Tobacco use in Haiti: findings from demographic and health survey.

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.

Socio-economic and demographic factors influencing open defecation in Haiti: a cross-sectional study.

BACKGROUND: Open defecation (OD) remains an important public health challenge in Haiti. The practice poses a significantly high risk of disease transmission. Considering these negative health consequences, this paper aims to identify socio-economic and demographic factors that influence OD practice among households in Haiti. METHODS: The study used secondary data from 13,405 households from the Haiti Demographic and Health Survey 2016-2017. Descriptive statistics and bivariate analysis were used to find the preliminary results. Further, multivariate analysis was performed to confirm the findings. RESULTS: Around one quarter (25.3%) of Haitian households still defecate in the open, almost 10% in urban areas, and nearly 36% in rural areas. Multivariate analysis revealed that the age and sex of the household head, household size, number of children aged 1-14 years old in the household, education level, wealth index, access to mass media, place of residence, and region were significant predictors of OD practice among households in Haiti. CONCLUSION: To accelerate the elimination of OD by 2030 and therefore achieve sustainable open defecation-free status, the government of Haiti and its partners should consider wealth disparities among regions and mobilize mass media and community-based networks to raise awareness and promote education about sane sanitation practices. Furthermore, because the possibilities to build toilets differ between rural and urban areas, specific interventions must be spearheaded for each of these regions. The public program can subsidize individual toilets in rural areas with room to collect dry excreta for the preparation of fertilizers, while in urban areas collective toilets can be built in slums. Interventions should also prioritize households headed by women and young people, two underpriviledged socioeconomic groups in Haiti.

Insufficient yet improving involvement of the global south in top sustainability science publications.

The creation of global research partnerships is critical to produce shared knowledge for the implementation of the UN 2030 Agenda for Sustainable Development. Sustainability science promotes the coproduction of inter- and transdisciplinary knowledge, with the expectation that studies will be carried out through groups and truly collaborative networks. As a consequence, sustainability research, in particular that published in high impact journals, should lead the way in terms of ethical partnership in scientific collaboration. Here, we examined this issue through a quantitative analysis of the articles published in Nature Sustainability (300 papers by 2135 authors) and Nature (2994 papers by 46,817 authors) from January 2018 to February 2021. Focusing on these journals allowed us to test whether research published under the banner of sustainability science favoured a more equitable involvement of authors from countries belonging to different income categories, by using the journal Nature as a control. While the findings provide evidence of still insufficient involvement of Low-and-Low-Middle-Income-Countries (LLMICs) in Nature Sustainability publications, they also point to promising improvements in the involvement of such authors. Proportionally, there were 4.6 times more authors from LLMICs in Nature Sustainability than in Nature articles, and 68.8-100% of local Global South studies were conducted with host country scientists (reflecting the discouragement of parachute research practices), with local scientists participating in key research steps. We therefore provide evidence of the promising, yet still insufficient, involvement of low-income countries in top sustainability science publications and discuss ongoing initiatives to improve this.

High Lead Exposure Associated With Higher Blood Pressure in Haiti: a Warning Sign for Low-Income Countries.

Cardiovascular disease is the leading cause of death in lower-income countries including Haiti. Environmental lead exposure is associated with high blood pressure and cardiovascular mortality in high-income countries but has not been systematically measured and evaluated as a potential modifiable cardiovascular risk factor in lower-income countries where 6.5 billion people reside. We hypothesized lead exposure is high in urban Haiti and associated with higher blood pressure levels. Blood lead levels were measured in 2504 participants ≥18 years enrolled in a longitudinal population-based cohort study in Port-au-Prince. Lead screening was conducted using LeadCare II (detection limit ≥3.3 µg/dL). Levels below detection were imputed by dividing the level of detection by √2. Associations between lead (quartiles) and systolic blood pressure and diastolic blood pressure were assessed, adjusting for age, sex, obesity, smoking, alcohol, physical activity, income, and antihypertensive medication use. The median age of participants was 40 years and 60.1% were female. The geometric mean blood lead level was 4.73µg/dL, 71.1% had a detectable lead level and 42.3% had a blood lead level ≥5 µg/dL. After multivariable adjustment, lead levels in quartile four (≥6.5 µg/dL) compared with quartile 1 (<3.4 µg/dL) were associated with 2.42 mm Hg (95% CI, 0.36-4.49) higher systolic blood pressure and 1.96 mm Hg (95% CI, 0.56-3.37) higher diastolic blood pressure. In conclusion, widespread environmental lead exposure is evident in urban Haiti, with higher lead levels associated with higher systolic and diastolic blood pressure. Lead is a current and potentially modifiable pollutant in lower-income countries that warrants urgent public health remediation. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03892265.

Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments.

Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a "threshold effect" (risk quotient <1), and an acceptable risk for substances having a "non-threshold effect", with the notable exception of arsenic (individual risk equal to 3.10(-6)).

Influence of ionic strength and soil characteristics on the behavior of Cryptosporidium oocysts in saturated porous media.

The physico-chemical behavior of Cryptosporidium oocysts was investigated during their transfer through an alluvial formation from Les Cayes (Haiti) via batch tests. Five approximately 3 kg soil samples were collected and combined prior to batch tests from the alluvial formations. The experiments were carried out at soil pH by equilibrating different ranges of pure oocysts concentrations and soil samples with 3mM CaCl2 and 1mM NaBr as electrolyte. We used the Debye-Hückel equation describing ion activity in a solution for a given ionic strength. The equilibrium adsorption mechanism is used to enumerate the oocysts in the soil. The results suggest that the oocysts behavior in porous media depends on soil characteristics such as soil pH, the nature of the mineral and organic constituents of the soil and the ionic strength and activities in solution. These results show that a total transfer in batch containing NaBr solutions against a partial one in batch containing CaCl2 solutions depends on the oocysts media concentration. To confirm the oocysts number retained in soil, confocal microscopy was successfully used and the images demonstrate that the majority of oocysts were retained at the range of concentrations tested. The findings from this study demonstrated that the retention of C. Parvum in soils may be influenced by chemical conditions and soils characteristics, which are important for groundwater risk assessment.

Assessing the mobility of lead, copper and cadmium in a calcareous soil of Port-au-Prince, Haiti.

The presence of heavy metals in the environment constitutes a potential source of both soil and groundwater pollution. This study has focused on the reactivity of lead (Pb), copper (Cu) and Cadmium (Cd) during their transfer in a calcareous soil of Port-au-Prince (Haiti). Kinetic, monometal and competitive batch tests were carried out at pH 6.0. Two simplified models including pseudo-first-order and pseudo-second-order were used to fit the experimental data from kinetics adsorption batch tests. A good fit of these data was found with pseudo-second-order kinetic model which indicates the applicability of this model to describe the adsorption rates of these metals on the soil. Monometal batch tests indicated that both Langmuir and Freundlich models allowed a good fit for experimental data. On the basis of the maximum adsorption capacity (qmax), the order affinity of Pb, Cu and Cd for the studied soil was Pb2+ > Cu2+ > Cd2+. Competitive sorption has proved that the competition between two or several cations on soils for the same active sites can decrease their qmax. These results show that, at high metal concentrations, Cd may pose more threat in soils and groundwater of Port-au-Prince than Pb and Cu.

Cryptosporidiosis in Haiti: surprisingly low level of species diversity revealed by molecular characterization of Cryptosporidium oocysts from surface water and groundwater.

The protozoan parasite Cryptosporidium sp. has emerged as one of the most important water contaminants, causing waterborne outbreaks of diarrhoeal diseases worldwide. In Haiti, cryptosporidiosis is a frequent cause of diarrhoea in children under the age of five years, HIV-infected individuals, and people living in low socioeconomic conditions, mainly due to the consumption of water or food polluted by Cryptosporidium oocysts. The aim of this study was to detect and identify Cryptosporidium oocysts present in 12 water samples collected in Port-au-Prince and 4 water samples collected in Cap Haïtien. Initial detection consisted of immunomagnetic separation - immunofluorescence assay (IMS-IFA), which was confirmed by nested PCR, targeting the most polymorphic region of the 18S rRNA gene in 15/16 samples. Genotyping was performed by PCR-restriction fragment length polymorphism (RFLP) analysis and DNA sequencing. Under our working conditions, neither nested PCR-RFLP nor direct DNA sequencing revealed the expected species diversity, as only Cryptosporidium parvum was identified in the water samples studied. This study highlights the difficulty of detecting mixed populations of Cryptosporidium species in environmental samples.

