BackgroundTo determine the prevalence of abuse by their partners and its association with mental disorders among female patients at walk-in clinics in Trinidad.MethodsFemale participants from 16 randomly selected walk-in clinics, previously stratified to represent all administrative regions and urban and rural settings, who were 18 years or older, were surveyed during May to August 2007 using the WAST-Short and PRIME-MD questionnaires.Results432 women participated (a 92% response rate), Of these 16% were aged 20-29, 11.8% 30-39 and 19% 40-49; 37% were married, 25% single; 44.7% were Indo- and 35% Afro-Trinidadian; 67.8% had achieved education up to age 14 only. 30.3% were employed and 3.0% reported incomes more than $5,001 TTD (Trinidad and Tobago Dollars) per month. Forty percent (173) of all respondents were positive for abuse as scored by the WAST-Short scale. Chi-square analysis suggested associations (p < 0.05) between abuse and age, employment status, being in a current relationship, and having the desire to cut down on alcohol intake. Further there were associations between abuse and the presence of depression, suicidal ideation, post-traumatic stress disorder and somatization as determined by the PRIME-MD scale. Logistic regression showed that the statistically significant (p < 0.05) predictors of woman abuse were age less than 49, wanting to cut down on alcohol use and currently being in a relationship.ConclusionAmong women of primarily lower socioeconomic status who attend walk-in clinics in Trinidad abuse as measured by the WAST-Short scale is high and there are statistically significant associations with mental disorders as determined by the PRIME-MD scale.
The objective of this study was to design a reliable, valid and culturally appropriate risk questionnaire and determine its effectiveness as a tool for the early detection of type 2 diabetes mellitus in Trinidad. Initially, a questionnaire with 21 close-ended questions on known risk factors for diabetes was administered to 456 patients, and a series of logistic regressions extracted the most significant factors (p<0.05). These factors were scored using their odds ratio and a tool/questionnaire was created and administered to 232 patients. The scoring system was revised following logistic regressions using combined data from both phases and a cut-off score determined with suitable specificity/sensitivity ratios. Trinidad Risk Assessment Questionnaire for Diabetes (TRAQ-D) was compared to body mass index (BMI) and age independently, using receiver operating characteristic (ROC) curves. TRAQ-D, includes seven factors: age, sex, BMI, family history of diabetes, ethnicity, smoking and waist circumference. A score ≥ 17 was used to recommend further testing (specificity: 90.7%, sensitivity: 61.4%). Compared with BMI and age, the area under the ROC curve for TRAQ-D was significantly higher (0.884). TRAQ-D is the only currently available non-invasive screening tool for type 2 diabetes that has been created and tested in the Trinidad population. It is reliable, inexpensive and a useful indicator of the need for any further screening tests.
The determinants of quality of life for patients on renal replacement therapy vary across the world. The aim of this study is to determine the quality of life of patients on renal replacement therapy in Trinidad and Tobago and predictors thereof. Patients and Methods: This cross-sectional study took place over a 1-year period. Data were obtained from 530 out of 1383 patients meeting inclusion criteria (100 transplants, 80 peritoneal dialyses, 350 hemodialyses) using the survey instruments. Stratified random sampling with proportional allocation was used to select patients at hemodialysis centres. The Kidney Disease Quality of Life questionnaire (KDQOL-36), EuroQol and demographic questionnaires were administered via face-to-face interviews. SPSS24, STATA14 and MINITAB18 were used for descriptive and inferential data analysis. Results: Of the 530 patients, 52.5% were male, 37.5% were in the 56-65 years age group and 51.3% were of Indo-Trinbagonian descent. Hypertension (25.5%) and type 2 diabetes mellitus (62.0%) were reported as the main causes of kidney disease in the dialysis group. In the transplant category, chronic glomerulonephritis (45%) was the main aetiology of kidney disease. The KDQOL-36 domain scores and significantly associated variables included modality of renal replacement, Charlson's Comorbidity Index, ethnicity, income and employment status. Transplant patients had higher mean subcomponent Kidney Disease Quality of Life scores and performed better in the EuroQol than patients on dialysis. Patients on peritoneal dialysis had a better quality of life than hemodialysis patients. Among patients on hemodialysis, an arteriovenous fistula significantly impacted their quality of life. Conclusion: Renal transplant recipients enjoy the best quality of life and health state among patients on renal replacement therapy in Trinidad and Tobago. Increasing patients' access to renal transplantation or peritoneal dialysis will markedly improve health status for the number of years of renal replacement therapy.
