WHEN the rains begin to fall in earnest across the Caribbean this year, Grenada, considered one of the lesser developed countries in the region, should be better placed than most to respond to the annual problem of dengue fever.

And they can chalk it all up to an institution which is determined to carve out a niche for itself in research and education in the Caribbean, but which is still fighting to gain the respect of a large number of regional politicians and scholars.

The St. George's University, which is spending millions on an ultra-modern campus at True Blue in the Spice Isle, and which is now offering a programme that stretches well beyond the "medicine" that, for most of its existence, characterised its very name, has been involved in practical research that could be the catalyst for significant growth in that country's economy.

Dr. Calum Macpherson, director of the Windward Islands Research and Education Foundation (WINDREF), a semi-autonomous agency set up by the university, explained that the institution was particularly proud of its progress in dengue fever research.

"Where we feel we have the greatest expertise is in dengue," Macpherson said.

"This year we plan before the dengue season starts to have a new diagnostic capability in place so that we can identify all the fever cases in Grenada, rapidly and accurately, for dengue. We'll be able to identify where the virus strain originated in the world and we'll be able to give the results back to the patients in two days.

"As you know, there is no treatment for dengue except symptomatic treatment, so the advantage of getting your results back quickly is that you will know what is causing the fever and all the other clinical manifestations and be able to start treatment earlier.

"We could not diagnose it in Grenada last year. In Barbados you send your tests to Trinidad. We were in the same boat as you. This year we will be better than you. When you send it to Trinidad I believe they have a quota limitation. I believe they take months to get the results back to you. I believe there is some degree of uncertainty on how the samples get to Trinidad - LIAT is not the most reliable method of transporting test samples. They may not arrive in the best shape ...

"In Grenada from this year we will get samples from the doctors, within hours we will have them at minus 70 degrees and we'll test them by the next day or so. That is a huge advance, but, unfortunately we will not be able to offer it to any other island just yet.

"We're going to look at the human cost of infection with dengue. In Barbados when you had an outbreak, I believe in 1997, people were off for six weeks and longer. What we don't know is how important is dengue as a cause of ill health, and we are going to use the diagnoses and questionnaire to find out how long people were sick, how long it took them to get back to normalcy.

"These results will be directly applicable to Barbados and other areas. We'll be able to say if it plays a greater role than the flu in terms of the health of the people."

WINDREF was set up in 1994 as a Grenadian non-governmental organisation and is also registered in London and New York as charitable trust. Sitting on its board of trustees is noted Barbadian doctor, Sir Kenneth Stuart.

According to Macpherson, it's the only institution of its kind in the Windward Islands, with three Grenadian PhD students working on hypertension and dengue. "We collaborate internationally with dozens of institutes in many countries, and in Guyana we worked with the Ministry of Health. In Barbados we worked with the Leptospirosis Laboratory on hunter viruses amongst rodents ... We collaborate with CAREC.

"We've carried out about 40 different projects, two-thirds of which were on infectious diseases, including AIDS. I would like to say that our institute stands out for working on a multitude of things, not one particular area. There are so many needs in this area we try not to focus on any particular area, because if we did we would be in competition with labs with huge resources and many experts."

Macpherson added: "We've worked on matters relating to the frog species in Grenada. We've worked on marine corals that may have anti-cancer properties. We've worked on medicinal plants used for diabetes. Every project we've ever done we've fed back information to the community, to individuals and to the Grenada Government. The government has changed policy at the national level based on the results of our research. We concentrate on applied research and when we find a problem we try to do something about it.

"For example we just found out that the prevalence of diarrhea in children in Grenada is over 20 per cent. So one fifth of all the school children had diarrhea when we did the survey. Half of those children had parasites and needed to be treated, and the information was fed back to government to try to reduce the statistic."

Malaria research

St. George's University, through WINDREF, also conducted extensive research on the malaria mosquito, despite the fact that the disease was eradicated from the region (with the exception of Haiti) in the 1960s.

"Now malaria in Guyana and other places is rising and visitations to these countries are increasing. So somebody with malaria could bring it back into the country. Our research was aimed at finding out if the mosquitoes that transmit malaria are now a serious problem, and they are not. I don't know for Barbados, but it would be interesting to find out.

"We were able to tell the government here that if somebody comes in with malaria the chances of an epidemic are very small because the mosquitoes are very seasonal. They are only found in the north end of the island, where few visitor go, and they are found only in the dry season in any large number. They breed in the rivers, but in the wet season the rivers come down the mountains very fast and wash all the larvae away."

While Macpherson stressed that the St. George's University would not forsake its Grenadian roots, the research foundation has its sights set on a much bigger picture.

"For the future we would very much like to become part of the research capability of this region; to be recognised by the Pan American Health Organisation (PAHO) and other agencies and to collaborate with PAHO and UWI (University of the West Indies) and other organisations - to be accepted as another organisation doing good quality research.

"We can have closer links with UWI through collaboration in research projects; collaboration and supervision of students doing research; sharing information at conferences; writing collaborative grant applications with UWI professionals. We have been doing a lot of this. We just need to keep going at it, because they are still not accepting us as true partners in education in the region.

Unity in research

"I think the barriers are coming down, and research is an area that can bring universities together. There is always competition between universities. It's healthy, but there should be mutual respect, and you can get that when you collaborate in research.

"We've had some success and I believe it's just a matter of time before closer collaborative links in research are forged. We recently had a number of UWI people come and talk about research collaboration with us at their initiative, which is wonderful."

See also:
     Dengue research ahead