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Yan LD, Sufra R, St Sauveur R, Jean-Pierre MC, Apollon A, Malebranche R, Théard M, Pierre G, Dévieux J, Lau J, Mourra N, Roberts NL, Rasul R, Nash D, Pirmohamed AM, Devereux RB, Lee MH, Kwan GF, Safford MM, Adrien L, Alfred JP, Deschamps M, Severe P, Fitzgerald DW, Pape JW, Rouzier V, McNairy ML. Spectrum of prevalent cardiovascular diseases in urban Port-au-Prince, Haiti: a population-based cross-sectional study. Lancet Reg Health Am 2024; 33:100729. [PMID: 38590326 PMCID: PMC11000196 DOI: 10.1016/j.lana.2024.100729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
Background Eighty percent of global cardiovascular disease (CVD) is projected to occur in low- and middle -income countries (LMICs), yet local epidemiological data are scarce. We provide the first population-based, adjudicated CVD prevalence estimates in Port-au-Prince, Haiti to describe the spectrum of heart disease and investigate associated risk factors. Methods Demographic, medical history, clinical, imaging and laboratory data were collected among adults recruited using multistage random sampling from 2019 to 2021. Prevalent CVD (heart failure, stroke, ischemic disease) were adjudicated using epidemiological criteria similar to international cohorts. Multivariable Poisson regressions assessed relationships between risk factors and prevalent CVD. Findings Among 3003 participants, median age was 40 years, 58.1% were female, 70.2% reported income <1 USD/day, and all identified as Black Haitian. CVD age-adjusted prevalence was 14.7% (95% CI 13.3%, 16.5%), including heart failure (11.9% [95% CI 10.5%, 13.5%]), stroke (2.4% [95% CI 1.9%, 3.3%]), angina (2.1% [95% CI 1.6%, 2.9%]), myocardial infarction (1.0% [95% CI 0.6%, 1.8%]), and transient ischemic attack (0.4% [95% CI 0.2%, 1.0%]). Among participants with heart failure, median age was 57 years and 68.5% of cases were among women. The most common subtype was heart failure with preserved ejection fraction (80.4%). Heart failure was associated with hypertension, obesity, chronic kidney disease, depression, and stress. Interpretation Early-onset heart failure prevalence is alarmingly high in urban Haiti and challenge modelling assumptions that ischemic heart disease and stroke dominate CVDs in LMICs. These data underscore the importance of local population-based epidemiologic data within LMICs to expedite the selection and implementation of evidence-based cardiovascular health policies targeting each country's spectrum of heart disease. Funding This study was funded by NIH grants R01HL143788, D43TW011972, and K24HL163393, clinicaltrials.govNCT03892265.
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Affiliation(s)
- Lily D. Yan
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | - Rodney Sufra
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Reichling St Sauveur
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Marie Christine Jean-Pierre
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Alexandra Apollon
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Rodolphe Malebranche
- Collège Haïtien de Cardiologie, Port-au-Prince, Haiti
- Department of Medicine and Pharmacology, Université d'État d'Haïti, Port-au-Prince, Haiti
| | - Michel Théard
- Collège Haïtien de Cardiologie, Port-au-Prince, Haiti
| | - Gerard Pierre
- Collège Haïtien de Cardiologie, Port-au-Prince, Haiti
| | - Jessy Dévieux
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Jennifer Lau
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | - Nour Mourra
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | | | - Rehana Rasul
- City University of New York Institute for Implementation Science in Population Health, New York, NY, USA
| | - Denis Nash
- City University of New York Institute for Implementation Science in Population Health, New York, NY, USA
| | | | | | - Myung Hee Lee
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
| | - Gene F. Kwan
- Division of Cardiology, Boston University School of Medicine, Boston, MA, USA
| | - Monika M. Safford
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | - Lauré Adrien
- Director General, Ministry of Public Health and Population, Haiti
| | - Jean Patrick Alfred
- Director of Studies and Programming, Ministry of Public Health and Population, Haiti
| | - Marie Deschamps
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Patrice Severe
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | | | - Jean W. Pape
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Vanessa Rouzier
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Margaret L. McNairy
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
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Philibert L, Lapierre J, Mulatris P, Kiki GM, Prophète A, Ntanda GM. Healthcare professionals' experience of teenage pregnancy and motherhood in Haiti. Int J Adolesc Med Health 2024; 0:ijamh-2023-0157. [PMID: 38575145 DOI: 10.1515/ijamh-2023-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/17/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES The aim of this study was to explore healthcare professionals' experience of pregnant and motherhood in adolescence in Haiti. METHODS The methodology for collecting and analyzing qualitative data was based on John Dewey's social survey. The study was conducted in nine health institutions in the North and North-East departments of Haiti from October 2020 to January 2021. Data were collected through individual semi-structured interviews with 15 healthcare professionals. All interviews were audio-recorded. The recordings were listened to carefully and transcribed in verbatim form. After checking and validation, the verbatims in Word format were exported to QDA Miner software version 6.0.5 for coding. The data were analyzed using Paillé and Mucchielli thematic analyses. RESULTS Health professionals such as gynecologists, nurses, midwives, nursing assistants, matrons and health workers took part in the study. These study participants indicate that teenage pregnancy and motherhood are social and public health problems whose negative consequences affect teenage girls, children, healthcare professionals, the healthcare system, and Haitian society in general. The services offered to adolescent girls are medical, educational, psychological, economic, and social in nature. When caring for pregnant adolescents during the transition to motherhood, healthcare professionals face many challenges that are linked to the socio-economic status and physiological reality of adolescents, as well as the healthcare system. CONCLUSIONS Programs involving home care visits should also be set up to offer ongoing support to pregnant or parenting teenagers. The distribution of food aid or materials such as clothing, hygiene products and baby kits should also be considered.
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Affiliation(s)
- Léonel Philibert
- 647717 Université de l'Ontario français , Toronto, ON, Canada
- Faculty of Nursing, 4440 Université Laval , Québec, QC, Canada
| | - Judith Lapierre
- Faculty of Nursing, 4440 Université Laval , Québec, QC, Canada
| | - Paulin Mulatris
- 647717 Université de l'Ontario français , Toronto, ON, Canada
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Henderson R. Invisible cancers: Seeing, knowing, enacting and proving cancers in Haiti. Soc Sci Med 2024; 347:116733. [PMID: 38493681 DOI: 10.1016/j.socscimed.2024.116733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/08/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
In Haiti, pathological confirmation of a cancer diagnosis is often delayed or impossible, imaging is expensive and imperfect, and many tests are unavailable. Physicians frequently struggle to establish cancers at a level of certainty required by "evidence based" standards, delaying definitive diagnosis and rendering some cancers permanently "suspected." I use 22 months of participant observation at the two largest cancer treatment programs in Haiti, as well as throughout Haiti's fragmented healthcare system, to look closely at processes of diagnosis and management of suspected 'cancers' which may never fully come to be. I argue that as global oncology becomes increasingly standardized, local practices are forced into alignment with a global knowledge basis that governs the knowability/unknowability of cancer. Using three case studies drawn from this work, I examine relationships among visibility, power, expertise and the replication of inequity through the governance of knowledge production. Finally, I examine the implications of these processes for cancer care in the global south.
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Decelles S, Nardocci M, Mildon A, Salameh B, Sebai I, Arasimowicz S, Batal M. Determinants of continued breastfeeding in children aged 12-23 months in three regions of Haiti. Rev Panam Salud Publica 2024; 48:e6. [PMID: 38464872 PMCID: PMC10921905 DOI: 10.26633/rpsp.2024.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 03/12/2024] Open
Abstract
Objectives To identify the prevalence and determinants of continued breastfeeding in Haitian children aged 12-23 months. Methods Three cross-sectional surveys were conducted yearly during the summers of 2017 to 2019 as part of a 4-year (2016-2020) multisectoral maternal and infant health initiative in the regions of Les Cayes, Jérémie, and Anse d'Hainault in Haiti. A total of 455 children 12-23 months of age and their mothers participated in the study. A child was considered to be continuing breastfeeding if the mother reported giving breast milk in the 24-hour dietary recall. Unadjusted and adjusted prevalence ratios were estimated, and associations were assessed between continued breastfeeding and explanatory factors related to sociodemographic characteristics, household food security, maternal nutrition, and breastfeeding knowledge and practices. Results The prevalence of continued breastfeeding was 45.8%. Continued breastfeeding was significantly more prevalent among younger children, children who did not have a younger sibling, children whose mother was not pregnant, those living in the Jérémie region, children who had been exclusively breastfed for less than 1 month, and children whose mother knew the World Health Organization's recommendation for continued breastfeeding up to 2 years or beyond. Conclusions The study results highlight the need for geographically equitable access to tailored and adequate health services and education that support breastfeeding in a way that is compatible with the local context.
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Affiliation(s)
- Stéphane Decelles
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Milena Nardocci
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Alison Mildon
- Independent consultantTorontoCanadaIndependent consultant, Toronto, Canada.
| | - Bana Salameh
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Ines Sebai
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Sabrina Arasimowicz
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Malek Batal
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
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Secor AM, Célestin K, Jasmin M, Honoré JG, Wagner AD, Beima-Sofie K, Pintye J, Puttkammer N. Electronic Medical Record Data Missingness and Interruption in Antiretroviral Therapy Among Adults and Children Living With HIV in Haiti: Retrospective Longitudinal Study. JMIR Pediatr Parent 2024; 7:e51574. [PMID: 38488632 PMCID: PMC10986334 DOI: 10.2196/51574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Children (aged 0-14 years) living with HIV often experience lower rates of HIV diagnosis, treatment, and viral load suppression. In Haiti, only 63% of children living with HIV know their HIV status (compared to 85% overall), 63% are on treatment (compared to 85% overall), and 48% are virally suppressed (compared to 73% overall). Electronic medical records (EMRs) can improve HIV care and patient outcomes, but these benefits are largely dependent on providers having access to quality and nonmissing data. Objective We sought to understand the associations between EMR data missingness and interruption in antiretroviral therapy treatment by age group (pediatric vs adult). Methods We assessed associations between patient intake record data missingness and interruption in treatment (IIT) status at 6 and 12 months post antiretroviral therapy initiation using patient-level data drawn from iSanté, the most widely used EMR in Haiti. Missingness was assessed for tuberculosis diagnosis, World Health Organization HIV stage, and weight using a composite score indicator (ie, the number of indicators of interest missing). Risk ratios were estimated using marginal parameters from multilevel modified Poisson models with robust error variances and random intercepts for the facility to account for clustering. Results Data were drawn from 50 facilities and comprised 31,457 patient records from people living with HIV, of which 1306 (4.2%) were pediatric cases. Pediatric patients were more likely than adult patients to experience IIT (n=431, 33% vs n=7477, 23.4% at 6 months; P<.001). Additionally, pediatric patient records had higher data missingness, with 581 (44.5%) pediatric records missing at least 1 indicator of interest, compared to 7812 (25.9%) adult records (P<.001). Among pediatric patients, each additional indicator missing was associated with a 1.34 times greater likelihood of experiencing IIT at 6 months (95% CI 1.08-1.66; P=.008) and 1.24 times greater likelihood of experiencing IIT at 12 months (95% CI 1.05-1.46; P=.01). These relationships were not statistically significant for adult patients. Compared to pediatric patients with 0 missing indicators, pediatric patients with 1, 2, or 3 missing indicators were 1.59 (95% CI 1.26-2.01; P<.001), 1.74 (95% CI 1.02-2.97; P=.04), and 2.25 (95% CI 1.43-3.56; P=.001) times more likely to experience IIT at 6 months, respectively. Among adult patients, compared to patients with 0 indicators missing, having all 3 indicators missing was associated with being 1.32 times more likely to experience IIT at 6 months (95% CI 1.03-1.70; P=.03), while there was no association with IIT status for other levels of missingness. Conclusions These findings suggest that both EMR data quality and quality of care are lower for children living with HIV in Haiti. This underscores the need for further research into the mechanisms by which EMR data quality impacts the quality of care and patient outcomes among this population. Efforts to improve both EMR data quality and quality of care should consider prioritizing pediatric patients.
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Affiliation(s)
- Andrew M Secor
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Kemar Célestin
- Centre Haïtien pour le Renforcement du Système de Santé, Port-au-Prince, Haiti
| | - Margareth Jasmin
- Centre Haïtien pour le Renforcement du Système de Santé, Port-au-Prince, Haiti
| | - Jean Guy Honoré
- Centre Haïtien pour le Renforcement du Système de Santé, Port-au-Prince, Haiti
| | - Anjuli D Wagner
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Kristin Beima-Sofie
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Jillian Pintye
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Nancy Puttkammer
- International Training and Education Center for Health, Seattle, WA, United States
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Kim Y, Shin B, Kim SE, Cajuste B, Kwon JA. A retrospective study on cholera understanding and WASH (water, sanitation, and hygiene) behavior among adolescents in three regions of La Gonâve, Haiti. J Infect Public Health 2024; 17:443-449. [PMID: 38266516 DOI: 10.1016/j.jiph.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/13/2023] [Accepted: 12/31/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUNDS This study assesses the impact of Water, Sanitation, and Hygiene (WASH) interventions on cholera understanding and hygiene practices in La Gonâve Island, Haiti. It examines the changes after implementing interventions in seven villages across the Downtown, Mountain, and Seaside regions. METHODS A retrospective investigation surveyed 210 school students from each region using a validated questionnaire. It assessed knowledge, attitudes, practices (KAP), and environmental aspects related to cholera and hygiene. Data analysis involved descriptive statistics and chi-square tests. RESULTS The study highlights significant disparities in education levels, toilet ownership, and healthcare access. Challenges in finding public toilets (86.67%) and accessing water sources (67.78%) are consistent across regions, with Seaside facing financial constraints (85.00%) and water cost concerns (91.67%). Attitudes toward hygiene vary, with the Mountain region having the highest 'Never' responses for handwashing (38.89%), and Downtown leading in water treatment practices (11.67%). There is a strong willingness to share health knowledge, particularly in Downtown (100.00%). Seaside (83.33%) and Downtown (73.33%) revealed a higher cholera awareness, while nearly half of Mountain students lacked knowledge (54.44%). CONCLUSIONS This study highlights significant disparities in WASH practices among La Gonâve's adolescents in Downtown, Mountain, and Seaside regions. Urgent interventions are crucial for improving sanitation, ensuring clean water access, and implementing targeted hygiene education, especially in the resource-constrained Mountain and Seaside areas. The findings underscore the vital roles of adolescents and schools in disseminating knowledge, with further research needed to explore intervention differences.
