Jacques Boncy - Academia.edu (original) (raw)
Papers by Jacques Boncy
Infectious Diseases of Poverty, May 22, 2023
Background Malaria continues to cause burden in various parts of the world. Haiti, a Caribbean co... more Background Malaria continues to cause burden in various parts of the world. Haiti, a Caribbean country, is among those aiming to eliminate malaria within a few years. Two surveys were conducted in Haiti during which we aimed to evaluate the performance of the simple and rapid procedure for ultra-rapid extraction-loop-mediated isothermal amplification (PURE-LAMP) method with dried blood spots as an alternative diagnostic method for malaria in the context of low to very low rates of transmission. Methods Febrile and afebrile people were recruited from three administrative divisions within Haiti: Nippes, Sud and Grand' Anse, during the summers of 2017 (early August to early September) and 2018 (late July to late August). Their blood samples were tested by microscopy, rapid diagnostic tests (RDT), PURE-LAMP and nested PCR to detect Plasmodium infection. Sensitivity, specificity, positive and negative predictive values and kappa statistics were estimated with the nested PCR results as the gold standard. Among 1074 samples analyzed, a positive rate of 8.3% was calculated based on the nested PCR results. Among febrile participants, the rates in 2017 and 2018 were 14.6% and 1.4%, respectively. Three positives were detected among 172 afebrile participants in 2018 by PURE-LAMP and nested PCR, and all three were from the same locality. There was no afebrile participants recruited in 2017. The PURE-LAMP, RDT and microscopy had respective sensitivities of 100%, 85.4% and 49.4%. All of the testing methods had specificities over 99%. This study confirmed the high performance of the PURE-LAMP method to detect Plasmodium infection with dried blood spots and recommends its use in targeted mass screening and treatment activities in low endemic areas of malaria.
PubMed, 1977
The in vitro proliferative response of rat lymphoctes culitivated in increasing concentrations of... more The in vitro proliferative response of rat lymphoctes culitivated in increasing concentrations of calf serm (LCS) was measured by the incorporation of 3H-thymidine. Results showed that in contrast to the response of PHA, the response to concanavlin A (conA) was greatly dependent on the concentration of serum in the medium. Kinetics of the response of ConA indicated that increasing concentrations of LCS unblocked the non-response to supraoptimal doses of the mitogen. The supportive effect of LCS was not due to an increase in cell viability and was abolished when serum was dialyzed. By contrast, lipopolysaccharide (LPS) exerted an adjuvant effect on the response to optimal and suboptimal concentrations of ConA without unblocking the non-response to high doses. LPS facilitated the response to ConA of a distinct subpopulation of T cell isolated by separation on nylon wool columns. This in vitro model allowed us to study some factors which may be implicated in tolerance and immunity.
medRxiv (Cold Spring Harbor Laboratory), Oct 10, 2022
Background: Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during t... more Background: Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti. Methods: A case-control study of children 6-36 months of age enrolled 99 cases with diarrhea and 96 asymptomatic controls. Assessments were performed at enrollment and one month follow-up. Established PCR methodologies targeted DEC using fecal swabs. The association between pathogens and anthropometric z-scores was determined using multiple linear regression. : Enterotoxigenic Escherichia coli (ETEC) was identified in 21.9% of cases vs. 16.1% of controls with heat-stable producing ETEC significantly associated with symptomatic disease. Enteroaggregative E. coli (EAEC) was found in 30.2% of cases vs. 27.3% of controls, and typical enteropathogenic E. coli in 6.3% vs. 4.0% of cases and controls, respectively. Multivariate linear regression demonstrated ETEC and EAEC were significantly associated with reduced weight-age zscore (WAZ) and height-age z-score (HAZ) after adjusting for confounders. Conclusions: DEC are prevalent in north Haitian children. ETEC, EAEC, household environment, and diet are associated with unfavorable anthropometric measures. Further studies may quantify the contribution of individual pathogens to adverse health outcomes.