Evaluation of ecotoxicological risks related to the Discharge of Combined Sewer Overflows (CSOs) in a periurban River.

Discharges of Combined Sewer Overflows (CSOs) into periurban rivers present risks for the concerned aquatic ecosystems. In this work, a specific ecotoxicological risk assessment methodology has been developed as management tool to municipalities equipped with CSOs. This methodology comprises a detailed description of the spatio-temporal system involved, the choice of ecological targets to be preserved, and carrying out bioassays adapted to each compartment of the river receiving CSOs. Once formulated, this methodology was applied to a river flowing through the outskirts of the city of Lyon in France. The results obtained for the scenario studied showed a moderate risk for organisms of the water column and a major risk for organisms of the benthic and hyporheic zones of the river. The methodology enabled identifying the critical points of the spatio-temporal systems studied, and then making proposals for improving the management of CSOs.

Ecological risk assessment of urban and industrial systems: a review.

Numerous ecological risk assessment methodologies have been developed over the last twenty years around the world for evaluating urban and industrial systems and installations, by both the organisations responsible for implementing regulations and the scientific community. Although these methodologies share the general principle underlying their use, they differ widely with respect to the approaches chosen and the resources employed to apply them. Also, they may even have different objectives: prior assessment as part of an impact study before building a new installation, or retrospective assessment, for example, in view to explaining the reasons for an impact recorded or for forecasting additional expected impacts. This article provides a synthesis of the different approaches used around the world for carrying out each of the major steps common to all ecological risk assessment methodologies. The advantages and limitations of these different options are discussed in order to provide elements for formulating any new methodology adapted to a given scenario. To conclude, perspectives for improving the tools required for these methodologies are proposed, and the research works to which priority should be given are identified.

Cryptosporidium contamination of surface and water supplies in Haiti.

Cryptosporidiosis is one of the most frequent causes of diarrhea in Haiti. Transmission in children less than five years-old, HIV-infected individuals, and people living in low socio-economic conditions is frequently due to consumption of water or food contaminated by Cryptosporidium oocysts. This study examined the circulation of Cryptosporidium oocysts in surface waters and in public water supplies in the district of Port-au-Prince. Data were gathered from December 2000 to June 2002 in 37 sites. In the district of Port-au-Prince, 24/37 samples of water collected (65%) were contaminated by Cryptosporidium oocysts and 10/11 (91%) of those collected in reservoirs used by people living in peripheral areas. The rate of contamination was 7/13 (54%) in water from public standpipes provided by the public company of water distribution. All surface water (4/4) collected was highly contaminated.

Groundwater contamination by microbiological and chemical substances released from hospital wastewater: health risk assessment for drinking water consumers.

Contamination of natural aquatic ecosystems by hospital wastewater is a major environmental and human health issue. Disinfectants, pharmaceuticals, radionuclides and solvents are widely used in hospitals for medical purposes and research. After application, some of these substances combine with hospital effluents and, in industrialised countries, reach the municipal sewer network. In certain developing countries, hospitals usually discharge their wastewater into septic tanks equipped with diffusion wells. The discharge of chemical compounds from hospital activities into the natural environment can lead to the pollution of water resources and risks for human health. The aim of this article is to present: (i) the steps of a procedure intended to evaluate risks to human health linked to hospital effluents discharged into a septic tank equipped with a diffusion well; and (ii) the results of its application on the effluents of a hospital in Port-au-Prince. The procedure is based on a scenario that describes the discharge of hospital effluents, via septic tanks, into a karstic formation where water resources are used for human consumption. COD, Chloroform, dichlomethane, dibromochloromethane, dichlorobromomethane and bromoform contents were measured. Furthermore, the presence of heavy metals (chrome, nickel and lead) and faecal coliforms were studied. Maximum concentrations were 700 NPP/100 ml for faecal coliforms and 112 mg/L for COD. A risk of infection of 10(-5) infection per year was calculated. Major chemical risks, particularly for children, relating to Pb(II), Cr(III), Cr(VI) and Ni(II) contained in the ground water were also characterised. Certain aspects of the scenario studied require improvement, especially those relating to the characterisation of drugs in groundwater and the detection of other microbiological indicators such as protozoa, enterococcus and viruses.

