PubMed | Quisqueya University, Mount Sinai School of Medicine, Port-au-Prince University and Hopital Albert Schweitzer
Type: Journal Article | Journal: World neurosurgery | Year: 2014
To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti.Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome.Of the 7628 patients admitted to the ED during this study, 1243 patients had a neurologic disorder, yielding an ED-based neurologic disease prevalence of 16%. The 3 most common neurologic diseases were cerebrovascular disease (31%), neurotrauma (28%), and altered mental status (12%). Neurosurgical pathologies represented 19% of all neurologic admissions with a combined ED-based disease prevalence of 3%. Mortality rate was 9%. The most common neurosurgical disease was neurotrauma (87%), caused by motor vehicle accidents (59%), falls (20%), and assault (17%). Neurosurgical procedures were performed in 14 of 208 patients with a mortality rate of 33%.This prospective survey represents the first study of neurosurgical or neurologic disease patterns in Haiti. The results suggest specific disease priorities for this population that can guide efforts to improve Haitian health care and conduct more comprehensive epidemiologic studies in Haiti.
Schwartzbord J.R.,Cornell University |
Emmanuel E.,Quisqueya University |
Brown D.L.,Cornell University
Clinical Toxicology | Year: 2013
Context. The Republic of Haiti is a developing country in the Caribbean region with a history that challenges toxicologists, yet the historical panoply of toxicological hazards in Haiti has received little scholarly attention. Objectives. The primary objectives of this paper are to review what is known about Haiti's current toxicological hazards, with a focus on chronic food-borne aflatoxin exposure and heavy metal contamination of water resources, and to compare these with previous large-scale, acute exposures to toxic substances: the 1995-1996 diethylene glycol (DEG) intoxications and the 2000-2001 ackee fruit poisonings. Methods. MEDLINE/PUBMED and the library website of Cornell University were searched using the terms "Haiti" and either "heavy metals," "aflatoxin", "diethylene glycol", or "ackee". The search was inclusive of articles from 1950 to 2012, and 15 out of the 37 returned were peer-reviewed articles offering original data or comprehensive discussion. One peer-reviewed article in press, two newspaper articles, two personal communications, and one book chapter from the personal databases of the authors were also referenced, making a total of 21 citations. Results. Elevated concentrations of aflatoxins (greater than 20 μg/kg) were documented for staples of the Haitian food supply, most notably peanut butters and maize. Human exposure to aflatoxin was confirmed with analysis of aflatoxin blood biomarkers. The implications of aflatoxin exposure were reviewed in the light of Haiti's age-adjusted liver cancer risk-the highest in the Caribbean region. Measurement of heavy metals in Port-au-Prince ground water showed contamination of lead and chromium in excess of the US Environmental Protection Agency's 15 μg/L Action Level for lead and 100 μg/L Maximum Contamination Level Goal for total chromium. The DEG contamination of paracetamol (acetaminophen) containing products in 1995-1996 claimed the lives of 109 children and the 2000-2001 epidemic of ackee fruit poisoning resulted in 60 cases of intoxication. Lessons for the Haitian Government. The DEG and ackee epidemics overwhelmed local Haitian public health resources. Yet, periods of 8 and 4 months, respectively, passed before the Haitian government sought assistance following the initial poisonings. To our knowledge, the Haitian government did not enact policy to promote drug safety and prevent future poisonings. This will not likely change in the near future because of the state's finance and personnel crises. While protection of its people remains the prerogative of the Haitian government, it is extremely limited in managing chemical exposure to environmental toxins, including aflatoxin and heavy metals. Conclusions: The cases of DEG and ackee fruit poisoning demonstrate that environmental exposures to chemicals have occurred in Haiti. Current low-level exposures to aflatoxin and heavy metals highlight the risk that large-scale poisonings can occur. While awareness of toxicological hazards in Haiti must be acknowledged more widely within the government and non-governmental sectors, the lessons of these exposures are relevant to all developing countries where the capacity to discern and manage toxicological risks is absent or not yet effective. Copyright © 2013 Informa Healthcare USA, Inc.
Angerville R.,University of Lyon |
Angerville R.,Quisqueya University |
Perrodin Y.,University of Lyon |
Bazin C.,INSAVALOR |
Emmanuel E.,Quisqueya University
International Journal of Environmental Research and Public Health | Year: 2013
Discharges of Combined Sewer Overflows (CSOs) into periurban rivers present risks for the concerned aquatic ecosystems. In this work, a specific ecotoxicological risk assessment methodology has been developed as management tool to municipalities equipped with CSOs. This methodology comprises a detailed description of the spatiotemporal system involved, the choice of ecological targets to be preserved, and carrying out bioassays adapted to each compartment of the river receiving CSOs. Once formulated, this methodology was applied to a river flowing through the outskirts of the city of Lyon in France. The results obtained for the scenario studied showed a moderate risk for organisms of the water column and a major risk for organisms of the benthic and hyporheic zones of the river. The methodology enabled identifying the critical points of the spatio-temporal systems studied, and then making proposals for improving the management of CSOs. © 2013 by the authors; licensee MDPI, Basel, Switzerland.
