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

IntroAs 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. MethodsFrom 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. ResultsIn 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 19th. 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 theyd take a free of charge vaccine.