Background: The options for renal replacement therapy for end stage renal disease include haemodialysis (HD), peritoneal dialysis (PD) and renal transplantation. In this study demographic, sociocultural and biological factors were assessed over a 1-year period for patients on renal replacement therapy. Methods: This cross-sectional study included all patients 18 years and older and on renal replacement therapy for at least 3 months in Trinidad and Tobago. Five hundred and thirty participants were recruited from our organ transplantation unit, all centres facilitating PD and a stratified random sample of all HD centres (100 T, 80 PD, 350 HD from October 2015 to October 2016. A questionnaire was administered and included demographics, knowledge and understanding and biological factors impacting on renal replacement therapy. Results: Thirty eight percent of all patients were between 56 to 65 years of age. The Indo Trinidadian population accounted for 51% of the subjects. 52.5% were male and 47.5% were female. From the data, 72% of patients were diabetic and/or hypertensive. In the transplant recipients, 39% were diabetic and/or hypertensive and 27% reported chronic glomerulonephritis as the aetiology of their kidney failure. The diagnosis of chronic kidney disease was made when patients were at end stage renal disease requiring intervention in 84.2% of persons. The employed population of patients constituted 65% of renal transplant recipients, 43.75% of peritoneal dialysis patients and 22.86% of haemodialysis patients. The patient's physician had the greatest influence on renal replacement therapy choice (85.4% haemodialysis, 85% peritoneal dialysis, 71% transplant
Purpose:The determinants of quality of life for patients on renal replacement therapy vary across the world. In this cross sectional study, the factors accounting for a good quality of life in the resource-constrained twin-island of Trinidad and Tobago will be explored.Patients and methods:Five hundred and fifty three patients met inclusion criteria for the study. From the 103 patients receiving renal transplants, 100 participated and among the 84 on peritoneal dialysis, 80 took part in the study. Among the 1000-odd patients who were receiving hemodialysis, 350 were studied using convenience sampling. To be included, one had to be on renal replacement therapy for 3 months or more and at least 18 years of age. The Kidney Disease Quality of Life (KDQOL-36) and the EuroQol (EQ-5D-3L) instruments were administered after demographic data was collected. Transplant recipients were further evaluated with the Kidney Transplant Questionnaire (KTQ). Inferential analysis of data included 95% confidence intervals, ordinary least squares regression, analysis of variance, pairwise correlation and Pearson’s bivariate analysis. SPSS24, STATA14 and MINITAB18 were used.Results:Of the 530 patients, 52.5% were male, 37.5% were in the 56-65 years age group and 51.3% were of Indo-Trinbagonian descent. Hypertension (25.5%) and type 2 diabetes mellitus (62.0%) were reported as the main causes of kidney disease in the dialysis group. In the transplant category, chronic glomerulonephritis (45%) was the main aetiology of kidney disease. The KDQOL-36 domain scores and significantly associated variables included modality of renal replacement, Charlson’s Comorbidity Index, ethnicity, income and employment status. Transplant patients performed the best in the KDQOL-36 and EQ-5D-3L. Patients on peritoneal dialysis had a better quality of life than hemodialysis patients. Increasing patients’ access to renal transplantation or peritoneal dialysis will markedly improve health status for the number of years on renal replacement therapy. Among patients on hemodialysis, an arteriovenous fistula or graft significantly impacted on quality of life.Conclusion:Renal transplant recipients enjoy the best quality of life and health state among patients on renal replacement therapy in Trinidad and Tobago. Given the limitations in resources, patients on peritoneal dialysis also enjoy a good quality of life while the presence of an arteriovenous fistula or graft improved quality of life scores for those receiving hemodialysis. Policies should be implemented to achieve an acceptable quality of life for all patients receiving renal replacement therapy.
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