• CORESO

    Improvement of the health – and financial literacy of the population of Curaçao.

    Summary

    This project aims to explore the relationship between financial literacy and health literacy in the Caribbean context, with a focus on determinants related to social relations and cultural values.

    To be able to test health literacy and financial literacy longitudinally, a public community environment needs to be set up. This involves organizing a community of individuals who have agreed to be available for interviews, talks, and discussions over the internet. This Community for Research and Society (CORESO) is sourced from a random sample of addresses. In addition to the internet community, special groups will be sampled and consulted face-to-face, (e.g. people without internet access). Together these groups will form a good reflection of the population of Curaçao.

    Through CORESO, data will be collected on health and financial literacy, knowledge, and behavior. Additional underpinning determinants of health and financial literacy/behavior such as attitudes, beliefs, and characteristics of a person’s social network will be explored. Results will be linked back to the participating community members and the wider Curaçao population. This will be accomplished through collaboration with participating (non-profit) professional organizations in the field that will assist in translating the research findings into preventive strategies. The results will be used for education, awareness raising, poverty reduction and to stimulate informed policy making in the Dutch Caribbean. The Community for Research and Society (CORESO) itself may also suggest topics for surveying among the community members. All data will be available for other researchers via an online database.

     

    Study period

    2017 – 2020
     

    Principal applicant

    Prof. Rob Alessie, PhD. — Professor micro-economics, University of Groningen
     

    Primary Caribbean partner

    Tineke Alberts, PhD. – Head of Department of Social Sciences, CBHRI
     

    Research team

    Corrie Vis, PhD. – Project manager
    Renske Pin, PhD.
    Merel Griffith, PhD.
    Tim Martina, BSc.
    Jasmira Wiersma, MSc.
     

    Partners

    University of Groningen, Faculty of Economics and Business, Economics, Econometrics & Finance
    Curaçao Biomedical and Health Research Institute (CBHRI)
    CentERdata, Institute for Data Collection and Research, Tilburg

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  • DUCAMID

    Dutch Caribbean preparedness for mosquito-borne infectious diseases

    Background

    With their dependence of tourism, the climatic conditions favoring mosquito establishment, and their central position in wildlife migratory routes, the Dutch Caribbean are potential hot spots for outbreaks of virus diseases spread by arthropod vectors (arboviruses), like Zika virus, yellow fever, and others. The Dutch Caribbean have staff with expert knowledge on arboviruses in the local context, but limited resources to detect and investigate such biological invasions and pathogen spread, both in terms of tools and infrastructure. DUCAMID is a project subsidized by the Dutch grant agency NWO and is aimed to investigate potential factors that facilitate introduction of new viruses in the Dutch Caribbean, where Curacao and St Eustatius are the representatives of the different islands. The approach of this project is to screen resident mosquitoes for presence of different arboviruses and factors such as a their virome as determinant of susceptibility. Also the immunity of the population will be studied as a parameter that prevent or stimulate introduction of a new arbovirus in the islands. The overarching goal of this project is to develop tools for implementation in future risk-based surveillance targeting mosquitoes and reservoir hosts such as birds, that can be operated in the local research institutes with a public health mandate. DUCAMID brings together the key players in Curacao, and Sint Eustatius with partners in the Netherlands (Erasmus MC as WHO collaborating center for arboviruses and director of the EID research theme, and Wageningen University with its vector ecology research program), focussing on a comprehensive program of arbovirus preparedness research. The partners involved in DUCAMID from the Dutch Caribbean islands play an important role in research on vector-borne diseases on the island of Curacao, and are linked to regional research and public health expertise (Ross Institute, University of Florida, Pan American Health Organization), thus securing a problem-oriented research agenda that is relevant to the disease problems in the region, and translation of research findings in the same context.
     

    Study questions

    Several studies will be conducted to assess the risk for arbovirus introduction in the Dutch Caribbean. The following questions will be addressed:
    1. Is there evidence for presence of certain arboviruses in mosquitoes in Curacao and St Eustatius?
    2. Is there an association of mosquito virome and susceptibility to arbovirus infection?
    3. Is there evidence for presence of arboviruses in different species of birds in Curacao and St Eustatius?
    4. What is the competence of Culex and Aedes mosquitoes for several arboviruses?
    5. How does the cross-reactive immune response to alpha- and flaviviruses affect infection with a new alpha- and flaviviruses?
     

    Study period

    2017 – 2021
     

    Partners

    Erasmus Medical Center
    Wageningen University
    Curacao Biomedical & Health Research Institute (CBHRI)
    Caribbean Netherlands Science Institute (CNSI)
    Eastern Caribbean Public Health Foundation (ECPHF)

     

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  • Multiple Myeloma

    Burden of Multiple Myeloma Patient Care on Health Care in Curaçao

     

    Background

    Multiple myeloma (MM) is a hematological malignancy characterized by clonal proliferation of plasma cells in the bone marrow resulting in end-organ damage with morbidity and early mortality if left untreated. Even though patients with myeloma may experience long disease free periods after first line treatment, all eventually relapse and die of their disease.

    Clinical features of MM include hypercalcemia, renal failure, anemia and osteolytic bone lesions. MM accounts for approximately 1% of all malignancies and 13% of hematological malignancies. In the United States the annual incidence is 4 to 5 per 100,000. Myeloma incidence varies with ethnicity, with the incidence in African Americans and blacks from Africa being two to three times higher than in the caucasian population. The median age at diagnosis is approximately 70 years, where the average age of diagnosis has been shown to be significantly lower in blacks as compared to caucasians.