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Affiliation(s)
- Yuna Kim
- Global Care International, Seoul, the Republic of Korea
| | - Bohye Shin
- The Department of Health Convergence, Graduate School of Ewha Womans University, Seoul, the Republic of Korea
| | | | - Bernard Cajuste
- Oaktree Ministry, Baie-Tortue, Anse-à-Galets, Gonave Island, Haiti
| | - Jeoung A Kwon
- National Cancer Control Institute, National Cancer Center, Goyang, the Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, the Republic of Korea.
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Bolous NS, Mercredi P, Bonilla M, Friedrich P, Bhakta N, Metzger ML, Gassant PY. Determining the cost and cost-effectiveness of childhood cancer treatment in Haiti. Ecancermedicalscience 2024; 18:1675. [PMID: 38439808 PMCID: PMC10911665 DOI: 10.3332/ecancer.2024.1675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Indexed: 03/06/2024] Open
Abstract
Haiti is a low-income country with one of the lowest human development index rankings in the world. Its childhood cancer services are provided by a single hospital with the only dedicated paediatric oncology department in the country. Our objective was to assess the cost and cost-effectiveness of all types of childhood cancer in Haiti to help prioritise investments and to support national cancer control planning. All costing data were collected from the year 2017 or 2018 hospital records. Costs were classified into 11 cost categories, and the proportion of the overall budget represented by each was calculated and converted from Haitian Gourde to United States dollars. The 5-year survival rate was retrieved from hospital records and used to calculate the cost-effectiveness of disability-adjusted life year (DALY) averted, using a healthcare costing perspective. Additional sensitivity analyses were conducted accounting for late-effect morbidity and early mortality and discounting rates of 0%, 3% and 6%. The annual cost of operating a paediatric oncology unit in Haiti treating 74 patients with newly diagnosed cancer was $803,184 overall or $10,854 per patient. The largest cost category was pharmacy, constituting 25% of the overall budget, followed by medical personnel (20%) and administration (12%). The cost per DALY averted in the base-case scenario was $1,128, which is 76% of the gross domestic product per capita, demonstrating that treating children with cancer in Haiti is very cost-effective according to the World Health Organisation Choosing Interventions that are Cost-Effective (WHO-CHOICE) threshold. In the most conservative scenario, the cost per DALY averted was cost-effective by WHO-CHOICE criteria. Our data will add to the growing body of literature illustrating a positive return on investment associated with diagnosing and treating children with cancer in even the most resource-limited environments. We anticipate that these data will aid local stakeholders and policymakers when identifying cancer control priorities and making budgetary decisions.
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Affiliation(s)
- Nancy S Bolous
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | | | - Miguel Bonilla
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Paola Friedrich
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | | | - Pascale Y Gassant
- Nos Petit Frères et Sœurs-St Damien Hospital, Port-au-Prince 6124, Haiti
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Casebolt T. The HIV epidemic in Haiti: is disability a factor? AIDS Care 2024:1-8. [PMID: 38381850 DOI: 10.1080/09540121.2024.2318241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 02/07/2024] [Indexed: 02/23/2024]
Abstract
People with disabilities (PWD) are thought to be low risk for HIV because of social norms regarding disability and sex. However, qualitative studies indicate they are at risk and are not being reached by HIV programs. The Demographic and Health Survey (DHS) conducted in Haiti in 2016 included HIV biomarker data and disability status. Crude and adjusted odds ratios were calculated using a disability severity indicator as the independent variable and HIV infection as the dependent variable. Covariates were selected based on theory and previous studies. Individuals reporting milder disabilities had a higher odds of HIV infection in the crude model (OR:1.65; CI: 1.16-2.34) and those adjusted for demographics (OR:1.73; CI:1.19-2.51) and sexual activity (OR:1.60; CI:1.06-2.42). Those with moderate and more severe disabilities have the same odds of HIV infection as the general population. PWD are HIV-positive and at risk of HIV infection. Based on this, it is essential that HIV education, testing, and treatment programs are inclusive of PWD. Accessible HIV education materials need to be created. HIV testing programs should involve PWD in planning and implementation. Providers of HIV care must be trained regarding the needs of PWD for reproductive healthcare.
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Affiliation(s)
- Tara Casebolt
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, IL, USA
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Chery MJ, Henderson R, Dubique K, Camilus A, Eliacin HC, Pinard J, Toussaint E, Clisbee M. "I Am Half of a Person": Lived Experiences of Individuals Living With Ostomy After Surgery in Rural Haiti. Qual Health Res 2024:10497323241229420. [PMID: 38332547 DOI: 10.1177/10497323241229420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Intestinal ostomy can have significant effects on lives and lived experiences. However, limited research exists on the experiences of persons with ostomy in low-resource settings, such as rural Haiti. This study aimed to explore the lived experiences of Haitians with an ostomy, focusing on the physical, psychological, and social aspects of their post-operative lives. We conducted 9 semi-structured, in-depth interviews with participants who had undergone ostomy surgery at the Hôpital Universitaire de Mirebalais in Haiti. Employing interpretative phenomenological analysis (IPA), we iteratively examined transcripts to identify convergent and divergent codes, which were then grouped into themes to better understand the participants' experiences. Three themes emerged: (a) ostomy as a social disease, which has severe impacts on relationships and place in society; (b) ostomy as altering self-image, leading participants to reflect on their identity and the underlying causes of their condition and to reevaluate their necessities and abilities; and (c) ostomy as an arduous medical journey, characterized by pain, distress, uncertainty, and disillusionment, but also resiliency, improvisation, and hope. This study highlights the multifaceted experiences of persons with ostomy in the low-resource rural environment of Haiti and underscores the need for improved access to medical care, financial support, and psychosocial and caregiving resources for these individuals. Findings also emphasize the importance of medical providers' improved understanding in making medical decisions, and cultural and socioeconomic factors in developing effective support strategies.
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Affiliation(s)
- Maurice J Chery
- Research Department, Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Rebecca Henderson
- Research Department, Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Kobel Dubique
- Research Department, Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Adler Camilus
- Research Department, Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Henry Claude Eliacin
- Surgery Department Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Jacquemine Pinard
- Surgery Department Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Eric Toussaint
- Surgery Department Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Mary Clisbee
- Research Department, Zanmi Lasante/Partners in Health Mirebalais, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
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10
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Antabe R, Sano Y. Endorsement of HIV misconceptions over time among females and males in Haiti. HIV Res Clin Pract 2024; 25:2316538. [PMID: 38396369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
To address high HIV prevalence rates in Haiti, disseminating information about HIV transmission has been emphasized. Yet, after several decades, we do not know how effective HIV information dissemination has been in reducing HIV misconceptions. Using the 2005-06, 2012, and 2016-17 Haiti Demographic and Health Surveys and applying logistic regression, we found nuanced gender dynamics in endorsing HIV misconceptions over time. Among females at the bivariate level, the odds of endorsement of HIV misconceptions in 2012 (OR = 0.87, p < 0.05) and 2016-17 (OR = 0.68, p < 0.001) had declined compared to 2005-06. At the multivariate level, however, we observed that demographic factors suppressed the difference between 2005-06 and 2012, although those in 2016-17 (OR = 0.71, p < 0.001) were still less likely to endorse HIV misconceptions. However, this relationship disappeared once we added behavioral factors (OR = 0.93, p > 0.05). Among males, after controlling for demographic, socioeconomic, and behavioral factors at the multivariate level, those in 2012 (OR = 1.55, p < 0.001) and 2016-17 (OR = 1.24, p < 0.01) were more likely to endorse HIV misconceptions compared to men in 2005-06. We recommend that while improving women's access to HIV services, it is important to incorporate the HIV needs of males into the National HIV policy priority areas.
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Affiliation(s)
- Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Yujiro Sano
- Department of Sociology and Anthropology, Nipissing University, North Bay, ON, Canada
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11
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Forbes VE, Chamberlin MD, Dusabejambo V, Walker T, Bensen SP, Haynes N, Nunes K, Saint-Joy V, Makrauer FL. Education and Training Models for Remote Learning. Hematol Oncol Clin North Am 2024; 38:185-197. [PMID: 37635048 DOI: 10.1016/j.hoc.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Our international partnerships have fostered longstanding collaborative relationships leading to the development of unique, locally-designed, and sustainable training programs that serve as models for global health education and cooperation.
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Affiliation(s)
- Victoria E Forbes
- University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - Mary D Chamberlin
- Dartmouth-Hitchcock Medical Center, One Medical Center Drive Lebanon, NH 03756, USA
| | - Vincent Dusabejambo
- University of Rwanda College of Medicine and Health Sciences, KG 11 Avenue, Kigali, Rwanda
| | - Tim Walker
- Calvary Mater Newcastle, 20 Edith Street, Waratah NSW 2298, Australia
| | - Steve P Bensen
- Dartmouth-Hitchcock Medical Center, One Medical Center Drive Lebanon, NH 03756, USA
| | - Norrisa Haynes
- Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
| | - Kathryn Nunes
- Sidney Kimmel Medical College, 1025 Walnut Street, #100, Philadelphia, PA 19107, USA
| | - Veauthyelau Saint-Joy
- Centre Hospitalier de la Basse-Terre, 97100 Avenue, Gaston Feuillard, Basse-Terre 97109, Guadeloupe, France
| | - Frederick L Makrauer
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
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12
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Matias WR, Guillaume Y, Cene Augustin G, Vissieres K, Ternier R, Slater DM, Harris JB, Franke MF, Ivers LC. Effectiveness of the Euvichol® oral cholera vaccine at 2 years: A case-control and bias-indicator study in Haiti. Int J Infect Dis 2024; 139:153-158. [PMID: 38000510 PMCID: PMC10784151 DOI: 10.1016/j.ijid.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/21/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES The World Health Organization recommends the use of oral cholera vaccine (OCV) in cholera control efforts. Euvichol®, pre-qualified in 2015, is the leading component of the Global OCV stockpile, but data on its field effectiveness are limited. To evaluate Euvichol® vaccine effectiveness (VE), we conducted a case-control study between September 2018 to March 2020 following an OCV campaign in November 2017 in Haiti. METHODS Cases were individuals with acute watery diarrhea. Stool samples were tested by culture and real-time polymerase chain reaction of the Vibrio cholerae ctxA gene. Cases were matched to four community controls without diarrhea by residence, enrollment time, age, and gender, and interviewed for sociodemographics, risk factors, and self-reported vaccination. Cholera cases were analyzed by conditional logistic regression in the VE study. Non-cholera diarrhea cases were analyzed in a bias-indicator study. RESULTS We enrolled 15 cholera cases matched to 60 controls, and 63 non-cholera diarrhea cases matched to 249 controls. In the VE analysis, eight (53%) cases reported vaccination with any number of doses compared to 43 (72%) controls. Adjusted two-dose OCV VE was 69% (95% CI -71 to 94%). CONCLUSIONS Between 10-27 months after vaccination, Euvichol® was effective and similar to Shanchol™, suggesting that it can serve as one component of multi-sectoral comprehensive cholera control.
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Affiliation(s)
- Wilfredo R Matias
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, USA; Center for Global Health, Massachusetts General Hospital, Boston, USA.
| | | | | | | | | | - Damien M Slater
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Jason B Harris
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Molly F Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
| | - Louise C Ivers
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Center for Global Health, Massachusetts General Hospital, Boston, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA; Harvard Global Health Institute, Cambridge, USA
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13
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Galvin M, Michel G, Pierre E, Manguira E, Cénat JM. Maladi Nanm, Maladi Zonbi, & Maladi Lalin: A qualitative study of cultural concepts of distress in northern Haiti. Transcult Psychiatry 2024; 61:60-69. [PMID: 37946493 DOI: 10.1177/13634615231211477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Cultural Concepts of Distress (CCDs) are culturally constructed diagnostic categories that exist within a specific society or culture. While several studies have assessed CCDs around the world, few studies have examined them in Haiti. This qualitative study examines manifestations of anxiety and depression via "sent spirits" in the form of maladi nanm ("Soul disorder") and maladi zonbi ("Zombie disorder"), and bipolar disorder in the form of maladi lalin ("Moon disorder"). Examples of CCDs were recorded as part of a study which interviewed 96 outpatients at the first mental health center in northern Haiti. Using qualitative methods, the authors identified three specific CCDs as reported by mental health patients. Maladi nanm and maladi zonbi represent alternative explanatory models of anxiety and depression in which the sufferer views mental illness as stemming from a sent spirit, or spirit which is intentionally sent supernaturally with the intent to cause harm. Maladi lalin is experienced by patients with bipolar disorder who associate cycles of mania and depression as in-sync with the phases of the moon. Understanding culture-bound forms of mental distress in settings such as Haiti is essential to developing accurate psychometrics for measuring mental health, as well as ensuring culturally appropriate and effective diagnosis and treatment.
