The WHO Injury Surveillance Guidelines were published in English in 2001. Since then, the manual has been translated into at least three other languages and been applied to a wide range of situations in countries from China to the Czech Republic to Colombia. From the 127 scientific citations, this paper explores the several uses of the Guidelines, some obvious, others unique and unexpected.
Under-reporting of maternal deaths in Jamaica in 2008 was attributable to delayed registration of coroners' cases and misclassification. Timely registration of coroners' cases and training of nosologists to recognize and code maternal deaths is needed.
Scabies infestation has been reported to the PAHO/WHO Caribbean Epidemiology Centre (CAREC) from Trinidad and Tobago (T&T), Grenada, Dominica, the Turks and Caicos Islands (T&CI) and, more recently, St Lucia. Epidemic scabies was being reported from T&CI in 1981 (1200/100,000 population), but there were no reports from T&T until 1982 (8/100,000). The first phase of the bimodal epidemic in Grenada occurred between 1982 and 1984 (132/100,000) and the explosive second phase from 1985 to 1987 (474-699/100,000). In T&T there was a low incidence of scabies until 1985 (0-59/100,000) and in Dominica the rate fluctuated (67-14/100,000) during the same period. From 1986 to 1988, scabies infestation reached epidemic proportions in T&T (410-709/100,000) and fluctuated in Dominica (108-117/100,000). In Tobago alone, scabies was not reported until March 1986, and by December the incidence rate was 105/100,000; by 1988 it had increased to 1124/100,000 population. Although no secondary infections have been reported from Grenada, Dominica, T&CI or St Lucia, T&T has reported increased streptococcal skin infections and epidemic post-streptococcal acute glomerulonephritis (PSAGN). The observed trend of increasing scabies infestation, increasing streptococcal isolates from skin lesions, and increasing PSAGN in T&T is noteworthy.
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