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1.
Clin Infect Dis ; 2021 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-34471930

RESUMEN

After an initial wave of COVID-19 in Haiti in summer 2020 (primarily lineage B.1), seropositivity for anti-SARS-CoV-2 IgG was ~40%. Variant P.1 (gamma) was introduced in February 2021, with an initially limited introduction followed by exponential local dissemination within this unvaccinated population with prior exposure to earlier SARS-CoV-2 lineages.

2.
Port-au-Prince; OPS; 2021-08-04. (PS/HTI/21-0001).
No convencional en Francés | PAHO-IRIS | ID: phr2-54589

RESUMEN

Fondée en 1902 en tant qu’agence spécialisée et indépendante en santé du système interaméricain, l’Organisation panaméricaine de la Santé (OPS) a développé une compétence et une expertise reconnues pour fournir une coopération technique à ses États Membres, avec pour objectif de lutter contre les maladies transmissibles et non transmissibles et leurs causes, de renforcer les systèmes de santé et de riposter aux urgences et aux catastrophes dans toute la Région des Amériques. Qui plus est, agissant en sa capacité de Bureau régional de l’Organisation mondiale de la Santé, l’OPS participe activement à l’équipe de pays des Nations Unies et collabore avec d’autres agences, fonds et programmes du système des Nations Unies pour contribuer à la réalisation des objectifs de développement durable (ODD) au niveau des pays. Ce rapport annuel pour 2020 reflète la coopération technique de l’OPS au niveau des pays pour cette période, c’est-à-dire la mise en œuvre de la stratégie de coopération technique et la réponse aux priorités et besoins nationaux, tout en respectant le cadre des mandats régionaux et mondiaux de l’Organisation ainsi que les ODD. Sous le thème général de « Santé universelle et pandémie  systèmes de santé résilients », le rapport met en exergue la riposte de l’OPS face à la pandémie de COVID-19, de même que ses efforts constants dans des domaines prioritaires tels que les maladies transmissibles, les maladies non transmissibles, la santé mentale, la santé tout au long du parcours de vie et les urgences sanitaires. Il fournit également un résumé financier pour l’année en revue.


Asunto(s)
Prioridades en Salud , Sistemas de Salud , Acceso Universal a los Servicios de Salud , Enfermedades Transmisibles , Enfermedades no Transmisibles , Factores de Riesgo , Programas Nacionales de Salud , Política de Salud , Américas , Haití
5.
Artículo en Inglés | MEDLINE | ID: mdl-34209792

RESUMEN

This analysis of surveys from six low- and middle-income countries (LMICs) aimed to (i) estimate the prevalence of disability among older adults and (ii) compare experiences and participation in key life areas among older people with and without disabilities which may show vulnerability during the COVID-19 pandemic. Data were analysed from district-level or national surveys in Cameroon, Guatemala, Haiti, India, Nepal and the Maldives, which across the six databases totalled 3499 participants aged 60 years and above including 691 people with disabilities. Disability was common among adults 60+, ranging from 9.7% (8.0-11.8) in Nepal to 39.2% in India (95% CI 34.1-44.5%). Mobility was the most commonly reported functional difficulty. In each setting, older people with disabilities were significantly less likely to be working and reported greater participation restrictions and environmental barriers in key life areas compared to people in the same age categories without disabilities (p < 0.05). Disability is common in this population, and older people with disabilities may have greater difficulties participating in COVID-19 responses and have high economic vulnerabilities. It is imperative to prioritise the needs of older people with disabilities in the COVID-19 pandemic, including ensuring accessibility of both health services and the community in general.


Asunto(s)
COVID-19 , Personas con Discapacidad , Anciano , Camerún , Países en Desarrollo , Guatemala , Haití , Humanos , India/epidemiología , Islas del Oceano Índico , Nepal/epidemiología , Pandemias , SARS-CoV-2
6.
BMJ Open ; 11(6): e048690, 2021 06 21.
Artículo en Inglés | MEDLINE | ID: mdl-34155081

