The Zika project aims to investigate the association between Zika virus infection and microcephaly and Guillain–Barré syndrome (GBS). Together with the department of immunology, the immune response in infected individuals will be studied, both in single or double infections (Zika and dengue / Zika and chikungunya). In addition, the effect of arbovirus outbreak in general and Zika virus in particular on blood transfusion in Curaçao and the Caribbean will be investigated.
Improvement of the health – and financial literacy in Curaçao.
The SONORO community is fundamental for the SONORO project. It will consist of a very large number of households, representative for the population of Curaçao. Every year, we ask the community 4 times to reflect on topics such as health and well-being.
Prof. Rob Alessie PhD – Professor micro-economics, University of Groningen
Primary Caribbean partner
Tineke Alberts PhD – Head of the Department of Social Science – CBHRI
Corrie Vis BA – Project Manager
Jasmira Wiersma, MSc – Researcher Financial Behavior
Renske Pin PhD – Researcher Health Behavior
Tim Q. Martina – Community Manager
University of Groningen, Faculty of Economics and Business – Economics, Econometrics & Finance, The Netherlands
Anthropological Institute of the Netherlands Antilles/Allen Social Research and Consultancy, Curaçao
Project website: www.sonoro.community
Burden of Multiple Myeloma Patient Care on Health Care in Curaçao
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:
- What is the incidence of MM in Curaçao?
- What is the time to start second-line treatment of MM patients in Curaçao.
- How did patients undergoing HDM-ASCT fare as compared to non-transplant treated patients.
- What is the burden of MM care as expressed by treatment costs, number of days spent in hospital, number of radiotherapy treatments etc.
- Given the incidence of MM in Curaçao, what would be the financial impact of employing different new treatment modalities?
August – November 2016
Meulenberg, medical student
Schnog, internist-hematologist/medical oncologist
Samson, radiation oncologist
Andrea, radiation oncologist
For more information contact:
Dutch Caribbean preparedness for mosquito-borne infectious diseases
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.
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?
2017 – 2021
Erasmus Medical Center
Curacao Biomedical & Health Research Institute (CBHRI)
Caribbean Netherlands Science Institute (CNSI)
Eastern Caribbean Public Health Foundation (ECPHF)
The dengue research aims to understand the role of microbial translocation in severe dengue. In addition, studies are conducted to discover biomarkers of severe disease. Together with the department of epidemiology we will sequence virus strains of each outbreak in order to monitor virus circulating endemically and viruses introduced from other regions.