European journal of public health, Sep 1, 2020
With the support of the European Union, the National Laboratory for Public Health and partners di... more With the support of the European Union, the National Laboratory for Public Health and partners did an analysis of the primary healthcare and hospital laboratories in health facilities and identified strengths and weaknesses of the national network of public health laboratories. With that knowledge the LNSP developed in a participatory way a new national Laboratory Policy and thereafter a Strategic Plan 2019 -2024 that guides the country in strengthening the labs at all levels. This is very much needed as Haiti still suffers of high levels of malaria, tuberculosis, HIV and other infectious diseases. The policy fits in the international Health Security Agenda. Most important lesson learned: by a systematic step by step process of analysis, policy formation and action planning, a research institute can -with support of stakeholders -make an impact on policies and practices. 5.H. Workshop: Developing more responsive systems to deliver catch-up vaccination to migrants arriving in Europe
Bulletin De La Societe De Pathologie Exotique, 1983
American Journal of Field Epidemiology
On December 12, 2022, a panel seminar organized by the American Journal of Field Epidemiology (AJ... more On December 12, 2022, a panel seminar organized by the American Journal of Field Epidemiology (AJFE) was held with the enthusiastic support of the National Institute of Health of Colombia. More than 200 professionals from Colombia, Peru, Brazil, El Salvador, Canada, the USA, Ecuador, Costa Rica, Chile, and Mexico participated. The panelists, moderated by Dr. Marjorie Pollack, member of the AJFE Editorial Board and associate editor of ProMED, presented the epidemiological characteristics of the pandemic in Colombia, Brazil, Costa Rica, Puerto Rico, Haiti, and the Dominican Republic, as well as the public health response with which it was responded to mitigate and control it. The panelists emphasized the value of the preparation provided by the existence of field epidemiology training programs, the existence of a response plan, of establishing good communication with decision makers to make them collectively. The Costa Rican experience of using epidemiology to facilitate the provision...
Emerging Infectious Diseases, 2021
The American Journal of Tropical Medicine and Hygiene, 2019
Hepatitis E virus (HEV) infection is associated with a high fatality rate among pregnant women, a... more Hepatitis E virus (HEV) infection is associated with a high fatality rate among pregnant women, and gestational complications have been reported among pregnant women infected with hepatitis A virus (HAV). The aim of this study was to determine the seroprevalence of HAV and HEV infections among pregnant women in Haiti. We stratified the population (n = 1,307) between West and non-West regions. Specimens were tested for total HAV antibody (anti-HAV), and IgM and IgG HEV antibody (anti-HEV). Overall, 96.8% pregnant women were positive for total anti-HAV, 10.3% for IgG anti-HEV, and 0.3% for IgM anti-HEV. The prevalence of IgG anti-HEV in the non-West region (12.3%) was significantly greater than that in the West region (5.3%) (P < 0.0001). Most pregnant women in Haiti had evidence of past exposure and immunity to HAV. The non-West region had a higher prevalence of HEV. Improvement in water and sanitation will help in the prevention and control of these infections in Haiti.
