Among the most disproportionate disease burdens documented specifically in Haitians. Prevalence in Haiti vastly exceeds global averages, with early-onset patterns and high rates of end-stage presentation.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| POAG Prevalence in Haiti | 14.2–19.1% | vs. 1–2% in European-descent populations | Critical |
| Glaucoma Suspects (Little Haiti, Miami) | 25.5% | 939 Haitian Afro-Caribbeans screened, 2011–2013 | Critical |
| 1st-Degree Relatives Affected | 30.8% | Cascade screening at Bascom Palmer Eye Institute | High |
| End-Stage at 1st Presentation | 35.1% | Delayed diagnosis due to care access gaps | Critical |
| Average Age of Diagnosis | 52.3 yrs | ~10 yrs earlier than European-descent populations | High |
| POAG in Neighboring Barbados | 10.3% | Haiti rate is nearly double | High |
Mechanism / Etiology
Key Sources
Hypertension rates in Haiti rival or exceed those of U.S. Black Americans, with a striking pattern of early onset and dramatically elevated heart failure prevalence — even in adults under 40.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| Hypertension Prevalence (Port-au-Prince) | 30.4% | Haiti CVD Cohort Study, 3,005 adults (2019–2021) | Critical |
| Elevated Blood Pressure Overall | 53.5% | Includes prehypertension (23.1%) + hypertension (30.4%) | Critical |
| Early-Onset HTN (Ages 18–30) | 12% | vs. 3.4–5.3% in similarly-aged U.S. Black Americans | Critical |
| Heart Failure Prevalence | 11.9% | vs. 3.6% in non-Hispanic Black Americans (AHA data) | Critical |
| Heart Failure Under Age 40 | 4.6% | 10× higher than Americans in same age range (0.4%) | Critical |
| HTN in Haitian Immigrants (Chile) | 31.5% | Including 33% in the 25–44 age group — confirms systemic pattern | High |
Mechanism / Etiology
Key Sources
Haiti carries one of the highest sickle cell trait prevalences in the Caribbean. SCD disease rates in newborns are more than twice that of African Americans. No national screening program currently exists.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| Sickle Hemoglobin (HbS) Carrier Rate — Northern Haiti | 15.1% | 95% CI: 12.2–18% (Bethesda Medical Center study) | High |
| HbS Carrier Rate — Miami Haitian Immigrants | 8.0% | DNA genotyping, Pegelow & Mack 1989 | High |
| SCD in Haitian Newborns (HbSS + HbSC) | 1 in 173 | More than twice the rate among African-American newborns | Critical |
| HbS Mutation Frequency | 7.2% | Genotyping study; HbC also 6.9% | High |
| SCD Prevalence at Birth | ~0.7% | Fondation Pierre Fabre estimate; no national policy exists | High |
| Neonatal Screening Coverage | ~22% | 78% of births occur outside hospitals; universal screening not yet achieved | Critical |
Mechanism / Etiology
Key Sources
APOL1 G1 and G2 risk alleles — dominant in West African-ancestry populations — are prevalent in Haitians and explain up to 70% of excess kidney disease risk in those of African descent.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| APOL1 Excess CKD Risk Explained | ~70% | Of excess kidney disease risk in African-descent populations | Critical |
| High-Risk Genotype in African Americans | ~13% | G1/G1, G2/G2, or G1/G2; comparable rate expected in Haitians | High |
| CKD Prevalence — Port-au-Prince CVD Cohort | 8.8% | Haiti Cardiovascular Disease Cohort Study (2019–2021) | High |
| ESRD Risk Increase (APOL1 High-Risk vs. Low) | ~4× higher | Odds ratio 4.0 for lower eGFR in APOL1 HR carriers (DRC study) | Critical |
| FSGS Link | 67–78% | APOL1 risk carrier prevalence among African-ancestry patients with glomerular disease | High |
Mechanism / Etiology
Key Sources
Haiti has the highest HIV prevalence in the Caribbean. Though rates have declined significantly since 2000 due to ART programs, HIV remains a major driver of disease burden, especially among women.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| HIV Prevalence (Adults 15–49) | 1.7% | UNAIDS/PNLS 2023 estimate | High |
| HIV Prevalence — Women | 2.1% | vs. 1.3% in men (UNAIDS 2023) | High |
| HIV Mortality (Age-Adjusted) | 28.3 per 100k | 2019 estimate; declined 82.8% from 2000–2019 | High |
| Syphilis Co-Infection in Pregnancies | 2.5% | 205,892 pregnancies reported in 2022 | High |
| On Antiretroviral Therapy — Ouest Dept. | 50,000+ | At risk of service disruption due to political instability | High |
| HIV in Haitian Immigrants (Chile) | 2.4% | 95% CI 1.3–4.2%; markedly higher than host population | High |
Mechanism / Etiology
Key Sources
Haiti carries one of the highest TB incidence rates in the Caribbean. A biosafety level 3 laboratory was only recently established to support MDR-TB detection.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| TB Incidence Rate (2023) | 149 per 100k | World Bank / WHO; among highest in the Caribbean | High |
| TB Mortality (Age-Adjusted, 2019) | 9.2 per 100k | Men: 10.5; Women: 7.9 | Moderate |
| MDR-TB Detection Capability | Est. 2020s | Biosafety level 3 lab built with CDC support; prior detection was limited | Moderate |
Mechanism / Etiology
Key Sources
Haiti is the only country in the Western Hemisphere with ongoing endemic cholera. The 2010 epidemic killed nearly 10,000 people; the disease resurged in 2022 following gang violence and water infrastructure collapse.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| Cumulative Cases (2010–2019) | 820,000+ | 9,792 deaths; true burden likely higher due to underreporting | Critical |
| 2022 Resurgence — Suspected Cases (by May 2023) | 41,944 | 38,420 hospitalizations; 685 deaths across all 10 departments | High |
| Case Fatality Rate (2022 Outbreak) | 3.0% | 14-day moving average (CDC/MSPP) | High |
| Clean Water Access | 18.9% | Only 18.9% of population has public network water access | Critical |
Mechanism / Etiology
Key Sources
Haiti and the Dominican Republic account for 95% of LF burden in the Americas. Mass drug administration programs have substantially reduced prevalence in children.
Research Findings
| Metric | Finding | Context / Study | Severity |
|---|---|---|---|
| Historical Antigen Prevalence (Children, 2001) | 7.3% | Population-weighted CFA prevalence; found in 88% of communes | High |
| Post-MDA Prevalence (TAS-1, 2017–2022) | 0.15% | 5,239 children tested; below WHO threshold of 2% in Culex-endemic settings | Low |
| Share of LF Burden in Americas | 95% | Haiti and Dominican Republic combined | High |
Mechanism / Etiology
Key Sources