Quisqueya University

This study aimed to analyze scientometric profile of publications on neglected tropical diseases (NTDs) in Haiti, 1923-2022. We conducted a scientometric study based on indexed scientific productions related to NTDs in Haiti. The search syntax in the Scopus database was based on key terms for NTDs recognized by the World Health Organization in 2022, focusing on keywords, titles, and abstracts. VOSviewer 1.6.18 was used to create bibliographic networks according to authorship, country of origin, institution, and descriptors. A total of 281 publications were identified, 87.9% (247/281) original articles, with an increase of 45.1% (127/281, annual average of 12.7 publications) in the last decade (2013-2022) compared to the first half of the analyzed period (1923-1975, annual average of 0.21 publications). The authors with the highest number of publications were: Lammie PJ (n = 51), Eberhard ML (n = 29), and Wallace RM (n = 25). A total of 83 institutions participated in the research and the Centers for Disease Control and Prevention (United States) had the highest proportion of affiliations in the coauthorship versus organizations analysis (n = 86), with authors from 35 countries. Coauthorship by country shows publications between institutions in the Americas (n = 13), Europe (n = 9), and Asia (n = 5). The analysis of cooccurrence versus author keywords shows higher occurrence of the terms “dengue” and “rabies”. There is a very limited number of publications on NTDs in Haiti throughout a century of publications, despite the relative increase in recent decades. Such publications are concentrated among foreign authors, with limited national coauthorship.

Introduction Haiti is on the verge of possibly eliminating malaria, an endemic parasitic infection primarily caused by Plasmodium falciparum on the island of Hispaniola. Owing to its associated morbidity and mortality, malaria is a leading public health priority in Haiti. This scoping review aims to identify the scope of research on access and coverage of malaria surveillance, diagnosis, and treatment in Haiti in the elimination setting. Methods We compiled, analyzed, and synthesized the literature on access and coverage of antimalarial services in Haiti in the elimination setting based on Arksey and O’Malley’s framework for scoping reviews and held a formal meeting with the PNCM leadership and stakeholders of malaria programs in Haiti. Results were reported following PRISMA-ScR guidelines. Results We found 376 citations and five technical reports related to our keywords from 2016 to 2023 and retained 225 after eliminating duplicates. Based on our selection criteria, we retrieved 81 citations and excluded 56 after in-depth readings. Therefore, the review includes 26 articles and five technical reports. The Ministry of Health established a strategic plan covering the 2021–2030 period, providing a framework for operational planning to increase efficiency, strengthen the health system, and ensure the sustainability of interventions. However, the current weaknesses in surveillance underline a lack of well-trained personnel, difficulty in establishing the epidemiological profile of malaria, unreliability, lack of completeness of data, and delay in their transmission. In addition, access to malaria diagnosis and treatment in Haiti is limited due to a lack of available state-of-the-art testing modalities, variations in the geographic availability of rapid diagnostic tests and microscopy, and the widespread use of substandard antimicrobial drugs. Conclusion Research and reports on malaria surveillance, diagnosis, and treatment access and coverage in Haiti are limited; however, the available sources reveal significant shortcomings and challenges in implementing WHO-recommended policies and strategies for malaria elimination. Future studies should aim to fill this gap and investigate the determinants of the persistence of malaria cases in certain municipalities and departments of the country.