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Affiliation(s)
- Michael Galvin
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Mental Health Center at Morne Pelé, Cap-Haïtien, Haiti
| | - Guesly Michel
- Mental Health Center at Morne Pelé, Cap-Haïtien, Haiti
| | - Edny Pierre
- Mental Health Center at Morne Pelé, Cap-Haïtien, Haiti
| | | | - Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
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14
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Millien C, Henderson R, Joel Saint Hubert J, Parra-Herran C, Randall T. A case of placental site trophoblastic tumor managed in a low resource setting. Gynecol Oncol Rep 2024; 51:101329. [PMID: 38322734 PMCID: PMC10843990 DOI: 10.1016/j.gore.2024.101329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/30/2023] [Accepted: 01/21/2024] [Indexed: 02/08/2024] Open
Abstract
Placental trophoblastic site tumor (PSTT) is a rare type of gestational trophoblastic neoplasia (GTN). PSTT has a higher mortality than other types of gestational trophoblastic disease (GTD), with a rate of 16.1%, due to its relatively unpredictable behavior and reduced response to chemotherapy. Its diagnostic and management are very challenging in Low resources settings particularity in Haiti where MRI, PET Scan and IHC are not available. Further, the follow-up is very difficult because of social, political, and economic issues limiting the capacity of our patients to be present at all scheduled visits. No case of PSTT has been publicly described yet the Haitian experience in the literature in the management of such case compared to the developed world. We present a case of PSTT successfully diagnosed and managed at Mirebalais University Hospital (MUH) in Haiti with the support of telepathology and intentional partners while highlighting the difference that we observed compare to the developed world.
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Affiliation(s)
| | | | | | | | - Thomas Randall
- Department of Gynecologic Oncology, Massachusetts General Hospital, Boston, MA, USA
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15
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Park T, Pierre-Louis J, Jean T, Barua P, Ilma TT, Pinanez MA, Ravenell J, Castor C, Gousse Y. COVID-19 knowledge and mental health impact assessment in Haiti. Glob Ment Health (Camb) 2024; 11:e19. [PMID: 38414724 PMCID: PMC10897491 DOI: 10.1017/gmh.2024.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
Mental health is a significant public health challenge globally, and one anticipated to increase following the COVID-19 pandemic. In many rural regions of developing nations, little is known about the prevalence of mental health conditions and factors that may help mitigate poor outcomes. This study assessed the impact of the COVID-19 pandemic on mental health and social support for residents of rural Haiti. Data were collected from March to May 2020. The Patient Health Questionnaire subscales for anxiety and depression, and the Perceived Stress Scale were utilized in addition to tailored questions specific to COVID-19 knowledge. Half (51.8%) of the 500 survey respondents reported COVID-19-related anxiety and worrying either daily or across a few days. Half (50.2%) also reported experiencing depression daily or across several days. Most (70.4%) did not have any social support, and 28.0% experienced some stress, with 13.4% indicating high perceived stress. Furthermore, 4.6% had suitable plumbing systems in their homes. The results were immediately actionable, informing the implementation of a mental health counseling program for youth following a loss of social support through school closures. Long-term investments must be made as part of public health responses in rural communities in developing nations, which remain under-studied.
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Affiliation(s)
- Taehwan Park
- Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY, USA
| | | | - Tachel Jean
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Prachurjya Barua
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Taheera T Ilma
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Mariana A Pinanez
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Joseph Ravenell
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Chimene Castor
- Department of Nutritional Sciences, Howard University, Washington, DC, USA
| | - Yolene Gousse
- Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY, USA
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Vardeman ET, Kennelly EJ, Vandebroek I. Haitian women in New York City use global food plants for women's health. J Ethnobiol Ethnomed 2024; 20:8. [PMID: 38217006 PMCID: PMC10785501 DOI: 10.1186/s13002-024-00648-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Despite the availability of mainstream biomedical healthcare in New York City (NYC), community-based ethnomedicine practices remain a low-cost, culturally relevant treatment for many immigrants. Previous urban ethnobotany research in NYC has established that several Caribbean communities continue using medicinal plants for women's health after immigration. This study sought to address to what extent: (1) NYC Haitian women continue using medicinal plants for women's health after migration; (2) their plants and the conditions treated were similar to those identified in an earlier survey with NYC immigrants from the Dominican Republic. METHODS Through an ethnobotanical survey, 100 Haitian women living in NYC and born in Haiti were interviewed about their knowledge of medicinal plants for women's health conditions. Reported species were purchased based on local names in NYC Haitian stores and markets, vouchered, and identified. RESULTS Nearly all Haitian women (97%) reported using medicinal plants while living in Haiti. Most Haitian women continued using medicinal plants after coming to the USA (83%). The 14% decrease, although significant (z = 3.3; p = 0.001), was mainly due to logistical difficulties with sourcing plants after recent immigration. Popular medicinal plant species reported were primarily global food plants, re-emphasizing the intertwined food-medicine relationship in Caribbean diasporas. Comparison with data from NYC Dominicans identified childbirth and puerperium, gynecological infections, and vaginal cleansing as priority Haitian women's health concerns treated with plants. CONCLUSION Our findings support the global nature of Caribbean migrant plant pharmacopeia, predominantly centered around food plants and adapted to transnational urban settings. They underscore cultural diversity, dispelling the notion of one uniform traditional knowledge system labeled "Caribbean." The importance of preventative medicine for women's health, particularly the regular consumption of "healthy" foods or teas highlights the role food plants play in maintaining health without seeking treatment for a particular condition. Cross-cultural comparisons with other NYC Caribbean immigrants emphasize the importance of conducting ethnobotanical surveys to ground-truth plant use in the community. Such surveys can also identify culture-specific health priorities treated with these plants. Healthcare providers can leverage these insights to formulate culturally relevant and community-tailored healthcare strategies aligned with Haitian women's health beliefs and needs.
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Affiliation(s)
- Ella T Vardeman
- The Institute of Economic Botany, The New York Botanical Garden, 2900 Southern Boulevard, Bronx, NY, 10458, USA
- PhD Program in Biology, The Graduate Center, City University of New York, 365 5th Ave, New York, NY, 10016, USA
- Department of Biological Sciences, Lehman College, City University of New York, 250 Bedford Park Blvd W, Bronx, NY, 10468, USA
| | - Edward J Kennelly
- PhD Program in Biology, The Graduate Center, City University of New York, 365 5th Ave, New York, NY, 10016, USA
- Department of Biological Sciences, Lehman College, City University of New York, 250 Bedford Park Blvd W, Bronx, NY, 10468, USA
| | - Ina Vandebroek
- The Institute of Economic Botany, The New York Botanical Garden, 2900 Southern Boulevard, Bronx, NY, 10458, USA.
- PhD Program in Biology, The Graduate Center, City University of New York, 365 5th Ave, New York, NY, 10016, USA.
- Department of Life Sciences and Caribbean Centre for Research in Bioscience (CCRIB), Faculty of Science and Technology, The University of the West Indies, Mona, Kingston 7, Jamaica.
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Joseph F, Jean Simon D, Kondo Tokpovi VC, Kiragu A, Toudeka MRAS, Nazaire R. Trends and factors associated with recent HIV testing among women in Haiti: a cross-sectional study using data from nationally representative surveys. BMC Infect Dis 2024; 24:74. [PMID: 38212702 PMCID: PMC10782569 DOI: 10.1186/s12879-023-08936-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION In the Latin America and Caribbean region, Haiti is one of the countries with the highest rates of HIV. Therefore, this study examined the factors associated with HIV testing among women in Haiti and trends in HIV testing in 2006, 2012, and 2016/17. METHODS Data from the last three Haitian Demographic and Health Surveys (2006, 2012, and 2016/17) were used. The analysis was restricted to women aged of 15-49 years who made their sexual debut. STATA/SE 16.0 was employed to analyze the data by computing descriptive statistics, Chi‑square, and multilevel regression model to describe the trends and identify factors associated with HIV testing in Haiti. P-value less than 0.05 was taken as a significant association. RESULTS HIV testing prevalence increased more than twofold from 2006 (8.8%) to 2017 (21.3%); however, it decreased by 11.6% between 2012 and 2016/17. Additionally, the results indicated that age, place of residence, region, education level, wealth index, mass media exposure, marital status, health insurance, age at first sex and number of sexual partners were significantly associated with HIV testing. CONCLUSIONS To significantly increase HIV testing prevalence among women, the Haitian government must invest much more in their health education while targeting vulnerable groups (youth, women in union, and women with low economic status).
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Affiliation(s)
- Fanor Joseph
- Doctoral School of Social and Human Sciences, University of Antananarivo, Antananarivo, Madagascar
- Bureau d'Etudes Et de Recherche en Statistiques Appliquées, Suivi Et Evaluation (BERSA-SE), Port-au-Prince, Haiti
| | - David Jean Simon
- Bureau d'Etudes Et de Recherche en Statistiques Appliquées, Suivi Et Evaluation (BERSA-SE), Port-au-Prince, Haiti.
| | | | - Ann Kiragu
- Department of Law and Political and Social Sciences, University of Sorbonne Paris Nord, Paris, France
| | | | - Roodjmie Nazaire
- Faculté de Médecine et de Pharmacie (FMP), Université d'Etat d'Haïti (UEH), Port-Au-Prince, Haiti
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Nsengiyumva NP, Khan A, Gler MMTS, Tonquin ML, Marcelo D, Andrews MC, Duverger K, Ahmed S, Ibrahim T, Banu S, Sultana S, Morales ML, Villanueva A, Efo E, Onjare B, Celan C, Schwartzman K. Costs of Digital Adherence Technologies for Tuberculosis Treatment Support, 2018-2021. Emerg Infect Dis 2024; 30:79-88. [PMID: 38146969 PMCID: PMC10756355 DOI: 10.3201/eid3001.230427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Digital adherence technologies are increasingly used to support tuberculosis (TB) treatment adherence. Using microcosting, we estimated healthcare system costs (in 2022 US dollars) of 2 digital adherence technologies, 99DOTS medication sleeves and video-observed therapy (VOT), implemented in demonstration projects during 2018-2021. We also obtained cost estimates for standard directly observed therapy (DOT). Estimated per-person costs of 99DOTS for drug-sensitive TB were $98 in Bangladesh (n = 719), $119 in the Philippines (n = 396), and $174 in Tanzania (n = 976). Estimated per-person costs of VOT were $1,154 in Haiti (87 drug-sensitive), $304 in Moldova (173 drug-sensitive), $452 in Moldova (135 drug-resistant), and $661 in the Philippines (110 drug-resistant). 99DOTS costs may be similar to or less expensive than standard DOT. VOT is more expensive, although in some settings, labor cost offsets or economies of scale may yield savings. 99DOTS and VOT may yield savings to local programs if donors cover infrastructure costs.
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Frechette R, Colas N, Augustin M, Edema N, Pyram G, Louis S, Crevecoeur CE, Mathurin C, Louigne R, Patel B, Humphreys M, Chapital A, Martin M, Ayoub Q, Hottinger D, McCurdy MT, Tran Q, Skupski R, Zimmer D, Walsh M. Sustainable surgical resource initiative for Haiti: the SSRI-Haiti project. Glob Health Action 2023; 16:2180867. [PMID: 36856725 PMCID: PMC9980030 DOI: 10.1080/16549716.2023.2180867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
In response to the 2010 earthquake and subsequent cholera epidemic, St Luke's Medical Center was established in Port-au-Prince, Haiti. Here, we describe its inception and evolution to include an intensive care unit and two operating rooms, as well as the staffing, training and experiential learning activities, which helped St Luke's become a sustainable surgical resource. We describe a three-phase model for establishing a sustainable surgical centre in Haiti (build facility and acquire equipment; train staff and perform surgeries; provide continued education and expansion including regular specialist trips) and we report a progressive increase in the number and complexity of cases performed by all-Haitian staff from 2012 to 2022. The results are generalised in the context of the 'delay framework' to global health along with a discussion of the application of this three-phase model to resource-limited environments. We conclude with a brief description of the formation of a remote surgical centre in Port-Salut, an unforeseen benefit of local competence and independence. Establishing sustainable and collaborative surgery centres operated by local staff accelerates the ability of resource-limited countries to meet high surgical burdens.