Annals of Internal Medicine, 1994
To determine the prevalence and clinical manifestations of Cyclospora in Haitians infected with h... more To determine the prevalence and clinical manifestations of Cyclospora in Haitians infected with human immunodeficiency virus (HIV) who have diarrhea and to evaluate therapy and prophylaxis. Cohort study. From 1990 to 1993, stool samples were collected from adults seropositive for HIV who had had diarrhea for at least 3 weeks. A clinic in Haiti. Stool samples were examined for enteric protozoa after acid-fast staining. Patients with Cyclospora infection were treated with trimethoprimsulfamethoxazole (160 mg and 800 mg, respectively) given orally four times a day for 10 days. After completion of therapy, patients were evaluated weekly and re-treated if clinical and parasitologic recurrences occurred, followed by trimethoprim-sulfamethoxazole prophylaxis three times a week. 804 of 2400 patients (33%) seropositive for HIV had a history of chronic or intermittent diarrhea; 502 of these 804 patients (62%) currently had diarrhea, and 450 patients each provided two stool specimens for examination. Enteric protozoa identified included Cryptosporidium (30%), Isospora belli (12%), Cyclospora species (11%), Giardia lamblia (3%), and Entamoeba histolytica (1%). Forty-three patients with diarrhea and Cyclospora infection were studied; their symptoms were indistinguishable from those seen in patients with isosporiasis or cryptosporidiosis. In all patients, diarrhea ceased and results from stool examinations were negative within 2.5 days after beginning oral trimethoprim-sulfamethoxazole therapy. Recurrent symptomatic cyclosporiasis developed in 12 of 28 patients (43%) followed for 1 month or more, but it also responded promptly to trimethoprim-sulfamethoxazole therapy. These 12 patients received trimethoprim-sulfamethoxazole three times a week as secondary prophylaxis, with only a single recurrence after 7 months. Cyclospora infection is common in Haitian patients with HIV infection, responds to trimethoprim-sulfamethoxazole therapy, and has a high recurrence rate that can be largely prevented with long-term trimethoprim-sulfamethoxazole prophylaxis.
PLOS global public health, May 5, 2023
Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth ... more Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti. We performed pre-specified secondary analysis of a case-control study of community-dwelling children, 6-36 months of age, enrolled 96 cases with diarrhea and 99 asymptomatic controls. Assessments were performed at enrollment and one month later at follow-up. Established endpoint PCR methodologies targeted DEC gDNA isolated from fecal swabs. The association between DEC and anthropometric z-scores at enrollment was determined using multivariate linear regression. Lastly, we assessed the association between specific biomarkers, choline and docosahexaenoic acid (DHA) and diarrheal burden. Enterotoxigenic Escherichia coli (ETEC) was identified in 21.9% of cases vs. 16.1% of controls with heat-stable producing ETEC significantly associated with symptomatic disease. Enteroaggregative E. coli (EAEC) was found in 30.2% of cases vs. 27.3% of controls, and typical enteropathogenic E. coli in 6.3% vs. 4.0% of cases and controls, respectively. Multivariate linear regression, controlled for case or control status, demonstrated ETEC and EAEC were significantly associated with reduced weight-age z-score (WAZ) and height-age
BackgroundA massive cholera epidemic struck Haiti on October 2010. As part of the national choler... more BackgroundA massive cholera epidemic struck Haiti on October 2010. As part of the national cholera elimination plan, the Haitian government, UNICEF and other international partners launched a nationwide alert-response strategy from July 2013. This strategy established a coordinated methodology to rapidly target cholera-affected communities with WaSH (water sanitation and hygiene) response interventions conducted by field mobile teams. An innovative red-orange-green alert system was established, based on routine surveillance data, to weekly monitor the epidemic.Methodology/Principal findingsWe used cholera consolidated surveillance databases, alert records and details of 31,306 response interventions notified by WaSH mobile teams to describe and assess the implementation of this approach between July 2013 and June 2017. Response to red and orange alerts was heterogeneous across the country, but significantly improved throughout the study period so that 75% of red and orange alerts we...
Bulletin De La Societe De Pathologie Exotique, Aug 28, 2018
Open Forum Infectious Diseases, 2015
BMJ Open, Mar 1, 2020
Strengths and limitations of the study ► This is the first study assessing the prevalence of Chla... more Strengths and limitations of the study ► This is the first study assessing the prevalence of Chlamydia trachomatis (CT) and Neisseria Gonorrhoeae in key populations in Haiti. ► The lower prevalence of CT among people living with HIV underlined the importance to presumptively test and treat for sexually transmitted infection (STI), regardless of HIV status. ► Periodic risk assessment and testing, with algorithms tailored for MSM should be part of the upcoming guidelines on STI management in Haiti. ► Fear of discrimination and stigmatisation might be a limited factor to reliable answers to the questionnaire beside our best efforts to provide a judgementfree environment for our study.
