Acute Respiratory Illness in Rural Haiti

Abstract

Objectives: Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention. Methods: Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015.Results: Most common viruses detected were Rhinovirus (36%), Influenza A (16%) and Adenovirus (7%), and bacteria were Streptococcus pneumoniae (58%) and Staphylococcus aureus (28%). Compared to older children, children aged 3-5 years had more Influenza A (28% vs. 9%, p = 0.002) and Adenovirus detected (14% vs. 3%, p = 0.01). Similarly, S. pneumoniae was greatest in children 3-5 years old (71% 3-5yrs; 58% 6-15 years; 25% 16-20 years; p = 0.008). Children 3-10 years old presented with fever more than children 11-20 years old (22% vs 7%; p = 0.02) and were more often diagnosed with pneumonia (28% vs 4%, p < 0.001). Conclusions: Younger children had increased fever, pneumonia, and detection of Influenza A and S. pneumoniae. These data support the need for influenza and pneumococcus vaccination in early childhood in Haiti.

Independent infections of porcine deltacoronavirus among Haitian children

“…Pig farming in the country is at a subsistence level, and, to our knowledge, no cases of PDCoV infection have been reported to date in pigs. Between 2012 and 2020, our group monitored the occurrence of illness among children seen at a free school clinic operated by the Christianville Foundation school system in the Gressier region of Haiti 21 – 24 . Respiratory and diarrhoeal illnesses were most common among children presenting to the clinic for care, followed by acute undifferentiated febrile illnesses (that is, fever with no clear localizing symptoms), which accounted for approximately 16% of clinic cases 21 .…”

Emergence of porcine delta-coronavirus pathogenic infections among children in Haiti through independent zoonoses and convergent evolution

“…Pig farming in the country is at a subsistence level, and, to our knowledge, no PDCoV cases have been reported to date in pigs. Our group monitored occurrence of illness among children attending school within a school system operated by the Christianville Foundation in the Gressier region of Haiti from 2012 to 2020 [21][22][23][24] . During that time period, free medical care was provided to children at the school clinic.…”

Implementation of a pediatric telemedicine and medication delivery service in a resource-limited setting: A pilot study for clinical safety and feasibility

“…If a patient’s complaint/illness did not fit within the scope of the guidelines, nurse providers contacted an on-call physician for guidance and correspondingly adjusted the assessment/plan. Given that the study area had a low rate of pneumococcal vaccination 24 and high rates of pneumococcal infection in children with acute ARI 25 , amoxicillin was indicated for most children with ARI. The study occurred after the 2010 cholera outbreak 26 and during the onset of the COVID-19 pandemic.…”