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Affiliation(s)
- Richard Frechette
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Nathalie Colas
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Marc Augustin
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Nathalie Edema
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Gerson Pyram
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Stanley Louis
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Carl Eric Crevecoeur
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Carmeline Mathurin
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Raphael Louigne
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Bhavesh Patel
- Departments of Critical Care Medicine, Urology and Surgery, Mayo Clinic and Global, Surgical, Destination, Healthcare Inc., Phoenix, AZ, USA
| | - Mitchell Humphreys
- Departments of Critical Care Medicine, Urology and Surgery, Mayo Clinic and Global, Surgical, Destination, Healthcare Inc., Phoenix, AZ, USA
| | - Alyssa Chapital
- Departments of Critical Care Medicine, Urology and Surgery, Mayo Clinic and Global, Surgical, Destination, Healthcare Inc., Phoenix, AZ, USA
| | - Mallory Martin
- Departments of Critical Care Medicine and Surgery, Saint Luke's Medical Center, Port-au-Prince, Haiti
| | - Qamarissa Ayoub
- Bamiyan Maternal and Child Health Project and the Andeshgah Library, Kabul, Afghanistan
| | - Daniel Hottinger
- Department of Anesthesia, Metropolitan Anesthesia Network, LLP, Plymouth, MN, USA
| | - Michael T McCurdy
- Division of Pulmonary & Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Quincy Tran
- Division of Pulmonary & Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Richard Skupski
- Department of Medical Education, University of Indiana School of Medicine, South Bend/Notre Dame Campus, South Bend, IN, USA.,Department of Anesthesia, Memorial Hospital Beacon Medical Group of South Bend, South Bend, IN, USA
| | - Donald Zimmer
- Department of Medical Education, University of Indiana School of Medicine, South Bend/Notre Dame Campus, South Bend, IN, USA.,Department of Emergency Medicine, Memorial Hospital Beacon Medical Group of South Bend, South Bend, IN, USA
| | - Mark Walsh
- Department of Medical Education, University of Indiana School of Medicine, South Bend/Notre Dame Campus, South Bend, IN, USA.,Departments of Emergency and Internal Medicine, Saint Joseph Regional Medical Center, Mishawaka, IN, USA
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Chery MJ, Dubique K, Higgins JM, Faure PA, Phillips R, Morris S, Clisbee M, Conserve DF, Ricthwood T, Lefruit RM, Hedt-Gauthier BL. COVID-19 vaccine acceptance in three rural communes in Haiti: A cross-sectional study. Hum Vaccin Immunother 2023; 19:2204048. [PMID: 37157153 PMCID: PMC10171132 DOI: 10.1080/21645515.2023.2204048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Vaccines are the most effective mechanism for ending the COVID-19 pandemic. However, reluctance to accept vaccines has hindered the efforts of health authorities to combat the virus. In Haiti, as of July 2021, less than 1% of the country's population has been fully vaccinated in part due to vaccine hesitancy. Our goal was to assess Haitian attitudes toward COVID-19 vaccination and investigate the primary reasons for Moderna vaccine hesitancy. We conducted a cross-sectional survey across three rural Haitian communities, in September 2021. The research team used electronic tablets to collect quantitative data from 1,071 respondents, selected randomly across the communities. We report descriptive statistics and identify variables associated with vaccine acceptance using logistic regression built using a backward stepwise approach. Among 1,071 respondents, the overall acceptance rate was 27.0% (n = 285). The most common reason for vaccine hesitancy was "concern about side effects" (n = 484, 67.1%) followed by "concern about contracting COVID-19 from the vaccine" (n = 472, 65.4%). Three-quarters of respondents (n = 817) identified their healthcare workers as their most trustworthy source for information related to the vaccine. In the bivariate analysis, male gender (p = .06) and no history of drinking alcohol (p < .001) were significantly associated with being more likely to take the vaccine. In the final reduced model, only those with a history of drinking alcohol were significantly more likely to take the vaccine (aOR = 1.47 (1.23, 1.87) p < .001). The acceptance rate for the COVID-19 vaccine is low, and public health experts should design and strengthen vaccination campaigns to combat misinformation and public distrust.
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Affiliation(s)
- Maurice J Chery
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Kobel Dubique
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Julia M Higgins
- Strategic Information Systems, Partners in Health, Boston, MA, USA
| | - Peterson Abnis Faure
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Roslyn Phillips
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Sarah Morris
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Mary Clisbee
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Donaldson F Conserve
- Department of Prevention and Community Health, George Washington University School of Public Health and Health Services: The George Washington University Milken Institute of Public Health, Washington, DC, USA
| | - Tiarney Ricthwood
- Department of Medicine & Community Health and Global Health, Duke Institute of Global Health, Durham, NC, USA
| | - Ralph M Lefruit
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Bethany L Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- The Cross-Site COVID-19 Cohort Technical Working Group is Composed of the Following Members- Partners In Health/Boston: Jean Claude Mugunga, Donald Fejfar, Stefanie Joseph; Partners In Health/Haiti: Wesler Lambert, Mary Clisbee, Fernet Leandre; Partners In Health/Liberia: Prince F. Varney; Partners In Health/Lesotho: Melino Ndayizigiye, Patrick Nkundanyirazo, Afom Andom; Partners In Health/Malawi: Emilia Connolly, Chiyembekezo Kachimanga, Fabien Munyaneza; Partners In Health/Mexico: Zeus Aranda; Partners In Health/Peru: Jesus Peinado, Marco Tovar; Partners In Health/Rwanda: Vincent Cubaka, Nadine Karema; Partners In Health/Sierra Leone: Foday Boima, Gregory Jerome; Harvard Medical School: Bethany Hedt-Gauthier, Isabel Fulcher, Dale Barnhart, Megan Murray
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Millien H, Joseph T. Assessment of patient satisfaction level in the State University of Haiti Hospital and responsible factors: a cross-sectional mixed-methods study protocol. BMJ Open 2023; 13:e074199. [PMID: 38135339 DOI: 10.1136/bmjopen-2023-074199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Over the past few years, the healthcare industry has undergone a significant transformation where patients' perceptions of healthcare have gained a huge importance in assessing quality. Considering that it is now highly competitive, their contentment is a vital aspect in improving performance. However, practitioners in developing countries have traditionally overlooked the importance of patient views in healthcare, and this neglect is particularly prevalent in low-resource settings such as the State University of Haiti Hospital. The aim of this study is to assess patient satisfaction and identify influencing factors. METHODS AND ANALYSIS We will conduct a mixed-methods cross-sectional survey at Haiti's largest hospital centre from January to August 2024. First, patient satisfaction will be assessed using RAND Corporation's 18-Item-Patient Satisfaction Questionnaire, a valid self-administered questionnaire with strong potential for use in different settings. It will be translated into Creole and then tested in a pilot study. Second, a qualitative study based on individual interviews will explore patients' views on the care they have received. Data analysis will include descriptive statistics, χ2 tests, logistic regression and thematic analysis. ETHICS AND DISSEMINATION Ethical approval is granted from the Laboratoire Médecine Ethique et Société. Findings will be published in a corresponding peer-reviewed journal, shared with hospital staff and students. Social media posts, blog posts and conference debates will also be considered.
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Affiliation(s)
- Hugins Millien
- Université d'Etat d'Haïti Faculté de Médecine et de Pharmacie, Port-au-Prince, Haïti
| | - Thaïmye Joseph
- Université d'Etat d'Haïti Faculté de Médecine et de Pharmacie, Port-au-Prince, Haïti
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22
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Paul B, Jean Simon D, Kondo Tokpovi VC, Kiragu A, Balthazard-Accou K, Emmanuel E. Tobacco use in Haiti: findings from demographic and health survey. BMC Public Health 2023; 23:2504. [PMID: 38097954 PMCID: PMC10720190 DOI: 10.1186/s12889-023-17409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Although tobacco has harmful effects on the physical and mental health of individuals, its use remains significant, according to the World Health Organization. To understand this phenomenon, studies have been carried out in many countries around the world, while in Haiti where more than 5,000 people die each year due to tobacco use, little is known about the use of this substance. The aim of this study was to examine the prevalence and the factors associated with tobacco use in Haiti. METHODS We used data from the 2016/17 Haitian Demographic Health Survey. Both descriptive and multivariate analyses were conducted using STATA 16.0 software to assess the prevalence and identify factors associated with tobacco use. Results were reported as adjusted odds ratios with 95% confidence intervals. Statistical significance was declared at p < 0.05. RESULTS The prevalence of tobacco use was estimated at 9.8% (95% CI: 9.2-10.4) among men and 1.7% (95% CI: 1.5-1.9) among women. Although the prevalence of tobacco use was low among young people, it increased with age. Respondents aged 35 and above, with no formal education, non-Christians, divorced/separated/widowed, from poorest households, rural areas, "Aire Métropolitaine de Port-au-Prince" region, with high media exposure had a higher likelihood of tobacco use. CONCLUSION The low prevalence of tobacco use among Haitian women and youth represents a public policy opportunity to prevent these vulnerable groups from starting smoking. Adult male smokers should also be targeted by appropriate policy to reduce the different health burdens associated with tobacco, both for the smokers and other people they may expose to passive smoking. Government and health sector stakeholders, along with community leaders, should create and enforce awareness strategies and rules to control advertisements that encourage irresponsible and health-risky consumption behaviors.
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Affiliation(s)
- Bénédique Paul
- Department of Agro-socio-economics, Chibas, Université Quisqueya, Port-au-Prince, Haiti.
- Groupe d'Etude sur les Sciences de la Durabilité, Université Quisqueya, Port-au-Prince, Haiti.
| | - David Jean Simon
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti
| | | | - Ann Kiragu
- Department of Law and Political and Social Sciences, University of Sorbonne Paris Nord, Paris, France
| | - Ketty Balthazard-Accou
- Groupe d'Etude sur les Sciences de la Durabilité, Université Quisqueya, Port-au-Prince, Haiti
- Espace universitaire One Health, Université Quisqueya, Port-au-Prince, Haiti
| | - Evens Emmanuel
- Espace universitaire One Health, Université Quisqueya, Port-au-Prince, Haiti
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23
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Hock L, Zahl M, Woolley PM, Dejean CB, Pean CA, Israelski R. Haitian State Hospital Orthopedic Grand Rounds Series: A Virtual Curriculum to Address Global Surgery Needs. Ann Glob Health 2023; 89:86. [PMID: 38077263 PMCID: PMC10705029 DOI: 10.5334/aogh.4304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
Background Orthopedic Relief Services International (ORSI), in partnership with the Foundation for Orthopedic Trauma and the department of Orthopedic Surgery of La Paix University Hospital in Haiti, has developed a year-round Orthopedic Grand Round series. This series is moderated by Haitian faculty, features presentations by American orthopedic surgeons, and is broadcast to major state hospitals in Haiti for residents and attendings. Objective To introduce clinical concepts and increase knowledge in an area that is medically underserved, especially in the field of orthopedics, through lectures that tailor to the educational needs of Haiti. Methods Topics for lecture series are requested by Haitian attending orthopedic surgeons and residents in collaboration with American orthopedic surgeons to meet the educational needs of the residents in Haiti. These lectures reflect the case mix typically seen at state hospitals in Haiti and consider the infrastructural capacity of participating centers. Grand rounds are held an average of twice per month for an hour each, encompassing an educational lesson followed by an open forum for questions and case discussion. Feedback is taken from Haitian residents to ensure the sessions are beneficial to their learning. Findings and Conclusions To date 95 sessions hosted by 32 lecturers have been completed over Zoom between the US and Haiti. The fourth year of the lecture series is currently ongoing with an expansion of topics. In an underserved medical area such as Haiti, programs that educate local surgeons are crucial to continuing the growth and development of the medical community. Programs like this have the potential to contribute to the educational infrastructure of countries in need, regardless of the specialty. The model of this program can be used to produce similar curricula in various specialties and areas around the world.
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Affiliation(s)
- Lindsay Hock
- Touro College of Osteopathic Medicine, Middletown, NY, United States
| | - Melissa Zahl
- Touro College of Osteopathic Medicine, Middletown, NY, United States
| | - Pierre-Marie Woolley
- Department of Orthopaedics, HUP La Paix State University Hospital, Port-au-Prince, Haiti
| | - Christina Barau Dejean
- Department of Orthopaedics, HUP La Paix State University Hospital, Port-au-Prince, Haiti
| | - Christian A. Pean
- Department of Orthopaedic Trauma Surgery, Duke University School of Medicine, Durham, NC, United States
| | - Ronald Israelski
- Orthopedic Relief Services International (ORSI), United States
- Department of Orthopaedic Surgery, Touro College of Osteopathic Medicine, Middletown, NY, United States
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Andreassen KE, Kirkengen AL, Johansen ML. "I base my life on sadness": Apparently paradoxical sources of resilience among young Haitians. Transcult Psychiatry 2023; 60:985-996. [PMID: 37753635 PMCID: PMC10725111 DOI: 10.1177/13634615231202094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Haitian expressions of resilience also hold deep knowledge of human vulnerability. This longitudinal, qualitative study with young Haitians from urban shantytowns combines ethnographic and participatory methods to explore the complexities behind such idioms. Artistic and creative products made by or with the youth facilitated interviews, focus group discussions, and workshops. Through the life stories of participants and rich ethnographic material, this study presents locally situated idioms of resilience (and distress). By including local social ecology, the idioms were framed as historically and culturally rooted, thus shaping contextual, pragmatic, and gendered coping strategies grounded in embodied experiences of vulnerability and resistance. The study adds essential insights into Haitian resilience, revealing the local logics behind seemingly paradoxical statements. By drafting a conceptual framework for further studies on idioms of resilience, the study also makes a theoretical contribution to international resilience research.
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Affiliation(s)
| | - Anna Luise Kirkengen
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - May-Lill Johansen
- General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway Faculty of Health Sciences, Tromsø, Norway
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25
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Omer M, Trepanowski N, Yumeen S, Mirza FN, Goldbach HS, Joshipura D, Woo SB, Nuovo GJ, Robinson-Bostom L. Focal epithelial hyperplasia associated with human papillomavirus-13 in a healthy Haitian adult. JAAD Case Rep 2023; 42:52-55. [PMID: 38053542 PMCID: PMC10694523 DOI: 10.1016/j.jdcr.2023.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Affiliation(s)
- Mohamed Omer
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Pathology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Nicole Trepanowski
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Boston University School of Medicine, Boston, Massachusetts
| | - Sara Yumeen
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fatima N. Mirza
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Hayley S. Goldbach
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Deep Joshipura
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sook-Bin Woo
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Gerard J. Nuovo
- Department of Pathology, Ohio State University Medical Center, Columbus, Ohio
- GnomeDX, Powell, Ohio
| | - Leslie Robinson-Bostom
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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26
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PHILIBERT LÉONEL, NGANGUE PATRICE, LAPIERRE JUDITH, MULATRIS PAULIN, PROPHÈTE ALICE, KIKI GBÈTOGOMAXIME, NTANDA GISÈLEMANDIANGU. Perception and experience of relatives of pregnant teenagers: A qualitative study in the North and Northeast departments of Haiti. J Public Health Afr 2023; 14:2436. [PMID: 38500697 PMCID: PMC10946304 DOI: 10.4081/jphia.2023.2436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
Teenage pregnancy remains a global problem because of its consequences for the teenager, her child, her family, and society. In Haiti, this type of pregnancy burdens the family economy. In addition, the adolescent fertility rate is still high, despite efforts to reduce it. This article aims to analyze the perception and experiential experience of relatives of pregnant adolescents in Haiti. A qualitative study design based on Dewey's social survey was conducted. Data were collected from 17 relatives (partners, parents, guardians, and others) of pregnant adolescents in Haiti's North and Northeast departments. These data were analyzed using thematic analysis. According to the results, teenage pregnancy is seen as a disaster or a social problem in Haiti. It leads to many psychosocial and economic difficulties for the relatives, who are the only source of economic and social support for pregnant adolescents. Considering the vulnerability of relatives, policies, and interventions aimed at reducing the negative consequences of teenage pregnancy should consider this group of individuals.