Journal of Clinical Microbiology, 2015
We evaluated the use of matrix-assisted laser desorption ionization-time of flight mass spectrome... more We evaluated the use of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MS) for the identification of Vibrio cholerae. MS identified all 42 isolates of V. cholerae O1 and O139 and 7 of 9 non-O1/O139 isolates. MS correctly discriminated between all Aeromonas and V. cholerae isolates. Overall, MS performed as well as or better than biochemical methods.
Journal of Clinical Virology, Mar 1, 2016
Background-Hepatitis B vaccine administered shortly after birth is highly effective in preventing... more Background-Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule. Objectives-Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT.
Emerging Infectious Diseases, Nov 1, 2018
We obtained 78 human blood samples from areas in Haiti with high transmission of malaria and foun... more We obtained 78 human blood samples from areas in Haiti with high transmission of malaria and found no drug resistance-associated mutations in Plasmodium falciparum chloroquine resistance transporter and Kelch 13 genes. We recommend maintaining chloroquine as the first-line drug for malaria in Haiti. Artemisinin-based therapy can be used as alternative therapy. H aiti is a unique country in the Americas because malaria is caused there mainly by Plasmodium falciparum. Despite chloroquine being used for treatment of malaria since 1955, P. falciparum is generally still susceptible to this drug (1). Thus, chloroquine, plus a single dose of the gametocytocidal drug primaquine, is still the first-line treatment for uncomplicated malaria in Haiti, as indicated by the ministry of health. This regimen began to be challenged 9 years ago after a study reported chloroquine-resistant
The impact of phage predation on bacterial pathogens in the context of human disease is not curre... more The impact of phage predation on bacterial pathogens in the context of human disease is not currently appreciated. Here, we show that predatory interactions of a phage with an important environmentally transmitted pathogen, Vibrio cholerae, can modulate the evolutionary trajectory of this pathogen during the natural course of infection within individual patients. We analyzed geographically and temporally disparate cholera patient stool samples from Haiti and Bangladesh and found that phage predation can drive the genomic diversity of intra-patient V. cholerae populations. Intra-patient phage-sensitive and phage-resistant isolates were isogenic except for mutations conferring phage resistance, and moreover, phage-resistant V. cholerae populations were composed of a heterogeneous mix of many unique mutants. We also observed that phage predation can significantly alter the virulence potential of V. cholerae shed from cholera patients. We provide the first molecular evidence for predatory phage shaping microbial community structure during the natural course of infection in humans.
IJID regions, Sep 1, 2022
![Research paper thumbnail of Effectiveness of monovalent rotavirus vaccine against hospitalizations due to all rotavirus and equine-like G3P[8] genotypes in Haiti 2014–2019](https://attachments.academia-assets.com/110738060/thumbnails/1.jpg)
](Vaccine, Jul 1, 2021
Background: Rotavirus vaccines are effective in preventing severe rotavirus. Haiti introduced 2-d... more Background: Rotavirus vaccines are effective in preventing severe rotavirus. Haiti introduced 2-dose monovalent (G1P[8]) rotavirus vaccine recommended for infants at 6 and 10 weeks of age in 2014. We calculated the effectiveness of rotavirus vaccine against hospitalization for acute gastroenteritis in Haiti. Methods: We enrolled children 6-59 months old admitted May 2014-September 2019 for acute watery diarrhea any sentinel surveillance hospital. Stool was tested for rotavirus using enzyme immunoassay (EIA) and genotyped with multiplex one-step RT-PCR assay and Sanger sequencing for stratification by genotype. We used a case-negative design where cases were children positive for rotavirus and controls were negative for rotavirus. Only children eligible for vaccination were included and a child was considered vaccinated if vaccine was given ≥14 days before enrollment. We used unconditional logistic regression to calculate odds ratios and calculated 2-dose and 1-dose vaccine effectiveness (VE) as (1 − odds ratio) * 100. Results: We included 129 (19%) positive cases and 543 (81%) negative controls. Among cases, 77 (60%) were positive for equine-like G3P[8]. Two doses of rotavirus vaccine were 66% (95%