Societal Impact Statement Despite strong historical declines, Guadeloupe and Haiti's coffee sectors remain important to rural communities' livelihood and resilience. Coffee also holds value as part of the islands' historical legacy and cultural identities. Furthermore, it is often grown in agroforestry systems providing important ecosystem services, which will become more important as these vulnerable islands work to adapt to a changing climate. Current efforts to revitalize coffee farms and target strategically important specialty markets would benefit from understanding existing genetic resources and the historical factors that shaped them. Our study reveals the rich history reflected in current coffee stands on the islands. Summary The West Indies, particularly former French colonies like Haiti and Guadeloupe, were central to the spread of coffee in the Americas. The histories of these Islands are shared until the 19th century, where they diverged significantly. Still, both Islands experienced a strong decline in their coffee sector. Characterizing the genetic and varietal diversity of their coffee resources and understanding historical factors shaping them can help support revitalization efforts. To that end, we performed Kompetitve Allele‐Specific PCR (KASP) genotyping of 80 informative single nucleotide polymorphism (SNP) markers on field samples from across main coffee‐growing region of Guadeloupe, and two historically important ones in Haiti, as well as 146 reference accessions from international collections. We also compared bioclimatic variables from sampled geographic areas and searched for historical determinants of present coffee resources. At least five Coffea arabica varietal groups were found in Haiti, versus two in Guadeloupe, with admixed individuals in both. The traditional Typica variety is still present in both islands, growing across a variety of climatic environments. We also found Coffea canephora on both islands, with multiple likely origins, and identified C. liberica var. liberica in Guadeloupe. These differences are explained by the Islands' respective histories. Overall, Guadeloupe experienced fewer, but older introductions of non‐Typica coffee. By contrast, several recent introductions have taken place in Haiti, driven by local and global factors and reflecting the history of Arabica varietal development and spread. Diversity on these islands is dynamic, and our results reveal opportunities and limits to the future of Guadeloupean and Haitian coffee.

Introduction: Neonatal sepsis (NS) is a global public health concern, particularly affecting developing countries. Challenges in diagnostics, more specifically, culture and antimicrobial susceptibility testing hinder effective management of the disease. Objective: This study aims to evaluate the burden, describe the management, and assess the evolution of NS in a hospitalized pediatric population in Haiti. Methods: A retrospective cohort study from January 2013 to December 2018 at La Paix University Hospital was conducted. All-cause hospitalizations and deaths were extracted from hospital’s Neonatology Unit records and were used to derive data regarding hospitalization and death among patients under 28 days with NS. Clinical and laboratory data were extracted from the patients’ medical records. Results: Out of 2,424 post-childbirth hospitalizations, 1,590 involved sepsis. The percentage of hospitalization due to NS was approximately 69% and the percentage of deaths, 65%. The mean age of patients with NS was 3.75 days (0 - 22 days), with a slight male predominance (55%, p < 0.001). Peaks were observed from May to August (p = 0.02). Early NS cases (NS in patients aged less than 7 days) were most prevalent (86%, p < 0.001). Specimen culture and antimicrobial susceptibility testing was less frequent (7%) than complete blood count usage (65%). Findings regarding blood count included leukopenia (3%), thrombocytopenia (30%). A positive CRP and acute renal failure were noted in 76% and 21.7% of cases, respectively. The average hospital stay was 7.3 days. With regards to treatment, 73% of patients received a 2-drug antimicrobial therapy (ampicillin-gentamycin) and 22% received a 3-drug antimicrobial therapy (ampicillin-gentamycin-cefotaxime). Of all newborns hospitalized for NS, 49% received empirical antibiotic therapy within 3 hours of admission. Conclusions: This research highlights NS as a public health emergency in Haiti. The study advocates for improved access to culture and antibiotic susceptibility testing and emphasizes the impact of timely antibiotic administration. The findings of this study serve as a baseline for informing policymakers and medical practitioners dedicated to improving existing conditions of neonates in Haiti. Suggested targeted interventions include preventive measures during prenatal visits, strengthening laboratory capacities, improving infection prevention and control measures, and developing antimicrobial stewardship programs.

Background Despite many efforts to provide children with legal existence over the last decades, 1 in 4 children under the age of 5 (166 million) do not officially exist, with limited possibility to enjoy their human rights. In Latin America and the Caribbean, Haiti has one of the highest rates of undocumented births. This study aimed to analyze the prevalence and the determinant factors of undocumented childhood in Haiti. Methods For analysis of undocumented childhood and related socioeconomic determinants, data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the associated factors were analyzed using descriptive statistics and the binary logistic regression model. Results The prevalence of undocumented childhood in Haiti was 23% (95% CI: 21.9–24.0) among children under-five. Among the drivers of undocumented births, mothers with no formal education (aOR = 3.88; 95% CI 2.21–6.81), children aged less than 1 year (aOR = 20.47; 95% CI 16.83–24.89), children adopted or in foster care (aOR = 2.66; 95% CI 1.67–4.24), children from the poorest regions like “Artibonite” (aOR = 2.19; 95% CI 1.63–2.94) or “Centre” (aOR = 1.51; 95% CI 1.09–2.10) or “Nord-Ouest” (aOR = 1.61; 95% CI 1.11–2.34), children from poorest households (aOR = 6.25; 95% CI 4.37–8.93), and children whose mothers were dead (aOR = 2.45; 95% CI 1.33–4.49) had higher odds to be undocumented. Conclusion According to our findings, there is an institutional necessity to bring birth documentation to underprivileged households, particularly those in the poorest regions where socioeconomic development programs are also needed. Interventions should focus on uneducated mothers who are reknown for giving birth outside of medical facilities. Therefore, an awareness campaign should be implemented to influence the children late-registering behavior.

