RESUMO
In response to the recent cholera outbreak, a public health response targeted high-risk communities, including resource-poor communities in Port-au-Prince, Haiti. A survey covering knowledge and practices indicated that hygiene messages were received and induced behavior change, specifically related to water treatment practices. Self-reported household water treatment increased from 30.3% to 73.9%.
Assuntos
Cólera/epidemiologia , Surtos de Doenças , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cólera/prevenção & controle , Cólera/terapia , Água Potável/normas , Feminino , Hidratação , Haiti/epidemiologia , Humanos , Higiene , Masculino , Pessoa de Meia-Idade , Saúde Pública/educação , Inquéritos e Questionários , Adulto JovemRESUMO
Oral cholera vaccines (OCVs) have been recommended in cholera-endemic settings and preemptively during outbreaks and complex emergencies. However, experience and guidelines for reactive use after an outbreak has started are limited. In 2010, after over a century without epidemic cholera, an outbreak was reported in Haiti after an earthquake. As intensive nonvaccine cholera control measures were initiated, the feasibility of OCV use was considered. We reviewed OCV characteristics and recommendations for their use and assessed global vaccine availability and capacity to implement a vaccination campaign. Real-time modeling was conducted to estimate vaccine impact. Ultimately, cholera vaccination was not implemented because of limited vaccine availability, complex logistical and operational challenges of a multidose regimen, and obstacles to conducting a campaign in a setting with population displacement and civil unrest. Use of OCVs is an option for cholera control; guidelines for their appropriate use in epidemic and emergency settings are urgently needed.
Assuntos
Vacinas contra Cólera/administração & dosagem , Cólera/epidemiologia , Cólera/prevenção & controle , Surtos de Doenças , Terremotos , Administração Oral , Vacinas contra Cólera/provisão & distribuição , Emergências/epidemiologia , Haiti/epidemiologia , Humanos , Vacinação em MassaRESUMO
During the early weeks of the cholera outbreak that began in Haiti in October 2010, we conducted a case-control study to identify risk factors. Drinking treated water was strongly protective against illness. Our results highlight the effectiveness of safe water in cholera control.
Assuntos
Cólera/epidemiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Cólera/prevenção & controle , Surtos de Doenças , Água Potável/normas , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
We evaluated a high (6%) cholera case-fatality rate in Haiti. Of 39 community decedents, only 23% consumed oral rehydration salts at home, and 59% did not seek care, whereas 54% of 48 health facility decedents died after overnight admission. Early in the cholera epidemic, care was inadequate or nonexistent.
Assuntos
Cólera/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Cólera/epidemiologia , Cólera/terapia , Surtos de Doenças , Feminino , Hidratação , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
We conducted a case-control study to investigate factors associated with epidemic cholera. Water treatment and handwashing may have been protective, highlighting the need for personal hygiene for cholera prevention in contaminated urban environments. We also found a diverse diet, a possible proxy for improved nutrition, was protective against cholera.