Geographic Distribution and Mortality Risk Factors during the Cholera Outbreak in a Rural Region of Haiti, 2010-2011 |
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| Authors: | Anne-Laure Page Iza Ciglenecki Ernest Robert Jasmin Laurence Desvignes Francesco Grandesso Jonathan Polonsky Sarala Nicholas Kathryn P Alberti Klaudia Porten Francisco J Luquero |
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| Institution: | 1 Epicentre, Paris, France, ; 2 Médecins Sans Frontières, Geneva, Switzerland, ; 3 Ministère de la Santé Publique et de la Population, Cap Haitien, Haiti, ; Massachusetts General Hospital, UNITED STATES, |
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| Abstract: | BackgroundIn 2010 and 2011, Haiti was heavily affected by a large cholera outbreak that spread throughout the country. Although national health structure-based cholera surveillance was rapidly initiated, a substantial number of community cases might have been missed, particularly in remote areas. We conducted a community-based survey in a large rural, mountainous area across four districts of the Nord department including areas with good versus poor accessibility by road, and rapid versus delayed response to the outbreak to document the true cholera burden and assess geographic distribution and risk factors for cholera mortality.Conclusions/SignificanceThese results highlight important geographical disparities and demonstrate that the epidemic caused the highest burden both in terms of cases and deaths in the most remote areas, where up to 5% of the population may have died during the first months of the epidemic. Adapted strategies are needed to rapidly provide treatment as well as prevention measures in remote communities. |
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