A cross-sectional cohort study of prevalence of antibodies to COVID-19 in Port-au-Prince, Haiti

  1. Vincent DeGennaro
  2. Timothy Schwartz
  3. Rebecca Henderson
  4. Marie-Carmelle Elie

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Abstract

Intro

As of January 14, 2021, Haiti has had 10,781 confirmed (first case March 19th) and 45,927 suspected cases of COVID-19, with 240 official deaths.

Methods

From May until September, 2020, we tested visitors to 20 clinics, for COVID-19 in five neighborhoods of Port-au-Prince as part of a public health effort to determine prevalence of COVID-19 in the general community. In order to estimate changes in number of deaths, the team visited eighteen funeral homes to solicit data on the number of funerals conducted for each month in 2019 and through October 2020. We also sought to evaluate the attitudes of Port-au-Prince citizens towards a generic COVID-19 vaccine in April 2021.

Results

In May and July 2020, 11.4% and 9.1% of those tested were positive for antibodies to COVID-19, respectively. The number of funerals held in the Port-au-Prince area increased by 69.6.% (CI 95% 56.1-83.1) since the official arrival of COVID-19 on March 19 th . We found high rates of vaccine hesitancy with 76% saying they would not take a free COVID-19 vaccine. Further research is needed to validate the findings here, but there are strong suggestions that COVID-19 has had more of an impact than previously reported.

‘What is already known on this subject?’

Very little is known about the true epidemiology of COVID-19 in Haiti due to lack of testing, stigma, and lack of resources. The Ministry of Health reports Haiti has had 10,781 confirmed (first case March 19th) and 45,927 suspected cases of COVID-19, with 240 official deaths. Most officials accept these numbers as vast underestimates.

‘What does this study add?’’

This study estimates a prevalence of 10% for COVID-19 antibodies in the population of Port-au-Prince in May to August 2020. Only 19-38% of those surveyed with confirmed antibodies reported experiencing symptoms in the last few months prior to the survey. We found a 69% increase in funerals per month in Port-au-Prince for the first six months post-COVID (March 2020) compared to the 14 months prior.

Finally, we found significant vaccine hesitancy with only 24% reporting “Yes” or “Maybe” when asked if they’d take a free of charge vaccine.

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  1. ScreenIT

    SciScore for 10.1101/2021.06.30.21259815: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: All visitors were over 18 years old, including patients and family, were approached prior to entering the clinics for consent to a brief survey and a COVID-19 antibody test through a fingerstick.
    Sex as a biological variablenot detected.
    RandomizationWe attempted to contact by phone 140 people selected at random from the original May 2020 cohort.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Results were communicated to participants, and clinical guidance, including the need to self-isolate and to seek medical care if symptoms worsen, were provided for those testing positive for active infection as determined by the presence of IgM antibodies.
    IgM
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.06.30.21259815v1 on medRxiv