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Affiliation(s)
| | - PATRICE NGANGUE
- The Institute for Interdisciplinary Training and Research in Health Sciences and Education (IFRISSE), Burkina Faso
| | - JUDITH LAPIERRE
- Faculty of Nursing, Université Laval, Québec (Québec) G1V 0A6
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27
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Gilles B, Robergeau FG, Massena LM, Nazaire MK, Millien C. Amniocele associated with placental abruption: a case report. AJOG Glob Rep 2023; 3:100270. [PMID: 37868822 PMCID: PMC10587749 DOI: 10.1016/j.xagr.2023.100270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
Amniocele is a rare condition involving herniation of the amniotic sac through a uterine breach. Our case is of a 29-year-old pregnant woman at 31 weeks of pregnancy who presented to the maternity triage of the Mirebalais Teaching Hospital for abdominal pain and the passage of blood through the vagina. After an ultrasonographic evaluation, the diagnosis of amniocele was made. In practice, for a third-trimester, nonlaboring pregnant woman with this symptomatology, the most common diagnoses that come to mind are placenta previa and placental abruption. This case highlights that a diagnosis of silent uterine rupture should also be kept in mind knowing that a uterine rupture is a life-threatening event for both the mother and the fetus, therefore, early diagnosis is very important to improve the maternal-fetal prognosis.
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Affiliation(s)
- Bernard Gilles
- Department of Obstetrics and Gynecology, Mirebalais Teaching Hospital, Mirebalais, Center, Haiti
| | - Fridjof G.S. Robergeau
- Department of Obstetrics and Gynecology, Mirebalais Teaching Hospital, Mirebalais, Center, Haiti
| | - Larry M. Massena
- Department of Obstetrics and Gynecology, Mirebalais Teaching Hospital, Mirebalais, Center, Haiti
| | - Maky-Kenson Nazaire
- Department of Obstetrics and Gynecology, Mirebalais Teaching Hospital, Mirebalais, Center, Haiti
| | - Christophe Millien
- Department of Obstetrics and Gynecology, Mirebalais Teaching Hospital, Mirebalais, Center, Haiti
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28
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Morgan STURGIS, Victoria BUCKMAN, Samiya DIAWARA, F FIQUITASP, M ADRIENM, Xixi ZHAO, Supriya MEHTA, Jennifer TOWBIN, Stephanie CRANE. AN ESSENTIAL TOOL TO BE OPTIMIZED: SYNDROMIC MANAGEMENT OF VAGINAL DISCHARGE IN HAITI. Afr J Infect Dis 2023; 18:28-34. [PMID: 38058415 PMCID: PMC10696650 DOI: 10.21010/ajidv18i1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 12/08/2023] Open
Abstract
Background Haiti, like many low-income countries in crisis, has limited resources for etiologic diagnosis of vaginal discharge. As such, we sought to characterize variability in diagnoses of women presenting with vaginal discharge syndrome, with the goal to improve standardization of syndromic management. Materials and Methods Participants aged 18 years and older endorsing vaginitis, or dysuria were recruited at Jerusalem Clinic over two, one-week periods in April 2018 and July 2019. We calculated Spearman rank correlations among history, exam findings, and diagnoses based on clinical presentation, to understand presentation groupings and their management. Results Among 98 women, median age was 33.5 years, and most frequent symptoms were: vaginal discharge (97%), vaginal itch (73%), and/or suprapubic pain (68%). Most common physical exam findings were vaginal discharge (86%), suprapubic/lower quadrant tenderness (29%), cervical motion tenderness (24%), and cervical erythema (20%). Most symptoms and physical exam findings were weakly correlated with each other. Nearly one-third (31%) were diagnosed with normal physiologic vaginal discharge or no diagnosis, followed by Bacterial vaginosis (31%), vulvovaginal candidiasis (15%), cervicitis/PID (13%), and STI (7%). No reported symptoms strongly differentiated diagnostic categories. Diagnoses varied considerably by exam findings. Conclusions The weak correlations between symptoms, exam findings, and diagnoses could represent variability in assessment. In the absence of reliable and accessible laboratory testing, the importance of standardizing syndromic management becomes increasingly relevant. Results from our study support the utility of speculum examination and more standardized documentation of physical exam findings. Next steps include the development of local algorithms to promote standardization of treatment of vaginal discharge syndrome.
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Affiliation(s)
| | | | | | | | | | | | - MEHTA, Supriya
- University of Illinois School of Public Health, Chicago IL USA
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29
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Fang AP, Edmond MC, Marsh RH, Normil M, Poola N, Michel Payant SJ, Luc PR, Strokes N, Calixte M, Rimpel L, Rouhani SA. Outcomes of Invasive and Noninvasive Ventilation in a Haitian Emergency Department. Ann Glob Health 2023; 89:72. [PMID: 37868710 PMCID: PMC10588490 DOI: 10.5334/aogh.4009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 09/17/2023] [Indexed: 10/24/2023] Open
Abstract
Background Limited data exist on the outcomes of patients requiring invasive ventilation or noninvasive positive pressure ventilation (NIPPV) in low-income countries. To our knowledge, no study has investigated this topic in Haiti. Objectives We describe the clinical epidemiology, treatment, and outcomes of patients requiring NIPPV or intubation in an emergency department (ED) in rural Haiti. Methods This is an observational study utilizing a convenience sample of adult and pediatric patients requiring NIPPV or intubation in the ED at an academic hospital in central Haiti from January 2019-February 2021. Patients were prospectively identified at the time of clinical care. Data on demographics, clinical presentation, management, and ED disposition were extracted from patient charts using a standardized form and analyzed in SAS v9.4. The primary outcome was survival to discharge. Findings Of 46 patients, 27 (58.7%) were female, mean age was 31 years, and 14 (30.4%) were pediatric (age <18 years). Common diagnoses were cardiogenic pulmonary edema, pneumonia/pulmonary sepsis, and severe asthma. Twenty-three (50.0%) patients were initially treated with NIPPV, with 4 requiring intubation; a total of 27 (58.7%) patients were intubated. Among those for whom intubation success was documented, first-pass success was 57.7% and overall success was 100% (one record missing data); intubation was associated with few immediate complications. Twenty-two (47.8%) patients died in the ED. Of the 24 patients who survived, 4 were discharged, 19 (intubation: 12; NIPPV: 9) were admitted to the intensive care unit or general ward, and 1 was transferred. Survival to discharge was 34.8% (intubation: 22.2%; NIPPV: 52.2%); 1 patient left against medical advice following admission. Conclusions Patients with acute respiratory failure in this Haitian ED were successfully treated with both NIPPV and intubation. While overall survival to discharge remains relatively low, this study supports developing capacity for advanced respiratory interventions in low-resource settings.
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Affiliation(s)
- Anna P. Fang
- Boston Medical Center, Department of Emergency Medicine, One Boston Medical Center Place, Boston, MA, USA
| | - Marie Cassandre Edmond
- Emergency Department, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
- Zanmi Lasante, Port-au-Prince, Haiti
| | - Regan H. Marsh
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
- Partners In Health, Boston, MA, USA
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Manouchka Normil
- Zanmi Lasante, Port-au-Prince, Haiti
- Family Medicine, GHESKIO Centers, Port-au-Prince, Haiti
| | - Nivedita Poola
- Department of Emergency Medicine, SUNY Downstate/King’s County Hospital, Brooklyn, NY, USA
| | - Sherley Jean Michel Payant
- Zanmi Lasante, Port-au-Prince, Haiti
- Family Medicine, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Pierre Ricot Luc
- Emergency Department, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
- Zanmi Lasante, Port-au-Prince, Haiti
| | - Natalie Strokes
- Family Medicine, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Manise Calixte
- Emergency Department, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
- Zanmi Lasante, Port-au-Prince, Haiti
| | - Linda Rimpel
- Emergency Department, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
- Zanmi Lasante, Port-au-Prince, Haiti
| | - Shada A. Rouhani
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
- Partners In Health, Boston, MA, USA
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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30
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Mavian CN, Tagliamonte MS, Alam MT, Sakib SN, Cash MN, Moir M, Jimenez JP, Riva A, Nelson EJ, Cato ET, Ajayakumar J, Louis R, Curtis A, De Rochars VMB, Rouzier V, Pape JW, de Oliveira T, Morris JG, Salemi M, Ali A. Ancestral Origin and Dissemination Dynamics of Reemerging Toxigenic Vibrio cholerae, Haiti. Emerg Infect Dis 2023; 29:2072-2082. [PMID: 37735743 PMCID: PMC10521621 DOI: 10.3201/eid2910.230554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
The 2010 cholera epidemic in Haiti was thought to have ended in 2019, and the Prime Minister of Haiti declared the country cholera-free in February 2022. On September 25, 2022, cholera cases were again identified in Port-au-Prince. We compared genomic data from 42 clinical Vibrio cholerae strains from 2022 with data from 327 other strains from Haiti and 1,824 strains collected worldwide. The 2022 isolates were homogeneous and closely related to clinical and environmental strains circulating in Haiti during 2012-2019. Bayesian hypothesis testing indicated that the 2022 clinical isolates shared their most recent common ancestor with an environmental lineage circulating in Haiti in July 2018. Our findings strongly suggest that toxigenic V. cholerae O1 can persist for years in aquatic environmental reservoirs and ignite new outbreaks. These results highlight the urgent need for improved public health infrastructure and possible periodic vaccination campaigns to maintain population immunity against V. cholerae.
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Affiliation(s)
- Carla N. Mavian
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Massimiliano S. Tagliamonte
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Meer T. Alam
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - S. Nazmus Sakib
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Melanie N. Cash
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Monika Moir
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Juan Perez Jimenez
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Alberto Riva
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Eric J. Nelson
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Emilie T. Cato
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Jayakrishnan Ajayakumar
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Rigan Louis
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Andrew Curtis
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - V. Madsen Beau De Rochars
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Vanessa Rouzier
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Jean William Pape
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
| | - Tulio de Oliveira
- University of Florida, Gainesville, Florida, USA (C.N. Mavian, M.S. Tagliamonte, M.T. Alam, S.N. Sakib, M.N. Cash, J.P. Jimenez, A. Riva, E.J. Nelson, E.T. Cato, R. Louis, V.M. Beau De Rochars, J.G. Morris Jr., M. Salemi, A. Ali)
- Stellenbosch University, Stellenbosch, South Africa (M. Moir, T. de Oliveira)
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (J. Ajayakumar, A. Curtis)
- Les Centres GHESKIO, Port-au-Prince, Haiti (V. Rouzier, J.W. Pape)
- Weill Cornell Medical College, New York, New York, USA (V. Rouzier, J.W. Pape)
- University of KwaZulu-Natal, Durban, South Africa (T. de Oliveira)
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa (T. de Oliveira)
- University of Washington, Seattle, Washington, USA (T. de Oliveira)
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31
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Philibert L, Ngangue P, Lapierre J, Bernardino E, Kiki GM, Ntanda GM. Vulnerability analysis of Haitian adolescent girls before pregnancy: a qualitative study. Int J Adolesc Med Health 2023; 35:403-410. [PMID: 37671939 DOI: 10.1515/ijamh-2022-0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/26/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES This article aims to analyze the vulnerabilities experienced by Haitian adolescent girls before their pregnancy. METHODS A qualitative research design was developed from Dewey's social survey. From October 2020 to January 2021, semi-structured interviews were conducted with 33 pregnant adolescents living in Haiti's North and North-East departments. Thematic data analysis was performed using the qualitative data analysis software QDA miner, 6.0.5. RESULTS The adolescent girls interviewed were between 14 and 19. The study showed that adolescent girls experienced economic and social hardship, gender issues, and barriers to contraceptive use before pregnancy. These girls have experienced restrictive conditions that make them vulnerable to risky sexual practices and unwanted pregnancy. CONCLUSIONS The results have indicated that Haitian adolescent girls' vulnerabilities before their pregnancy result from economic, social, and cultural injustices to which they are exposed from early childhood. These adolescent girls are also highly vulnerable to sexual exploitation and rape, as well as pregnancy. It is essential to address these issues when implementing programs aimed at improving the living conditions of adolescents in Haiti, including the prevention of early and unwanted pregnancy.
