Publications by authors named "Natael Fenelon"

Article Synopsis
  • Integrated Bite Case Management (IBCM) in Haiti involves a multi-sectoral approach to manage animal bites and reduce rabies deaths, transitioning from paper-based methods (pIBCM) established in 2013 to an electronic app (eIBCM) introduced in 2018.
  • An evaluation of both systems from January 2013 to August 2019 compared their data quality, cost-effectiveness, and efficiency, revealing significant improvements in eIBCM, such as faster data transmission and increased data variables collected per investigation.
  • eIBCM was found to be more cost-effective ($1,247 per death averted) and efficient compared to pIBCM ($2,692 per death averted), with 100% of
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Elimination of dog-transmitted human rabies worldwide will require large-scale dog vaccination campaigns. However, this places participating vaccinators at increased risk. Data from the 2016-2017 Haitian mass rabies vaccination campaign was analyzed to determine dog bite incidence among vaccinators.

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The dissemination of COVID-19 around the globe has been followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. The identification of bacterial pathogens is challenging in low and middle income countries (LMIC), as there are no readily-available and cost-effective clinical or biological markers that can effectively discriminate between bacterial and viral infections.

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Article Synopsis
  • * A logistic regression model was developed based on Haiti's animal rabies surveillance data to assess the risk of rabies in biting dogs, identifying key factors like hypersalivation, paralysis, and lack of prior vaccination.
  • * The model demonstrates high accuracy and sensitivity, allowing for timely PEP recommendations after dog bites and potentially lowering unnecessary vaccination costs when the rabies risk is low.
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Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources.

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Article Synopsis
  • Haiti's integrated bite case management (IBCM) program offers guidance on rabies risks and treatment for animal-bite victims, alongside the Haiti Animal Rabies Surveillance Program (HARSP) to evaluate the animal exposures.
  • A study followed up with bite victims who received IBCM counseling between 2014 and 2015, assessing their healthcare actions and outcomes in relation to rabies exposure classification.
  • Results showed that IBCM counseling led to a 1.2x increase in those seeking medical care and a 2.4x rise in vaccination rates, potentially reducing rabies deaths by 65% among assessed victims.
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In Latin American and Caribbean (LAC) countries, the number of cases of dog-mediated human rabies is at its lowest since the onset of the Regional Program for Rabies Elimination in 1983, a commitment from LAC countries to eliminate dog-mediated rabies coordinated by the Pan American Health Organization. Despite minor setbacks, the decline in the number of human cases has been constant since 1983. While many LAC countries have significantly reduced rabies to a level where it is no longer significant public health concern, elimination has proven elusive and pockets of the disease remain across the region.

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Haiti has experienced numerous barriers to rabies control over the past decades and is one of the remaining Western Hemisphere countries to report dog-mediated human rabies deaths. We describe the circumstances surrounding a reported human rabies death in 2016 as well as barriers to treatment and surveillance reporting.

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The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average.

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Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities.

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