Children In Trinidad Research Articles

Latent profiles of home behaviour problems in Trinidad and Tobago.

Caregivers who interact with children at home can provide a critical, complementary perspective on a child's behaviour functioning. This research used a parent-administered measure of problem behaviours to study perceptions of child behaviours across home situations. We applied latent profile analysis to identify subgroups of children with common behavioural tendencies in a nationally representative sample (N = 709) of 4- to 13-year-old children in Trinidad and Tobago. This study (a) identified latent profiles of children's over- and underactive behaviour problems in varied home settings and (b) examined how profile membership predicted academic skills and teacher-observed problem behaviours. The best-fitting four-profile model included one profile of adjusted behaviours (56%), one of the elevated attention-seeking behaviours (21%), a profile featuring withdrawn and disengaged behaviours (15%) and a relatively rare profile emphasising aggressive behaviours (8%). Children classified in the last profile displayed the poorest academic outcomes and the highest levels of teacher-observed behaviour problems.

Exploring the early years needs of Venezuelan migrant children in Trinidad and Tobago

ABSTRACT Since 2015, Trinidad and Tobago experienced an influx of over 40,000 migrants from Venezuela. Having signed the Convention on the Rights of the Child and the Convention Relating to the Status of Refugees, young migrant children are entitled to education in Trinidad and Tobago. However, they face obstacles accessing schooling and social services [UNICEF EC (UNICEF Eastern Caribbean). 2019. “Making Friendly Spaces for Venezuelan Children.” Accessed September 14, 2019. https://www.unicef.org/easterncaribbean/media_39482.html]. Broadly, this conceptual study sought to answer one primary question: What are the key issues Trinidad and Tobago's government must address in order to support young children from Venezuelan migrant families in the early years setting? To answer this, data from policy documents, government releases, peer-reviewed articles and news reports were analysed. Six overarching themes emerged from the literature: policy gaps, fear/xenophobia, resource limitations, familial support, political risks and child rights infringements. Recommendations for overcoming challenges are included.

A Study on How Domestic Violence Impacts on the Physical, Psychological, and Financial Conditions of Women and Children in Trinidad and Tobago

A Study on How Domestic Violence Impacts on the Physical, Psychological, and Financial Conditions of Women and Children in Trinidad and Tobago

Recommendations for antibiotic prescriptions for upper respiratory symptoms in children in Trinidad and Tobago: GRADE-ADOLOPMENT APPROACH

Background: In Trinidad and Tobago, 22,329 and 18,594 cases of acute respiratory infections (ARI) in children less than 5 years were recorded for 2016 and 2017 respectively. Often, antimicrobials are over prescribed without proof of bacterial infection. Recommendations for management of ARIs are needed. Methods: The GRADE-ADOLOPMENT approach was used to formulate recommendations. We established a guideline panel who met in person or by web conferences. We prioritised recommendation questions and searched for guidelines and systematic reviews from 2010 to July 2018 in several medical databases and guideline producer websites. We also searched for patients’ values and preferences, acceptability, resources, and feasibility studies specific to the Caribbean or Trinidad and Tobago. We summarised the evidence in evidence-to-decision frameworks and formulated recommendations by consensus. Results: The guideline panel developed recommendations including: 1. For children 5 years old or younger who present with fever and respiratory symptoms not suggestive of serious illness, we recommend to either not prescribe antibiotics or to provide a delayed prescription (48 hours later) of amoxicillin or clarithromycin (when children have a history of allergy to penicillin) rather than an immediate prescription; 2. For children with symptoms suggestive of serious illness, we recommend immediate prescription of amoxicillin or clarithromycin (when children have a history of allergy to penicillin); and, 3. We suggest 7-10 days of treatment, depending on the suspected illness and antibiotic used. Conclusion: Guidelines aid medical practitioners, patients and supply chain managers. This guideline will form the backbone of the 1st national standardisation of treatment using the GRADE-ADOLOPMENT approach.

