The dentition of 27 enslaved African Americans from archaeological sites in Maryland and Virginia were examined. All 17 males and 7 of the 10 females in this study exhibited enamel hypoplastic defects indicative of systemic nutritional and disease stresses interfering with amelogenesis. Estimates of the ages of occurrence of these defects show that most occur between 1.5 and 4.5 years of age, 0.5-3.75 years later than historically documented weaning age (9-12 months of age) in similar plantation populations. Comparisons are made with studies of dental enamel hypoplasia in contemporaneous enslaved and free African American populations, including our data on 75 individuals from the First African Baptist Church cemetery in Philadelphia. These populations were highly stressed. While there appears to be a modest effect of early weaning stress, no direct relationship of peak frequencies to weaning age can be shown. These data raise questions about the attribution of peak hypoplasia frequencies to age at weaning or "post-weaning" stresses in previous paleopathological studies. High hypoplasia frequencies during the middle years of enamel development are more likely the result of a combination of 1) multiple environmental stresses, 2) differences in hypoplastic susceptibility in enamel, and 3) random factors.

Background: In the Caribbean, mosquito-borne diseases are a public health threat. In Sint Eustatius, dengue, Chikungunya and Zika are now endemic. To control and prevent mosquito-borne diseases, the Sint Eustatius Public Health Department relies on the community to assist with the control of Aedes aegypti mosquito. Unfortunately, community based interventions are not always simple, as community perceptions and responses shape actions and influence behavioural responses Objective: The aim of this study was to determine how the Sint Eustatius population perceives the Aedes aegypti mosquito, mosquito-borne diseases and prevention and control measures and hypothesized that increased knowledge of the virus, vector, control and prevention should result in a lower AQ1 prevalence and incidence of mosquito-borne diseases. Methods: This study was conducted in Sint Eustatius island in the Eastern Caribbean. We combined qualitative and quantitative designs. We conducted interviews and focus groups discussions among community member and health professional in 2013 and 2015. We also conducted cross-sectional survey to assess local knowledge on the vector, virus, and control and prevention. Results: The population is knowledgeable; ©however, mosquito-borne diseases are not the highest health priority. While local knowledge is sometimes put into action, it happens on the 20 household/individual level as opposed to the community level. After the 2014 CHIK outbreak, there was an increase in knowledge about mosquito control and mosquito-borne diseases. Discussion: In the context of Sint Eustatius, when controlling the Aedes population it may be a strategic option to focus on the household level rather than the community and build collaborations with households by supporting them when they actively practice mosquito 25 control. To further increase the level of knowledge on the significance of mosquito-borne diseases, it may also be an option to contextualize the issue of the virus, vector, prevention and control into a broader context. Conclusion: As evidenced by the increasing number of mosquito-borne diseases on the island, it appears that knowledge amongst the lay community may not be transferred into 30 action. This may be attributed to the perception of the Sint Eustatius populations that mosquitoes and the viruses they carry are not a high priority in comparison to other health concerns.

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Surveillance of vector-borne diseases (VBDs) exemplifies a One Health approach, which entails coordinated, collaborative, multidisciplinary, and cross-sectoral approaches to address potential or existing health risks originating at the animal-human-ecosystem interface. However, at the intervention stage of the surveillance system, it is sometimes difficult or even impossible to act. The human dimension of VBD control makes them wicked problems requiring an interdisciplinary systems approach beyond the One Health domain. Here, we make a case that the agenda of the UN Sustainable Development Goals (SDGs) can offer new opportunities to address these issues. The health of the population is a concern to us all and is more or less related to all 17 SDGs. The SDGs can provide a common language by which the interests of various stakeholders can be matched and the challenges that society faces identified, studied, and alleviated. To illustrate, the control and prevention of two VBDs, dengue and Lyme borreliosis, were selected and related to specific SDGs. Further, we use the framework proposed by the International Council of Science to: ( 1 ) show synergies and trade-offs between the various SDGs; and ( 2 ) present SDG 3 to identify policy that can be related to prevention. Engaging in an integrated approach will confront stakeholders with various viewpoints and through these oppositions, innovation can be nurtured. By adhering to the SDG agenda, we present policy advice including new opportunities for vector-borne disease control to reach its own health goals, while simultaneously supporting other sustainable development goals.

Four distinct serotypes of dengue viruses (DENV) are the cause of re-emerging dengue fever (DF) and dengue hemorrhagic fever (DHF). Dengue circulation in the Caribbean has gone from none or single serotype to multiple serotypes co-circulating with reports of continuing cycles of progressively more severe disease in the region. Few studies have investigated dengue on Sint Eustatius. Blood samples were collected to determine the prevalence of antibodies against dengue in the Sint Eustatius population. Greater than 90% of the serum samples (184 of 204) were positive for anti-flavivirus antibodies by enzyme linked immunosorbance assay (ELISA). Plaque reduction neutralization test (PRNT), specific for dengue viruses, showed that 171 of these 184 flavivirus antibody positive sera had a neutralization titer against one or more DENV serotypes. A majority of the sera (62%) had neutralizing antibody to all four dengue serotypes. Only 26 PRNT positive sera (15%) had monotypic dengue virus neutralizing antibody, most of which (20 of 26) were against DENV2. Evidence of infection with all four serotypes was observed across all age groups except in the youngest age group (10–19 years) which contained only DENV2 positive individuals. In a multiple logistic regression model, only the length of residence on the island was a predictor of a positive dengue PRNT50 result. To our knowledge this is the first dengue serosurveillance study conducted on Sint Eustatius since the 1970s. The lack of antibodies to the DEN1, 3, and 4 in the samples collected from participants under 20 years of age suggests that only DEN2 has circulated on island since the early 1990s. The high prevalence of antibodies against dengue (83.8%) and the observation that the length of time on the island was the strongest predictor of infection suggests dengue is endemic on Sint Eustatius and a public health concern that warrants further investigation.