Overview of the Main Species of Ticks and Animal and Human Tick-Related Diseases in the Caribbean, Particularly in Haiti

The Caribbean region faces a wide diversity of ticks and tick-borne diseases (TBDs) in animals and humans. But to date, these have been the subject of few studies, resulting in a relative lack of knowledge of their epidemiology, pathogenicity, and the best prevention and control methods. Ticks are hematophagous mites, which feed on the blood of mammals, birds, and reptiles. They are subdivided into two large families: the Ixodidae or hard ticks and the Argasidae or soft ticks. Each collection of blood by ticks from infected hosts can lead to their infection, which will contaminate other previously unharmed animals and contribute to the spread of tick-borne diseases caused mainly by bacteria, viruses, and parasites. It seems important to us to draw up a state of knowledge on ticks. Some long-known tick species like Rhipicephalus, Dermacentor, and Amblyomma and diseases like Anaplasmosis and Babesiosis deserve to be better studied, and others are yet to be identified for further research. The study consists of a review of the various documents published on this theme by Haitian and foreign researchers. The data are analyzed to assess the spatiotemporal distribution of ticks and identify the pathogenic germs they harbor and the various pathologies they induce in the Caribbean and Haiti

Contribution to the Diagnostic Study of Intestinal Parasitosis, Haiti

Parasitic intestinal diseases are widespread in the world with a higher prevalence in developing countries. They are generally a serious public health problem in tropical countries. In October 2020, a cross-sectional study was undertaken to determine the prevalence of intestinal parasites in patients visiting Fermathe Hospital in Haiti. Data were collected on stool results with the presence of parasites and we used systematic sampling for further information regarding patients with parasitology problems. A summary field survey was also carried out in the surrounding areas with more cases recorded such as Corail, Calbasse, Fort Jacques, Center / Marché Kenscoff, Doco, and Douret for direct observations of the inventory and voluntary interviews with the residents of the area on hygiene practices. The prevalence of intestinal parasites was 31.26% and the most common species were: Endolimax nana (39.13%), followed by Blastocystis hominis (14%), Blastocystis hominis / Giardia intestinales (12.07%), Entamoeba coli (5.31%), and others like Iodamoeba butschlii, Ascaris lumbricoides or combined parasites were less than 5%. The field survey revealed a strong relationship between parasitosis and drinking water, parasitosis, and place of defecation. Although there are health centers in the area, many people use self-medication or empiric therapy. The study highlights the important causes of gastrointestinal disorders that present themselves in this hospital and confirms intestinal parasitosis as a major public health problem in Haiti

Vector-Borne Diseases and Climate Change in the Environmental Context in Haiti

Climate change is one of the main challenges facing many countries, particularly developing countries, because of its negative impact on their various ecosystems and their socio-economic development, which very often leads them down a slow descent into poverty. This is because climate change can manifest itself in different forms such as climate variability and extreme events (droughts, epidemics, floods, storms and hurricanes), which can affect biodiversity and cause many human and animal diseases and deaths. In fact, the evolution of ecosystems is dependent on climate and environmental change and appears to be closely associated with many emerging or re-emerging diseases. In general, the ecosystems considered to be most exposed to climate change are those located in and around the intertropical convergence zone in particular. They are believed to be closely linked to the occurrence of several emerging diseases, particularly vector-borne diseases. For years, the Republic of Haiti has been experiencing the adverse effects of these global changes with a marked disruption of its rainfall pattern and prolonged periods of drought as well as a pronounced increase in temperatures even in high altitude areas. Although there is evidence that climate change is increasing the frequency of vector-borne diseases and may contribute to increasing the virulence of their pathogens, there are very few studies conducted in Haiti on the relationship between climate change and vector-borne diseases. The purpose of this chapter is to define the interrelationships between climate change and vector-borne diseases in Haiti by identifying avenues of research to better understand the effects of climate change on public health and to make appropriate recommendations to decision-makers to ensure proper management

Costs and effectiveness of alternative dog vaccination strategies to improve dog population coverage in rural and urban settings during a rabies outbreak.