A cross-sectional survey to ascertain the prevalence of oral habits among eleven to twelve year old children in Trinidad and Tobago

Abstract Objective The aim of this study was to determine the prevalence of oral habits in eleven to twelve year old children in Trinidad and Tobago and to determine if there is any association with ethnicity and gender. Design Cross-sectional survey. Methods An epidemiological survey of 975 high school students (566 females (58.1%) and 409 males (41.9%)) was conducted. A questionnaire was developed to record information on the presence of oral habits. A clinical examination was also conducted at the school site. Statistical analysis was undertaken using Chi-square test and binary logistic regression. Results There was a high prevalence of oral habits. The overall prevalence of habits was 93%. 81.3% of children had a tongue thrust, 46.3% nail biting habit, and 34.9% digit sucking habit. Afro-Trinidadian subjects and female subjects were more likely to have habits with tongue sucking in particular exhibiting a female (OR 0.419 95%CI 0.285, 0.616) and Afro-Trinidadian ethnic (OR 0.559 95%Ci 0.433, 0.721) predilection. Conclusion The prevalence of oral habits in eleven and twelve year old children in Trinidad and Tobago is high, with higher prevalence in females and Afro-Trinidadians with tongue thrusting being most prevalent oral habit overall.

It's Not All Tests and Norms! The Reach of Culture in Behavioral Research

Abstract Five major challenges experienced while conducting a study regarding the neurobehavioral developmental trajectories of primary school children in Trinidad and Tobago are reviewed. 1. Governing Principles. Institutional review of the scientific rationale for the work and safety of participants is required for research activities in any/all settings. 2. Design/Methodology. Cultural beliefs/values/goals shape the research endeavor from recruitment strategies, informed consent, research design, and data collection to outcome monitoring. 3. Participants. Research studies involving children are closely scrutinized. Children need additional protections because they cannot give informed consent. Who speaks for children and how? Children must be recruited via guardians - who may not be parents but societal institutions functioning as “proxy guardians”. The relationships between parents and different “proxy guardians” respond to cultural beliefs/values. 4. Behavioral Measurement-Tests. American psychology has been severely critiqued as focusing on a circumscribed sector of the population while neglecting 95% of the global community. A core concern is the use, in non-United States settings, of behavioral measures developed and normed in the U.S. No measure can be truly culture free: all brains are sculpted by interactions not only with the physical world but also with the psychological world of their own cultural heritage. 5. Behavioral Measurement-Rating Scales. In transferring research across cultures, language/dialect differences are frequently highlighted. Differences in literacy can be even more challenging. Lack of literacy cannot be used to exclude persons from potential research benefits, nor for the failure to conduct effective informed consent processes. Cultural variations in the value/use of the written word have direct impact on research design/methodology, data collection/quality, the training/conduct of research personnel, and on funding. Implications for the mounting research in international settings are discussed.

Early Childhood Caries in 3 to 5 Year Old Children in Trinidad and Tobago.

Background: This study was done to evaluate the prevalence and contributory factors of early childhood caries (ECC) and severe ECC (S-ECC) among preschool children of Kindergartens and Early Childhood Centres in Trinidad and Tobago. Methods: A cross-sectional study was carried out involving 342 preschool children aged 3 to 5 years. The school staff distributed a structured questionnaire to the children to be completed by the mother. Clinical examinations were conducted by calibrated examiners. Statistical significance was set at p < 0.05 in all analyses. Results: The prevalence of ECC and S-ECC was 50.3% and 52.3%, respectively. Dietary and oral hygiene factors particularly with bottle feeding and high plaque levels were major contributors to dental caries in this population. Conclusion: ECC and S-ECC are significant issues that occur in preschool children in Trinidad and Tobago. The development of ECC and S-ECC can be attributed to certain environmental factors like dietary habits and oral hygiene practices. Early dental assessment, broad-based oral health education programmes, increased parental/guardian engagement during oral hygiene practices and greater access to facilities for early childhood caries prevention and management can help alleviate the problems of ECC and S-ECC in this population.