PubMed | Quisqueya University, Port-au-Prince University, University of Picardie Jules Verne, Haiti State University and IRD Montpellier
Type: | Journal: Chemosphere | Year: 2014
The physico-chemical behavior of Cryptosporidium oocysts was investigated during their transfer through an alluvial formation from Les Cayes (Haiti) via batch tests. Five approximately 3 kg soil samples were collected and combined prior to batch tests from the alluvial formations. The experiments were carried out at soil pH by equilibrating different ranges of pure oocysts concentrations and soil samples with 3mM CaCl2 and 1mM NaBr as electrolyte. We used the Debye-Hckel equation describing ion activity in a solution for a given ionic strength. The equilibrium adsorption mechanism is used to enumerate the oocysts in the soil. The results suggest that the oocysts behavior in porous media depends on soil characteristics such as soil pH, the nature of the mineral and organic constituents of the soil and the ionic strength and activities in solution. These results show that a total transfer in batch containing NaBr solutions against a partial one in batch containing CaCl2 solutions depends on the oocysts media concentration. To confirm the oocysts number retained in soil, confocal microscopy was successfully used and the images demonstrate that the majority of oocysts were retained at the range of concentrations tested. The findings from this study demonstrated that the retention of C. Parvum in soils may be influenced by chemical conditions and soils characteristics, which are important for groundwater risk assessment.
Fritz H.M.,Georgia Institute of Technology |
Hillaire J.V.,Quisqueya University |
Moliere E.,Port-au-Prince University |
Wei Y.,National Oceanic and Atmospheric Administration |
And 2 more authors.
Pure and Applied Geophysics | Year: 2013
On 12 January 2010, a magnitude M w 7.0 earthquake occurred 25 km west-southwest of Haiti's capital Port-au-Prince causing an estimated 316,000 fatalities, thereby exceeding any previous loss of life from a similar size earthquake. In addition, tsunami waves triggered by the earthquake caused at least three fatalities at Petit Paradis due to a complete lack of tsunami awareness. The International Tsunami Survey Team (ITST) was deployed within weeks of the event and covered the greater Bay of Port-au-Prince and more than 100 km of Hispaniola's southern coastline. The collected survey data include more than 21 tsunami heights along with observations of coastal land level change. Maximum tsunami heights of 3 m have been measured for two independently triggered tsunamis. © 2012 Springer Basel AG.
Fifi U.,Quisqueya University |
Winiarski T.,CNRS Ecology of Natural and Anthropized Hydrosystems Laboratory |
Emmanuel E.,Quisqueya University
International Journal of Environmental Research and Public Health | Year: 2013
The presence of heavy metals in the environment constitutes a potential source of both soil and groundwater pollution. This study has focused on the reactivity of lead (Pb), copper (Cu) and Cadmium (Cd) during their transfer in a calcareous soil of Port-au-Prince (Haiti). Kinetic, monometal and competitive batch tests were carried out at pH 6.0. Two simplified models including pseudo-first-order and pseudo-second-order were used to fit the experimental data from kinetics adsorption batch tests. A good fit of these data was found with pseudo-second-order kinetic model which indicates the applicability of this model to describe the adsorption rates of these metals on the soil. Monometal batch tests indicated that both Langmuir and Freundlich models allowed a good fit for experimental data. On the basis of the maximum adsorption capacity (qmax), the order affinity of Pb, Cu and Cd for the studied soil was Pb2+ > Cu2+ > Cd2+. Competitive sorption has proved that the competition between two or several cations on soils for the same active sites can decrease their qmax. These results show that, at high metal concentrations, Cd may pose more threat in soils and groundwater of Port-au-Prince than Pb and Cu. © 2013 by the authors; licensee MDPI, Basel, Switzerland.
Perrodin Y.,CNRS Ecology of Natural and Anthropized Hydrosystems Laboratory |
Donguy G.,CNRS Ecology of Natural and Anthropized Hydrosystems Laboratory |
Emmanuel E.,Quisqueya University |
Winiarski T.,CNRS Ecology of Natural and Anthropized Hydrosystems Laboratory
Science of the Total Environment | Year: 2014
Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a "threshold effect" (risk quotient <1), and an acceptable risk for substances having a "non-threshold effect", with the notable exception of arsenic (individual risk equal to 3.10-6). © 2014 Elsevier B.V.
Clervil E.,CNRS Laboratory of Physical Chemistry and Microbiology for the Environment |
Clervil E.,Quisqueya University |
Usman M.,University of Agriculture at Faisalabad |
Usman M.,National Graduate School of Chemistry, Rennes |
And 5 more authors.
