Abstract
In 2013, the first government-led oral cholera vaccination (OCV) campaign in Haiti was implemented in Petite Anse and Cerca Carvajal. To evaluate vaccination coverage, barriers to vaccination, and adverse events following vaccination, we conducted a cluster survey. We enrolled 1,121 persons from Petite Anse and 809 persons from Cerca Carvajal, categorized by 3 age groups (1-4, 5-14, >15 years). Two-dose OCV coverage was 62.5% in Petite Anse and 76.8% in Cerca Carvajal. Two-dose coverage was lowest among persons >15 years of age. In Cerca Carvajal, coverage was significantly lower for male than female respondents (69% vs. 85%; p<0.001). No major adverse events were reported. The main reason for nonvaccination was absence during the campaign. Vaccination coverage after this campaign was acceptable and comparable to that resulting from campaigns implemented by nongovernmental organizations. Future campaigns should be tailored to reach adults who are not available during daytime hours.
Highlights
A month later, cholera spread into allofHaitiandtotheDominicanRepublic.On15January2013,642,832choleracaseshadbeen reportedinHaiti,ofwhich8,015haddied,forafatalityrateof1.2%,thatrepresentsthelargest epidemic ever recorded in a single country in the world
At the start of the epidemic, it was estimated in Haiti that 50% of urban residents and 30% of rural residents had no access to potable water, and83%ofthepopulationhadnoaccesstoadequatefacilitiesforexcretadisposal.1Thelackof goodhygienepracticesamongmostofthepopulation,andparticularlyamonggroupswithout access to basic health services, was among the factors that furthered the rapid spread of the disease
4.1.HistoryoftheEpidemic The cholera epidemic in Haiti began in October 2010 and was attributed to Vibrio cholerae, serogroup O1, serotype Ogawa, biotype El Tor
Summary
January11,2012 OnthesecondanniversaryoftheearthquakeinHaiti,theinternationalcommunitydeterminedthatitwas timetoputanendtothescourgeofcholerathroughshortͲandlongͲtermactionstohelpthepeopleofHaiti andtheDominicanRepubliccombatthispandemic.Inlightofthisconcern,thepresidentsofHaitiandthe DominicanRepublicon11January2012joinedthePanAmericanHealthOrganization/WorldHealth OrganizationPAHO/WHO,UnitedNationsChildren’sFund(UNICEF),andtheU.S.CentersforDisease ControlandPrevention(CDC)tolaunchanappealtomobilizemajorinvestmentsinwatersupplyand sanitationwiththeaimofeliminatingcholerafromtheislandofHispaniola. ThePlanofActionwillbeimplementedunderthesupervisionofahighͲlevelnationalsteering committee composed of all social sector ministries as well as the Ministry of Finance It will oversee the sustainability of the systems and infrastructure designed and built within the framework of the Plan of Action and accompanying budget. The plan includes enhancing the information system to enable national authorities to have reliable data for timely decisions pertaining to health care and interventions in water supply, sanitation, and waste management. This will consist of modernizing the health information system and strengthening epidemiological and microbiological surveillance, laboratory research,etc. Opportunities will be provided for public engagement in the decisionͲmaking process with regard to water supply and sanitation services at different levels: planning and budgeting, managementandoperations,regulationsandcompliance,andmonitoringandevaluation
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