Infectious Diseases of Poverty, May 22, 2023
Background Malaria continues to cause burden in various parts of the world. Haiti, a Caribbean co... more Background Malaria continues to cause burden in various parts of the world. Haiti, a Caribbean country, is among those aiming to eliminate malaria within a few years. Two surveys were conducted in Haiti during which we aimed to evaluate the performance of the simple and rapid procedure for ultra-rapid extraction-loop-mediated isothermal amplification (PURE-LAMP) method with dried blood spots as an alternative diagnostic method for malaria in the context of low to very low rates of transmission. Methods Febrile and afebrile people were recruited from three administrative divisions within Haiti: Nippes, Sud and Grand' Anse, during the summers of 2017 (early August to early September) and 2018 (late July to late August). Their blood samples were tested by microscopy, rapid diagnostic tests (RDT), PURE-LAMP and nested PCR to detect Plasmodium infection. Sensitivity, specificity, positive and negative predictive values and kappa statistics were estimated with the nested PCR results as the gold standard. Among 1074 samples analyzed, a positive rate of 8.3% was calculated based on the nested PCR results. Among febrile participants, the rates in 2017 and 2018 were 14.6% and 1.4%, respectively. Three positives were detected among 172 afebrile participants in 2018 by PURE-LAMP and nested PCR, and all three were from the same locality. There was no afebrile participants recruited in 2017. The PURE-LAMP, RDT and microscopy had respective sensitivities of 100%, 85.4% and 49.4%. All of the testing methods had specificities over 99%. This study confirmed the high performance of the PURE-LAMP method to detect Plasmodium infection with dried blood spots and recommends its use in targeted mass screening and treatment activities in low endemic areas of malaria.
PubMed, 1977
The in vitro proliferative response of rat lymphoctes culitivated in increasing concentrations of... more The in vitro proliferative response of rat lymphoctes culitivated in increasing concentrations of calf serm (LCS) was measured by the incorporation of 3H-thymidine. Results showed that in contrast to the response of PHA, the response to concanavlin A (conA) was greatly dependent on the concentration of serum in the medium. Kinetics of the response of ConA indicated that increasing concentrations of LCS unblocked the non-response to supraoptimal doses of the mitogen. The supportive effect of LCS was not due to an increase in cell viability and was abolished when serum was dialyzed. By contrast, lipopolysaccharide (LPS) exerted an adjuvant effect on the response to optimal and suboptimal concentrations of ConA without unblocking the non-response to high doses. LPS facilitated the response to ConA of a distinct subpopulation of T cell isolated by separation on nylon wool columns. This in vitro model allowed us to study some factors which may be implicated in tolerance and immunity.
medRxiv (Cold Spring Harbor Laboratory), Oct 10, 2022
Background: Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during t... more Background: Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti. Methods: A case-control study of children 6-36 months of age enrolled 99 cases with diarrhea and 96 asymptomatic controls. Assessments were performed at enrollment and one month follow-up. Established PCR methodologies targeted DEC using fecal swabs. The association between pathogens and anthropometric z-scores was determined using multiple linear regression. : Enterotoxigenic Escherichia coli (ETEC) was identified in 21.9% of cases vs. 16.1% of controls with heat-stable producing ETEC significantly associated with symptomatic disease. Enteroaggregative E. coli (EAEC) was found in 30.2% of cases vs. 27.3% of controls, and typical enteropathogenic E. coli in 6.3% vs. 4.0% of cases and controls, respectively. Multivariate linear regression demonstrated ETEC and EAEC were significantly associated with reduced weight-age zscore (WAZ) and height-age z-score (HAZ) after adjusting for confounders. Conclusions: DEC are prevalent in north Haitian children. ETEC, EAEC, household environment, and diet are associated with unfavorable anthropometric measures. Further studies may quantify the contribution of individual pathogens to adverse health outcomes.