Dog-rabies elimination programs have typically relied upon parenteral vaccination at central-point locations; however, dog-ownership practices, accessibility to hard-to-reach sub-populations, resource limitations, and logistics may impact a country's ability to reach the 70% coverage goal recommended by the World Organization for Animal Health (OIE) and World Health Organization (WHO). Here we report the cost-effectiveness of different dog-vaccination strategies during a dog-rabies outbreak in urban and peri-urban sections of Croix-des-Bouquets commune of the West Department, Haiti, in 2016. Three strategies, mobile static point (MSP), mobile static point with capture-vaccinate-release (MSP?+?CVR), and door-to-door vaccination with oral vaccination (DDV?+?ORV), were applied at five randomly assigned sites and assessed for free-roaming dog vaccination coverage and total population coverage. A total of 7065 dogs were vaccinated against rabies during the vaccination campaign. Overall, free-roaming dog vaccination coverage was estimated at 52% (47%-56%) for MSP, 53% (47%-60%) for DDV?+?ORV, and 65% (61%-69%) for MSP?+?CVR (differences with MSP and DDV?+?ORV significant at p?<?0.01). Total dog vaccination coverage was 33% (95% CI: 26%-43%) for MSP, 49% (95% CI: 40%-61%) for MSP?+?CVR and 78% (77%-80%) for DDV?+?ORV (differences significant at p?<?0.001). Overall, the least expensive campaign was MSP, with an estimated cost of about $2039 per day ($4078 total), and the most expensive was DDV?+?ORV with a cost of $3246 per day ($6492 total). Despite the relative high cost of an ORV bait, combining DDV and ORV was the most cost-effective strategy in our study ($1.97 per vaccinated dog), largely due to increased efficiency of the vaccinators to target less accessible dogs. Costs per vaccinated dog were$2.20 for MSP and $2.28 for MSP?+?CVR. We hope the results from this study will support the design and implementation of effective dog vaccination campaigns to achieve the goal of eliminating dog-mediated human rabies deaths by 2030

Every Dog Has Its Data:Evaluation of a Technology-Aided Canine Rabies Vaccination Campaign to Implement a Microplanning Approach

Background: Robust dog vaccination coverage is the primary way to eliminate canine rabies. Haiti conducts annual canine mass vaccination campaigns, but still has the most human deaths in the Latin American and Caribbean region. We conducted an evaluation of dog vaccination methods in Haiti to determine if more intensive, data-driven vaccination methods, using smartphones for data reporting and geo-communication, could increase vaccination coverage to a level capable of disrupting rabies virus transmission.Methods: Two cities were designated into “Traditional” and “Technology-aided” vaccination areas. Traditional areas utilized historical methods of vaccination staff management, whereas Technology-aided areas used smartphone-supported spatial coordination and management of vaccination teams. Smartphones enabled real time two-way geo-communication between campaign managers and vaccinators. Campaign managers provided geographic instruction to vaccinators by assigning mapped daily vaccination boundaries displayed on phone handsets, whilst vaccinators uploaded spatial data of dogs vaccinated for review by the campaign manager to inform assignment of subsequent vaccination zones. The methods were evaluated for vaccination effort, coverage, and cost.Results: A total of 11,420 dogs were vaccinated during the 14-day campaign. The technology-aided approach achieved 80% estimated vaccination coverage as compared to 44% in traditional areas. Daily vaccination rate was higher in Traditional areas (41.7 vaccinations per team-day) compared to in technology-aided areas (26.8) but resulted in significantly lower vaccination coverages. The cost per dog vaccinated increased exponentially with the associated vaccination coverage, with a cost of $1.86 to achieve 25$2.51 for 50% coverage, and $3.19 for 70% coverage.Conclusions: Traditional vaccination methods failed to achieve sufficiently high vaccination coverages needed to interrupt sustained rabies virus transmission, whilst the technology-aided approach increased coverage above this critical threshold. Over successive campaigns, this difference is likely to represent the success or failure of the intervention in eliminating the rabies virus. Technology-aided vaccination should be considered in resource limited settings where rabies has not been controlled by Traditional vaccination methods. The use of technology to direct health care workers based on near-real-time spatial data from the field has myriad potential applications in other vaccination and public health initiatives

Proyecto especial para Haïti

UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Agroalimentarias::Estación Experimental Agrícola Fabio Baudrit Moreno (EEAFBM