Alcohol Drinking among Primary School Children in Trinidad and Tobago: Prevalence and Associated Risk Factors

Background: Underage alcohol use is a pervasive problem with serious health, social and safety consequences. This study was undertaken to assess alcohol use by primary school children in Trinidad and Tobago, and to identify associated risk factors. Methods: We analysed data collected from 40 primary schools in Trinidad and Tobago by the National Alcohol and Drug Abuse Prevention Programme (NADAPP). The sample comprised of children aged 8 -15 years old, in standards 3, 4 and 5. Result: Out of the 2052 children, 648 (31.6%) have consumed alcohol in their lifetime, and same proportion reported ever being drunk (31.6%). Male gender was significantly associated with lifetime alcohol use (AOR =1.60, 95% CI= 1.25 - 2.05). Children not living with their father (AOR= 2.45, 95% CI=1.86- 3.24) and those whose fathers have either primary or secondary education (AOR = 1.88, 95%CI=1.07 - 3.31; AOR= 1.58, 95%CI=1.12 - 2.23 respectively) were at higher risk for lifetime alcohol consumption. However, age group 8 – 11 years was significantly inversely associated with lifetime alcohol consumption (AOR= 0.67, 95% CI=0.48 - 0.94). Conclusion: Being a male student, not living with father, and father attaining either primary or secondary education level were significantly associated with increased likelihood for lifetime alcohol use. However, children between 8 – 11 years were less likely to consume alcohol.

Parents’ perceptions of healthy eating practices in north-east Trinidad

Aim: The purpose of this study was to explore perceptions, facilitators, and barriers to healthy eating behaviors among parents of primary school-aged children. Methods: A purposive sampling design was used to select parents of primary school children from four different communities in north-east Trinidad. They were recruited via the school system with letters containing the research purpose and background. Four focus group sessions were conducted between May and June 2013. Each focus group had an average of five participants and lasted for approximately 60 min. The participants were asked to define healthy eating, identify healthy foods, and describe their concerns regarding healthy eating. The interview questions were developed and validated by the research team members. The data were transcribed and analyzed for themes. Results: Twenty-three ( N = 23) parents (78% female and 22% male) participated in the study. The participants define healthy foods as vegetables, starchy foods, porridge, tea, fiber, and foods low in fat. Parents also acknowledged that food cost, availability, parent’s inability to influence children to consume fruits and vegetables, and social barriers are some major challenges impeding healthy eating. Conclusion: Our study demonstrates that several barriers exist to healthy eating among primary school children in Trinidad. Community health professionals, school teachers, dietitians, and nutritionists need to play a more prominent role in teaching children and parents about the benefits of healthy eating. Future studies need to address the barriers to healthy eating. This might help to reduce the growing obesity prevalence in Trinidad.

Prevalence of oral habits in a child population in Trinidad, West Indies

ObjectivesThe purpose of this study was to determine the prevalence of oral habits (both nutritive and non-nutritive) in children in Trinidad, West Indies and to determine if there are any associated factors such as age, gender, ethnicity, social/familial factors, dietary practices and parental perception. Methods155 children aged 4–16 years and their parents were questioned using a structured interview about breast and bottle feeding history, history of oral habits, sibling habit history, parental education level and habit history and parental belief and perception. Oral habits such as pacifier use, digit sucking, tongue sucking, lip biting and sucking, nail biting, and object chewing were recorded. ResultsThere was a very high prevalence of oral habits (91.6%) with 63.9% of children having two or more habits. The most common oral habit was nail biting (52.9%) and ice crunching was most commonly found in females. Tongue sucking was predominant in children of African ethnicity. Oral habits were more common in children whose parents had a post primary education. 51% of parents were not concerned about oral habits and 64.5% believed that the child would stop the habit without any intervention. ConclusionThe prevalence of both nutritive and non-nutritive oral habits in Trinidad are high and some associations were found with gender, ethnicity, social, dietary and familial factors.

Oral health-related quality of life and early childhood caries among preschool children in Trinidad.