RESUMEN

BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, conferring a disparate burden on low-income and middle-income countries (LMICs). Haiti represents a resource-constrained setting, limited by a paucity of resources and trained cardiovascular professionals equipped to address the increasing burden of CVD. OBJECTIVE: Here, we describe the creation of a comprehensive cardiology curriculum delivered through a virtual classroom. The curriculum was created to augment cardiovascular education in LMICs such as Haiti. METHODS: Over one academic year (May 2019-2020), International Cardiology Curriculum Accessible by Remote Distance Learning-Haiti consisted of biweekly, live-streamed, synchronous didactic lectures, seminars and case presentations broadcasted to 16 internal medicine (IM) residents at Hôpital Universitaire de Mirebalais, one of only four IM training programmes in Haiti. The virtual classroom was created using commercially available videoconferencing and data-sharing platforms. Prelecture and postlecture surveys and an end of the year survey were administered to assess the impact of the curriculum. RESULTS: Participant performance analysis revealed that 80% of the curriculum demonstrated a positive trend in knowledge acquisition postintervention. Based on the end of the year evaluation, 94% of participants reported that the curriculum was educational and relevant to medical practice in Haiti and 100% reported that the curriculum was good to excellent. Additionally, the curriculum was cited as an effective means of maintaining trainee education during the COVID-19 pandemic. CONCLUSION: This international medical education pilot study demonstrates the feasibility of augmenting cardiology education in LMICs by creating a virtual curriculum made possible by local partnerships, internet access and technology.


Asunto(s)
COVID-19 , Cardiología , Cardiología/educación , Curriculum , Haití , Humanos , Pandemias , Proyectos Piloto , SARS-CoV-2
8.
AIDS Behav ; 25(5): 1366-1372, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33738698

RESUMEN

INTRODUCTION: Our study describes changes in HIV care service delivery and continuity of HIV antiretroviral therapy (ART) for people living with HIV (PLHIV) during the 8 weeks before and after diagnosis of the first coronavirus disease 2019 (COVID-19) cases in Haiti on March 19, 2020. METHODS: Using data from 96 out of 167 health facilities offering ART services, we compared four ART program indicators: (1) count of HIV visits; (2) proportion of ART dispenses in community-based settings (DAC); (3) proportion of multi-month dispensing of ART medications > 6 months (> 6 m MMD); and (4) proportion of timely ART refills. We used uncontrolled interrupted time series (ITS) models to estimate slope and level changes in each indicator with the arrival of COVID-19. RESULTS AND DISCUSSION: From week 1 to week 16, the average number of HIV visits fell from 121.5 to 92.5 visits, the proportion of DAC rose from 22.7% to 36.7%, the proportion of > 6 m MMD rose from 29.4% to 48.4%, and the proportion of timely ART refills fell from 51.9% to 43.8%. The ITS models estimated abrupt increases of 36% in > 6 m MMD (p < 0.001) and 37% in DAC (p < 0.001) at the time of COVID-19 arrival, and no change after arrival of COVID-19. The was an abrupt decline of 18% in timely ART refills with the arrival of COVID-19 and a decline of 1% per week thereafter, both non-statistically significant changes. CONCLUSIONS: The sudden changes in HIV service utilization represent dramatic adaptations needed to mitigate primary and secondary effects of the COVID-19 pandemic on PLHIV. This study underscores the urgency of optimizing ART delivery models in Haiti and beyond, in order to maintain progress toward HIV epidemic control.


Asunto(s)
Fármacos Anti-VIH , COVID-19 , Infecciones por VIH , Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Haití/epidemiología , Humanos , Pandemias , SARS-CoV-2
9.
J Community Psychol ; 49(7): 2938-2958, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33734451

RESUMEN

The threat generated by the COVID-19 pandemic has triggered sudden institutional changes in an effort to reduce viral spread. Restrictions on group gatherings and in-person engagement have increased the demand for remote service delivery. These restrictions have also affected the delivery of court-mandated interventions. However, much of the literature has focused on populations that voluntarily seek out face-to-face medical care or mental health services, whereas insufficient attention has been paid to telehealth engagement of court-mandated populations. This article draws on data gathered on an NIH/NIDA-funded study intervention implemented with juvenile justice-involved youths of Haitian heritage in Miami-Dade County, Florida, during the COVID-19 public health crisis. We explore the process of obtaining consent, technological access issues, managing privacy, and other challenges associated with remote delivery of family-based therapy to juvenile justice-involved youth. Our aim is to provide some insights for consideration by therapists, healthcare workers, advocates, researchers, and policymakers tasked with finding alternative and safer ways to engage nontraditional populations in health services. The clinical trial registration number is NCT03876171.


