Impact of patron saint festivities on cholera in three communes in Haiti
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RESEARCH ARTICLE
Open Access
Impact of patron saint festivities on cholera in three communes in Haiti Kenny Moise1* , Aude Mélody Achille1, Doudou Batumbo2, Bertiny Bourdeau1, Stanislas Rebaudet3, Gérald Lerebours1, Jean Hugues Henrys1 and Christian Raccurt1
Abstract Background: Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017. Methods: An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and 2 weeks later was weighted against patronal festivities and weekly precipitation rates. Results: In total, 3633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR = 0.4277 (97.5% CI: 0.2798–0.6193), p = 0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% 1 week following patronal festivities. Conclusion: This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017. Keywords: Cholera, Patronal festivities, Mass gatherings, Haiti
Background During a cholera epidemic, the human-to-human transmission such as that noted in large gatherings, without involving the aquatic environment becomes the most important route of transmission [1, 2]. In Haiti, the celebration of local * Correspondence: [email protected] 1 Equipe de Recherche sur les Maladies Infectieuses, Parasitaires et Tropicales, Université Quisqueya, 218 Avenue Jean-Paul II, Port-au-Prince 6110, Haiti Full list of author information is available at the end of the article
patron saints represents a highlight of cultural and religious life and involves large movements of thousands of pilgrims at fixed periods over the year. In 2014, the mishandling of a patron saint festivity in the Ar
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