Background A treated fabric device for emanating the volatile pyrethroid transfluthrin was recently developed in Tanzania that protected against night-biting Anopheles and Culex mosquitoes for several months. Here perceptions of community end users provided with such transfluthrin emanators, primarily intended to protect them against day-active Aedes vectors of human arboviruses that often attack people outdoors, were assessed in Port-au-Prince, Haiti. Methods Following the distribution of transfluthrin emanators to participating households in poor-to-middle class urban neighbourhoods, questionnaire surveys and in-depth interviews of end-user households were supplemented with conventional and Photovoice-based focus group discussions. Observations were assessed synthetically to evaluate user perceptions of protection and acceptability, and to solicit advice for improving and promoting them in the future. Results Many participants viewed emanators positively and several outlined various advantages over current alternatives, although some expressed concerns about smell, health hazards, bulkiness, unattractiveness and future cost. Most participants expressed moderate to high satisfaction with protection against mosquitoes, especially indoors. Protection against other arthropod pests was also commonly reported, although satisfaction levels were highly variable. Diverse use practices were reported, some of which probably targeted nocturnal Culex resting indoors, rather than Aedes attacking them outdoors during daylight hours. Perceived durability of protection varied: While many participants noted some slow loss over months, others noted rapid decline within days. A few participants specifically attributed efficacy loss to outdoor use and exposure to wind or moisture. Many expressed stringent expectations of satisfactory protection levels, with even a single mosquito bite considered unsatisfactory. Some participants considered emanators superior to fans, bedsheets, sprays and coils, but it is concerning that several preferred them to bed nets and consequently stopped using the latter. Conclusions The perspectives shared by Haitian end-users are consistent with those from similar studies in Brazil and recent epidemiological evidence from Peru that other transfluthrin emanator products can protect against arbovirus infection. While these encouraging sociological observations contrast starkly with evidence of essentially negligible effects upon Aedes landing rates from parallel entomological assessments across Haiti, Tanzania, Brazil and Peru, no other reason to doubt the generally encouraging views expressed herein by Haitian end users could be identified.

Today, rabies is enzootic in North, Central and South America. In contrast to the mainland, the Caribbean represents the largest region of the Americas that seems to be generally free of this zoonosis, with very few countries reporting enzootic rabies. An introspection of the human and animal populations on these islands provides a historical footnote to the origins of canine and wildlife rabies. The Caribbean islands were populated for thousands of years by Amerindians, prior to the arrival of Europeans. Domesticated dogs and several species of bats were indigenous on multiple islands, although vampire bats are extant only on Trinidad. Despite the presence of such potential reservoirs throughout the archipelago, there is scant Pre-Columbian evidence of rabies, in contrast to post-colonization. Bat rabies was likely present before European settlement and may extend beyond the vampire bat endemic island of Trinidad due to natural bat movement. Canine rabies appeared in the West Indies during the mid-eighteenth century. To date, the disease perpetuates with canine and mesocarnivore variants in Cuba, Grenada, Hispaniola, and Puerto Rico. After centuries of colonial introduction and ecological exacerbation, major challenges remain throughout this region related to the global elimination of canine rabies and the apparent risks posed by wildlife rabies to agriculture, conservation biology, and public health.