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Affiliation(s)
- Léonel Philibert
- Université de l'Ontario français, Toronto, ON, Canada
- Faculty of Nursing, Université Laval, Québec, Québec, Canada
| | - Patrice Ngangue
- Faculty of Nursing, Université Laval, Québec, Québec, Canada
| | - Judith Lapierre
- Faculty of Nursing, Université Laval, Québec, Québec, Canada
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32
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Clutter CH, Klarman MB, Cajusma Y, Cato ET, Abu Sayeed M, Brinkley L, Jensen O, Baril C, De Rochars VMB, Azman AS, Long MT, Cummings D, Leung DT, Nelson EJ. Population-Based Serologic Survey of Vibrio cholerae Antibody Titers before Cholera Outbreak, Haiti, 2022. Emerg Infect Dis 2023; 29:1864-1867. [PMID: 37487168 PMCID: PMC10461687 DOI: 10.3201/eid2909.230174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023] Open
Abstract
A Vibrio cholerae O1 outbreak emerged in Haiti in October 2022 after years of cholera absence. In samples from a 2021 serosurvey, we found lower circulating antibodies against V. cholerae lipopolysaccharide in children <5 years of age and no vibriocidal antibodies, suggesting high susceptibility to cholera, especially among young children.
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Affiliation(s)
| | | | - Youseline Cajusma
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Emilee T. Cato
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Md. Abu Sayeed
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Lindsey Brinkley
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Owen Jensen
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Chantale Baril
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - V. Madsen Beau De Rochars
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Andrew S. Azman
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Maureen T. Long
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
| | - Derek Cummings
- University of Utah, Salt Lake City, Utah, USA (C.H. Clutter, O. Jensen, D.T. Leung)
- University of Florida, Gainesville, Florida, USA (M.B. Klarman, Y. Cajusma, E.T. Cato, M.A. Sayeed, L. Brinkley, V.M. Beau De Rochars, M.T. Long, D. Cummings, E.J. Nelson)
- Université d'État d'Haïti, Port au Prince, Haiti (C. Baril)
- Johns Hopkins University, Baltimore, Maryland, USA (A.S. Azman)
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Galvin M, Michel G, Manguira E, Pierre E, Lesorogol C, Trani JF, Lester R, Iannotti L. Examining the Etiology and Treatment of Mental Illness Among Vodou Priests in Northern Haiti. Cult Med Psychiatry 2023; 47:647-668. [PMID: 35753013 PMCID: PMC9244373 DOI: 10.1007/s11013-022-09791-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 11/17/2022]
Abstract
This study assesses the perspectives and experiences of Vodou priests (ougan) in the treatment of mental illness in northern Haiti. Our goal is to explore the etiology and popular nosologies of mental illness in the context of Haitian Vodou, through understandings of illness and misfortune which are often viewed as a result of sent spirits-or spirits sent supernaturally by others with the intent to cause harm. Using a qualitative approach, this study conducted semi-structured in-depth interviews with 20 ougan living near the city of Cap-Haïtien. Interviews highlight a sample of healers with little formal training who maintain beliefs and practices that differ significantly from current biomedical models. Ougan treat mental illness through a variety of means including prayer and conjuring of spirits, leaves for teas and baths, as well as combinations of perfumes, rum, human remains, and other powdered concoctions that are either imbibed or rubbed on the skin. The primary purpose of these treatments is to expel the spirit causing harm, yet they can often result in additional harm to the patient. Findings suggest that while ougan are willing to collaborate with biomedical practitioners, significant barriers remain preventing cooperation between these two groups.
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Affiliation(s)
- Michael Galvin
- Fogarty Global Health Fellow (NIH), Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Guesly Michel
- Mental Health Center at Morne Pelé, Quartier Morin, Nord, Haiti
| | - Eurine Manguira
- Mental Health Center at Morne Pelé, Quartier Morin, Nord, Haiti
| | - Edny Pierre
- Mental Health Center at Morne Pelé, Quartier Morin, Nord, Haiti
| | - Carolyn Lesorogol
- Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO 63130 USA
| | - Jean-François Trani
- Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO 63130 USA
| | - Rebecca Lester
- Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO 63130 USA
| | - Lora Iannotti
- Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO 63130 USA
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34
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Matias WR, Guillaume Y, Augustin GC, Vissieres K, Ternier R, Charles RC, Harris JB, Franke MF, Ivers LC. Seroprevalence of Vibrio cholerae in Adults, Haiti, 2017. Emerg Infect Dis 2023; 29:1929-1932. [PMID: 37610182 PMCID: PMC10461664 DOI: 10.3201/eid2909.230401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
In Haiti in 2017, the prevalence of serum vibriocidal antibody titers against Vibrio cholerae serogroup O1 among adults was 12.4% in Cerca-la-Source and 9.54% in Mirebalais, suggesting a high recent prevalence of infection. Improved surveillance programs to monitor cholera and guide public health interventions in Haiti are necessary.
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35
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Coulibaly GL, Farand L, Champagne F. [Contextual factors influencing the delegation of tasks to Multi-skilled Community Health Workers in Haiti]. Sante Publique 2023; 35:183-192. [PMID: 37558623 DOI: 10.3917/spub.232.0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
INTRODUCTION In Haiti, the delegation of tasks to Multi-skilled Community Health Workers (locally called ASCP) is a strategy implemented by the Ministry of Public Health and Population to improve universal health coverage. PURPOSE OF RESEARCH To contribute to the successful implementation of this strategy, this article reports on a case study of its implementation in the northern health department of Haiti. More specifically, this article provides information on the contextual factors that facilitate or hinder the implementation of task delegation to ASCP. RESULTS The results obtained show notable progress in the implementation of task delegation to ASCP in the northern health department of Haiti. These mainly concern the following activities: selection, training, and deployment of ASCPs, endowment of work materials, supervision, collection and analysis of data on the results obtained. In September 2019, 215 ASCPs were active in the department. This corresponds to 44.3% of the 485 ASCPs planned to cover the department’s needs. Several contextual factors hindering or facilitating the implementation of this intervention were also identified with 35 resource persons during semi-structured interviews. These relate to the planning and monitoring of the implementation of the intervention (cited by 12 out of 35 people), the institutional context (10/35), and political (17/35), structural (30/35) and environmental factors (7/35). CONCLUSIONS This study highlights several contextual factors that need to be considered to ensure the successful implementation of the delegation of tasks to ASCP in Haiti and possibly in other contexts.
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Affiliation(s)
| | - Lambert Farand
- Université de Montréal, École de santé publique – Montréal – Canada
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Galvin M, Michel G, Pierre E, Manguira E, Lesorogol C, Trani JF, Iannotti L. Determinants of mental illness and care seeking behaviours in Northern Haiti: an assessment of demographic, social, and religio-cultural factors among patients at the first mental health clinic in the region. Ment Health Relig Cult 2023; 26:238-260. [PMID: 38037562 PMCID: PMC10688242 DOI: 10.1080/13674676.2023.2202901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/10/2023] [Indexed: 12/02/2023]
Abstract
Populations in countries such as Haiti demonstrate a high level of need for mental health care despite a lack of services and trained professionals. In addition to the dearth of biomedical services, local belief systems and explanatory models contribute to a majority of the population relying on traditional medicine as their first option for care. Using a mixed-methods approach, we aim to characterise mental illness at the first mental health clinic in the region - Sant Sante Mantal Mòn Pele (SSMMP) - by interviewing 96 patients with a demographic questionnaire as well as Anxiety, Depression, and Functionality Scales. Multivariate logistic and linear regression models were conducted examining the impact of demographic variables on whether patients believed their illness was caused by sent spirits or previously visited a Vodou priest for treatment, as well as Depression, Anxiety, and Functionality Scale scores. Factors associated with mental illness in this sample included sex, number of traumatic events, physical health status, and number of sessions attended at SSMMP. Factors which impacted traditional beliefs or practices related to mental illness included sex, age, and income.
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Affiliation(s)
- Michael Galvin
- Department of Psychiatry, Boston Medical Center (BMC), Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Mental Health Center at Morne Pelé, Nord, Haiti
| | | | - Edny Pierre
- Mental Health Center at Morne Pelé, Nord, Haiti
| | | | | | | | - Lora Iannotti
- Washington University in St. Louis, St. Louis, MO, USA
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Bansal E, Patel K, Lacossade S, Gue B, Acceme K, Robinson O, Kwan GF, Wilentz JR. Population health and sociodemographic variables as predictors of access to cardiac medicine and surgery in Haiti. Glob Health Res Policy 2023; 8:27. [PMID: 37468963 PMCID: PMC10354940 DOI: 10.1186/s41256-023-00308-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND In Haiti, cardiovascular disease is a leading cause of morbidity and mortality, with congenital and rheumatic heart disease comprising a large portion of disease burden. However, domestic disparities in cardiac care access and their impact on clinical outcomes remain poorly understood. We analyzed population-level sociodemographic variables to predict cardiac care outcomes across the 10 Haitian administrative departments. METHODS This cross-sectional study combined data from a 2016-17 Haitian national survey with aggregate outcomes from the Haiti Cardiac Alliance (HCA) database (n = 1817 patients). Using univariate and multivariable regression analyses, the proportion of HCA patients belonging to each of three clinical categories (active treatment, lost to follow-up, deceased preoperatively) was modeled in relation to six population-level variables selected from national survey data at the level of the administrative department. RESULTS In univariate analysis, higher department rates of childhood growth retardation were associated with a lower proportion of patients in active care (OR = 0.979 [0.969, 0.989], p = 0.002) and a higher proportion of patients lost to follow-up (OR = 1.016 [1.006, 1.026], p = 0.009). In multivariable analysis, the proportion of department patients in active care was inversely associated with qualified prenatal care (OR = 0.980 [0.971, 0.989], p = 0.005), and child growth retardation (OR = 0.977 [0.972, 0.983]), p = 0.00019). Similar multivariable results were obtained for department rates of loss to follow-up (child growth retardation: OR = 1.018 [1.011, 1.025], p = 0.002; time to nearest healthcare facility in an emergency: OR = 1.004 [1.000, 1.008, p = 0.065) and for preoperative mortality (prenatal care: OR = 0.989 [0.981, 0.997], p = 0.037; economic index: OR = 0.996 [0.995, 0.998], p = 0.007; time to nearest healthcare facility in an emergency: OR = 0.992 [0.988, 0.996], p = 0.0046). CONCLUSIONS Population-level survey data on multiple variables predicted domestic disparities in HCA clinical outcomes by region. These findings may help to identify underserved areas in Haiti, where increased cardiac care resources are required to improve health equity. This approach to analyzing clinical outcomes through the lens of population-level survey data may inform future health policies and interventions designed to increase cardiac care access in Haiti and other low-income countries.
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Affiliation(s)
- Esha Bansal
- Arnhold Institute of Global Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA.
| | - Krishna Patel
- Arnhold Institute of Global Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Samantha Lacossade
- Saint Damien Pediatric Hospital, Nos Petits Frères et Sœurs, Port-au-Prince, Haiti
- Haiti Cardiac Alliance, 47 Maple Street, Suite 213, Burlington, VT, 05401, USA
| | - Bennisoit Gue
- Saint Damien Pediatric Hospital, Nos Petits Frères et Sœurs, Port-au-Prince, Haiti
- Haiti Cardiac Alliance, 47 Maple Street, Suite 213, Burlington, VT, 05401, USA
| | - Kessy Acceme
- Saint Damien Pediatric Hospital, Nos Petits Frères et Sœurs, Port-au-Prince, Haiti
- Haiti Cardiac Alliance, 47 Maple Street, Suite 213, Burlington, VT, 05401, USA
| | - Owen Robinson
- Haiti Cardiac Alliance, 47 Maple Street, Suite 213, Burlington, VT, 05401, USA
| | - Gene F Kwan
- Section of Cardiovascular Medicine, Boston University School of Medicine, 72 East Concord St, Boston, MA, 808, USA
| | - James R Wilentz
- Arnhold Institute of Global Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
- Haiti Cardiac Alliance, 47 Maple Street, Suite 213, Burlington, VT, 05401, USA
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Lucchi E, Schuberth M. Negotiating humanitarian space with criminal armed groups in urban Latin America. Disasters 2023; 47:700-724. [PMID: 36379913 DOI: 10.1111/disa.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Humanitarian and development agencies intervening in Latin American cities increasingly face the challenge posed by criminal armed groups (CAGs). Yet, there is a need for evidence-based comparative studies on how international agencies deal with them. Drawing on data collected in Colombia, El Salvador, Haiti, Honduras, and Mexico, this paper presents a novel typology of humanitarian organisations' access strategies that distinguishes between different levels of interaction with CAGs. The paper shows how humanitarian agencies assess a variety of risks and balance the potential consequences of their engagement with CAGs with the need to maintain constructive and trustful relationships with the state and the community with which they work. It finds that indirect dialogue or negotiation with CAGs via community leaders who act as intermediaries might provide a low-risk alternative to direct negotiation with CAG leaders, provided that 'do no harm' and humanitarian protection considerations vis-à-vis communities and intermediaries play a central role.
