Impact of patron saint festivities on cholera in three communes in Haiti

Abstract

Background Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017. Methods An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and 2 weeks later was weighted against patronal festivities and weekly precipitation rates. Results In total, 3633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR = 0.4277 (97.5% CI: 0.2798–0.6193), p = 0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% 1 week following patronal festivities. Conclusion This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017.

Informing policy via dynamic models: Cholera in Haiti

“…Fig 7 shows that the estimated seasonal transmission rate β mimics the rainfall dynamics in Haiti, despite Model 1 not having access to rainfall data. This is consistent with previous studies that incorporated rainfall as an important part of their mechanistic model or otherwise argue that rainfall is an important driver of cholera dynamics in Haiti [ 4 , 9 , 10 , 18 , 26 , 27 , 29 , 63 , 64 ]. The estimated seasonality also features an increased transmission rate during the fall, which was noticed at an earlier stage of the epidemic [ 10 ].…”

Observance Des Mesures Barrières De Lutte Contre La Maladie A Coronavirus-19 & Morbi-Mortalités Liées Au Cholera En Zone EndemoEpidémique De La République Démocratique Du Congo

“…A Moba, on constate des pics de notification des cas de choléra durant la période de Septembre à Avril. En effet, cette période correspond à la période de dégradation de l'hygiène environnemental, déjà précaire, suite aux pluies [2][9] [37]. Mais dans le conteste de Covid-19, cette règle n'a pas été respectée.…”