African yam bean, AYB (Sphenostylis stenocarpa) root nodules are colonized by various strains of plant growth-promoting rhizobacteria (PGPR) which, when isolated and applied to other legume species seeds, may assist early seedling growth. Four PGPR isolated from AYB root nodules, Bradyrhizobia isolates 1-1, 4-4 (OQ586405), 6-2-1, and Paenibacillus sp. 4-5-1 (OQ586406) were tested in a pot study for their vegetative growth promotion of the temperate legume, alfalfa (Medicago sativa) and the tropical legumes, AYB and Bambara groundnut (Vigna subterranea L. Verdc) and compared to control plants which were not inoculated. Biomass, shoot and root growth, along with nodule number was assessed six weeks after treatment (6 WAT). Legumes without PGPR served as the control. Bradyrhizobium spp. 6-2-1, 4-4, 1-1, and Paenibacillus sp. 4-5-1, all significantly (P < 0.05) supported the biomass dry weight (g) of alfalfa, 0.06 g, 0.07 g, 0.05 g, and 0.04 g respectively, when compared to the control with 0.01 g at 6 WAT. All PGPR enhanced the early growth of the legumes studied in the nitrogen-free vermiculite medium when compared to the control with yellowish leaves, indicating a lack of nitrogen at 6 WAT. These PGPR could be useful as bioinoculants for the sustainable production of temperate and tropical legumes in nitrogen-depleted soil conditions. Further studies are necessary for more information about the nitrogen fixation efficacy of these strains and the mechanisms underlying their plant growth-promotion.

Background A simple treated fabric device for passively emanating the volatile pyrethroid transfluthrin was recently developed in Tanzania that protected against nocturnal Anopheles and Culex mosquitoes for several months. Here these transfluthrin emanators were assessed in Port-au-Prince, Haiti against outdoor-biting Aedes. Methods Transfluthrin emanators were distributed to participating households in poor-to-middle class urban neighbourhoods and evaluated once every two months in terms of their effects on human landing rates of wild Aedes populations. A series of three such entomological assessment experiments were conducted, to examine the influence of changing weather conditions, various transfluthrin formulations and emanator placement on protective efficacy measurements. Laboratory experiments assessed resistance of local Aedes aegypti to transfluthrin and deltamethrin, and the irritancy and repellency of the transfluthrin-treated fabric used in the field. Results Across all three entomological field assessments, little evidence of protection against wild Ae. aegypti was observed, regardless of weather conditions, transfluthrin formulation or emanator placement: A generalized linear mixed model fitted to the pooled data from all three assessment rounds (921 females caught over 5129 hours) estimated a relative landing rate [95% Confidence interval] of 0.87 [0.73, 1.04] for users of treated versus untreated emanators (P = 0.1241). Wild Ae. aegypti in this setting were clearly resistant to transfluthrin when compared to a fully susceptible colony. Conclusions Transfluthrin emanators had little if any apparent effect upon Aedes landing rates by wild Ae. aegypti in urban Haiti, and similar results have been obtained by comparable studies in Tanzania, Brazil and Peru. In stark contrast, however, parallel sociological assessments of perspectives among these same end-users in urban Haitian communities indicate strong satisfaction in terms of perceived protection against mosquitoes. It remains unclear why the results obtained from these complementary entomological and sociological assessments in Haiti differ so much, as do those from a similar set of studies in Brazil. It is encouraging, however, that similar contrasts between the entomological and epidemiological results of a recent large-scale assessment of another transfluthrin emanator product in Peru, which indicate they provide useful protection against Aedes-borne arboviral infections, despite apparently providing only modest protection against Aedes mosquito bites.

Durable host plant resistance (HPR) to insect pests is critical for sustainable agriculture. Natural variation exists for aphid HPR in sorghum (Sorghum bicolor), but the genetic architecture and phenotype have not been clarified and characterized for most sources. In order to assess the current threat of a sorghum aphid (Melanaphis sorghi) biotype shift, we characterized the phenotype of Resistance to Melanaphis sorghi 1 (RMES1) and additional HPR architecture in globally admixed populations selected under severe sorghum aphid infestation in Haiti. We found RMES1 reduces sorghum aphid fecundity but not bird cherry‐oat aphid (Rhopalosiphum padi) fecundity, suggesting a discriminant HPR response typical of gene‐for‐gene interaction. A second resistant gene, Resistance to Melanaphis sorghi 2 (RMES2), was more frequent than RMES1 resistant alleles in landraces and historic breeding lines. RMES2 contributes early and mid‐season aphid resistance in a segregating F2 population; however, RMES1 was only significant with mid‐season fitness. In a fixed population with high sorghum aphid resistance, RMES1 and RMES2 were selected for demonstrating a lack of severe antagonistic pleiotropy. Associations with resistance colocated with cyanogenic glucoside biosynthesis genes support additional HPR sources. Globally, therefore, an HPR source vulnerable to biotype shift via selection pressure (RMES1) is bolstered by a second common source of resistance in breeding programs (RMES2), which may be staving off a biotype shift and is critical for sustainable sorghum production.