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Affiliation(s)
| | - Moritz Schuberth
- Visiting Fellow, London School of Economics and Political Science, United Kingdom
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Jean Paul A, Charles JH, Gedner GME, Roche R, Andre W, Saint Croix GR, Perue GG. Clinical characteristic of a Haitian stroke cohort and a scoping review of the literature of stroke among the Haitian population. J Clin Transl Res 2023; 9:153-159. [PMID: 37457547 PMCID: PMC10339410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/04/2023] [Accepted: 04/17/2023] [Indexed: 07/18/2023] Open
Abstract
Background and Aim There are significant disparities in stroke care and outcomes between low- and middle-income countries compared to high-income countries. Haiti, a lower-middle-income country, suffers from a lack of resources for acute stroke management. This study is the first to report the epidemiological profile of the Haitian population presenting with stroke symptoms at the largest academic hospital in the nation. Methods This is an observational study conducted over a period of 5 months from April 2021 to August 2021 in the Internal Medicine Department of the State University Hospital of Haiti. There were 51 included patients who were suspected to have had an acute stroke. A descriptive statistical analysis was conducted. A scoping review of the literature was also conducted. Results Over 50% of included patients were between 19 and 65 years old. The mean age at presentation was 61 years, and patients were predominantly female (64.7%). The prevalence of severe motor deficits was over 96%. The mean National Institutes of Health Stroke Scale was 12. Only 15.7% of patients (8/51) had a computed tomography (CT) scan during their hospitalization. The median time to CT scan was 84 h after symptom onset. About 80% of those with complications took more than 24 h to arrive at the hospital after the onset of symptoms. Eleven percent of patients had complications, and the mortality rate was 3.9%. There was a significant association between the Modified Rankin Scale and the occurrence of complications (p = 0.016). National Institutes of Health Stroke Scale (NIHSS) score had a significant association with the Glasgow score (F = 6.3; p < 0.001) where an inversely proportional correlation was observed between them (r = -0.7; p < 0.001) and a proportional correlation with the Rankin prediction score and the NIHSS (r = 0.3, p = 0.04). Little is known about the epidemiology of stroke patients in Haiti, and this limits the ability to develop targeted interventions to improve outcomes. In our scoping review, only three pertinent studies were identified over a 25-year period, this leads to a lack of data in regard to stroke care in Haiti mainly due to the absence of trained personnel. Conclusion In our cohort, stroke is mainly affecting female patients. The majority of stroke patients have moderate to severe motor deficits and took more than 24 h to arrive at the hospital. Urgent assistance is needed to strengthen personnel and infrastructure dedicated to stroke. Neurological assessment based on NIHSS and Rankin score should be systematic in stroke evaluation in Haiti. Relevance for Patients This study is relevant for patients because it emphasizes the challenges of stroke management in Haiti due to the non-availability of reference drugs, the time to arrive at the hospital to start treatment, as well as the means of diagnosis which are limited, like the CT scan. While stroke prevalence is on the rise in the country, it is the highest in the Caribbean and Latin America region.
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Affiliation(s)
- Axler Jean Paul
- Department of Internal Medicine, State University of Haiti, Port-au-Prince, West, Haiti
| | - Jude Hassan Charles
- Department of Neurology, University of Miami Hospital/Jackson Health System, Miami, Florida, United States of America
| | | | - Richardson Roche
- Department of Internal Medicine, State University of Haiti, Port-au-Prince, West, Haiti
| | - Wislet Andre
- Department of Internal Medicine, State University of Haiti, Port-au-Prince, West, Haiti
| | - Garly Rushler Saint Croix
- Interventional Cardiology, Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, United States of America
| | - Gillian Gordon Perue
- Department of Neurology, University of Miami Hospital/Jackson Health System, Miami, Florida, United States of America
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Guillaume Y, Debela M, Slater D, Vissieres K, Ternier R, Franke MF, Harris JB, Ivers LC. Poor Sensitivity of Stool Culture Compared to Polymerase Chain Reaction in Surveillance for Vibrio cholerae in Haiti, 2018-2019. Open Forum Infect Dis 2023; 10:ofad301. [PMID: 37383250 PMCID: PMC10296062 DOI: 10.1093/ofid/ofad301] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
We report on the sensitivity and specificity of stool culture compared to polymerase chain reaction for detecting Vibrio cholerae in Haiti during the waning period of the initial outbreak in 2018-2019. We found that stool culture (with a sensitivity of 33.3% and specificity of 97.4%) may not be sufficiently robust in this context.
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Affiliation(s)
- Yodeline Guillaume
- Correspondence: Yodeline Guillaume, MA, Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02148 (); Louise Ivers, MD, Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02148 ()
| | - Meti Debela
- University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Damien Slater
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kenia Vissieres
- Department of Clinical Programs, Zanmi Lasante, Croix-des-Bouquets, Haiti
| | - Ralph Ternier
- Department of Clinical Programs, Zanmi Lasante, Croix-des-Bouquets, Haiti
| | - Molly F Franke
- Department of Clinical Programs, Zanmi Lasante, Croix-des-Bouquets, Haiti
| | - Jason B Harris
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Louise C Ivers
- Correspondence: Yodeline Guillaume, MA, Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02148 (); Louise Ivers, MD, Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02148 ()
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Vincent JP, Existe AV, Komaki-Yasuda K, Boncy J, Kano S. Performance of the procedure for ultra-rapid extraction and loop-mediated isothermal amplification (PURE-LAMP) method to detect malaria in Haiti. Infect Dis Poverty 2023; 12:53. [PMID: 37217984 DOI: 10.1186/s40249-023-01097-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/24/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Malaria continues to cause burden in various parts of the world. Haiti, a Caribbean country, is among those aiming to eliminate malaria within a few years. Two surveys were conducted in Haiti during which we aimed to evaluate the performance of the simple and rapid procedure for ultra-rapid extraction-loop-mediated isothermal amplification (PURE-LAMP) method with dried blood spots as an alternative diagnostic method for malaria in the context of low to very low rates of transmission. METHODS Febrile and afebrile people were recruited from three administrative divisions within Haiti: Nippes, Sud and Grand'Anse, during the summers of 2017 (early August to early September) and 2018 (late July to late August). Their blood samples were tested by microscopy, rapid diagnostic tests (RDT), PURE-LAMP and nested PCR to detect Plasmodium infection. Sensitivity, specificity, positive and negative predictive values and kappa statistics were estimated with the nested PCR results as the gold standard. RESULTS Among 1074 samples analyzed, a positive rate of 8.3% was calculated based on the nested PCR results. Among febrile participants, the rates in 2017 and 2018 were 14.6% and 1.4%, respectively. Three positives were detected among 172 afebrile participants in 2018 by PURE-LAMP and nested PCR, and all three were from the same locality. There was no afebrile participants recruited in 2017. The PURE-LAMP, RDT and microscopy had respective sensitivities of 100%, 85.4% and 49.4%. All of the testing methods had specificities over 99%. CONCLUSIONS This study confirmed the high performance of the PURE-LAMP method to detect Plasmodium infection with dried blood spots and recommends its use in targeted mass screening and treatment activities in low endemic areas of malaria.
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Affiliation(s)
- Jeanne Perpétue Vincent
- Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, 305-8575, Japan
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | | | - Kanako Komaki-Yasuda
- Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Jacques Boncy
- Laboratoire National de Santé Publique, 6120, Port-au-Prince, Haiti
| | - Shigeyuki Kano
- Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, 305-8575, Japan.
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François M, Lin KS, Vaincoeur E, Rachmadona N, Khoo KS. Haitians' perceptions of biogas produced via human excreta: An approach to the democratization of energy systems. Chemosphere 2023; 334:138986. [PMID: 37209850 DOI: 10.1016/j.chemosphere.2023.138986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/01/2023] [Accepted: 05/17/2023] [Indexed: 05/22/2023]
Abstract
The utilization of organic matter (OM) to produce biogas is an attractive alternative for promoting sustainable development, addressing energy shortages and waste disposal problems, creating jobs, and investing in sanitation systems. Thus, this alternative is becoming increasingly important in developing countries. This study investigated the perceptions of residents in Delmas district, Haiti, regarding the use of biogas produced via human excreta (HE). A questionnaire containing closed- and open-ended questions was administered for this purpose. Sociodemographic aspects had no influence on locals' willingness to use biogas produced via different types of OM. The novelty of this research is that democratization and decentralization of the energy system are possible in the Delmas district using biogas produced from various organic wastes. Socio-characteristics of the interviewees did not influence their willingness towards a possible adopt biogas-based energy from several types of degradable organic matter. The results showed that more than 96% of the participants agreed that HE could be used to produce biogas and reduce energy shortages in their locality. In addition, 93.3% of the interviewees thought this biogas could be utilized for cooking food. However, 62.5% of respondents argued that using HE to produce biogas could be dangerous. Bad smell and fear of biogas produced via HE are the major concerns of users. In conclusion, this research could guide stakeholders' decisions to better address the problems of waste disposal and energy shortages and to create new jobs in the target study area. The research findings could help decision-makers better understand the willingness of locals to invest in household digester programs in Haiti. Further research is required to investigate farmers 'willingness to use digestates from biogas production.
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Affiliation(s)
- Mathurin François
- Department of Chemical Engineering and Materials Science/Environmental Technology Research Center, Yuan Ze University, Chung-Li District, Taoyuan City, 32003, Taiwan; Environmental Technology Research Center, Yuan Ze University, Chung-Li District, Taoyuan City, 32003, Taiwan
| | - Kuen-Song Lin
- Department of Chemical Engineering and Materials Science/Environmental Technology Research Center, Yuan Ze University, Chung-Li District, Taoyuan City, 32003, Taiwan; Environmental Technology Research Center, Yuan Ze University, Chung-Li District, Taoyuan City, 32003, Taiwan.
| | - Ernso Vaincoeur
- Département du génie Civil et d'architecture, Université GOC, Impasse GOC Ave, ML King Port-au-Prince, HAT61, Haiti
| | - Nova Rachmadona
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Jatinangor, West Java, 45363, Indonesia; Research Collaboration Center for Biomass and Biorefinery Between BRIN and Universitas Padjadjaran, Jatinangor, West Java, 45363, Indonesia
| | - Kuan Shiong Khoo
- Department of Chemical Engineering and Materials Science/Environmental Technology Research Center, Yuan Ze University, Chung-Li District, Taoyuan City, 32003, Taiwan.
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Schrodt CA, Dilius P, Gibson AD, Crowdis K, Fénelon N, Ross Y, Bonaparte S, Gamble L, Lohr F, Joseph HC, Wallace RM. Corrigendum: Electronic application for rabies management improves surveillance, data quality, and investigator experience in Haiti. Front Vet Sci 2023; 10:1204839. [PMID: 37228843 PMCID: PMC10203696 DOI: 10.3389/fvets.2023.1204839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/27/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fvets.2023.1052349.].
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Affiliation(s)
- Caroline A. Schrodt
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
- Epidemic Intelligence Service, CDC, Atlanta, GA, United States
| | - Pierre Dilius
- Haiti Ministry of Agriculture, Rural Development and Natural Resources, Port au Prince, Haiti
| | - Andrew D. Gibson
- Mission Rabies, Cranborne, Dorset, United Kingdom
- The Royal Dick School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Yasmeen Ross
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sarah Bonaparte
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Luke Gamble
- Mission Rabies, Cranborne, Dorset, United Kingdom
| | | | - Haïm C. Joseph
- Haiti Ministry of Agriculture, Rural Development and Natural Resources, Port au Prince, Haiti
| | - Ryan M. Wallace
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Muraro AP, Gugelmin SA, Martins MAC, da Costa Leão LH, Holub C, Silveira C. Food Insecurity Among Haitian Migrants Living In Brazil. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01618-1. [PMID: 37129784 PMCID: PMC10153032 DOI: 10.1007/s40615-023-01618-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To analyze the situation of food insecurity among Haitians living in Midwest of Brazil, based on questions of the Brazilian Scale of Food Insecurity (BSFI). METHODS A survey was carried out with a probabilistic sampling proportional to sex of Haitians aged over 18 years who lived in Cuiabá and Várzea Grande, Mato Grosso. Haitian migrants were interviewed by bilingual (Haitian Creole/Portuguese) individuals, and for the analysis of the BSFI questions. Because the BSFI is not validated for Haitians, the first eight questions of the scale were assessed separately, according to sex, debts incurred for the migration project and time of residence in Brazil. Chi-square was calculated to test the differences between groups. RESULTS A total of 404 Haitians were evaluated, 81.9% male individuals, 60.9% aged between 18 and 36 years. Among the respondents, 64.4% were worried about running out of food before having money to buy more food, and 62.6% answered that they ran out of food before having money to buy it. Higher proportions of positive answers were observed for women and those who reported having debts to finance the migration costs to Brazil. CONCLUSION The high proportion of positive answers to the BSFS questions by Haitians seems to indicate a situation of social vulnerability and food insecurity, especially among Haitian women, as well as among those who had debts to migrate to Brazil and those who have lived in the country for more than a year.
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Affiliation(s)
- Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, campus de Cuiabá, Mato Grosso, Brazil.
| | - Silvia Angela Gugelmin
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, campus de Cuiabá, Mato Grosso, Brazil
| | | | | | - Christina Holub
- Public Health, School of Health Sciences and Human Services, College of Education, Health and Human Services-California State University San Marcos, San Marcos, USA
| | - Cássio Silveira
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo-, São Paulo, Brazil
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Jean Simon D, Jean-Baptiste S, Nazaire R, Joseph G, Carmil JA, Joseph F, Kondo Tokpovi VC. Individual and community-level factors associated with caesarean section in Haiti: secondary analysis of data from the 2016-2017 Haitian Demographic and Health Survey. Trop Med Health 2023; 51:21. [PMID: 37069696 PMCID: PMC10108480 DOI: 10.1186/s41182-023-00513-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/09/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION For several decades, the rate of caesarean section (CS) has been increasing in the world. In some countries, the CS rate is below the WHO recommended range (10-15%), while in other countries, it is significantly higher. The aim of this paper was to identify individual and community-level factors associated with CS in Haiti. METHODS Secondary data analysis was conducted on nationally representative cross-sectional survey data from the 2016-2017 Haitian Demographic and Health Survey (HDHS). The analysis was restricted to 6303 children born in 5 years prior the survey (of the interviewed women). The study population' characteristics, and the prevalence of CS were analysed using descriptive analysis (univariate/bivariate). In addition, multilevel binary logistic regression analysis was performed to identify factors associated with CS. Both descriptive and multivariate analysis were conducted using STATA 16.0 software (Stata Corp, Tex, USA). Statistical significance was declared at p < 0.05. RESULTS The overall prevalence of CS delivery was estimated at 5.4% (95% CI 4.8-6.0) in Haiti. Results also revealed that mothers aged 35 and above (aOR = 1.38; 95% CI 1.00-1.96); who attended secondary (aOR = 1.95; 95% CI 1.39-2.76) and higher education level (aOR = 3.25; 95% CI 1.92-5.49); who were covered by health insurance (aOR = 2.57; 95% CI 1.57-4.19); with less than 3 children (aOR = 4.13; 95% CI 2.18-7.85) or 3-4 children (aOR = 2.07; 95% CI 1.09-3.94); who received 9 or more antenatal visits (aOR = 2.21; 95% CI 1.40-3.50) were significantly more likely to deliver by CS. Children in communities with high preponderance of private health facilities had greater odds to be delivered through CS (aOR = 1.90; 95% CI 1.25-2.85). Furthermore, children with an average birth weight (aOR = 0.66; 95% CI 0.48-0.91) were less likely to be delivered through CS than their counterparts with high birth weight. CONCLUSIONS While the CS prevalence was low in Haiti, it masks significant geographic, social and economic disparities. To better develop and implement maternal and child health programs that address CS deliveries, the government authorities and NGOs operating in the field of women's health in Haiti should take these disparities into account.
