Publications by authors named "Marie M Deschamps"

We monitored SARS-CoV-2 variants in Haiti from 2020-2023. Despite Haitian COVID-19 travel restrictions and in the setting of a vaccination rate of 2.7%, the timing and lineage evolution of the Haiti epidemic mirrored what was occurring in the rest of the world.

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Background: There are limited data on the effectiveness of differentiated service delivery (DSD) for HIV care during sociopolitical turmoil. We assessed outcomes with a DSD model of care that includes patient choice between community-based antiretroviral therapy (ART) centres, home-based ART dispensing, or facility-based care at GHESKIO clinic during a period of severe civil unrest in Port-au-Prince, Haiti.

Methods: This retrospective analysis included data on patients with at least one HIV visit at GHESKIO between May 1, 2019, and December 31, 2021.

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Hypertension is a leading contributor to mortality in low-middle income countries including Haiti, yet only 13% achieve blood pressure (BP) control. We evaluated the effectiveness of a community-based hypertension management program delivered by community health workers (CHWs) and physicians among 100 adults with uncontrolled hypertension from the Haiti Cardiovascular Disease Cohort. The 12-month intervention included: community follow-up visits with CHWs (1 month if BP uncontrolled ≥140/90, 3 months otherwise) for BP measurement, lifestyle counseling, medication delivery, and dose adjustments.

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Article Synopsis
  • Higher social vulnerability in low-income countries like Haiti is linked to increased risk of premature cardiovascular disease (CVD) and mortality, yet it remains under-researched in these regions.
  • This study aimed to examine the connection between social vulnerability and conditions such as hypertension and various CVD subtypes in Haiti, drawing parallels to other similar low-income nations.
  • The research, which included nearly 3,000 adults in urban and slum areas of Port-au-Prince, found significant variations in hypertension and CVD prevalence based on a modified Social Vulnerability Index, highlighting the necessity of addressing these social disparities in health outcomes.
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  • Chronic Kidney Disease (CKD) is a significant health issue in lower-income countries, and this study aimed to assess its prevalence and associated factors in urban Haiti, highlighting the lack of similar research in these areas.
  • The study analyzed data from 2,424 adults, finding a 14% prevalence of CKD, with diabetes and hypertension being major risk factors.
  • Only 12% of individuals with CKD received proper treatment, indicating a gap in healthcare access and guidelines in managing this condition.
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Women play an essential role in health care delivery, and it is vital that they have equal representation in health leadership for equity, innovation, and the strengthening of health systems globally. Yet women remain vastly underrepresented in global health leadership positions, providing a clear example of the deeply rooted power imbalances that are central to the calls to decolonize global health. We conducted a multi-country study in Haiti, Tanzania, India, and the USA to examine gender-based challenges to career advancement for women in the global health workforce.

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Background: Hypertension (HTN) is the leading cardiovascular disease (CVD) risk factor in Haiti and is likely driven by poverty-related social and dietary factors. Salt consumption in Haiti is hypothesized to be high but has never been rigorously quantified.

Methods: We used spot urine samples from a subset of participants in the population-based Haiti Cardiovascular Disease Cohort to estimate population mean daily sodium intake.

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Article Synopsis
  • Cardiovascular disease, particularly heart failure (HF), significantly impacts low- and middle-income countries, with insufficient data on its prevalence and risk factors in these regions.
  • A population study in Port-au-Prince, Haiti, involving 2981 participants, revealed an age-standardized HF prevalence of 3.2%, with prominent risk factors including age, hypertension, obesity, and poverty.
  • The one-year mortality rate for HF patients was markedly higher at 6.6% compared to 0.8% for non-HF individuals, highlighting a severe health concern in the Haitian population.
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Haiti is one of the most food-insecure (FIS) nations in the world, with increasing rates of overweight and obesity. This study aimed to characterize FIS among households in urban Haiti and assess the relationship between FIS and body mass index (BMI) using enrollment data from the Haiti Cardiovascular Disease Cohort Study. FIS was characterized as no/low, moderate/high, and extreme based on the Household Food Security Scale.