Though facing significant challenges, coffee (Coffea arabica) grown in Haitian agroforestry systems are important contributors to rural livelihoods and provide several ecosystem services. However, little is known about their genetic diversity and the variety mixtures used. In light of this, there is a need to characterize Haitian coffee diversity to help inform revitalization of this sector. We sampled 28 diverse farms in historically important coffee growing regions of northern and southern Haiti. We performed KASP-genotyping of SNP markers and HiPlex multiplex amplicon sequencing for haplotype calling on our samples, as well as several Ethiopian and commercial accessions from international collections. This allowed us to assign Haitian samples to varietal groups. Our analyses revealed considerable genetic diversity in Haitian farms, higher in fact than many farmers realized. Notably, genetic structure analyses revealed the presence of clusters related to Typica, Bourbon, and Catimor groups, another group that was not represented in our reference accession panel, and several admixed individuals. Across the study areas, we found both mixed-variety farms and monovarietal farms with the historical and traditional Typica variety. This study is, to our knowledge, the first to genetically characterize Haitian C. arabica variety mixtures, and report the limited cultivation of C. canephora (Robusta coffee) in the study area. Our results show that some coffee farms are repositories of historical, widely-abandoned varieties while others are generators of new diversity through genetic mixing.

Over the past decade, genomic selection (GS) has gained significant traction as a valuable tool for predicting the phenotypic performance in plant breeding populations and for expediting the development of new cultivars. Diverse statistical models and approaches have been developed to facilitate the integration of GS into plant breeding practices, with a growing emphasis on strategies that enhance accurate and resource‐efficient prediction. Since its inception in 2010, the sweet sorghum [Sorghum bicolor (L.) Moench] breeding program at Centre Haïtien d'Innovation en Biotechnologies et pour une Agriculture Soutenable has taken the lead in endeavors to cultivate and introduce varieties that exhibit resilience against both abiotic and biotic stresses. Among these challenges, drought stress holds particular prominence, given the reliance of growers on unpredictable rainfall patterns for successful sorghum production. The central objective of this study was to assess the predictive ability of genomic prediction models across varying environmental conditions in Haiti, employing two statistical methods. Our assessment encompassed 12 distinct sorghum traits, with genomic predictions conducted both within and across irrigated and water‐stress treatments, executed at different planting dates. Overall, the two methods showed similar results. Prediction accuracy was notably higher for within‐environment scenarios (ranging from 0.30 to 0.71) as opposed to across‐environment scenarios (ranging from 0.08 to 0.68). Furthermore, there was considerable variation in the prediction accuracy for all traits, with “total soluble solids” displaying the highest mean value (0.71), while “total stem number” exhibited the lowest (0.38). The attained genomic prediction accuracies in this study offer encouraging insights for the integration of GS strategies in small‐scale breeding programs, particularly those aimed at enhancing drought tolerance.

Climate risks linked to natural disasters are one of the most critical issues faced by Haitian farming. Losses due to hurricanes, droughts, floods, and diseases seriously threaten productivity. This paper aims to study the feasibility and acceptability of an agricultural package of technologies whose goal is to manage risk while improving the productivity of farming in Haiti. Significant risks faced by farmers seem to be uninsurable risks due to their systemic and catastrophic character. Therefore, the proposed package of technologies includes a paid-in-kind "stabilization accounts" component as a financial tool for risk management. We collected data from 28 agricultural experts and 1400 farmers, including 234 maize farmers in southern Haiti. We adopted the new product development (NPD) process to test the feasibility of the concept. We used Spearman correlation, Multinomial Logistic, and Linear Regression to determine factors affecting the openness of Haitian farmers to innovation. We also conducted the Cochran-Mantel Haenszel test to analyze the association between "saving habit" and "openness to innovation". Based on the results, 70% of farmers expressed their propensity to pay from 6% to more than 12 % of their harvested crop as a stabilization account. Farmers with “financial inclusion” are expected to be twice as likely to adopt innovative technologies, while farm size, gender, and association membership have a significant positive impact on openness to innovation. However, unlike the usual trend in the literature, we found that risk aversion may positively affect the acceptance and adoption of some technologies. The results also suggest that, in Haitian farming, risks linked to natural disasters are more related to financial incapacity than uncertainty. Therefore, access to proper inputs in due time completed by a financial tool to overcome uncertainty will be a significant boost to the adaptability and resilience of Haitian farmers toward weather risks.

