100 drug-naive HIV-1-infected persons. Subtype determination revealed that most viruses were of subtype B (94.9%) in both PR and RT genomic regions, followed by B/D recombinants (5.1%). Analysis of drug resistance mutations showed only one transmitted dug resistance mutation (TDRM) (V75M) in a single strain. The genetic data obtained can serve as a baseline for Suriname to monitor emerging mutations. This study reveals that the HIV-1 epidemic in Suriname is still characterized by a low TDRM rate (1%) and a low level of subtype diversity. However, both genes display a high genetic polymorphism. This high polymorphism may ultimately lead to drug resistance. Continuous monitoring of the baseline resistance is therefore a prerequisite to safeguard effective long-term treatment for people living with HIV-1 in Suriname

A scoping review of current climate change and vector-borne disease literacy and implications for public health interventions

Climate literacy assesses general understanding of climate, climate change, and its effects on the environment as well as human health. Despite vast scientific evidence to support climate change and its associated consequences, particularly with regards to vector-borne diseases, climate change knowledge, attitudes, and behaviors among the general population is relatively poor. In this study, we conducted a thorough review of the current literature to evaluate the scope of global climate and health literacy studies and identify key areas for improvement. We found that very few climate and health literacy studies were based in low- and middle-income countries, and those that were did not make mention of significant regional climate change impacts and specifically those that increase mosquito-borne disease transmission in high-risk areas. We also noted that of the twenty-three studies included in our final review, most focused their assessments on general climate and climate change knowledge, and not on literacy of the relationships between climate change and environmental impacts or subsequent health outcomes. Our findings make it clear that moving forward, there is a major need for climate and health literacy research to expand upon existing climate literature to include additional assessments of the relationships between certain climate change impacts and infectious diseases in particular, as well as to make available a more comprehensive overview of climate and health information to the public in the future

Sociodemographic Influences on Perceived Stress during Pregnancy: Results from the CCREOH Environmental Epidemiologic Study, Suriname

Screening for prenatal stress is not routine in Suriname, despite its significant impact on maternal and newborn health. This study assessed the prevalence of high perceived prenatal stress and its sociodemographic predictors in three geographic areas in Suriname. In this cross-sectional study, data from 1190 participants of the Caribbean Consortium for Research in Environmental and Occupational Health cohort study were analyzed. Cohen’s Perceived Stress Scale was completed during pregnancy to ascertain high perceived stress (cut-off score 20). The association between maternal sociodemographic factors and high perceived stress was examined using the chi-square test and logistic regression models; 27.5% of all participants had high perceived stress with statistically significant lower rates in Nickerie (18.8%) compared with Paramaribo (29.8%; p = 0.001) and the Interior (28.6%; p = 0.019). Maternal sociodemographic factors moderated the difference between the Interior and Nickerie. Participants from Paramaribo had statistically significant higher odds of high perceived stress compared to those from Nickerie, independent of their age and educational level (adjusted OR = 1.94; 95% confidence interval 1.32–2.86). Perceived stress during pregnancy is predicted by sociodemographic factors. These findings identified target groups for interventions in Suriname. Policy makers should consider integrating perceived stress assessment as a routine part of prenatal care

Factors associated with COVID-19 length of hospitalization and mortality during four epidemic waves, March 2020–November 2021, Suriname

Objectives. To determine the sociodemographic risk factors associated with coronavirus disease 2019 (COVID-19) mortality in Suriname. Methods. This was a retrospective cohort study. All registered deaths from COVID-19 in Suriname (n=1112) between March 13, 2020 and November 11, 2021 were included. Data were collected from medical records and included demographic variables and hospitalization duration of patients who died. Descriptive statistics, chi-squared tests, ANOVA models, and logistic regression analyses were used to determine associations between sociodemographic variables, length of hospitalization, and mortality during four epidemic waves. Results. The case fatality rate over the study period was 22 per 1 000 population. The first epidemic wave was from July to August 2020, the second from December 2020 to January 2021, the third from May to June 2021, and the fourth from August to September 2021. Significant differences were found in the number of deaths and hospitalization duration by wave (p<0.001). Patients were more likely to have a longer hospitalization during the first (OR 1.66; 95% CI: 0.98, 2.82) and third waves (OR 2.37; 95% CI: 1.71, 3.28) compared with the fourth wave. Significant differences in mortality were also seen between ethnicities by wave (p=0.010). Compared with the mixed and other group, people of Creole ethnicity (OR 2.7; 95% CI: 1.33, 5.29) and Tribal people (OR 2.8; 95% CI: 1.12, 7.02) were more likely to die during the fourth wave than the third wave. Conclusions. Tailored interventions are needed for males, people of Creole descent, Tribal and Indigenous peoples, and people older than 65 years

Characterization of Urinary Pesticide Metabolite Concentrations of Pregnant Women in Suriname

Prenatal exposure to pesticides and the association with adverse health outcomes have been examined in several studies. However, the characterization of pesticide exposure among Surinamese women during pregnancy has not been assessed. As part of the Caribbean Consortium of Research in Environmental and Occupational Health research program, 214 urine samples were collected from pregnant women living in three regions in Suriname with different agricultural practices: capital Paramaribo, the rice producing district Nickerie, and the tropical rainforest, the Interior. We used isotope dilution tandem mass spectrometry to quantify urinary concentrations of biomarkers of three pesticide classes, including phenoxy acid herbicides and organophosphate and pyrethroid insecticides, all of which are commonly used in agricultural and residential settings in Suriname. We observed that participants residing in Nickerie had the highest urinary metabolite concentrations of 2,4-dichlorophenoxyacetic acid and pyrethroids compared to those from Paramaribo or the Interior. Paramaribo had the highest concentrations of organophosphate metabolites, specifically dialkyl phosphate metabolites. Para-nitrophenol was detected in samples from Paramaribo and the Interior. Samples from Nickerie had higher median urinary pesticide concentrations of 2,4-dichlorophenoxyacetic acid (1.06 μg/L), and the following metabolites, 3,5,6-trichloro-2-pyridinol (1.26 μg/L), 2-isopropyl-4-methyl-6-hydroxypyrimidine (0.60 μg/L), and 3-phenoxybenzoic acid (1.34 μg/L), possibly due to residential use and heavy rice production

Influence of prenatal exposure to mercury, perceived stress, and depression on birth outcomes in suriname: Results from the mekitamara study

Prenatal exposure to mercury, stress, and depression may have adverse effects on birth outcomes. Little is known on the influence of chemical and non-chemical stressors on birth outcomes in the country of Suriname. We assessed the influence of prenatal exposure to mercury, perceived stress, and depression on adverse birth outcomes in 1143 pregnant Surinamese women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study. Associations between mercury (≥1.1 µg/g hair, USEPA action level/top versus bottom quartile), probable depression (Edinburgh Depression Scale ≥12), high perceived stress (Cohen’s Perceived Stress Scale ≥20), and adverse birth outcomes (low birthweight (<2500 g), preterm birth (<37 completed weeks of gestation), and low Apgar score (<7 at 5 min)) were assessed using bivariate and multivariate logistic regressions. Prevalence of elevated mercury levels, high perceived stress, and probable depression were 37.5%, 27.2%, and 22.4%, respectively. Mercury exposure was significantly associated with preterm birth in the overall study cohort (OR 2.47; 95% CI 1.05–5.83) and perceived stress with a low Apgar score (OR 9.73; 95% CI 2.03–46.70). Depression was not associated with any birth outcomes. These findings can inform policy-and practice-oriented solutions to improve maternal and child health in Suriname