Limits...
Tuberculosis in the aftermath of the 2010 earthquake in Haiti.

Koenig SP, Rouzier V, Vilbrun SC, Morose W, Collins SE, Joseph P, Decome D, Ocheretina O, Galbaud S, Hashiguchi L, Pierrot J, Pape JW - Bull. World Health Organ. (2015)

Bottom Line: Household-level screening for prolonged cough was effective in identifying patients with active tuberculosis in this study.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, BP 15727, Port-au-Prince, Haiti .

ABSTRACT

Problem: In 2010, Haiti sustained a devastating earthquake that crippled the health-care infrastructure in the capital city, Port-au-Prince, and left 1.5 million people homeless. Subsequently, there was an increase in reported tuberculosis in the affected population.

Approach: We conducted active tuberculosis case finding in a camp for internally displaced persons and a nearby slum. Community health workers screened for tuberculosis at the household level. People with persistent cough were referred to a physician. The National Tuberculosis Program continued its national tuberculosis reporting system.

Local setting: Even before the earthquake, Haiti had the highest tuberculosis incidence in the Americas. About half of the tuberculosis cases occur in the Port-au-Prince region.

Relevant changes: The number of reported tuberculosis cases in Haiti has increased after the earthquake, but data are too limited to determine if this is due to an increase in tuberculosis burden or to improved case detection. Compared to previous national estimates (230 per 100,000 population), undiagnosed tuberculosis was threefold higher in a camp for internally displaced persons (693 per 100,000) and fivefold higher in an urban slum (1165 per 100,000). With funding from the World Health Organization (WHO), active case finding is now being done systematically in slums and camps.

Lessons learnt: Household-level screening for prolonged cough was effective in identifying patients with active tuberculosis in this study. Without accurate data, early detection of rising tuberculosis rates is challenging; data collection should be incorporated into pragmatic disease response programmes.

No MeSH data available.


Related in: MedlinePlus

Number of persons diagnosed with tuberculosis, Haiti, 2009–2014
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Figure 1: Number of persons diagnosed with tuberculosis, Haiti, 2009–2014

Mentions: At the largest treatment centre in Haiti, the annual number of tuberculosis cases has more than doubled since the earthquake. The increase was first noted in paediatric patients. In 2010, 242 children younger than 10 years were diagnosed with tuberculosis, compared to 72 in 2009, a 336% increase. Fifty-two percent of cases were children younger than two years and 33% were two to five year-olds. Clinicians were concerned that this rise in paediatric cases indicated an increase in ongoing transmission from adults to children, as children are likely to develop active disease soon after exposure. Higher numbers of paediatric cases were followed by a progressive rise in adolescent and adult tuberculosis cases, from 1026 in 2009, to 2719 in 2014 (Fig. 1). Meanwhile, the total number of patient visits increased by only 5%, from 246 276 in 2009 to 258 089 in 2013.


Tuberculosis in the aftermath of the 2010 earthquake in Haiti.

Koenig SP, Rouzier V, Vilbrun SC, Morose W, Collins SE, Joseph P, Decome D, Ocheretina O, Galbaud S, Hashiguchi L, Pierrot J, Pape JW - Bull. World Health Organ. (2015)

Number of persons diagnosed with tuberculosis, Haiti, 2009–2014
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4490810&req=5

Figure 1: Number of persons diagnosed with tuberculosis, Haiti, 2009–2014
Mentions: At the largest treatment centre in Haiti, the annual number of tuberculosis cases has more than doubled since the earthquake. The increase was first noted in paediatric patients. In 2010, 242 children younger than 10 years were diagnosed with tuberculosis, compared to 72 in 2009, a 336% increase. Fifty-two percent of cases were children younger than two years and 33% were two to five year-olds. Clinicians were concerned that this rise in paediatric cases indicated an increase in ongoing transmission from adults to children, as children are likely to develop active disease soon after exposure. Higher numbers of paediatric cases were followed by a progressive rise in adolescent and adult tuberculosis cases, from 1026 in 2009, to 2719 in 2014 (Fig. 1). Meanwhile, the total number of patient visits increased by only 5%, from 246 276 in 2009 to 258 089 in 2013.

Bottom Line: Household-level screening for prolonged cough was effective in identifying patients with active tuberculosis in this study.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, BP 15727, Port-au-Prince, Haiti .

ABSTRACT

Problem: In 2010, Haiti sustained a devastating earthquake that crippled the health-care infrastructure in the capital city, Port-au-Prince, and left 1.5 million people homeless. Subsequently, there was an increase in reported tuberculosis in the affected population.

Approach: We conducted active tuberculosis case finding in a camp for internally displaced persons and a nearby slum. Community health workers screened for tuberculosis at the household level. People with persistent cough were referred to a physician. The National Tuberculosis Program continued its national tuberculosis reporting system.

Local setting: Even before the earthquake, Haiti had the highest tuberculosis incidence in the Americas. About half of the tuberculosis cases occur in the Port-au-Prince region.

Relevant changes: The number of reported tuberculosis cases in Haiti has increased after the earthquake, but data are too limited to determine if this is due to an increase in tuberculosis burden or to improved case detection. Compared to previous national estimates (230 per 100,000 population), undiagnosed tuberculosis was threefold higher in a camp for internally displaced persons (693 per 100,000) and fivefold higher in an urban slum (1165 per 100,000). With funding from the World Health Organization (WHO), active case finding is now being done systematically in slums and camps.

Lessons learnt: Household-level screening for prolonged cough was effective in identifying patients with active tuberculosis in this study. Without accurate data, early detection of rising tuberculosis rates is challenging; data collection should be incorporated into pragmatic disease response programmes.

No MeSH data available.


Related in: MedlinePlus