Assuntos
Antituberculosos/farmacologia , Busca de Comunicante/estatística & dados numéricos , Genes Microbianos , Controle de Infecções , Mycobacterium tuberculosis , Tuberculose Resistente a Múltiplos Medicamentos , França/epidemiologia , Técnicas de Genotipagem , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/microbiologiaRESUMO
There is increasing interest in US Medical schools in starting teaching programs in global settings. The University of Miami department of Family Medicine has been involved for the past 15 years in developing a training program in family medicine in Haiti. This experience, its challenges and accomplishments are reported. The creation and development of plastic surgery training in Haiti could greatly benefit from this pioneering effort.
Assuntos
Atenção Primária à Saúde/métodos , Cirurgia Plástica/organização & administração , Saúde Global , HumanosRESUMO
OBJECTIVE: To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. METHODS: During March 2001 and June 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. RESULTS: Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. CONCLUSIONS: CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered.
Assuntos
Síndrome da Rubéola Congênita/epidemiologia , Adolescente , Criança , Feminino , Haiti , Humanos , LactenteRESUMO
Objective. To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. Methods. During March 2001 and June 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Results. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. Conclusions. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered
Assuntos
Adolescente , Criança , Feminino , Humanos , Lactente , Síndrome da Rubéola Congênita/epidemiologia , HaitiRESUMO
Objective. To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. Methods. During March 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Results. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. Conclusions. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered (AU)
Assuntos
Criança , Humanos , Síndrome da Rubéola Congênita/etnologia , Haiti , Rubéola (Sarampo Alemão)/diagnóstico , Vacina contra Rubéola , Análise Custo-Benefício , Programas de Imunização/economiaRESUMO
BACKGROUND: There has been a recent resurgence of tuberculosis (TB) as a worldwide public health concern. It is a well-documented health problem in Haiti, where the reported prevalence is 123.9 per 100,000 population. While the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) policy papers for the eradication of TB recommend screening in shelters, prisons, and other congregate-living facilities, screening in institutional orphanages is not specifically mentioned. METHODS: A total of 445 orphans with no documentation of Bacillus Calmette-Guerin (BCG) vaccine at six orphanages representing urban, suburban, and rural Haiti were screened for TB using standardized purified protein derivative (PPD). An inoculum of 0.1 cc was introduced intradermally, with site checks for induration at 48-72 hours after inoculation. Induration >5 mm was recorded as positive. Active cases of TB were defined by symptoms such as fever, night sweats, cough greater than 1 month, or signs of extrapulmonary TB (like scrofula or Pott's disease). RESULTS: The number of positive PPD tests was 170 of the 445 children tested, or 38,202 per 100,000; there were 10 active cases. The overall prevalence of tuberculin positivity in the three orphanages with one or more active cases was 44%, compared to 13% in the three with no identified active cases. CONCLUSIONS: The data indicate that TB prevalence among the orphans screened was 1123 per 100,000. This is substantially greater than that reported for the general Haitian population. These data thus suggest children living in orphanages as a previously unidentified high-risk group for TB infection. Further investigation of TB is recommended for orphans in developing countries.
