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Haiti - Epidemic : Projection 100,000 people infected, Government strategy
30/10/2010 11:39:44

According to the World Health Organization (WHO), approximately 75% of those infected with V. cholerae, have no symptoms, although the bacterium is present in their faeces for 7 to 14 days after infection and was eliminated in the environment where it can potentially infect other people.

For those who develop symptoms, they remain mild to moderate in 80% of cases, while in approximately 20% of cases, acute watery diarrhea, accompanied by severe dehydration, develops. Without treatment, it can cause death. The incubation period of the disease can vary depending on the subjects of 1 to 5 days.

Taking the latest figures (provisional assessment) of the Ministry of Health dated of October 29, 2010, 4.714 people are hospitalized and suffering from cholera (25% of people with symptoms), this means that at least 14,000 people are infected "without getting sick" and are as many mobile vectors of the disease, which can potentially infect thousands of others (for 7 to 14 days, the duration of the total elimination of the bacillus of cholera).

We better understand the concern of health organizations, both local and international efforts and the considerable resources deployed, far beyond the Artibonite. On this subject, the Ministry for the Public health, revealed its strategy to respond to a national epidemic based on an assumption of 100,000 infected people (over one year.) requiring health services in Port-au-Prince and in the Artibonite (200,000 in the country).

National Epidemic Response Strategy
The Example of Metropolitan Port-au-Prince
Ministry of Public Health and Population
with the technical collaboration of PAHO/WHO, UNFPA,
and other agencies of the United Nations System

Description of the Strategy

The national response strategy for the cholera epidemic involves the following three levels:

Protection of families in the community.
Reinforcement of the 80 primary health care centers in the Metropolitan Area
Management of severe cases in the CTC and 8 main hospitals.

This strategy is illustrated by the example of Port-au-Prince.

Projection: 100,000 cases in need of health services in Port-au-Prince and Artibonite (~200 000 in the country)

Level 1. Protection of families

Description:

The goal is first and foremost to guarantee basic protection for families, distributing oral rehydration salts directly to them in their communities.
At the same time, disease prevention and health promotion messages will be transmitted by various means (criers, sound track, the media, etc).
Then, a cadre of community health workers will be developed and deployed in the most populous and vulnerable areasin particular, densely populated disadvantaged neighborhoods and displaced persons camps.

1. The community health workers’ only mission will be to identify people with diarrhea and refer them to the cholera treatment centers (CTC).
2. These workers will have oral rehydration salts at their disposal so that patients can have an initial source of hydration before reaching the CTC.
Thus, a cadre of community prevention and detection personnel will gradually be deployed, with 1 for every 25 families.

Objectives:

Community prevention
Community health promotion
Community identification and referral of diarrhea cases.

Level 2. Reinforcement of 80 health centers in the Metropolitan Area

Description:

The goal is to reinforce the 80 primary care structures so that they can:

1. perform triage
2. observe cases
3. provide medical hydration
4. refer the patients who show up.
To accomplish this, teams of health workers will man a post at the entrance to the health center 24/7.

Objectives:

Guarantee triage of patients
Put cases under observation
Ensure medical rehydration of cases
Refer patients to the CTC

Level 3. Management of severe cases

Description:

This involves the deployment of 10 CTC, each with a 200 bed capacity, on the outskirts of the Metropolitan Area
Reinforcement of PAPfs 8 main hospitals for rapid case management and referral to a CTC, as needed

Objectives:

Management of severe cases (in the case of hospitals)
Referral to the CTC

To adequately implement this strategy, an operations center will be set up and put into operation to ensure management, supervision, and control.

S/ HaitiLibre