European journal of public health, Sep 1, 2020
With the support of the European Union, the National Laboratory for Public Health and partners di... more With the support of the European Union, the National Laboratory for Public Health and partners did an analysis of the primary healthcare and hospital laboratories in health facilities and identified strengths and weaknesses of the national network of public health laboratories. With that knowledge the LNSP developed in a participatory way a new national Laboratory Policy and thereafter a Strategic Plan 2019 -2024 that guides the country in strengthening the labs at all levels. This is very much needed as Haiti still suffers of high levels of malaria, tuberculosis, HIV and other infectious diseases. The policy fits in the international Health Security Agenda. Most important lesson learned: by a systematic step by step process of analysis, policy formation and action planning, a research institute can -with support of stakeholders -make an impact on policies and practices. 5.H. Workshop: Developing more responsive systems to deliver catch-up vaccination to migrants arriving in Europe
Bulletin De La Societe De Pathologie Exotique, 1983
American Journal of Field Epidemiology
On December 12, 2022, a panel seminar organized by the American Journal of Field Epidemiology (AJ... more On December 12, 2022, a panel seminar organized by the American Journal of Field Epidemiology (AJFE) was held with the enthusiastic support of the National Institute of Health of Colombia. More than 200 professionals from Colombia, Peru, Brazil, El Salvador, Canada, the USA, Ecuador, Costa Rica, Chile, and Mexico participated. The panelists, moderated by Dr. Marjorie Pollack, member of the AJFE Editorial Board and associate editor of ProMED, presented the epidemiological characteristics of the pandemic in Colombia, Brazil, Costa Rica, Puerto Rico, Haiti, and the Dominican Republic, as well as the public health response with which it was responded to mitigate and control it. The panelists emphasized the value of the preparation provided by the existence of field epidemiology training programs, the existence of a response plan, of establishing good communication with decision makers to make them collectively. The Costa Rican experience of using epidemiology to facilitate the provision...
Emerging Infectious Diseases, 2021
The American Journal of Tropical Medicine and Hygiene, 2019
Hepatitis E virus (HEV) infection is associated with a high fatality rate among pregnant women, a... more Hepatitis E virus (HEV) infection is associated with a high fatality rate among pregnant women, and gestational complications have been reported among pregnant women infected with hepatitis A virus (HAV). The aim of this study was to determine the seroprevalence of HAV and HEV infections among pregnant women in Haiti. We stratified the population (n = 1,307) between West and non-West regions. Specimens were tested for total HAV antibody (anti-HAV), and IgM and IgG HEV antibody (anti-HEV). Overall, 96.8% pregnant women were positive for total anti-HAV, 10.3% for IgG anti-HEV, and 0.3% for IgM anti-HEV. The prevalence of IgG anti-HEV in the non-West region (12.3%) was significantly greater than that in the West region (5.3%) (P < 0.0001). Most pregnant women in Haiti had evidence of past exposure and immunity to HAV. The non-West region had a higher prevalence of HEV. Improvement in water and sanitation will help in the prevention and control of these infections in Haiti.