COVID-19: Perception of the Pandemic and the Importance of Barrier Measures by the Fruit and Vegetable Sellers of Port-Au-Prince

Covid-19 has triggered an unprecedented crisis that not only concerns health, it is also an economic, social, political and possibly humanitarian crisis. In March 2020, the WHO declared the disease to be pandemic and recommended the application of barrier measures. The research question here is to establish the level of social perception of fruit and vegetable sellers of the application of barrier measures in Haiti. This study was based on a mainly qualitative approach. A survey was carried out on a random sample of 50 fruit and vegetable sellers, a vulnerable social category of the metropolitan region of Port-au-Prince (RMPP). 98% of the population studied were women; 92% of them came from rural areas. Only 4% of the respondents declared that they practiced physical distancing versus 96% who declared that they were not able to practice it, or place one of their family members in quarantine. It appears pertinent to grasp, in future, the perception of COVID-19 by the Haitian population on the basis of a comparative approach that places several social classes and several economic activities in the contexts of their respective situations

Retrospective Cohort Study to Assess the Risk of Rabies in Biting Dogs, 2013–2015, Republic of Haiti

Background: In canine rabies endemic countries the World Health Organization recommends post-exposure prophylaxis (PEP) be initiated immediately after exposure to an animal suspected to have rabies. Limited capacity in low and middle income countries to assess biting animals for rabies may result in the over prescription of rabies biologics. Few guidelines exist to determine the risk of whether a dog that has bitten someone is rabid. Given PEP cost and access limitations in many countries, accurate and timely assessment of dogs that have bitten people may reduce unwarranted PEP use and improve healthcare seeking behaviors. Methods: Haiti’s animal rabies surveillance program utilizes veterinary professionals to conduct rabies assessments on reported biting dogs and records characteristics of the dog, health outcomes, and laboratory results in a national database. Characteristics of rabid dogs were assessed through a retrospective cohort study of biting dogs investigated during the period from January 2013–December 2015. 1409 biting dogs were analyzed; 1361 dogs that were determined to not have rabies were compared to 48 laboratory-confirmed rabid dogs. Rate ratios, sensitivity, specificity, positive predictive values, negative predictive values, likelihood ratios, quarantine survival of biting dogs, and a risk matrix were developed. Findings: The assessor’s determination that the animal likely had rabies was the most significant predictive factor for a rabid dog (RR = 413.4, 95% CI 57.33–2985, Sn = 79.17, Sp = 91.92). Clinical factors significantly associated with rabid dogs included hypersalivation, paralysis, and lethargy (RR = 31.2, 19.7, 15.4, respectively). Rabid dogs were 23.2 times more likely to be found dead at the time of the investigation compared to case negative dogs (95% CI 14.0–38.6). Rabid dogs were also significantly more likely to lack a history of rabies vaccination or be unowned (RR = 10.3 95% CI 2.5–42.3 and RR = 4.5 95% CI 2.0–10.1, respectively). Rabid dogs were four times more likely to have bitten multiple people (RR = 4.0 95% CI 1.9–8.3). Most rabid dogs died or were killed before quarantine (75%) and all died by day 3 of quarantine, compared to &lt;1% of quarantined case-negatives. The greatest risk of death was predicted to be for persons bitten on the head or neck from symptomatic dogs. Bites from dogs deemed healthy by veterinary assessors and which were available for quarantine presented less than a 0.05% risk of rabies death to the victim. Conclusions: Vaccination of all persons exposed to a suspected rabid dog is a highly effective approach to minimize human rabies deaths. However, this may place undue financial burden on bite victims that have had a low-risk exposure and over-prescription may contribute to regional supply shortages. The results here indicate that in a low-resource country such as Haiti, a well-trained veterinary assessor can provide an accurate risk assessment of biting dogs based on a standard case investigation protocol. In canine rabies endemic countries with limited access to PEP, or where PEP costs may cause undue burden on bite victims, structured risk assessments by trained professionals may be a reliable method of triaging PEP for bite victims. Evaluating rabies risk through a matrix of bite location and risk factor in the dog presents a clear delineation of high and low risk encounters and should be used to develop data-derived PEP recommendations