Chemical Geology | Year: 2013
The sorption of nalidixic acid (NA) onto artificial sediments composed of Fe-oxides, Al-oxides, clay and quartz sand was studied under both static batch and dynamic flow conditions. Kinetic and equilibrium sorption experiments showed that the presence of clay increased the sorption capacity of synthetic sediment and that bentonite had the highest sorption coefficient compared to kaolinite. Solute reactive transport experiments showed that the breakthrough point and steepness of the breakthrough curve (BTC) were dependent on both clay type and water velocity. Agreement between batch and column results in terms of sorbed amount and retardation factor was poor regardless of the sediment tested. The presence of even a small amount of clay (3%) can decrease the permeability of the mixed bed and lead to the formation of preferential flow paths in the column system. Different sets of column experiments at various flow rates gave rise to different sorbed amounts at complete breakthrough, leading to chemical nonequilibrium in the flow system. However, this kinetic limitation cannot completely explain the breakthrough behavior of NA in the bentonite column, suggesting that other factors are responsible for this disparity. The presence of immobile water regions was unlikely in the column since more than 90% of the pore water was mobile according to the tracer tests. The inaccessibility of reactive sites and limited physical diffusion in the clay-packed column may play a significant role under flow-through conditions. The reactive transport behavior of NA is therefore strongly dependent on the mineralogy of the clay present in sediments. © 2012 Elsevier B.V.
PubMed | Quisqueya University and Mount Sinai School of Medicine
Type: Journal Article | Journal: Annals of global health | Year: 2015
During a 3-year time frame, a partnership between medical trainees in Haiti and the United States was forged with the objective of implementing an emergency response skills curriculum at a medical school in Port-au-Prince. The effort sought to assess the validity of a near-peer, bidirectional, cross-cultural teaching format as both a global health experience for medical students and as an effective component of improving medical education and emergency response infrastructure in developing countries such as Haiti.Medical students and emergency medicine (EM) residents from a North American medical school designed and taught a module on emergency response skills in PAP and certified medical students in basic cardiac life support (BLS) over 2 consecutive years. Five-point Likert scale self-efficacy (SE) surveys and multiple-choice fund of knowledge (FOK) assessments were distributed pre- and postmodule each year and analyzed with paired t tests and longitudinal follow-up of the first cohort. Narrative evaluations from participants were collected to gather feedback for improving the module.Challenges included bridging language barriers, maintaining continuity between cohorts, and adapting to unexpected schedule changes. Overall, 115 students were certified in BLS with significant postcurriculum improvements in SE scores (2.75 0.93 in 2013 and 2.82 1.06 in 2014; P < 0.001) and FOK scores (22% 15% in 2013 and 41% 16% in 2014; P < 0.001). Of 24 Haitian students surveyed at 1-year follow-up from the 2013 cohort, 7 (29.3%) reported using taught skills in real-life situations since completing the module. The US group was invited to repeat the project for a third year.Near-peer, cross-cultural academic exchange is an effective method of medical student-centered emergency training in Haiti. Limitations such as successfully implementing sustainability measures, addressing cultural differences, and coordinating between groups persist. This scalable, reproducible, and mutually beneficial collaboration between North American and Haitian medical trainees is a valid conduit for building Haitis emergency response infrastructure and promoting global health.
Altenor S.,University of the French West Indies and Guiana |
Ncibi M.C.,University of the French West Indies and Guiana |
Emmanuel E.,Quisqueya University |
Gaspard S.,University of the French West Indies and Guiana
Biochemical Engineering Journal | Year: 2012
The adsorptive removal capacities of highly available Turbinaria turbinata alga and its derived carbonaceous products (i.e. pyrolyzed, physically and chemically activated carbons) were investigated in this study. Several textural and chemical characterizations were performed on the alga and its activated carbons (ACs). Besides, kinetics and isotherms assays were performed and modeled in order to monitor the sorption capacities and dynamic behaviors.The main results showed that the raw Turbinaria biomass has a non porous structure. Then, after thermo-chemical treatments, a porous matrix starts to develop and the total pore volume drastically increased from 0.001cm 3/g for the algal precursor (turb-raw) to 1.316cm 3/g for its derived chemically AC (turb-P1). As well, the specific surface area improved from m 2/g for (turb-raw) to 1307m 2/g for (turb-P1). Consequently, the maximum sorption capacity went from 63mg/g for the algal biomass up to 411mg/g for the chemically ACs.Moreover, the removal rate was taken into consideration in order to set a more reliable and realistic approach to figure out the most efficient AC.Thus, based on those criteria, it was found that the chemically activated carbon " turb-P1" is the most efficient Turbinaria-derived sorbent to adsorb and remove methylene blue (MB) molecules from aqueous solutions with 169. g of the dye using 1. kg of raw alga (considering an AC production yield of 49%). © 2012 Elsevier B.V.