5 research outputs found
Mosquitoborne Infections after Hurricane Jeanne, Haiti, 2004
After Hurricane Jeanne in September 2004, surveillance for mosquitoborne diseases in GonaĂŻves, Haiti, identified 3 patients with malaria, 2 with acute dengue infections, and 2 with acute West Nile virus infections among 116 febrile patients. These are the first reported human West Nile virus infections on the island of Hispaniola
Risk factors for adverse outcomes in women with high-risk pregnancy and their neonates, Haiti
Objectives. To determine the prevalence of maternal death, stillbirth and low birthweight in women with (pre-)
eclampsia and complicated pregnancies or deliveries in Centre de Références des Urgences Obstétricales,
an obstetric emergency hospital in Port-au-Prince, Haiti, and to identify the main risk factors for these adverse
pregnancy outcomes.
Methods. We conducted a retrospective cohort study of pregnant women admitted to Centre de Référence
des Urgences Obstétricales between 2013 and 2018 using hospital records. Risk factors investigated were
age group, type of pregnancy (singleton, multiple), type of delivery and use of antenatal care services.
Results. A total of 31 509 women and 24 983 deliveries were included in the analysis. Among these, 204
(0.6%) maternal deaths (648 per 100 000 women giving birth), 1962 (7.9%) stillbirths and 11 008 (44.1%)
low birthweight neonates were identified. Of all admissions, 10 991 (34.9%) were women with (pre-)eclampsia. Caesarean section significantly increased the risk of maternal death in the women with a complicated
pregnancy and women with (pre-)eclampsia, but reduced the risk of stillbirth in such women. Not attending
antenatal care was associated with a significantly higher risk of stillbirth (odds ratio (OR) 4.82; 95% confidence interval (CI) 3.55â6.55) and low birthweight (OR 1.40; 95% CI 1.05â1.86) for women with complicated
pregnancies.
Conclusion. To prevent and treat pregnancy complications as early as possible, antenatal care attendance
is crucial. Improving the quality of and access to antenatal care services and providing it free to all pregnant
women in Haiti is recommended
Cholera Prevention Training Materials for Community Health Workers, Haiti, 2010â2011
Stopping the spread of the cholera epidemic in Haiti required engaging community health workers (CHWs) in prevention and treatment activities. The Centers for Disease Control and Prevention collaborated with the Haitian Ministry of Public Health and Population to develop CHW educational materials, train >1,100 CHWs, and evaluate training efforts
High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohnâs Disease
International audienceBackground & AimsLittle is known about the magnitude of the risk of anal and rectal cancer in patients with anal and/or perineal Crohnâs disease. We aimed to assess the risk of anal and rectal cancer in patients with Crohnâs perianal disease followed up in the Cancers Et Surrisque AssociĂ© aux Maladies Inflammatoires Intestinales En France (CESAME) cohort.MethodsWe collected data from 19,486 patients with inflammatory bowel disease (IBD) enrolled in the observational CESAME study in France, from May 2004 through June 2005; 14.9% of participants had past or current anal and/or perianal Crohnâs disease. Subjects were followed up for a median time of 35 months (interquartile range, 29â40 mo). To identify risk factors for anal cancer in the total CESAME population, we performed a case-control study in which participants were matched for age and sex.ResultsAmong the total IBD population, 8 patients developed anal cancer and 14 patients developed rectal cancer. In the subgroup of 2911 patients with past or current anal and/or perianal Crohnâs lesions at cohort entry, 2 developed anal squamous-cell carcinoma, 3 developed perianal fistulaârelated adenocarcinoma, and 6 developed rectal cancer. The corresponding incidence rates were 0.26 per 1000 patient-years for anal squamous-cell carcinoma, 0.38 per 1000 patient-years for perianal fistulaârelated adenocarcinoma, and 0.77 per 1000 patient-years for rectal cancer. Among the 16,575 patients with ulcerative colitis or Crohnâs disease without anal or perianal lesions, the incidence rate of anal cancer was 0.08 per 1000 patient-years and of rectal cancer was 0.21 per 1000 patient-years. Among factors tested by univariate conditional regression (IBD subtype, disease duration, exposure to immune-suppressive therapy, presence of past or current anal and/or perianal lesions), the presence of past or current anal and/or perianal lesions at cohort entry was the only factor significantly associated with development of anal cancer (odds ratio, 11.2; 95% CI, 1.18-551.51; P = .03).ConclusionsIn an analysis of data from the CESAME cohort in France, patients with anal and/or perianal Crohnâs disease have a high risk of anal cancer, including perianal fistulaârelated cancer, and a high risk of rectal cancer