Nutritional and Vaccination Status of Children in the Terre Noir Neighborhood of Port-au-Prince, Haiti

BACKGROUND: History of International Nutritional Measurement and Definitions: For many years, growth has been measured as a surrogate for the overall health of individuals and populations. Though this method is insufficient for understanding the complete health of an individual or population, it acknowledges that many physiologic processes must converge to achieve normal growth. Historically, young children have been the focus of surveys of growth because they are most at risk of having their physiologic processes of growth disrupted. Child growth is a proxy for a child’s nutritional status, which itself is a marker of dietary intake and overall health. Under the UNICEF conceptual framework on causes of malnutrition, dietary intake and overall health status are related to food, health, and care resources, which are themselves determined by the political and economic structures and sociocultural environments in a country.Master of Public Healt

Human Papillomavirus Awareness in Haiti: Preparing for a National HPV Vaccination Program

Cervical cancer morbidity and mortality are pressing public health issues impacting women in Haiti. To inform efforts to develop a human papillomavirus (HPV) vaccination program in Haiti, we sought to understand HPV awareness and willingness to get HPV vaccination in Haiti

Awareness of Cervical Cancer Causes and Predeterminants of Likelihood to Screen Among Women in Haiti:

Cervical cancer is the leading cause of cancer deaths among women in Haiti. Given this high disease burden, we sought to better understand women's knowledge of its causes and the sociodemographic and health correlates of cervical cancer screening. Participants were 410 adult women presenting at clinics in Léogâne and Port-au-Prince, Haiti. We used bivariate and multivariate logic regression to identify correlates of Pap smear receipt. Only 29% of respondents had heard of human papillomavirus (HPV), whereas 98% were aware of cervical cancer. Of those aware of cervical cancer, 12% believed that sexually transmitted infections (STIs) cause it, and only 4% identified HPV infection as the cause. Women with a previous sexually transmitted infection were more likely to have had Pap smear (34% vs 71%, odds ratio = 3.45; 95% CI = 1.57-7.59). Screening was also more likely among women who were older than the age of 39 years, better educated, and employed (all p < .05). Almost all women (97%) were willing to undergo cervical cancer screening. This sample of Haitian women had limited awareness of HPV and cervical cancer causes; but when provided with health information, they saw the benefits of cancer screening. Future initiatives should provide health education messages, with efforts targeting young and at-risk women

Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population

Human papillomavirus (HPV) testing as primary cervical cancer screening has not been studied in Caribbean women. We tested vaginal self-collection versus physician cervical sampling in a population of Haitian women

Interstitial lung disease in a veterans affairs regional network; a retrospective cohort study.

BackgroundThe epidemiology of Interstitial Lung Diseases (ILD) in the Veterans Health Administration (VHA) is presently unknown.Research questionDescribe the incidence/prevalence, clinical characteristics, and outcomes of ILD patients within the Veteran's Administration Mid-Atlantic Health Care Network (VISN6).Study design and methodsA multi-center retrospective cohort study was performed of veterans receiving hospital or outpatient ILD care from January 1, 2008 to December 31st, 2015 in six VISN6 facilities. Patients were identified by at least one visit encounter with a 515, 516, or other ILD ICD-9 code. Demographic and clinical characteristics were summarized using median, 25th and 75th percentile for continuous variables and count/percentage for categorical variables. Characteristics and incidence/prevalence rates were summarized, and stratified by ILD ICD-9 code. Kaplan Meier curves were generated to define overall survival.Results3293 subjects met the inclusion criteria. 879 subjects (26%) had no evidence of ILD following manual medical record review. Overall estimated prevalence in verified ILD subjects was 256 per 100,000 people with a mean incidence across the years of 70 per 100,000 person-years (0.07%). The prevalence and mean incidence when focusing on people with an ILD diagnostic code who had a HRCT scan or a bronchoscopic or surgical lung biopsy was 237 per 100,000 people (0.237%) and 63 per 100,000 person-years respectively (0.063%). The median survival was 76.9 months for 515 codes, 103.4 months for 516 codes, and 83.6 months for 516.31.InterpretationThis retrospective cohort study defines high ILD incidence/prevalence within the VA. Therefore, ILD is an important VA health concern