Adsorption studies of methylene blue and phenol onto vetiver roots activated carbon prepared by chemical activation.

Vetiver roots have been utilized for the preparation of activated carbon (AC) by chemical activation with different impregnation ratios of phosphoric acid, X(P) (gH(3)PO(4)/g precursor): 0.5:1; 1:1 and 1.5:1. Textural characterization, determined by nitrogen adsorption at 77K shows that mixed microporous and mesoporous structures activated carbons (ACs) with high surface area (>1000 m(2)/g) and high pore volume (up to 1.19 cm(3)/g) can be obtained. The surface chemical properties of these ACs were investigated by X-ray photoelectron spectroscopy (XPS) and Boehm titration. Their textural and chemical characteristics were compared to those of an AC sample obtained by steam activation of vetiver roots. Classical molecules used for characterizing liquid phase adsorption, phenol and methylene blue (MB), were used. Adsorption kinetics of MB and phenol have been studied using commonly used kinetic models, i.e., the pseudo-first-order model, the pseudo-second-order model, the intraparticle diffusion model and as well the fractal, BWS (Brouers, Weron and Sotolongo) kinetic equation. The correlation coefficients (R(2)) and the normalized standard deviation Deltaq (%) were determined showing globally, that the recently derived fractal kinetic equation could best describe the adsorption kinetics for the adsorbates tested here, indicating a complex adsorption mechanism. The experimental adsorption isotherms of these molecules on the activated carbon were as well analysed using four isotherms: the classical Freundlich, Langmuir, Redlich-Peterson equations, but as well the newly published deformed Weibull Brouers-Sotolongo isotherm. The results obtained from the application of the equations show that the best fits were achieved with the Brouers-Sotolongo equation and with the Redlich-Peterson equation. Influence of surface functional groups towards MB adsorption is as well studied using various ACs prepared from vetiver roots and sugar cane bagasse. Opposite effects governing MB and phenol adsorption mechanism on ACs are demonstrated. The various effects involved in adsorption mechanisms of each molecule are demonstrated.

Adsorption of heavy metals on to sugar cane bagasse: improvement of adsorption capacities due to anaerobic degradation of the biosorbent.

In this work, anaerobic degradation of sugar cane bagasse was studied with a dual objective: the production of biogas and the improvement of the material's characteristics for its implementation in adsorption processes. The biogas production was determined by means of biomethane potential tests carried out over two months of incubation at 35 degrees C. Biogas and methane cumulative productions were assumed to follow a first-order rate of decay. Theoretical cumulative methane and biogas productions were calculated using Buswell's equation. The anaerobic digestion resulted in a 92% decrease in the leachable organic fraction and a 40% mass loss of bagasse. The average productions of biogas and methane from the whole set of experiments were 293 +/- 6 and 122 +/- 4 mL g(-1) of volatile solids, respectively. The anaerobic incubation of the raw material led to an increase in adsorption capacities towards metal ions, which were multiplied by around 2.0 for Zn2+ and 2.3 for Cd2+.

Fate of glutaraldehyde in hospital wastewater and combined effects of glutaraldehyde and surfactants on aquatic organisms.