Asunto(s)
COVID-19/epidemiología , Terapia Familiar , Telemedicina , Adolescente , COVID-19/prevención & control , Florida , Haití , Humanos , Rol Judicial , Delincuencia Juvenil/prevención & control , Pandemias , Psicología del Adolescente , Servicio Social , Trastornos Relacionados con Sustancias/prevención & control
10.
J Surg Educ ; 78(5): 1629-1636, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33573909

RESUMEN

OBJECTIVE: The Haitian Annual Assembly of Orthopaedic Trauma (HAAOT) is an annual continuing medical education (CME) conference for Haitian orthopedists and trainees converted to a pilot virtual format in 2020 due to the COVID-19 pandemic. We evaluated this virtual format's effectiveness at teaching, facilitating bilingual discussion, and encouraging cross-cultural exchange of experiences - all aimed at improving orthopedic knowledge in a low-resource country like Haiti. DESIGN: Planned collaboratively between North American and Haitian colleagues, the conference involved 4 bilingual weekly Zoom meetings comprised of 4 to 6 prerecorded presentations and live-translated discussion. Pre- and postmeeting knowledge assessments in French (Haitian language of medical instruction) were administered weekly with results compared via 2-sample t-tests. An online postconference survey evaluated attendee satisfaction with the virtual format. SETTING: Virtual. PARTICIPANTS: Weekly attendance involved approximately 50 Haitian orthopedists and trainees, with 20 to 25 completing pre- and postmeeting assessments. RESULTS: Statistically significant increases between pre/post scores were seen during 3 of 4 sessions. Session-wide significant score increases occurred for residents and attending surgeons with <10 years of experience. 85.7% of attendees reported the virtual platform exceeded expectations and 100% indicated likely or extremely likely participation in further virtual events. CONCLUSIONS: The pilot virtual HAAOT was extremely well received with high desire for future sessions. Beyond short-term knowledge retention among attendees, nonmeasurable benefits included collaboration between orthopedists and trainees in the United States, Canada, United Kingdom, Haiti, and Burkina Faso. As COVID-19 spurs online learning in high-income nations, the successful low-resource context adjustments and local partnership underlying this model attest that travel restrictions need not impede delivery of virtual CME conferences in lower-income nations. Attendee learning and the decreased cost and travel requirements allude to this platform's sustainability and reproducibility in facilitating future international education and capacity building. Further studies will assess long-term retention of presented material.


Asunto(s)
COVID-19 , Ortopedia , Competencia Clínica , Educación Médica Continua , Haití , Humanos , Ortopedia/educación , Pandemias , Reproducibilidad de los Resultados , SARS-CoV-2
11.
Psychiatry Res ; 297: 113714, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33453497

RESUMEN

OBJECTIVES: Currently, there is little data on the mental health consequences of the COVID-19 pandemic in low- and middle-income countries (LMICs). This study aims to examine the pooled and separate prevalence and determinants of depression during the pandemic in samples from four LMICs. METHODS: Participants (N= 1267, 40.9% women) were recruited from the Democratic Republic of the Congo (DRC), Haiti, Rwanda, and Togo. They completed an online cross-sectional survey on sociodemographics, exposure and stigmatization related to COVID-19, the Hopkins Symptom Checklist depression subscale, and the Connor-Davidson Resilience Scale-2. RESULTS: The pooled prevalence for depression symptoms was 24.3% (95% CI: 22.08-26.79%), with significant differences across countries. Younger age, gender (women), and high levels of exposure and stigmatization related to COVIID-19, and resilience were associated with depression in the pooled data. There were significant variations at the country level. Stigmatization (but not exposure to COVID-19 and resilience) was a strong predictor among the four countries. CONCLUSIONS: The prevalence of depression symptoms in the LMICs are similar to those reported in China and in most high-income countries during the pandemic. The findings emphasize the need for implementing non-fear-based education programs during epidemics to reduce stigmatization.


Asunto(s)
Ansiedad/epidemiología , COVID-19/psicología , Depresión/epidemiología , SARS-CoV-2 , Estigma Social , Adulto , Ansiedad/psicología , COVID-19/epidemiología , Estudios Transversales , República Democrática del Congo/epidemiología , Escolaridad , Femenino , Haití/epidemiología , Humanos , Renta , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Pobreza , Prevalencia , Rwanda/epidemiología , Estereotipo , Togo , Adulto Joven
12.
J Psychiatr Res ; 132: 13-17, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33035760

RESUMEN

OBJECTIVE: Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. METHODS: A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. RESULTS: Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 (ß = 0.06, p = .005), stigmatization related to COVID-19 (ß = 0.03, p < .001), and resilience (ß = -0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries (ß = 0.02, p < .00; ß = 0.05, p = .013; ß = 0.03, p = .021; ß = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). CONCLUSIONS: The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.


Asunto(s)
Ansiedad/epidemiología , COVID-19/epidemiología , Países en Desarrollo/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Resiliencia Psicológica , Estigma Social , Adulto , Ansiedad/etiología , Congo/epidemiología , Femenino , Haití/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores Protectores , Factores de Riesgo , Rwanda/epidemiología , Togo/epidemiología
13.
BMC Public Health ; 20(1): 1853, 2020 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-33272250

RESUMEN

BACKGROUND: In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. METHODS: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N = 55) and analyzed using content analysis. RESULTS: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country's healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. CONCLUSION: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus's spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries' response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country's communities and healthcare systems.