Introduction Although tobacco has harmful effects on the physical and mental health of individuals, its use remains significant, according to the World Health Organization. To understand this phenomenon, studies have been carried out in many countries around the world, while in Haiti where more than 5,000 people die each year due to tobacco use, little is known about the use of this substance. The aim of this study was to examine the prevalence and the factors associated with tobacco use in Haiti. Methods We used data from the 2016/17 Haitian Demographic Health Survey. Both descriptive and multivariate analyses were conducted using STATA 16.0 software to assess the prevalence and identify factors associated with tobacco use. Results were reported as adjusted odds ratios with 95% confidence intervals. Statistical significance was declared at p < 0.05. Results The prevalence of tobacco use was estimated at 9.8% (95% CI: 9.2–10.4) among men and 1.7% (95% CI: 1.5–1.9) among women. Although the prevalence of tobacco use was low among young people, it increased with age. Respondents aged 35 and above, with no formal education, non-Christians, divorced/separated/widowed, from poorest households, rural areas, “Aire Métropolitaine de Port-au-Prince” region, with high media exposure had a higher likelihood of tobacco use. Conclusion The low prevalence of tobacco use among Haitian women and youth represents a public policy opportunity to prevent these vulnerable groups from starting smoking. Adult male smokers should also be targeted by appropriate policy to reduce the different health burdens associated with tobacco, both for the smokers and other people they may expose to passive smoking. Government and health sector stakeholders, along with community leaders, should create and enforce awareness strategies and rules to control advertisements that encourage irresponsible and health-risky consumption behaviors.

The precipitation variability and trends were investigated in the Usumacinta River Basin (URB) for the period 1959–2018, based on imputed and homogenized data records from 60 meteorological stations in Mexico and Guatemala. The homogenization process played a crucial role in enhancing the quality of the original precipitation series, reducing regional inconsistencies and improving temporal and spatial coherence. The dataset reliably captured large‐scale climate variations, revealing three regions with similar precipitation variability and trends in the URB. Notably, maximum precipitation occurred at 636 m a.s.l., while minimum precipitation was at 1531 m a.s.l., indicating an orographic effect in the region. Extreme precipitation events were linked to El Niño–Southern Oscillation. Although the Mann–Kendall test showed statistically significant negative trends in only 18% of the stations, integration of Sen's slope analysis and 30‐year normals and dry year occurrences highlighted a progressive shift towards dryer conditions throughout the study period in the URB. These drier conditions could notably affect regions with higher precipitation, requiring special attention due to possible socioeconomic impacts associated with drought events. By identifying these vulnerable regions, policymakers and stakeholders can proactively plan and execute adaptive measures to mitigate the potential impacts of droughts on communities, ecosystems, and economic activities within the basin.

Economic history is mobilized by neo institutionalists to explain the different paths to development observed in post-colonial countries. Acemoglu and Robinson have considered Haiti as an archetype of colonial institutional legacy to describe why Nations fail. Is this deterministic lecture sufficient to understand the troubled development journey of the first free Black Country? In this research, we show, with empirical and historical evidence, that institutional path dependence theory is not the best analytical framework for the case of Haiti. Critical juncture theory appears to be more appropriate to capture what is really going on in neocolonial Haiti. We also contribute to the Critical juncture theory with long term historical evidence.

Background Open defecation (OD) is recognised as an important public health challenge in low-income and middle-income countries. Although agriculture is the main occupation in these countries, few if any study on OD has focused on agricultural households. In order to enhance the prevention of OD and contribute to a better understanding of this health-threatening behaviour, this paper analyses the socio-economic factors associated with OD practice among agricultural households in Haiti. Methods The study used primary data from 1269 households selected in 5 out of 10 geographic departments of Haiti surveyed in 2020–2021. Descriptive statistics and bivariate analysis were used to identify households’ characteristics that were significantly associated with OD. In addition, a multivariate analysis was performed using binary logistic regression to study the factors associated with the probability to defecate in the open. Results Findings show that one out of five (20.1%) agricultural households in Haiti practices OD. More than 26% of the households did not have any member with secondary school education level. Multivariate analysis revealed that in addition to the location, the probability of OD practices among agricultural households was correlated with socio-economic factors such as education, access to the media, plot number and livestock, level of specialisation in the agriculture, agricultural income and participation in local organisations. Conclusion While Haiti is struggling with cholera among other health issues, this paper sheds light on factors associated with OD, a health-threatening and unsustainable sanitation behaviour. According to the results, in addition to toilet acquisition subsidies, awareness campaigns need to make use of mass media and local organisations particularly women and community ones. Elimination of OD among agricultural households is of great significance for better quality of foods and vegetables at watershed level.

Changes in marine productivity of the last five centuries in the Gulf of Tehuantepec were investigated using a high-resolution record of diatoms, organic carbon (C org ), total nitrogen (TN), Ni/Al, and Cu/Al. The laminated sediments were dated by using ²¹⁰ Pb and ¹⁴ C, with a bayesian age model providing a new Δ R = 247 ± 30 years for the bulk sediment. The Little Ice Age (LIA) (~1500 to ~1858 CE) was characterized by the predominance of cold-water and high productivity diatoms ( Chaetoceros spores, Thalassionema nitzschioides, Lioloma pacificum, Thalassiosira nanolineata, and Rhizossolenia setigera) and high values of geochemical productivity proxies. A transition period (~1860 to ~1919 CE) toward warmer conditions related to the end of the LIA and the beginning of the Current Warm Period (CWP), was indicated by the appearance of warm-water diatoms ( Neodelphineis pelagica, Thalassiosira tenera, and Rhizossolenia bergonii), as well as lower values of C org , TN, Ni/Al, and Cu/Al. The most recent period of the CWP (~1920 CE to today) was characterized by the increased abundance warm-water taxa ( N. pelagica, Cymatodiscus planetophorus, T. tenera, Plagiogramma minus, Nitzschia interruptestriata, and R. bergonii), and by the prevalence of low values of C org , TN, Ni/Al, and Cu/Al. These changes in productivity during the LIA and CWP were likely driven by changes in solar irradiance and the migration of the Intertropical Convergence Zone. This study highlights the spatial extent of the LIA in the Eastern Tropical North Pacific and contributes to the knowledge of the productivity response to climate in tropical regions.

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87–2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74–1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90–2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.

This study aims to reconstruct the hydro-climatic variations over the last 1000years in Haiti using mineralogical and geochemical composition of well dated lacustrine sediment core retrieved from Lake Azuei. The results show changes in sedimentological processes linked to environmental and climatic variations. The general pattern suggests a wetter Medieval Climate Anomaly (MCA), drier Little Ice Age (LIA), high climate variability during the MCA-LIA transition and more anthropogenic impacts that dominate natural climate during the Current Warm Period (CWP). The MCA period (~1000–1100 CE) thus appears marked by increase sedimentation rate supported by higher terrigenous input linked to erosive events particularly increases in precipitation. During the LIA, particularly from ~1450 to 1600 CE, there is a great variation toward a decrease of terrigenous input, which is related to a decrease on sedimentation rate and increase Mg-calcite precipitation, suggesting less precipitation and high evaporation respectively during dry climate conditions. The MCA-LIA transition (~1200–1400 CE) is characterized by variations between terrigenous input, Mg-calcite formation and organic matter deposition, which indicate succession of dry and humid conditions. The CWP (1800–2000CE) shows a progressive increase on sedimentation rate and decrease of gray level, which indicate more organic matter sedimentation as consequence of anthropogenic activities in the surrounding basin of the lake. High- resolution gray level analysis, which reflects principally variations in terrigenous input, carbonate mineral formation and organic matter deposition, shows that the AMO, NAO, PDO and ENSO are the principal modes affecting the hydro-climatic changes in Haiti during the last millennium. In addition, temporal correlation of other Caribbean paleoclimate records with our geochemical and mineralogical data, suggests that trends observed in Lake Azuei were controlled by regional climate, likely associated with shifts in the position of the ITCZ.