Glutaraldehyde (GA), an aliphatic dialdehyde disinfectant, and surfactants, one of the major components of detergents, are widely used in hospitals in order to eliminate pathogenic organisms causing nosocomial infectious diseases. After their use, disinfectants and surfactants reach the wastewater network together. The discharge of chemical compounds from hospital activities into wastewater is also a well-known problem, causing pollution of water resources and constituting an ecological risk for aquatic organisms. In this study, the chemistry and toxicology of GA and surfactant mixtures were reviewed in order to estimate their fate in aquatic ecosystems. Furthermore, their joint effects on aquatic organisms were experimentally assessed in the laboratory. A simple model of the additive joint action of toxicants was used to determine combined acute toxicity effects on the bacteria luminescence and Daphnia mobility of three mixtures containing GA at 1.5 x EC50 24 h [in mg/L] on Daphnia and anionic, cationic and nonionic surfactants at twice their critical micellar concentration (CMC). The mixture of GA and a cationic surfactant gave an EC50 30 min on Vibrio fischeri of 0.158%, with a concentration of 0.04 mg GA/L and 1.04 mg CTAB/L, which provided an additive action. The interaction between GA and an anionic surfactant on V. fischeri produced an antagonistic joint action with an EC50 30 min of 3.95%, containing 1.06 mg GA/L and 33.2 mg SDS/L. A synergistic action with an EC50 30 min of 8.4% on V. fischeri was observed for the mixture containing GA and a nonionic surfactant. Antagonistic interactions were observed for the joint action between GA and the surfactants studied on Daphnia. The mixture of GA and CTAB was more toxic (EC50 24 h=0.02%) than the two other mixtures (EC50 24 h GA+SDS=6%; EC50 24 h GA+TX 100=10%). This study provides new data on the toxicity of certain hospital pollutants entering the aquatic environment and detected in surface and groundwaters. It is necessary to study the joint effects of GA and surfactant mixtures following chronic and sublethal standard bioassays in order to estimate the contribution of the additive joint action models in assessing the environmental risk of hospital wastewater (HW).

Toxicological effects of disinfections using sodium hypochlorite on aquatic organisms and its contribution to AOX formation in hospital wastewater.

Sodium hypochlorite (NaOCl) is often used for disinfecting hospital wastewater in order to prevent the spread of pathogenic microorganisms, causal agents of nosocomial infectious diseases. Chlorine disinfectants in wastewater react with organic matters, giving rise to organic chlorine compounds such as AOX (halogenated organic compounds adsorbable on activated carbon), which are toxic for aquatic organisms and are persistent environmental contaminants. The aim of this study was to evaluate the toxicity on aquatic organisms of hospital wastewater from services using NaOCl in pre-chlorination. Wastewater samples from the infectious and tropical diseases department of a hospital of a large city in southeast of France were collected. Three samples per day were collected in the connecting well department at 9 a.m., 1 p.m. and 5 p.m. during 8 days from 13 March to 22 March 2001, and a mixture was made at 6 p.m. with the three samples in order to obtain a representative sample for the day. The toxicity test comprised the 24-h EC50 on Daphnia magna and a bioluminescence assay using Vibrio fischeri photobacteria. Fecal coliforms and physicochemical analyses such as total organic carbon (TOC), chloride, AOX, total suspended solids (TSS) and chemical oxygen demand (COD) were carried out. Wastewater samples highlighted considerable acute toxicity on D. magna and V. fischeri photobacteria. However, low most probable numbers (MPN), ranging from <3 to 2400 for 100 ml, were detected for fecal coliforms. Statistical analysis, with a confidence interval of 95%, gave a strong linear regression assessed with r=0.98 between AOX concentrations and EC50 (TU) on daphnia. The identification of an ideal concentration of NaOCl in disinfecting hospital wastewater, i.e. its non-observed effect concentration (NOEC) on algae and D. magna, seems to be a research issue that could facilitate the control of AOX toxicity effects on aquatic organisms. Therefore, it would be necessary to monitor the biocide properties of NaOCl on fecal coliforms at various doses and its toxicity effects on aquatic organisms.

[Determining the optimal fluorine dose in the drinking water of the South Center hydrological region of Haiti]. / Détermination de la dose optimale de fluor de l'eau destinée à la consommation humaine de la région hydrographique Centre-Sud de la république d'Haïti.

This study aims at determining the optimal dose of fluorine in the drinking water in the South Center region of Haiti. This region has an average daily temperature ranging from 17 to 33 C. Water samples were collected from November 15th to December 20th 2000 on the water resource of some of the counties of the hydrological South Center region of Haiti. The results show that the concentration of fluorine in this region varies between 0 and 0.83 mg/litre. However, the calculated optimal dose based on the temperature measured show that fluorine concentration of water should be between 0.7 and 1 mg/litre.