Impact of Patron Saint Festivities on Cholera in Three Communes in Haiti

Abstract

Abstract Introduction 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 epidemiology of cholera in three communes in Haiti (Cabaret, Carrefour and Croix-des- Bouquets) in 2017 and assess the spatiotemporal influence of patron saint festivities on cholera incidence in communal sections.Materials/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 two weeks later was weighted against patronal festivities and weekly precipitation rates.Results In total, 3 633 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 at the communal sections, the patronal festivities significantly reduced the annual incidence of cholera by 57.23%. The probability of occurrence of cholera cases one week after patronal festivities decreased by 25.41%.Conclusion This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the occurrence of patronal festivities in communal sections and a reduced probability of subsequent outbreaks. Although further assessments are necessary, these findings suggest an impactful prevention and response strategy around the festivities in 2017.