Clinical Evolution and Risk Factors of Hospitalized Patients with COVID-19, Haiti, March-June 2020

In December 2019, a coronavirus epidemic emerged in China. Within months, the epidemic was considered a public health emergency of international concern. In Haiti, the first laboratory-confirmed cases of COVID-19 were reported on March 19, 2020, in a context where there was some limitations of knowledge on the modes of transmission, the severity, the clinical characteristics and the risk factors of the disease. This study has made it possible to characterize the epidemic and investigate the associations between the risk factors, co morbidities, and clinical evolution of the disease. To develop the epidemiological and clinical profile of patients with COVID-19 in Haiti, data were collected from the clinical records of patients hospitalized for COVID-19 from March 16 to June 16, 2020, in 22 healthcare facilities. Univariate, bivariate, and logistic regression model analyses were performed to describe and explore the risk factors, comorbidities, and treatments associated with patients’ clinical evolution. Statistical significance was determined using a 95% confidence interval or p-value of ?0.05.  Diabetes and high blood pressure were the main comorbidities that had a statistically significant association with the severe form of the disease and the occurrence of death. The likelihood of dying increased with age, and patients in the severe form were almost four times more likely to die. The administration of ceftriaxone to patients was significantly related to recovery from the disease. Diabetes, high blood pressure, and age were the major risk factors for the severity and mortality of people infected with COVID19. Ceftriaxone administration was protective against recovery

Migration and coverage and inequalities in maternal and child health: an analysis from Haiti and Dominican Republic.

The present dissertation was elaborated during the master's degree program in the Postgraduate Program in Epidemiology (PPGE) of the Federal University of Pelotas (UFPel) under the guidance of Professor Fernando C. Wehrmeister and co-orientation of Dr. Giovanna Gatica-Domínguez. The research project began in August 2017 and the dissertation was completed in December 2018. The analyzes were developed at the International Center for Equity in Health (ICEH) using data from standardized DHS and MICS in low- and middle-income countries. With the objective of comparing indicators of maternal and child health in Haitians (immigrants in the DR or residents of the country) and Dominican women. Nine indicators of coverage were compared: satisfied demand for family planning (DFPSm), number of antenatal consultations (ANC4), skilled birth attendance (SBA), vaccination of children (BCG, measles and DPT3), use of oral rehydration salts for diarrhea (ORS), seek for care for suspected acute respiratory infection (CAREP), and a composite coverage index 1. The results suggest that the coverages were smaller for DFPSm, ANC4, SBA, CAREP, CCI and higher for ORS among Haitian residents while Haitian immigrants had lower coverage in DPT3, ORS and greater search for respiratory infection care. In the case of inequalities, Haitians present greater inequalities by level of wealth and place of residence, while Dominican women have smaller ones, with a generally pro-rich and pro-urban pattern. According to the program's regulations, the complete volume is composed of five items: the Research project, the project modifications, the fieldwork report, the original article and the press release.Sem bolsaA presente dissertação foi elaborada ao longo do curso de mestrado no Programa de Pós-Graduação em Epidemiologia (PPGE) da Universidade Federal de Pelotas (UFPel) sob a orientação do Professor Fernando C. Wehrmeister e coorientação da Dra Giovanna Gatica-Domínguez. O projeto de pesquisa iniciou no mês de agosto de 2017 e a dissertação foi concluída no mês de dezembro de 2018. As análises foram desenvolvidas no Centro Internacional de Equidade em Saúde (International Center for Equity in Health – ICEH) utilizando dados de inquéritos padronizados de DHS e MICS realizados em países de baixa e média renda. Com o objetivo de comparar indicadores de saúde materno-infantil em haitianas (imigrantes na RD ou residentes no país) e dominicanas. Foram comparados nove indicadores de cobertu-ra: demanda satisfeita por planejamento familiar (DFPSm), número de consultas pré-natais (ANC4), atendimento ao parto por profissional qualificado (SBA), vacinação de crianças (BCG, sarampo e DPT3), uso de soro de reidratação oral para diarreia (SRO), busca por cuidado em caso de suspeita de infecção respiratória aguda (CAREP) e um índice composto de cobertura 1. Os resultados sugerem que as co-berturas foram menores para DFPSm, ANC4, SBA, CAREP, CCI e maior para SRO entre as residentes haitianas enquanto as imigrantes haitianas tiveram menor cober-tura na DPT3, SRO e maior busca por cuidado para infecção respiratória. Em caso das desigualdades, as haitianas apresentam maiores desigualdades por nível de riqueza e local de residência, enquanto as dominicanas apresentam menores, com padrão geralmente pró-rico e pró-urbano. A maior cobertura de intervenções de sa-úde materna e infantil encontrada nas imigrantes haitianas do que as residentes hai-tianas, expressam uma maior disponibilidade de serviços à saúde para estas, em seu novo país de residência. Conforme o regimento do Programa, o volume completo está composto por cinco itens: 1) o projeto de Pesquisa redigido durante as disciplinas de Prática de Pesquisa I a IV no ano de 2017, 2) as modificações do projeto apresentam as principais alterações que originaram o artigo, 3) o relatório do trabalho de campo abarcam um resumo do trabalho realizado como bolsista do ICEH, bem como as etapas de planejamento de trabalho de campo e coleta de dados realizadas através do Consórcio de Pesquisa do mestrado, 4) o artigo original contém os principais resultados do estudo, a ser submetido ao periódico “Cadernos de Saúde Pública” e a comunicação para a imprensa apresentando os principais resultados da pesquisa para divulgação na mídia