    With the advent of improved supportive care (antibiotics, transfusions, radiotherapy) and especially since the development of new effective therapies, survival of myeloma patients has improved dramatically over the course of the last decades. Where the median survival was less than one year before the introduction of alkylating agents, the median survival of myeloma patients is now approximately eight years.

    All patients diagnosed with MM in Curaçao are treated at the Department of Hematology/Medical Oncology and Radiotherapy at the Sint Elisabeth Hospital. Clinical observation suggests an increased incidence of MM as compared to literature. Also, high dose melphalan (HDM) followed by autologous stem cell transplant (ASCT) has not been used frequently as many patients were either not transplant eligible due to medical condition or due to choice (balancing the impact of several months away from their kin for a palliative treatment). However, contrary to expectation of several experts in the field, the advent of new treatment modalities has not obliviated the need for HDM and ASCT but seems to add to its effectiveness. These observations, together with the explosion of new but often expensive treatment modalities necessitates critical analysis of MM in Curaçao.

     

    Study questions and methods

    A retrospective analysis of all patients diagnosed with MM (and smoldering myeloma) of the period 2009-2016 will be performed at the Department of Hematology/Medical Oncology and Radiotherapy. The following questions will be addressed:

    1. What is the incidence of MM in Curaçao?
    2. What is the time to start second-line treatment of MM patients in Curaçao.
    3. How did patients undergoing HDM-ASCT fare as compared to non-transplant treated patients.
    4. What is the burden of MM care as expressed by treatment costs, number of days spent in hospital, number of radiotherapy treatments etc.
    5. Given the incidence of MM in Curaçao, what would be the financial impact of employing different new treatment modalities?

     

    Study period

    August – November 2016

     

    Investigators

    Meulenberg, medical student

    Schnog, internist-hematologist/medical oncologist

    Samson, radiation oncologist

    Andrea, radiation oncologist

    Coronel, pathologist

     

    For more information contact:

    Dr. John – John Schnog
    Head of the department of Oncology
    Address: Pater Eeuwensweg 36
    Willemstad, Curaçao
    Tel: +5999 522 6613
    Email: j.schnog@cbhri.com

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  • Combined Modality Treatment

    Outcome of Combined Modality Treatment Employing Modern Chemotherapy with Cobalt Based Radiotherapy in Curaçao

     

    Background

    Many cancers are currently treated with the combination of radiotherapy and chemotherapy as a radiosensitizer (combined modality treatment, CMT). In Curaçao, radiotherapy is delivered employing a cobalt radiation machine (Theratronics (1981) and Plato treatment planning system (2002)). For most indications randomized controlled trials are lacking between linear accelerator based radiotherapy and cobalt based radiation. With the exception of specific cases, structurally referring patients to centers employing linear accelerator based radiotherapy, is not economically feasible. All patients in Curaçao eligible for CMT are treated at the Department of Hematology/Medical Oncology and Radiotherapy in the Saint Elisabeth Hospital. As a measure of quality of the care delivered, we want to assess outcome of CMT in Curaçao and compare this to published trial data as well as published ‘real world data’ in both low, middle and high income countries.

     

    Study questions and methods

    A retrospective analysis of all patients treated with CMT for the cancers stated below during the period 2010-2014 will be performed in order to answer the following questions:

    1. What are the characteristics of the patients treated with CMT on Curaçao for rectal cancer, head and neck cancer, cervical cancer, lung cancer, esophageal cancer and anal cancer.
    2. What is the progression free survival (PFS) of patients treated with CMT in Curaçao for rectal cancer, head and neck cancer, cervical cancer, lung cancer, esophageal cancer and anal cancer?
    3. What are patterns of treatment failure in patients treated with CMT in Curaçao for rectal cancer, head and neck cancer, cervical cancer, lung cancer, esophageal cancer and anal cancer?
    4. What are the determinants of PFS in these patients?
    5. What are the rates of grade 3 and 4 toxicity during and after treatment?
    6. How does our outcome compare to the literature, specifically to:
    • Clinical trial data?
    • Real world data in high income countries?
    • Real world data in low- and middle income countries?

    Study period

    June – December 2016

     

    Investigators

    R van der Horst, medical student

    Schnog, internist-hematologist/medical oncologist

    Samson, radiation oncologist

    Andrea, radiation oncologist

    Coronel, pathologist

     

    For more information contact:

    Dr. John – John Schnog
    Head of the department of Oncology
    Address: Pater Eeuwensweg 36
    Willemstad, Curaçao
    Tel: +5999 522 6613
    Email: j.schnog@cbhri.com

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  • physiotherapy antiviral effective treatment for several diseases

    Antiviral

    A folk remedy (Phytotherapy) may be an effective treatment for several diseases. The use of botanical remedies for the treatment of various ailments is very popular in Curaçao. The medicinal power of plants should not be trivialized. During the chikungunya virus (CHIKV) outbreak in Curaçao, local plants were used by several patients to alleviate symptoms. There is circumstantial evidence that two plants had a positive effect on symptoms of patients. The department of virology works closely together with national and international collaborators to generate drug candidates for viruses for which there is either no drug available or an existing drug has unacceptable side effects. This will be accomplished by analyzing medicinal plants from Curaçao and together with collaborating partners develop better extracting solutions.

     

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