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Affiliation(s)
- David Jean Simon
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti.
| | | | - Roodjmie Nazaire
- Université d'Etat d'Haïti (UEH), Faculté de Médecine et de Pharmacie (FMP), Port-au-Prince, Haiti
| | - Ghislaine Joseph
- Centre de Recherche Cultures Arts Sociétés (CELAT), University of Laval, Quebec City, Canada
| | | | - Fanor Joseph
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti
- University of Antananarivo, Doctoral School of Social and Human Sciences, Antananarivo, Madagascar
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Karyadi E, Reddy JC, Dearden KA, Purwanti T, Mardewi, Asri E, Roquero LB, Juguan JA, Sapitula‐Evidente A, Anand B, Warvadekar K, Bhardwaj A, Alam MK, Das S, Nair GK, Srivastava A, Raut MK. Antenatal care is associated with adherence to iron supplementation among pregnant women in selected low-middle-income-countries of Asia, Africa, and Latin America & the Caribbean regions: Insights from Demographic and Health Surveys. Matern Child Nutr 2023; 19:e13477. [PMID: 36705031 PMCID: PMC10019046 DOI: 10.1111/mcn.13477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/02/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023]
Abstract
Anaemia is a global public health problem affecting 800 million women and children globally. Anaemia is associated with perinatal mortality, child morbidity and mortality, mental development, immune competence, susceptibility to lead poisoning and performance at work. The objective of this article is to identify whether antenatal care-seeking was associated with the uptake of iron supplementation among pregnant women, adjusting for a range of covariates. This article used data from the cross-sectional recent Demographic and Health Surveys (DHS) of 12 countries in Asia, Africa and Latin America & the Caribbean regions. The individual-level data from 273,144 women of reproductive age (15-49 years) were analysed from multi-country DHS. Multiple Logistic regression analyses were conducted using Predictive Analytics Software for Windows (PASW), Release 18.0. Receiving at least four antenatal care visits was significantly associated with the consumption of 90 or more iron-containing supplements in 12 low and middle income countries across three regions after adjusting for different household and respondent characteristics, while mass media exposure was found to be a significant predictor in India and Indonesia. Antenatal care seems to be the most important predictor of adherence to iron intake in the selected countries across Africa, Asia, Latin America and Caribbean regions.
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Affiliation(s)
- Elvina Karyadi
- Former Country Director, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - J. C. Reddy
- Senior Program Officer, Research and Evaluation, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Kirk A. Dearden
- Senior Technical Advisor for Nutrition and WASHIMA World Health/Corus InternationalWashingtonDistrict ColumbiaUSA
| | - Tutut Purwanti
- Former Maternal and Child Nutrition Advisor, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - Mardewi
- Former Program Coordinator ‐ Maternal and Child Health, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - Eriana Asri
- Former Adolescent Nutrition Advisor, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - Loreto B. Roquero
- Former Country DirectorNutrition International, Philippines Country OfficeManilaPhilippines
| | - Jocelyn A. Juguan
- Country Program Coordinator, Nutrition InternationalPhilippines Country OfficeManilaPhilippines
| | | | - Binu Anand
- Technical Assistance to Nutrition, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Kirti Warvadekar
- Regional Program Officer, Research and Evaluation, Asia, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Anjali Bhardwaj
- Regional Technical Advisor, Adolescent and Women's Health and Nutrition, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Md. K. Alam
- Project DirectorSave the ChildrenDhakaBangladesh
| | - Susmita Das
- Deputy Regional Director, Nutrition InternationalAsia Regional OfficeNew DelhiIndiaIndia
| | - Gopa K. Nair
- Chief Executive OfficerLeo and Mia FoundationLondonUK
| | | | - Manoj K. Raut
- Asia Regional Technical Advisor, Research and Evaluation, Global Technical ServicesNutrition InternationalNew DelhiIndia
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Jean Simon D, Paul B, Kiragu A, Olorunsaiye CZ, Joseph F, Joseph G, N'Gou MD. Prevalence and factors associated with condom use among sexually active young women in Haiti: evidence from the 2016/17 Haiti demographic and health survey. BMC Womens Health 2023; 23:146. [PMID: 36991441 PMCID: PMC10061838 DOI: 10.1186/s12905-023-02295-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Young women in Haiti remain vulnerable to sexually transmitted infections and unintended pregnancy. However, little is known about condom use among this population. This study examined the prevalence and the factors associated with condom use among sexually active young women in Haiti. METHODS Data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the factors associated with condom use among sexually active young women in Haiti were assessed using descriptive statistics and binary logistic regression model. RESULTS The prevalence of condom use was 15.4% (95% CI 14.0-16.8). Being teenage (AOR = 1.34; 95% CI: 1.04-1.74), living in urban areas (AOR = 1.41; 95% CI = 1.04-1.90), having higher education level (AOR = 2.39; 95% CI: 1.44-4.00), being in the middle or rich category of household wealth index (AOR = 2.32; 95% CI: 1.53-3.53 and AOR = 2.93; 95% CI: 1.90-4.52), having correct knowledge of ovulatory cycle (AOR = 1.65; 95% CI: 1.30-2.10), having 2-3 lifetime sexual partners and one lifetime sexual partner (AOR = 2.04; 95% CI: 1.36-3.06 and AOR = 2.07; 95% CI: 1.35-3.17) had significantly higher odds of using condom. In addition, sexually active young women whose last partner was their boyfriend (AOR = 4.38; 95% CI: 2.82-6.81), and those whose last partner was a friend/casual acquaintance/commercial sex worker (AOR = 5.29; 95% CI: 2.18-12.85) were associated with increased likelihood of using condom compared with their counterparts whose partner was their spouse. CONCLUSION The Haitian government as well as institutions involved in sexual health should consider these factors when designing sexual and reproductive health interventions targeting young women. More specifically, to increase condom use and reduce risky sexual behaviors, they should combine efforts to raise awareness and induce sexual behavioral changes at two levels. In the education system, they should reinforce sexual education in primary and secondary schools while paying special attention to rural areas. In the whole society, it is important to deepen efforts toward increased awareness on family planning and condom use, through mass media and local organizations including religious ones. Priority should be given to the poorer households, young people and women, and rural areas, in order to maximize reduction in early and unintended pregnancy, and sexually transmitted infections. Interventions should include a condom price subsidy and a campaign to destigmatize condom use which is actually a "male affair".
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Affiliation(s)
- David Jean Simon
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti
| | - Bénédique Paul
- Department of Agro-socio-economics, Chibas, Université Quisqueya, Port-au-Prince, Haiti.
- Groupe d'Etude sur les Sciences de la Durabilité, Université Quisqueya, Port-au-Prince, Haiti.
| | - Ann Kiragu
- Department of Law and Political and Social Sciences, University of Sorbonne Paris Nord, Paris, France
| | | | - Fanor Joseph
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti
- Doctoral School of Social and Human Sciences, University of Antananarivo, Antananarivo, Madagascar
| | - Ghislaine Joseph
- Centre de Recherche Cultures Arts Sociétés (CELAT), University of Laval, Quebec, Canada
| | - M'Boh Delphin N'Gou
- Centre de Recherche de l'Institut de Démographie de l'Université de Paris (CRIDUP), Paris 1 Pantheon Sorbonne University, Paris, France
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Masonbrink AR, Hurley EA, Schuetz N, Rodean J, Rupe E, Lewis K, Boncoeur MD, Miller MK. Sexual behaviors, contraception use and barriers among adolescents and young adults in rural Haiti. BMC Womens Health 2023; 23:137. [PMID: 36973773 PMCID: PMC10045756 DOI: 10.1186/s12905-023-02268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) in Haiti experience a high unintended pregnancy rate, in part due to unmet contraception needs. Little is known about AYA opinions of and experiences with contraception that may explain remaining gaps in coverage. We aimed to describe barriers and facilitators to contraception use among AYAs in Haiti. METHODS We conducted a cross-sectional survey and semi-structured qualitative interviews with a convenience sample of AYA females aged 14-24 in two rural communities in Haiti. The survey and semi-structured interviews assessed demographics, sexual health and pregnancy prevention behaviors and explored contraception opinions and experiences according to Theory of Planned Behavior constructs: attitudes, subjective norms, and perceived behavioral control. We used descriptive statistics to report means and responses to Likert scale and multiple-choice questions. Guided by content analysis, we analyzed interview transcripts through inductive coding and team debriefing. RESULTS Among 200 survey respondents, 94% reported any past vaginal sexual activity, and 43% reported ever being pregnant. A large majority were trying to avoid pregnancy (75%). At last sexual activity, 127 (64%) reported use of any contraceptive method; Among them, condoms were the most common method (80%). Among those with previous condom use, most reported use less than half the time (55%). AYAs were concerned about parental approval of birth control use (42%) and that their friends might think they are looking for sex (29%). About one-third felt uncomfortable going to a clinic to ask for birth control. In interviews, AYAs desired pregnancy prevention but frequently noted concerns about privacy and parental, community and healthcare provider judgement for seeking care for reproductive health needs. AYAs also noted a lack of contraception knowledge, evident by frequent misconceptions and associated fears. CONCLUSION Among AYAs in rural Haiti, a large majority were sexually active and desire pregnancy avoidance, but few were using effective contraception due to numerous concerns, including privacy and fear of judgement. Future efforts should address these identified concerns to prevent unintended pregnancy and improve maternal and reproductive health outcomes in this population.
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Affiliation(s)
- Abbey R Masonbrink
- Children's Mercy Hospital, Kansas City, MO, US.
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, US.
- Department of Pediatrics, Children's Mercy Kansas City, 2401 Gilham Rd, Kansas City, MO, 64108, US.
| | - Emily A Hurley
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, US
- Division of Health Services and Outcomes Research, Children's Mercy, Kansas City, MO, US
- Department of Population Health, University of Kansas Medical Center, Kansas City, MO, US
| | - Nikolaus Schuetz
- Division of Health Services and Outcomes Research, Children's Mercy, Kansas City, MO, US
| | | | - Emily Rupe
- University of Kansas School of Medicine, Wichita, KS, US
| | - Kemi Lewis
- Children's Mercy Hospital, Kansas City, MO, US
| | | | - Melissa K Miller
- Children's Mercy Hospital, Kansas City, MO, US
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, US
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Charles ML. A glimmer of hope: My reflections on global health efforts in Haiti. Public Health Nurs 2023; 40:322-323. [PMID: 36510672 DOI: 10.1111/phn.13159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/16/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
Many factors impact access to care and global health equity, which can be transformed by nursing. When healthcare infrastructure is suboptimal, nursing's role expands exponentially. In this reflection, I share my experiences accessing healthcare as a child in a low-resource community and highlight nursing activities to improve global health equity. Nurses can facilitate change by becoming active in communities, humanitarian organizations, policymaking, and advocacy.
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Affiliation(s)
- Marie Lourdes Charles
- College of Health Professions, Lienhard School of Nursing, Pace University, New York, New York
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Rao VV, DellaValle J, Gelin G, Day J. Mission POCUS in Haiti. J Radiol Nurs 2023; 42:77-84. [PMID: 36742420 PMCID: PMC9890376 DOI: 10.1016/j.jradnu.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction Point-of-care ultrasound (POCUS) has enhanced patient care and safety around the world. Clinicians can now use a small diagnostic ultrasound imaging device to answer some binary clinical questions and manage patients more effectively. Since the COVID-19 pandemic, there has been a significant adoption of POCUS by clinicians worldwide. Materials and Methods A basic cardiac POCUS training was conducted in Haiti with focus on physics, instrumentation, and basic echocardiography. Results The Mission POCUS team trained 15 Haitian physicians interested in better serving their patients with the implementation of POCUS cardiac in their patient assessment. Conclusion POCUS skills will empower clinicians from around the world to make rapid and accurate diagnosis and help save lives by diagnosing life threatening conditions and manage patient appropriately. Our experience in Haiti showed that a short POCUS training course can help improve the knowledge of physicians.
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Affiliation(s)
- Victor V Rao
- Point-of-Care Ultrasound Certification Academy, Inteleos, Rockville, Maryland
| | - James DellaValle
- United Health Services, Johnson City, New York
- Upstate Medical University, Syracuse, New York
| | - Gedeon Gelin
- Emmanuel Community Hospital of Peredo-Haiti, Haiti
- Polyclinique Universitaire de Pernier-ECG Sono Gnle- Echo Doppler Laboratoire, Pernier 35, Rue Charles Legrand, Haiti
| | - James Day
- Point-of-Care Ultrasound Certification Academy, Inteleos, Rockville, Maryland
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