RESUMO
Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of rabid animals. Canine rabies vaccination practices also improved, from a 2010 level of approximately 12% to a 2015 dog population coverage level estimated to be 45%. Rabies vaccine coverage is still below the goal of 70%, however, the positive trend is encouraging. Gaps exist in the capacity to conduct national surveillance for human rabies cases and access to human rabies vaccine is lacking in many parts of the country. However, control has improved over the past 5 years as a result of the efforts of Haiti's health and agriculture sectors with assistance from multiple international organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve as a great example to many developing countries struggling with similar barriers and limitations.
Assuntos
Erradicação de Doenças , Doenças do Cão/prevenção & controle , Vacina Antirrábica/uso terapêutico , Raiva/prevenção & controle , Animais , Países em Desenvolvimento , Vetores de Doenças , Doenças do Cão/transmissão , Cães , Haiti , Humanos , Cooperação Internacional , Vigilância em Saúde Pública , Raiva/diagnóstico , Raiva/transmissão , Raiva/veterináriaRESUMO
An oral rehydration program in rural Haiti was evaluated by quality assurance sampling. The quality assurance sampling method and its application are described. The indicators measured were knowledge of the oral rehydration salts packet, knowledge of preparation of the solution from the packet, oral rehydration therapy use, and knowledge of preparation of the solution from salt and sugar. Coverages of the first two indicators were adequate, coverages of the latter two were inadequate. The method is a useful low-cost approach to evaluation of program coverage.
Assuntos
Hidratação , Avaliação de Programas e Projetos de Saúde/métodos , Garantia da Qualidade dos Cuidados de Saúde , Pré-Escolar , Diarreia/terapia , Feminino , Haiti , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Mães , Saúde da População Rural , Estudos de AmostragemRESUMO
An epidemiological survey is conducted by spot-checks over about 10% of the population of Tortuga Island in order to estimate the prevalence of intestinal helminthiasis in that region of the Republic of Haïti, by researching the presence of eggs in faeces. Population sample is representative of the whole of the island's population excepting the 0-4 years old group whose faeces are difficult to obtain. Faeces are examined through the Kato method, a very simple, quick and remarkably accurate procedure. Trichuriasis and ascariasis, which are transmitted in the area around the house, affect mainly children, but also adults. Women seem to be more often infested than men by Ascaris lumbricoides. Necatoriasis, the farmer's disease, hits primarily young men and elderly women who spend most time in the fields. It is observed in inland villages where people are engaged in agricultural production, with a higher incidence if they are located in a not so sloping zone.
Assuntos
Ascaríase/epidemiologia , Ascaridíase/epidemiologia , Infecções por Uncinaria/epidemiologia , Enteropatias Parasitárias/epidemiologia , Necatoríase/epidemiologia , Tricuríase/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Fezes , Feminino , Haiti , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Contagem de Ovos de ParasitasRESUMO
Results of the numbering of T. trichiura, A. lumbricoides et N. americanus eggs found in the stool, taken from a representative sample of the population of Tortuga island, shows the importance of parasital load borne by people attacked by the parasites. Those who produce the greatest number of eggs for a gram of faeces are young children. For adults, the evolution of the parasital load follow that of the prevalence, for each Nematodes, with an increase of the average number of eggs of A. lumbricoides per gram of faeces for adults aged 30 to 44, and of the average number of N. amercanus per gram of faeces for adults aged 45 to 59. Moreover women adults show a higher number of parasites than men. Farmers from villages within the interior of the island who are more often attacked than those from the coast, also bear a parasital load which is twice as high. Victims less than 5 years old and more than 30, particularly women, whose faeces are richest in eggs, seem to present the greatest danger for the transmission of ascaridiosis and necatorosis in Toruga Island.