BackgroundEarly childhood caries (ECC) is a public health problem in developed and developing countries. The purpose of this study was to describe the relationship between oral health-related quality of life (OHRQoL) and ECC among preschool children in a Caribbean population.MethodParents/primary caregivers of children attending nine, randomly selected preschools in central Trinidad were invited to complete an oral health questionnaire and have their child undertake an oral examination. The questionnaire included the Early Childhood Oral Health Impact Scale (ECOHIS). Visible caries experience was assessed using WHO criteria. Logistic regression models were used to determine the factors associated with OHRQoL and ECC.ResultsThree hundred nine parents/caregivers participated in the study (age-range 25–44 years) and 251 children (mean age 3.7 years) completed oral examinations. Adjusting for other factors, the odds for a child aged 4 years of having dental caries were greater than the odds for a child aged 3 years (OR 3.61; 95% CI (1.76, 6.83). The odds for children having difficulty drinking hot or cold drinks were greater for those with dental caries than the odds for children who have no such difficulty. Similarly, the odds for children who had difficulty eating were greater for those with dental caries than the odds ratios for children who had no difficulty eating (OR 8.29; 95% CI (2.00, 43.49). Adjusting for the effects of other factors, the odds of parents/caregivers feeling guilty were greater if their child had experienced dental caries in comparison to parents/caregivers whose child did not have dental caries (OR 3.50; 95% CI (1.32, 9.60). Adjusting for other factors, the odds of parents/primary caregivers having poor quality of life was increased when they had a child with a dmft in the range 1–3 (OR 2.68; 95% CI (1.30, 5.64) dmft > 4 (OR 8.58; 95%CI (3.71, 22.45), in comparison to those whose child had a dmft = 0.ConclusionIn this sample of preschool children OHRQoL was associated with ECC. More negative impacts were found in children with a greater severity of visible caries experience. This suggests the need for strategies to prevent and manage ECC in this Caribbean population.

A cross-sectional study to determine the prevalence of obesity and other risk factors for type 2 diabetes among school children in Trinidad, West Indies

Background:Our previous work has shown that type 2 diabetes mellitus is a problem in the school-aged population of Trinidad, West Indies. The current study evaluated the prevalence in this population of selected risk factors for diabetes, viz: obesity, family history of diabetes and acanthosis nigricans.Objective:To assess the prevalence of the following risk factors for type 2 diabetes (T2DM) in school children in Trinidad: obesity, family history of diabetes in first- or second-degree relatives and the presence of acanthosis nigricans (AN).Methods:A cross-sectional survey was performed among school children aged 7–18 years from September 2009 to June 2010. A convenience sample was selected from a random sample of 32 schools drawn from all educational districts. A self-administered questionnaire was employed to record family history, gender and ethnicity. AN was assessed and scored clinically at the neck and obesity was measured by anthropometry and bio-impedance.Results:There were 2130 participants in the study. Fifteen per cent were obese and 17% were overweight. Primary school children had a higher prevalence of obesity (22·9% vs 11·0%) and overweight (20·0% vs 15·6%) than secondary school children (P<0·05). A greater proportion of males than females had combined overweight/obesity as measured by BMI for age (35·8 vs 29·4%, P<0·05). The overall prevalence of AN was 43·4%. However, just over 18% of all school children have a degree of AN greater than grade 2, which clinically is readily recognisable. Females displayed this physical sign more commonly than males (P<0·05). The prevalences of a family history of diabetes in first- and second-degrees relatives were 11·0% and 1·1%, respectively. Forty-three per cent had one risk factor for diabetes, 23·1% had two and 2·9% had three.Conclusion:Risk factors for T2DM are very common among school children in Trinidad. More than 40% had at least one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Trinidadian school children are urgently warranted.

Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers.

