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Gonaives, mortality, diarrhoea, cholera, Gaspard., rate, watery, survey, were, acute, with, period, attack, [95%CI:, Haiti, retrospective, reported, overall, specific, interest, based, conducted, during, epidemic, October, deaths, than, surveillance, morbidity, rural


Population based retrospective survey to assess morbidity and mortality due to
cholera in Haiti
National surveillance data in Haiti have reported more than 250,000 cholera cases and almost 5000 deaths due to cholera since October 2010.
Nonetheless, the actual extension of the epidemic and the related death
toll at community level remain uncertain. Four retrospective surveys, covering the period of the epidemic, were conducted in the departments of
Artibonite, Nord and Nord-Ouest with the aim of estimating the morbidity
and mortality due to cholera in highly affected rural and urban sites. Here,
we present the preliminary results of two of the surveys in the town of
Gonaives and in the remote rural area of Gaspard.
We conducted a retrospective cohort study in both sites, using a household based cluster sampling survey in Gonaives and an exhaustive survey in Gaspard. The required sample size for Gonaives was 16,007 individuals (100 clusters of 32 houses). The main outcomes of interest were
the attack rate of acute watery diarrhoea and the overall and diarrhoea
specific mortality rate over the period of interest (17 October 2010 to survey date in April 2011).
Overall, 18,290 individuals were recruited in Gonaives and 21,182 in
Gaspard. The attack rate of acute watery diarrhoea during the period
was 10.8% in Gonaives and 22.6% in Gaspard. The crude mortality rate
(expressed as number of deaths per 10,000 per day) was 0.6 [95%CI:
0.4-0.6] in Gonaives and 0.9 in Gaspard, with 0.4 [95%CI: 0.3-0.5] and
0.7 diarrhoea specific mortality rates respectively. The reported case fatality ratio of acute watery diarrhoea was 5.3% [95%CI: 3.8%-6.8%] in
Gonaives and 6.0% in Gaspard.
Both the overall attack rate of acute watery diarrhoea and the associated
mortality during the epidemic were higher than those reported by surveillance data. Adaptations in the response to cholera outbreaks, especially
in sites with difficult access to health care, are needed.
Francisco Luquero on behalf of the Epicentre Cholera Haiti Working Group ; Médecins sans Frontières ; Ministère de la Santé Publique et de la Population d’Haiti.
These abstracts are not to be quoted for publication

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