Plasmodium falciparum parasites have been endemic to Haiti for >40 years without evidence of chloroquine (CQ) resistance. In 2006 and 2007, we obtained blood smears for rapid diagnostic tests (RDTs) and fi lter paper blots of blood from 821 persons by passive and active case detection. P. falciparum infections diagnosed for 79 persons by blood smear or RDT were confi rmed by PCR for the small subunit rRNA gene of P. falciparum. Amplifi cation of the P. falciparum CQ resistance transporter (pfcrt) gene yielded 10 samples with amplicons resistant to cleavage by ApoI. A total of 5 of 9 samples had threonine at position 76 of pfcrt, which is consistent with CQ resistance (haplotypes at positions 72-76 were CVIET [n = 4] and CVMNT [n = 1]); 4 had only the wild-type haplotype associated with CQ susceptibility (CVMNK). These results indicate that CQ-resistant haplotype P. falciparum malaria parasites are present in Haiti. T he island of Hispaniola is the only area in the CaribbeanSea where Plasmodium falciparum malaria is endemic (1). It has been reported that up to 75% of the population of Haiti lives in malarious areas, especially at altitudes <300 m above sea level (2,3). P. falciparum is the only malaria parasite species that causes malaria in Haiti. The last confi rmed endogenous case of P. vivax malaria was in 1983 (4); 6 cases of P. malariae malaria were reported recently in Haitian refugees in Jamaica (5).Haiti has been a remarkable outlier as a country in which P. falciparum malaria is endemic without evidence of chloroquine (CQ) resistance (3,6-8). Even though Haiti has had no comprehensive national malaria control program for 20 years (9), several reports have found no evidence of CQ resistance in Haiti (3,[6][7][8]. Those reports are consistent with the conclusions of domestic and international health agencies, which recommend CQ for the prevention of malaria in Haiti and the treatment of patients with malaria acquired in Haiti (8-10).Accordingly, the original objectives of this research focused not on CQ resistance but on quantifying P. falciparum infection, including the heterogeneity and multiplicity of infection, and on identifying factors associated with low-intensity transmission in the Artibonite Valley of Haiti (11,12). We describe secondary analyses of blood samples for CQ-resistant P. falciparum haplotypes from samples collected in 2006 and 2007 that previously tested positive (11-13). Materials and Methods Ethical ApprovalThe protocols for these studies were reviewed and approved by the Institutional Review Boards of Tulane University and the Hôpital Albert Schweitzer (Deschapelles, Haiti). All samples were collected after obtaining informed consent. Study SiteStudies were performed in the low-lying Artibonite Valley. The valley has abundant rainfall and is heavily farmed; 80% is irrigated for the cultivation of rice and other crops. The major peak in malaria cases (>99% caused by P. falciparum)

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The aim of the study was to determine the etiology of meningitis and sepsis in the newborn at the State University Hospital of Haiti and evaluate the susceptibility 'in vitro' of the pathogens to the antibiotics commonly used. This was a prospective case series study over a 10-month period (May 1997-February 1998) of 42 newborns with sepsis and/or meningitis. Besides the clinical signs, a positive blood culture and/or a positive culture of cerebrospinal fluid was present in each case. Gram-negative bacteria were most commonly found as a cause of early onset sepsis, with Enterobacter aerogenes as the most common agent. There were no such difference between gram-negative and gram-positive in late onset sepsis. Group B Streptococcus was associated with neonatal meningitis (44 per cent of cases) which was more related to gram-positive bacteria (66 per cent). Risk factors were vaginal discharge and dysuria in mothers, and low apgar score in newborns. Thirty-three per cent of the pathogens found, among them Klebsiella pneumoniae, were resistant 'in vitro' to ampicillin and gentamycin. All were susceptible to amikacin. Enterobacter aerogenes is an important pathogen in the etiology of early onset sepsis in the newborn at the State University Hospital of Haiti, while Group B Streptococcus is the leading cause of meningitis in that age group. Resistance to gentamycin should be taken into consideration for the treatment of sepsis and meningitis in the newborn.

Background:The main objective of this study was to determine the frequency and patterns of HIVDR-associated mutations among children <18 months old born to HIV-1-positive mothers enrolled in the prevention of mother-to-child transmission (PMTCT) services in Haiti. Methods:Between January 1, 2013 and December 31, 2014, HIV-positive remnant dried blood spots (DBS) collected from children under 18 months old for Early Infant Diagnosis (EID) at the National Public Health Laboratory were used for HIV-1 genotyping. HIVDR mutations were analyzed using the Stanford Drug Resistance HIVdb program.Results: Of the 3,555 DBS collected for EID, 360 (10.1%) were HIV-positive and 355 were available for genotyping. Of these, 304 (85.6%) were successfully genotyped and 217 (71.4%) had ≥ one DR mutation. Mutations conferring resistance to NRTIs and NNRTIs were present in 40.5% (123) and 69.1% (210), respectively. The most frequent mutations were K103N/S (48.0%), M184V (37.5%), and G190A/S (15.1%), and Y181C/G/V (14.1%). Predicted drug resistance

This study is an important first step in addressing the issue of prevalence of rubella virus infection among Haitian women and in dealing with the still-underrecognized public health problem of congenital rubella syndrome in Haiti. We recommend additional research that uses randomized sampling and includes a significant proportion of women from rural areas of the country.