Annals of Internal Medicine, 1994
To determine the prevalence and clinical manifestations of Cyclospora in Haitians infected with h... more To determine the prevalence and clinical manifestations of Cyclospora in Haitians infected with human immunodeficiency virus (HIV) who have diarrhea and to evaluate therapy and prophylaxis. Cohort study. From 1990 to 1993, stool samples were collected from adults seropositive for HIV who had had diarrhea for at least 3 weeks. A clinic in Haiti. Stool samples were examined for enteric protozoa after acid-fast staining. Patients with Cyclospora infection were treated with trimethoprimsulfamethoxazole (160 mg and 800 mg, respectively) given orally four times a day for 10 days. After completion of therapy, patients were evaluated weekly and re-treated if clinical and parasitologic recurrences occurred, followed by trimethoprim-sulfamethoxazole prophylaxis three times a week. 804 of 2400 patients (33%) seropositive for HIV had a history of chronic or intermittent diarrhea; 502 of these 804 patients (62%) currently had diarrhea, and 450 patients each provided two stool specimens for examination. Enteric protozoa identified included Cryptosporidium (30%), Isospora belli (12%), Cyclospora species (11%), Giardia lamblia (3%), and Entamoeba histolytica (1%). Forty-three patients with diarrhea and Cyclospora infection were studied; their symptoms were indistinguishable from those seen in patients with isosporiasis or cryptosporidiosis. In all patients, diarrhea ceased and results from stool examinations were negative within 2.5 days after beginning oral trimethoprim-sulfamethoxazole therapy. Recurrent symptomatic cyclosporiasis developed in 12 of 28 patients (43%) followed for 1 month or more, but it also responded promptly to trimethoprim-sulfamethoxazole therapy. These 12 patients received trimethoprim-sulfamethoxazole three times a week as secondary prophylaxis, with only a single recurrence after 7 months. Cyclospora infection is common in Haitian patients with HIV infection, responds to trimethoprim-sulfamethoxazole therapy, and has a high recurrence rate that can be largely prevented with long-term trimethoprim-sulfamethoxazole prophylaxis.
PLOS global public health, May 5, 2023
Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth ... more Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti. We performed pre-specified secondary analysis of a case-control study of community-dwelling children, 6-36 months of age, enrolled 96 cases with diarrhea and 99 asymptomatic controls. Assessments were performed at enrollment and one month later at follow-up. Established endpoint PCR methodologies targeted DEC gDNA isolated from fecal swabs. The association between DEC and anthropometric z-scores at enrollment was determined using multivariate linear regression. Lastly, we assessed the association between specific biomarkers, choline and docosahexaenoic acid (DHA) and diarrheal burden. Enterotoxigenic Escherichia coli (ETEC) was identified in 21.9% of cases vs. 16.1% of controls with heat-stable producing ETEC significantly associated with symptomatic disease. Enteroaggregative E. coli (EAEC) was found in 30.2% of cases vs. 27.3% of controls, and typical enteropathogenic E. coli in 6.3% vs. 4.0% of cases and controls, respectively. Multivariate linear regression, controlled for case or control status, demonstrated ETEC and EAEC were significantly associated with reduced weight-age z-score (WAZ) and height-age
BackgroundA massive cholera epidemic struck Haiti on October 2010. As part of the national choler... more BackgroundA massive cholera epidemic struck Haiti on October 2010. As part of the national cholera elimination plan, the Haitian government, UNICEF and other international partners launched a nationwide alert-response strategy from July 2013. This strategy established a coordinated methodology to rapidly target cholera-affected communities with WaSH (water sanitation and hygiene) response interventions conducted by field mobile teams. An innovative red-orange-green alert system was established, based on routine surveillance data, to weekly monitor the epidemic.Methodology/Principal findingsWe used cholera consolidated surveillance databases, alert records and details of 31,306 response interventions notified by WaSH mobile teams to describe and assess the implementation of this approach between July 2013 and June 2017. Response to red and orange alerts was heterogeneous across the country, but significantly improved throughout the study period so that 75% of red and orange alerts we...
Bulletin De La Societe De Pathologie Exotique, Aug 28, 2018
Open Forum Infectious Diseases, 2015
BMJ Open, Mar 1, 2020
Strengths and limitations of the study ► This is the first study assessing the prevalence of Chla... more Strengths and limitations of the study ► This is the first study assessing the prevalence of Chlamydia trachomatis (CT) and Neisseria Gonorrhoeae in key populations in Haiti. ► The lower prevalence of CT among people living with HIV underlined the importance to presumptively test and treat for sexually transmitted infection (STI), regardless of HIV status. ► Periodic risk assessment and testing, with algorithms tailored for MSM should be part of the upcoming guidelines on STI management in Haiti. ► Fear of discrimination and stigmatisation might be a limited factor to reliable answers to the questionnaire beside our best efforts to provide a judgementfree environment for our study.