Asunto(s)
COVID-19/prevención & control , Gobierno , Guías como Asunto , Brasil/epidemiología , COVID-19/epidemiología , China/epidemiología , Haití/epidemiología , Humanos , Investigación Cualitativa , República de Corea/epidemiología , Reino Unido/epidemiología , Estados Unidos/epidemiología
15.
Am J Trop Med Hyg ; 103(5): 1986-1988, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32978934

RESUMEN

The COVID-19 pandemic poses a unique threat to patients with multidrug-resistant tuberculosis (MDR-TB). We describe a case of a patient with pulmonary MDR-TB and COVID-19 in Port-au-Prince, Haiti, and highlight the challenges and approach to managing a patient with both diseases.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Tuberculosis Resistente a Múltiples Medicamentos/complicaciones , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Adulto , COVID-19 , Haití/epidemiología , Humanos , Masculino , Pandemias , SARS-CoV-2
16.
Psychol Trauma ; 12(6): 569-571, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32816516

RESUMEN

In the 1st trimester of 2020, there were mixed feelings among Haitians about the spread of the COVID-19 pandemic. In effect, many of the concerns emanating from the relatively weak health infrastructure in Haiti were analyzed from a resilience perspective. Many professionals living in Haiti with whom we have conversed believe that Haitians were better prepared to cope with the social distancing and mental health outcomes associated with the pandemic because of their 3-month exposure to the effects of Peyi Lòk ("country in lockdown") as well as previous major natural disasters. In that regard, previous traumatic exposures may serve as a buffer against the debilitating effects of the COVID-19 pandemic among Haitians. For the past 3 months, Haitians have naturally adopted a practical posture to cope with the pandemic where only school buildings are closed. Consequently, we remain convinced that from a psychological perspective, individuals from high-income countries that are severely affected by the COVID-19 pandemic could learn from the Haitian way of coping with large-scale disasters. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Adaptación Psicológica , Actitud Frente a la Salud , Betacoronavirus , Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Resiliencia Psicológica , COVID-19 , Haití , Humanos , Pandemias , SARS-CoV-2
18.
Ann Glob Health ; 86(1): 69, 2020 06 29.
Artículo en Inglés | MEDLINE | ID: mdl-32676298

RESUMEN

Several characteristics of refugee and migrant populations make them susceptible to acquire COVID-19. To fully understand the impact of COVID-19 on refugees and migrants in the Americas, it is important to consider the broader geopolitical context and appreciate the differences among migratory groups. There are three migrant groups in the Americas that are particularly susceptible to COVID-19: Central American migrants at the northern Mexico border, Venezuelans within South America, and Haitians in the Dominican Republic. Refugees and displaced migrants are the world's collective responsibility, and thus, it would be imprudent to displace their care to resource constrained developing nations.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Refugiados , Migrantes , Betacoronavirus , COVID-19 , América Central/etnología , Países en Desarrollo , República Dominicana/epidemiología , Haití/etnología , Humanos , México/epidemiología , Pandemias , SARS-CoV-2 , América del Sur/epidemiología , Venezuela/etnología , Poblaciones Vulnerables
19.
Am J Trop Med Hyg ; 103(2): 605-608, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32597389

RESUMEN

As COVID-19 cases continue to increase globally, fragile health systems already facing challenges with health system infrastructure, SARS-CoV-2 diagnostic capacity, and patient isolation capabilities may be left with few options to effectively care for acutely ill patients. Haiti-with only two laboratories that can perform reverse transcriptase PCR for SARS-CoV-2, a paucity of hospital beds, and an exponential increase in cases-provides an example that underpins the need for immediate infrastructure solutions for the crisis. We present two COVID-19 treatment center designs that leverage lessons learned from previous outbreaks of communicable infectious diseases and provide potential solutions when caseload exceeds existing capacity, with and without access to SARS-CoV-2 testing. These designs are intended for settings in which health facilities and testing resources for COVID-19 are surpassed during the pandemic, are adaptable to local conditions and constraints, and mitigate the likelihood of nosocomial transmission while offering an option to care for hospitalized patients.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Atención a la Salud/métodos , Arquitectura y Construcción de Instituciones de Salud , Instituciones de Salud , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Capacidad de Reacción , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Haití/epidemiología , Recursos en Salud/provisión & distribución , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , SARS-CoV-2
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