Submission ID 116913
| Issue/Objective | Haiti reported lower than expected COVID-19 incidence and mortality rates, raising concerns about the completeness and accuracy of national surveillance data. This study aimed to explore the factors that may have led to the underreporting of COVID-19 cases and deaths in Haiti, focusing on geographic and socio-economic disparities in screening and care facilities, and individual-level risk factors. |
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| Methodology/Approach | We analyzed national COVID-19 surveillance data from March 2020 to December 2021. Using cluster detection, time series analysis, and cartographic mapping, we assessed the distribution of the epidemic. Multivariate Quasi-Poisson regression models were applied to evaluate socioeconomic factors associated with incidence and mortality, while mixed-effect logistic regression was used to identify individual risk factors linked to COVID-19 infection. |
| Results | Out of Haiti's 140 communes, 57 (40.7%) had COVID-19 screening centers, and the incidence was six times higher in these communes. Only 22 (15.7%) communes had COVID-19 care centers, and mortality was five times higher in communes with care centers. Wealthier communes had significantly better access to both screening and care, while poorer communes were largely underserved. Additionally, factors such as male gender, older age, and having only Haitian nationality (a proxy for low socioeconomic conditions in Haiti) were associated with an increased risk of infection. |
| Discussion/Conclusion | The study highlights significant geographical and socio-economic disparities in Haiti's COVID-19 response, particularly the limited availability of screening and care centers in poorer communes. These disparities likely contributed to the underreporting of COVID-19 cases and deaths, underscoring the need for more equitable healthcare infrastructure in low- and middle-income countries to effectively address public health crises. |
| Presenters and affiliations | Marcmy Presume University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France Jean Gaudart Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM, AP-HM, Hospital La Timone, BioSTIC Unit, Marseille, France Edwige Michel Directorate of Epidemiology Laboratories and Research (DELR), Ministry of Public Health and Population (MSPP) Samson Marseille Directorate of Epidemiology Laboratories and Research (DELR), Ministry of Public Health and Population (MSPP) Mathias Altmann University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre |
