Thomas Druetz

• PhD
• Professor (Associate) at Université de Montréal

The article recently published by Aye et al. (2024) in Health Policy and Planning is a major contribution to understanding the medium-term (5 years) effects of the free healthcare policy introduced in 2016 in Burkina Faso. The study makes rigorous use of interrupted time series with a nonequivalent control group and presents a wealth of information...

Hispaniola, which is shared by Haiti and the Dominican Republic, remains the last island in the Caribbean that is still endemic for malaria, with Haiti bearing the highest caseload. Few studies have examined the ecology of malaria vectors in Haiti. Five species of Anopheles have been described on the island, but the exophilic Anopheles albimanus (...

Introduction Burkina Faso implemented stringent measures in response to the COVID-19 pandemic that profoundly affected its economy and might have exacerbated food insecurity. While prior studies have assessed the impact of these measures on consumers, there is a dearth of evidence of its effects on food producers in Sub-Saharan Africa. This study a...

Presenting the COVID-19 crisis as a pandemic misleadingly implies a certain homogeneity between the regions of the Globe in terms of their burden and reactions. However, from the outset of the crisis, countries presented different epidemiological realities and sometimes adopted divergent, even opposing measures. Curiously, the heterogeneity of resp...

Objectives This scoping study aims to identify environmental road safety measures implemented in low- and middle-income countries (LMICs) to reduce pedestrian injuries from collisions with motor vehicles. Methods This review followed Arksey and O’Malley’s approach and reported results using the PRISMA-SCR 2018 checklist. A literature review was co...

Background Improving infant immunization completion and promoting equitable vaccination coverage are crucial to reducing global under-5 childhood mortality. Although there have been hypotheses that the impact of the COVID-19 pandemic would decrease the delivery of health services and immunization campaigns in low- and middle-income countries, the a...

The COVID-19 pandemic in the Canadian province of Quebec has increased demand for labour in long-term care facilities, or ‘Centre d’hébergement de soins de longue durée (CHSLDs)’. This study explored the challenges experienced by Certified Nurse Assistants (CNAs) in CHSLDs in Montreal, Quebec’s largest city, during the COVID-19 pandemic and how the...

Targeting malaria interventions in elimination settings where transmission is heterogeneous is essential to ensure the efficient use of resources. Identifying the most important risk factors among persons experiencing a range of exposure can facilitate such targeting. A cross-sectional household survey was conducted in Artibonite, Haiti, to identif...

For a malaria elimination strategy, Haiti’s National Malaria Control Program piloted a mass drug administration (MDA) with indoor residual spraying (IRS) in 12 high-transmission areas across five communes after implementing community case management and strengthened surveillance. The MDA distributed sulfadoxine–pyrimethamine and single low-dose pri...

Background: Unmet needs for contraception constitute a major public health problem in sub-Saharan Africa. Several mechanisms have been tested to reduce the financial barrier and facilitate access to family planning services, with inconclusive results. Based on the positive impacts following the introduction of free health care for pregnant women,...

Objective Homelessness is a serious social and public health concern in Canada. Individuals experiencing homelessness face numerous health problems and barriers in accessing health services. Visual impairment can exacerbate the lower quality of life experienced by people who are homeless, but its incidence among this population has been poorly docu...

Introduction Serological methods provide useful metrics to estimate age-specific period prevalence in settings of low malaria transmission; however, evidence on the use of seropositivity as an endpoint remains scarce in studies to evaluate combinations of malaria control measures, especially in children. This study aims to evaluate the immediate ef...

Serological data can provide estimates of human exposure to both malaria vector and parasite based on antibody responses. A multiplex bead-based assay was developed to simultaneously detect IgG to Anopheles albimanus salivary gland extract (SGE) and 23 Plasmodium falciparum antigens among 4185 participants enrolled in Artibonite department, Haiti i...

Evidence on how the COVID-19 pandemic has affected women’s reproductive health remains scarce, particularly for low- and middle-income countries. Deleterious indirect effects seem likely, particularly on access to contraception and risk of unwanted pregnancies, but rigorous evaluations using quasi-experimental designs are lacking. Taking a diachron...

Résumé pour le grand public Le Burkina Faso est l'un des premiers pays d'Afrique subsaharienne à abolir les frais de consultation pour les services de planification familiale. Introduite à titre pilote en juin 2019, cette politique couvre les principaux coûts, y compris les contraceptifs, pour toutes les femmes en âge de procréer (15–49 ans). Nous...

Clinical relevance: Homeless populations have lower health indicators, including in eye care. Few data exist on the levels and causes of visual impairment in Canadian homeless populations, and none in Montreal. Background: This study aims to characterise the causes and levels of visual impairment, as well as eye care services utilisation among t...

Según la Organización Mundial de la Salud (OMS), la hipertensión arterial, la hiperglucemia en ayunas, el sobrepeso y la obesidad se encuentran entre los principales factores de riesgo de muerte de la población mundial. Estas alteraciones fueron responsables de 23% de las muertes en el mundo en el 2004 y de 31% de las registradas en las Américas en...

In Burkina Faso, in July 2016, user fees were removed at all public healthcare facilities, but only for children under 60 months of age and for "mothers", i.e. for reproductive care. This study was conducted in five rural communities in Boulsa District (Burkina Faso) (1) to understand the perceptions and practices of stakeholders regarding complian...

Background In 2016, the national user fee exemption policy for women and children under five was introduced in Burkina Faso. It covers most reproductive healthcare services for women including prenatal care, delivery, and postnatal care. In subsequent years, the policy was gradually extended to include family planning. While studies have shown that...

Background Haiti is planning targeted interventions to accelerate progress toward malaria elimination. In the most affected department (Grande-Anse), a combined mass drug administration (MDA) and indoor residual spraying (IRS) campaign was launched in October 2018. This study assessed the intervention’s effectiveness in reducing Plasmodium falcipar...

L’objectif de cette étude est double : 1) comprendre les perceptions et les pratiques du personnel de santé et des bénéficiaires à l’égard du respect des critères d’éligibilité à la politique de gratuité des soins de santé et 2) explorer les tensions éthiques qui en ont découlé et les éventuels modes de résolution. L’étude suggère que les critères...

Background Prompt and effective malaria diagnosis and treatment is a cornerstone of malaria control. Case management guidelines recommend confirmatory testing of suspected malaria cases, then prescription of specific drugs for uncomplicated malaria and for severe malaria. This study aims to describe case management practices for children aged 1–59...

Background: Over the past decade, an increasing number of low-and middle-income countries have reduced or removed user fees for pregnant women and/or children under five as a strategy to achieve universal health coverage. Despite the large number of studies (including meta-analyses and systematic reviews) that have shown this strategy's positive ef...

Introduction Most of the literature on terrorist attacks’ health impacts has focused on direct victims rather than on distal consequences in the overall population. There is limited knowledge on how terrorist attacks can be detrimental to access to healthcare services. The objective of this study is to assess the impact of terrorist attacks on the...

Background: As in most eliminating countries, malaria transmission is highly focal in Haiti. More granular information, including identifying asymptomatic infections, is needed to inform programmatic efforts, monitor intervention effectiveness, and identify remaining foci. Easy access group (EAG) surveys can supplement routine surveillance with mo...

The island of Hispaniola aims to eliminate malaria by 2025; however, there are limited data to describe epidemiologic risk factors for malaria in this setting. A prospective case-control study was conducted at four health facilities in southwest Haiti, aiming to describe factors influencing the risk of current and past malaria infection. Cases were...

In our aim to eliminate malaria, more sensitive tools to detect residual transmission are quickly becoming essential. Antimalarial antibody responses persist in the blood after a malaria infection and provide a wider window to detect exposure to infection compared to parasite detection metrics. Here, we aimed to select antibody responses associated...

Haiti is striving for zero local malaria transmission by the year 2025. Chloroquine remains the first-line treatment, and sulfadoxine/pyrimethamine (SP) has been used for mass drug-administration pilot programs. In March 2016, nationwide molecular surveillance was initiated to assess molecular resistance signatures for chloroquine and SP. For 778 s...

The challenges raised by sustainability of the free health care policy in Burkina Faso deserve particular attention. The linking of free health care with the Universal Health Insurance National Fund, both of which are measures aiming to improve universal health coverage, raises issues of efficiency, sustainability and social justice. While many sci...

Measuring antimalarial antibodies can estimate transmission in a population. To compare outputs, standardized laboratory testing is required. Here we describe the in-country establishment and quality control (QC) of a multiplex bead assay (MBA) for three sero-surveys in Haiti. Total IgG data against 21 antigens were collected for 32,758 participant...

Background: Serological data indicating the presence and level of antibodies against infectious disease antigens provides indicators of exposure and transmission patterns in a population. Laboratory testing for large-scale serosurveys is often hindered by time-consuming immunoassays that employ multiple tandem steps. Some nations have recently beg...

Accurate malaria diagnosis is foundational for control and elimination, and Haiti relies on HRP2-based rapid diagnostic tests (RDTs) identifying Plasmodium falciparum in clinical and community settings. In 2017, one household and two easy-access group (EAG) surveys tested all participants (N=32,506) by conventional and high-sensitivity RDTs (cRDT/h...

Background Nationally-representative household surveys are the standard approach to monitor access to and treatment with artemisinin-based combination therapy (ACT) among children under 5 years (U5), however these indicators are dependent on caregivers’ recall of the treatment received. Methods A prospective case–control study was performed in Mal...

