{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T16:51:46Z","timestamp":1781974306587,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL149121"],"award-info":[{"award-number":["R01HL149121"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018170","name":"Fondation Pierre Fabre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018170","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. Racial and Ethnic Health Disparities"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Haitians have a high incidence of sickle cell disease. The Comparative Study of Children in Haiti and Miami with Sickle Cell Disease (CSHSCD) assessed clinical and social characteristics of children of Haitian immigrants and African American controls comparing them with Haitian children living in Haiti with the purpose of overcoming differences during follow-up. We hypothesized that at baseline there would be significant differences and that time since migration may correlate with improved access to medical care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline clinical characteristics and parental self-reported barriers to care were compared. Acculturation measured as English proficiency was assessed among Haitian American parents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred fifty-five children (mean age 38\u00a0months) were recruited: 204 Haitians, 32 Haitian Americans and 19 African Americans. African American and Haitian American children with hemoglobin SS were more likely receiving hydroxyurea (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and were less likely to have experienced a vaso-occlusive crisis than children in Haiti (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Being in the United States over 10\u00a0years was associated with better English proficiency. Children in Haiti were more anemic, more likely to be malnourished and to lack pneumococcal conjugate vaccinations. Haitian families could not afford treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Longer length of stay in the United States was associated with appropriate pneumococcal vaccination, higher parental education, and better English competency. Haitians living in Haiti were at a significant disadvantage in every aspect of care, requiring ongoing assistance with community resources, medications and vaccines. We encourage global partnerships to decrease barriers to care in disadvantaged populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40615-026-03046-3","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T16:33:59Z","timestamp":1781973239000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline Characteristics and Social Challenges of Children with Sickle Cell Disease in Haiti and after Immigration to the United States: A Comparative Cohort Study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4811-267X","authenticated-orcid":false,"given":"Ofelia A.","family":"Alvarez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmeline","family":"Lerebours","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Paul Hanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rony","family":"Saint Fleur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanise","family":"Muscadin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulonne","family":"Bien-Aim\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis Herns","family":"Marcelin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric C.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Metalonis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"issue":"9757","key":"3046_CR1","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1016\/S0140-6736(10)61029-X","volume":"376","author":"DC Rees","year":"9757","unstructured":"Rees DC, Williams TN, Gladwin MT. Sickle-cell disease. Lancet. 9757;376(9757):2018\u201331. https:\/\/doi.org\/10.1016\/S0140-6736(10)61029-X.","journal-title":"Lancet"},{"issue":"8","key":"3046_CR2","first-page":"e585","volume":"10","author":"GBD 2021 Sickle Cell Disease Collaborators","year":"2021","unstructured":"GBD 2021 Sickle Cell Disease Collaborators. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000\u20132021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol. 2021;10(8):e585\u201399.","journal-title":"Lancet Haematol"},{"issue":"25","key":"3046_CR3","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1056\/NEJM198606193142501","volume":"314","author":"MH Gaston","year":"1986","unstructured":"Gaston MH, Verter JI, Woods G, et al. Prophylaxis with oral penicillin in children with sickle cell anemia. A randomized trial. 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Approval was initially granted by the University of Miami Institutional Review Board on August 9, 2019 and by the Comit\u00e9 National de Bio\u00e9thique (Haitian National Bioethics Committee) on March 4, 2020. Continuing reviews were submitted yearly and approved by the two committees.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Written informed consent was obtained from the parents in English or Haitian Creole according to preferred language.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Not applicable. We do not have any personal information or figure about the participants in this publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Publish"}},{"value":"Authors have no financial or non-financial conflicts of interest to disclose specific to this work. Dr. Alvarez participates in clinical trials sponsored by Novo Nordisk.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}