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Article Synopsis
  • - Hypertension is a major risk factor for cardiovascular disease in low and middle-income countries, and reliable blood pressure measurements are crucial for identifying at-risk individuals.
  • - A study in Haiti compared blood pressure measurements taken in the community versus clinics, finding a strong correlation, with 36% of participants screening positive for hypertension in the community compared to 30% in clinics.
  • - The results highlight that community blood pressure screenings are an effective and accessible method for identifying hypertension and estimating its prevalence in populations with limited access to clinics.
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  • * The study found that factors such as age, income, and sex are associated with higher obesity rates, with women experiencing a much greater prevalence—89.2% of those classified as obese were women, and 68.3% of women had abdominal obesity.
  • * Findings suggest a critical need for targeted interventions in Haiti, especially for women, as they face a six-fold higher obesity risk compared to men, exacerbating health vulnerabilities in the population.
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  • * A study of low-income adults in Port-au-Prince revealed that less than 1% met fruit and vegetable intake recommendations, with high consumption of fried foods and sugar-sweetened beverages, particularly among young males.
  • * The findings highlight the urgent need for public health initiatives aimed at improving dietary habits, especially targeting young men and those who cook at home, to combat rising health issues linked to poor diets.
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Cardiovascular disease (CVD) is the number one cause of death in low-income countries including Haiti, with hypertension (HTN) being the leading risk factor. This study aims to identify gaps in the HTN continuum of screening, diagnosis, treatment, and blood pressure (BP) control. Sociodemographic and clinical data were collected from a population-based sample of adults ≥18 years in Port-au-Prince (PAP) from March 2019 to April 2021.

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Hypertension in pregnancy is a key driver of mortality and morbidity among Haitian women. HIV infection and treatment may worsen hypertension and increase cardiovascular disease risk. The authors examined blood pressure and hypertension patterns among 1965 women (2306 pregnancies ending in live births) in a prevention of maternal-to-child transmission (PMTCT) program in Port-au-Prince, Haiti, between 2007 and 2017.

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After an initial wave of coronavirus disease 2019 (COVID-19) in Haiti in summer 2020 (primarily lineage B.1), seropositivity for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) was ~40%. Variant P.

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Article Synopsis
  • The study evaluated the effectiveness of an HPV vaccination program for girls aged 9-14 in Haiti and identified factors influencing the completion of the two-dose series.
  • Data were collected during vaccination campaigns in Port-au-Prince, analyzing 2,445 participants, with completion rates showing higher success in school-based programs compared to non-school programs.
  • Factors like having started menstruation, previous visits to GHESKIO clinics, and participation in school programs significantly increased the likelihood of completing the vaccination series.
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Background: Cardiovascular disease (CVD) is the leading cause of mortality among Haitians, having surpassed HIV in the last decade. Understanding the natural history of CVD in Haitians, including the age of onset, prevalence, incidence, and role of major risk factors and social determinants, is urgently needed to develop prevention and treatment interventions. Aim 1: Establish a population-based cohort of 3000 adults from Port-au-Prince and assess the prevalence of CVD risk factors and diseases and their association with social and environmental determinants.

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Objective: To evaluate mother and infant outcomes in the largest prevention of mother-to-child-transmission (PMTCT) programme in Haiti in order to identify gaps towards elimination of HIV and syphilis.

Methods: Based on retrospective data from HIV+ pregnant women and their infants enrolled in PMTCT care from 1999 to 2014, we assessed maternal enrolment in PMTCT, receipt of antiretrovirals before delivery, maternal retention through delivery as well as infant enrolment in PMTCT, HIV testing and HIV infection. Four PMTCT programme periods were compared: period 1 (1999-2004, mono ARV), period 2 (2005-2009, dual ARV), period 3 (2010-2012, Option B) and period 4 (Oct 2012-2014, Option B+).

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Background: Identifying cohorts of Caribbean women with HIV infection rates sufficient for inclusion in HIV vaccine efficacy trials has been challenging. HVTN 907 determined the feasibility of identifying and retaining a cohort of women at high risk for HIV acquisition by focusing recruitment on female sex workers (FSWs).

Methods: HIV uninfected FSWs, residing in Haiti, Dominican Republic, and Puerto Rico, who reported unprotected sex and met previously described more stringent site-specific eligibility criteria, were eligible.

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Haitian women are twice as likely as men to have HIV/AIDs. Factors underlying the feminization of HIV are complex. Self-esteem is an important correlate of sexual behavior.

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For 3 decades, GHESKIO (the Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes), the Haitian Ministry of Health, and Weill Cornell have pursued a tripartite mission of service, training, and translational research. The initial focus was on AIDS and tuberculosis. The mission has expanded to include the local community and now provides maternal-child health, family planning, cancer prevention and treatment, immunizations (including human papillomavirus, cholera), and primary education through vocational and microcredit programs.

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Successful and sustained efforts have been made to curtail the major cholera epidemic that occurred in Haiti in 2010 with the promotion of hygiene and sanitation measures, training of health personnel and establishment of treatment centers nationwide. Oral cholera vaccine (OCV) was introduced by the Haitian Ministry of Health as a pilot project in urban and rural areas. This paper reports the successful OCV pilot project led by GHESKIO Centers in the urban slums of Port-au-Prince where 52,357 persons received dose 1 and 90.

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