Background Haiti and the Dominican Republic, the only two Caribbean countries with endemic malaria transmission, are committed to eliminating malaria. With a Plasmodium falciparum prevalence under 1% and a highly focal transmission, the efforts towards elimination in Haiti will include several community-based interventions that must be tailored to...

Background: The lack of primary healthcare integration has been identified as one of the main limits to programs' efficacy in low- and middle-income countries. This is especially relevant to the Millennium Development Goals, whose health objectives were not attained in many countries at their term in 2015. While global health scholars and decision...

Randomized controlled trials have established that seasonal malaria chemoprevention (SMC) in children is a promising strategy to reduce malaria transmission in Sahelian West Africa. This strategy was recently introduced in a dozen countries, and about 12 million children received SMC in 2016. However, evidence on SMC effectiveness under routine pro...

Seasonal malaria chemoprevention (SMC) for children < 5 is a strategy that is gaining popularity in West African countries. Although its efficacy to reduce malaria incidence has been demonstrated in trials, the effects of SMC implemented in routine program conditions, outside of experimental contexts, are unknown. In 2014 and 2015, a survey was con...

With solid evidence that free healthcare increases the utilization of health services, Burkina Faso recently exempted all children under five and pregnant women from direct payment at health facilities. However, there is little insight into the capacity to maintain the gains attributable to free healthcare under routine conditions of implementation...

Background Stunting affects 165 million children worldwide, with repercussions on their survival and development. A contaminated environment is likely to contribute to stunting: frequent faecal-oral transmission possibly causes environmental enteropathy, a chronic inflammatory disorder that may contribute to faltering growth in children. This study...

Malaria is holo-endemic in Burkina Faso and causes approximately 40,000 deaths every year. In 2010, health authorities scaled up community case management of malaria with artemisinin-based combination therapy. Previous trials and pilot project evaluations have shown that this strategy may be feasible, acceptable, and effective under controlled impl...

Introduction: Larval source management has contributed to malaria decline over the past years. However, little is known about the impact of larval control practices undertaken at the household level on malaria transmission. Methods: The study was conducted in Kaya health district after the 2010 mass distribution of insecticide treated-nets and t...

Introduction: Burkina Faso started nationwide community case management of malaria (CCMm) in 2010. In 2011, health center user fees for children under five were abolished in some districts. Objective: To assess the effects of concurrent implementation of CCMm and user fees abolition on treatment-seeking practices for febrile children. Methods:...

À travers des mécanismes de financement et d’aide au développement, les organisations internationales (dont sont membres les États) et les organisations non gouvernementales jouent un rôle prédominant dans la définition et l’adoption des politiques sanitaires des pays à faible revenu (Lee et al., 2001). D’une part, les organisations émettent des re...

Thirty years after Alma-Ata, there has been an upsurge of interest in community health workers (CHWs) in low- and middle-income countries. This echoes several strategic policies recently endorsed by the World Health Organization and its global call to re-establish the primary healthcare (PHC) policy. However, we are witnessing a reframing of this a...

The use of community health workers to administer prompt treatments is gaining popularity in most sub-Saharan African countries. Their performance is a key challenge because it varies considerably, depending on the context, while being closely associated with the effectiveness of case management strategies. What determines community health workers’...

Background Periodic mass distributions contribute significantly to universal access to insecticide-treated nets (ITNs). However, due to the limited number of nets distributed, needs remain unsatisfied, particularly in large households. Methods This study was conducted in Kaya health district following the 2010 mass distribution of ITNs in Burkina...

Background: Malaria is holo-endemic in Burkina Faso and causes the death of approximately 40,000 individuals every year. Local health authorities have been implementing population interventions such as universal bednet distribution and community case management of malaria in every village. However, recent studies conducted in other countries have r...

Pneumonia causes around 750 000 child deaths per year in sub-Saharan African (SSA) countries. The lack of accessibility to prompt and effective treatment is an important contributor to this burden. Community case management of pneumonia (CCMp) uses trained community health workers (CHWs) to administer antibiotics to suspected child pneumonia cases...

Every year 40,000 people die of malaria in Burkina Faso. In 2010, the Burkinabè authorities implemented a national malaria control program that provides for the distribution of mosquito nets and the home-based treatment of children with fever by community health workers. The objective of this study was to measure the implementation fidelity of this...

Content fidelity of activities in Kaya District. Source: survey data. (PDF)

Coverage fidelity of activities in Kaya District. Source: survey data. (PDF)

Coverage fidelity of activities in Zorgho District. Source: survey data. (PDF)

Content fidelity of activities in Zorgho District. Source: survey data. (PDF)

No abstract available.