Journal of Clinical Microbiology, 2015
We evaluated the use of matrix-assisted laser desorption ionization-time of flight mass spectrome... more We evaluated the use of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MS) for the identification of Vibrio cholerae. MS identified all 42 isolates of V. cholerae O1 and O139 and 7 of 9 non-O1/O139 isolates. MS correctly discriminated between all Aeromonas and V. cholerae isolates. Overall, MS performed as well as or better than biochemical methods.
Journal of Clinical Virology, Mar 1, 2016
Background-Hepatitis B vaccine administered shortly after birth is highly effective in preventing... more Background-Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule. Objectives-Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT.
Emerging Infectious Diseases, Nov 1, 2018
We obtained 78 human blood samples from areas in Haiti with high transmission of malaria and foun... more We obtained 78 human blood samples from areas in Haiti with high transmission of malaria and found no drug resistance-associated mutations in Plasmodium falciparum chloroquine resistance transporter and Kelch 13 genes. We recommend maintaining chloroquine as the first-line drug for malaria in Haiti. Artemisinin-based therapy can be used as alternative therapy. H aiti is a unique country in the Americas because malaria is caused there mainly by Plasmodium falciparum. Despite chloroquine being used for treatment of malaria since 1955, P. falciparum is generally still susceptible to this drug (1). Thus, chloroquine, plus a single dose of the gametocytocidal drug primaquine, is still the first-line treatment for uncomplicated malaria in Haiti, as indicated by the ministry of health. This regimen began to be challenged 9 years ago after a study reported chloroquine-resistant
The impact of phage predation on bacterial pathogens in the context of human disease is not curre... more The impact of phage predation on bacterial pathogens in the context of human disease is not currently appreciated. Here, we show that predatory interactions of a phage with an important environmentally transmitted pathogen, Vibrio cholerae, can modulate the evolutionary trajectory of this pathogen during the natural course of infection within individual patients. We analyzed geographically and temporally disparate cholera patient stool samples from Haiti and Bangladesh and found that phage predation can drive the genomic diversity of intra-patient V. cholerae populations. Intra-patient phage-sensitive and phage-resistant isolates were isogenic except for mutations conferring phage resistance, and moreover, phage-resistant V. cholerae populations were composed of a heterogeneous mix of many unique mutants. We also observed that phage predation can significantly alter the virulence potential of V. cholerae shed from cholera patients. We provide the first molecular evidence for predatory phage shaping microbial community structure during the natural course of infection in humans.
IJID regions, Sep 1, 2022
Vaccine, Jul 1, 2021
Background: Rotavirus vaccines are effective in preventing severe rotavirus. Haiti introduced 2-d... more Background: Rotavirus vaccines are effective in preventing severe rotavirus. Haiti introduced 2-dose monovalent (G1P[8]) rotavirus vaccine recommended for infants at 6 and 10 weeks of age in 2014. We calculated the effectiveness of rotavirus vaccine against hospitalization for acute gastroenteritis in Haiti. Methods: We enrolled children 6-59 months old admitted May 2014-September 2019 for acute watery diarrhea any sentinel surveillance hospital. Stool was tested for rotavirus using enzyme immunoassay (EIA) and genotyped with multiplex one-step RT-PCR assay and Sanger sequencing for stratification by genotype. We used a case-negative design where cases were children positive for rotavirus and controls were negative for rotavirus. Only children eligible for vaccination were included and a child was considered vaccinated if vaccine was given ≥14 days before enrollment. We used unconditional logistic regression to calculate odds ratios and calculated 2-dose and 1-dose vaccine effectiveness (VE) as (1 − odds ratio) * 100. Results: We included 129 (19%) positive cases and 543 (81%) negative controls. Among cases, 77 (60%) were positive for equine-like G3P[8]. Two doses of rotavirus vaccine were 66% (95%