RESUMO
Between November 1991 and June 1993, approximately 11,000 Haitian migrants were screened for active tuberculosis and human immunodeficiency virus type 1 (HIV-1) infection at the U.S. Naval Base in Guantánamo Bay, Cuba. Cultures of specimens from 37 of these patients yielded Mycobacterium tuberculosis; eight (22%) of these isolates were resistant to standard medications, including isoniazid (22%), rifampin (0), ethambutol (3%), and streptomycin (3%). Two isolates (5.4%) were resistant to two drugs simultaneously. All but one of 340 patients who were treated for presumptive active tuberculosis and who were followed up for about 1 month had a favorable initial clinical response to a standard four-drug regimen. Among 259 HIV-1-infected patients who had normal findings on screening chest radiographs and who received prophylaxis with isoniazid, there were 1.8 incident cases of active tuberculosis per 100 person-years; this rate was 76% lower than that (reported by others) among HIV-1-infected Haitian patients who were not treated with isoniazid. No serious toxic effects due to standard four-drug regimens or to prophylaxis with isoniazid were observed. These data suggest that standard empirical therapeutic interventions for tuberculosis are adequate and well tolerated in Haitian migrants.
Assuntos
Mycobacterium tuberculosis/efeitos dos fármacos , Resistência Microbiana a Medicamentos , Haiti , Humanos , Testes de Sensibilidade Microbiana , MigrantesRESUMO
Beginning in November 1991, the United States Department of Defense established a Joint Task Force (JTF) to deal with the mass migration of Haitians. During the next 9 months, pending a determination of their immigration status, 34,000 Haitians were managed by uniformed service personnel at a temporary camp facility at the U.S. Naval Base in Guantanamo Bay, Cuba. To meet the urgent clinical and public health needs of this population, the JTF developed a camp medical system. This article describes the system of uniformed service medical support for the Haitians at the Guantanamo Bay facility during May 1992, the busiest month of the operation, when 11,400 Haitians (34% of the total) arrived.