A descriptive analysis of malaria at Foi et Vie clinic of Saint Boniface Haiti foundation

Introduction

According to the World Health Organization (WHO), in 2020 there were an estimated 241 million cases of malaria worldwide (1). The estimated number of deaths attributable to malaria amounted to 627,000 (1). Malaria is endemic in Haiti, especially during the rainy season and represents a real public health problem (2). More than 90% of all reported cases of malaria on the island of Hispaniola in 2019, were from Haiti (3). It has been estimated that more than 220,000 cases is currently present, and 80 % of the population at risk of acquiring the disease in the country mainly those living below 300 m altitudes (4). Patients with fever as chief complaints presenting to clinics in Haiti have 3 to 47 % to be malaria positive (5). The Haitian National Health Policy has placed chloroquine, with the incorporation of primaquine, at the first-line drug for the treatment of uncomplicated malaria(6). The Ministry of Public Health and Population (MSPP), in partnership with the Center for Disease Control and Prevention (CDC), authorized in 2012, rapid diagnostic test (RDT) as an official diagnostic method for malaria in Haiti (5). Despite these progress, malaria remains one of the top ten causes of death in Haiti (2). Data from the MSPP in 2021 indicates that the pathology mainly affects the departments of the Sud-Est (13.1%) and Grande-Anse (9.8%)(2). The Foi et Vie clinic being a reference in the Sud-Est department, we chose to conduct a study in this institution in order to evaluate the frequency of malaria in different age groups, over a period of 22 month from August 2020 to July 2022.

Materials and Method

This is a simple descriptive report. We collected a total of 49 confirmed cases of malaria from the clinic database over the study period. When the patient came with symptoms related to malaria, mainly fever, a rapid diagnostic test (RDT) was carry out, available on site. And if the test indicated that the patient is positive for malaria, the staff of the center provided immediate care. Data was collected and analyzed using Excel 2016 and IBM SPSS Statistics 20.

Results

The mean age was 28.9± 2.17 years. The age of the patients at the time of their visit was between 3 years and 92 years. We found that adults between 18 and 64 years of age were much more affected than other ranges of age represented by 81.6% of the cohort (n =40/49). In our study, male patients were the most affected by the disease (Male with malaria versus Female with malaria: 65.3.% vs 34.7% (M/F = 1.88).The majority of patients were from Côtes-de-fer , which is the town where the medical center is located , represented by 42.9% of the patients (n = 21/49).Only one case was from Petit-Goâve, represented by 2%. A large part of the patients were seen in consultation in an outpatient clinic (n = 33/49) represented by 67.3% of patient. And the others were consulted and cared for in the emergency room ( n = 16/49) represented by 32.7% of the patients. Female children were most affected by the disease (n=5/8), while in adults, male patients were most affected (n= 29/40).

Conclusion

Malaria is an infectious disease threatening the lives of many Haitians, in rural areas as well as in urban areas. Despite the measures taken by the Ministry of Health in Haiti to fight against malaria, it remains endemic. Very often patients only come to a medical center when the serious forms appear. A ban on building in flood-prone areas should greatly improve the health situation in relation to this pathology. Further studies must be carried out to better understand the impact of this disease on the Haitian population.