BackgroundLittle is known about oral health in early childhood in the West Indies or the views and experiences of caregivers about preventive oral care and dental attendance The aims of this study were to explore and understand parents and caregivers’ experience of oral healthcare for their preschool aged children and how, within their own social context, this may have shaped their oral health attitudes and behaviours. These data can be used to inform oral health promotion strategies for this age group.MethodAfter ethical approval, a qualitative study was undertaken using a focus group approach with a purposive sample of parents and caregivers of preschool children in central Trinidad.Group discussions were initiated by use of a topic guide. Audio recording and field notes from the three focus groups, with a total of 18 participants, were transcribed and analysed using a thematic approach.ResultsDespite some ambivalence toward the importance of the primary teeth, the role of fluoride and confusion about when to take a child for their first dental visit, most participants understood the need to ensure good oral hygiene and dietary habits for their child. Problems expressed included, overcoming their own negative experiences of dentistry, which along with finding affordable and suitable dental clinics, affected their attitude to taking their child for a dental visit. There was difficulty in establishing good brushing routines and controlling sweet snacking in the face of many other responsibilities at home. Lack of availability of paediatric dental services locally and information on oral health care were also highlighted. Many expressed a need for more contact with dental professionals in non-clinic settings, for oral health care advice and guidance.ConclusionParents and caregivers in this qualitative study showed generally positive attitudes towards oral health but appear to have encountered several barriers and challenges to achieving ideal preventive care for their child, with respect to healthy diet, good oral hygiene and dental attendance. Oral health promotion should include effective dissemination of oral health information, more practical health advice and greater access to dental care for families with preschool children.

Is the APLS formula used to calculate weight-for-age applicable to a Trinidadian population?

BackgroundIn paediatric emergency medicine, estimation of weight in ill children can be performed in a variety of ways. Calculation using the ‘APLS’ formula (weight = [age + 4] × 2) is one very common method. Studies on its validity in developed countries suggest that it tends to under-estimate the weight of children, potentially leading to errors in drug and fluid administration. The formula is not validated in Trinidad and Tobago, where it is routinely used to calculate weight in paediatric resuscitation.MethodsOver a six-week period in January 2009, all children one to five years old presenting to the Emergency Department were weighed. Their measured weights were compared to their estimated weights as calculated using the APLS formula, the Luscombe and Owens formula and a “best fit” formula derived (then simplified) from linear regression analysis of the measured weights.ResultsThe APLS formula underestimated weight in all age groups with a mean difference of −1.4 kg (95% limits of agreement 5.0 to −7.8). The Luscombe and Owens formula was more accurate in predicting weight than the APLS formula, with a mean difference of −0.4 kg (95% limits of agreement 6.9 to −6.1%). Using linear regression analysis, and simplifying the derived equation, the best formula to describe weight and age was (weight = [2.5 x age] + 8). The percentage of children whose actual weight fell within 10% of the calculated weights using any of the three formulae was not significantly different.ConclusionsThe APLS formula slightly underestimates the weights of children in Trinidad, although this is less than in similar studies in developed countries. Both the Luscombe and Owens formula and the formula derived from the results of this study give a better estimate of the measured weight of children in Trinidad. However, the accuracy and precision of all three formulae were not significantly different from each other. It is recommended that the APLS formula should continue to be used to estimate the weight of children in resuscitation situations in Trinidad, as it is well known, easy to calculate and widely taught in this setting.

The effects of a school-based intervention programme on dietary intakes and physical activity among primary-school children in Trinidad and Tobago

Childhood obesity is increasingly being recognized as a major public health problem in the Caribbean. The objective of the present study was to evaluate the effectiveness of a short-term, school-based, multi-component education intervention on improving the knowledge, attitudes and behaviour of primary-school children towards better dietary and activity habits. The study was a randomized, controlled, school-based nutrition education and physical activity intervention. Participating schools were randomly assigned to the intervention (IVG) and non-intervention (NIVG) groups. All primary schools in Sangre Grande, north-east Trinidad. Five hundred and seventy-nine pupils in their sixth year of primary-school education were enrolled from twelve schools in Sangre Grande, north-east Trinidad. Approximately 23 % of participants had BMI >or= 85th percentile of the Centers for Disease Control and Prevention age- and gender-specific cut-off values. In multivariate regression equations controlling for age, gender, BMI and baseline value, intervention was associated with lower intake levels of fried foods, snack foods high in fat, sugar and salt (HFSS) and sodas (P < 0.05). In similar analyses, intervention was associated with higher knowledge scores (P < 0.01). Intervention was not significantly associated with physical activity and Children's Eating Attitude Test-26 (ChEAT26) scores after controlling for age, gender, BMI and the relevant baseline values. The intervention was associated with lower intake levels of fried foods, HFSS foods, sodas and higher knowledge scores independent of age, gender, BMI, ethnicity and the appropriate baseline value. Finally, the intervention was not associated with changes in physical activity behaviours in multivariate analyses.

Comparative and International Education: A Bibliography (2008)

Comparative and International Education: A Bibliography (2008)

Distribution and seasonality of rhinovirus and other respiratory viruses in a cross-section of asthmatic children in Trinidad, West Indies

BackgroundChildhood asthma in the Caribbean is advancing in prevalence and morbidity. Though viral respiratory tract infections are reported triggers for exacerbations, information on these infections with asthma is sparse in Caribbean territories. We examined the distribution of respiratory viruses and their association with seasons in acute and stable asthmatic children in Trinidad.MethodsIn a cross-sectional study of 70 wheezing children attending the emergency department for nebulisation and 80 stable control subjects (2 to 16 yr of age) in the asthma clinic, nasal specimens were collected during the dry (n = 38, January to May) and rainy (n = 112, June to December) seasons. A multitarget, sensitive, specific high-throughput Respiratory MultiCode assay tested for respiratory-virus sequences for eight distinct groups: human rhinovirus, respiratory syncytial virus, parainfluenza virus, influenza virus, metapneumovirus, adenovirus, coronavirus, and enterovirus.ResultsWheezing children had a higher [χ2 = 5.561, p = 0.018] prevalence of respiratory viruses compared with stabilized asthmatics (34.3% (24) versus (vs.) 17.5% (14)). Acute asthmatics were thrice as likely to be infected with a respiratory virus (OR = 2.5, 95% CI = 1.2 – 5.3). The predominant pathogens detected in acute versus stable asthmatics were the rhinovirus (RV) (n = 18, 25.7% vs. n = 7, 8.8%; p = 0.005), respiratory syncytial virus B (RSV B) (n = 2, 2.9% vs. n = 4, 5.0%), and enterovirus (n = 1, 1.4% vs. n = 2, 2.5%). Strong odds for rhinoviral infection were observed among nebulised children compared with stable asthmatics (p = 0.005, OR = 3.6, 95% CI = 1.4 – 9.3,). RV was prevalent throughout the year (Dry, n = 6, 15.8%; Rainy, n = 19, 17.0%) and without seasonal association [χ2 = 0.028, p = 0.867]. However it was the most frequently detected virus [Dry = 6/10, (60.0%); Rainy = 19/28, (67.9%)] in both seasons.ConclusionEmergent wheezing illnesses during childhood can be linked to infection with rhinovirus in Trinidad's tropical environment. Viral-induced exacerbations of asthma are independent of seasons in this tropical climate. Further clinical and virology investigations are recommended on the role of infections with the rhinovirus in Caribbean childhood wheeze.

Advocacy among Street Children in Trinidad and Tobago

Advocacy among Street Children in Trinidad and Tobago

Street children in Trinidad and Tobago: understanding their lives and experiences

A community-based action research process, over a three-year period, employed interviews and participant observations with five children living on the streets in Port of Spain, the capital of Trinidad and Tobago. Data revealed violence in the family to be a contributing factor to children's presence on the streets: it was also a feature of their lives on the streets. A complex pattern emerged of violence, hostility, and distorted social interactions amidst negative attitudes and disdainful behaviour all around them. It is argued that, although it is not easy, more people – professionals and citizens – would do well to listen to, and understand the lives of, street children in order to be motivated for change.

Street Children in Trinidad and Tobago

Street Children in Trinidad and Tobago