Predictors of disease severity in patients admitted to a cholera treatment center in urban Haiti.

• Type of Material: Article
• Authors: Claude-Lyne Valcin, Dartmouth Medical School; Karine Severe, Les Centres GHESKIO; Claudia T. Riche, Les Centres GHESKIO; Benedict S. Anglade, Les Centres GHESKIO; Colette Guiteau Moise, Les Centres GHESKIO; Michael Woodworth, Emory University; Macarthur Charles, Les Centres GHESKIO; Zhongze Li, Biostatistics Shared Resource; Patrice Joseph, Les Centres GHESKIO; Jean W. Pape, Cornell University; Peter F. Wright, Dartmouth Medical School
• Language: English
• Date: 2013-10
• Publisher: American Society of Tropical Medicine and Hygiene
• Publication Version: Final Published Version
• Copyright Statement: ©The American Society of Tropical Medicine and Hygiene
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.4269/ajtmh.13-0170
• Title of Journal or Parent Work: American Journal of Tropical Medicine and Hygiene
• ISSN: 0002-9637
• Volume: 89
• Issue: 4
• Start Page: 625
• End Page: 632
• Grant/Funding Information: NICEF cholera Grant « Renforcement et maintien des activités dans le cadre de la réponse pour le Cholera ». Centers for Disease Control: 5U2GGH000545-02 and The National Institutes of Health: 1K24 AI098627-02; 5 U2R TW006896-10; 5D43 TW 000018-25; 4UM1AI069421-07.
• Keywords: Haiti; Dehydration; Cities; Child; Adult; Humans; Cholera; Female; Adolescent; Time Factors; Multivariate Analysis; Male; Risk Factors; Epidemics; Young Adult; Rain; Middle Aged; Child, Preschool
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Cholera, previously unrecognized in Haiti, spread through the country in the fall of 2010. An analysis was performed to understand the epidemiological characteristics, clinical management, and risk factors for disease severity in a population seen at the GHESKIO Cholera Treatment Center in Port-au-Prince. A comprehensive review of the medical records of patients admitted during the period of October 28, 2010-July 10, 2011 was conducted. Disease severity on admission was directly correlated with older age, more prolonged length of stay, and presentation during the two epidemic waves seen in the observation period. Although there was a high seroprevalence of human immunodeficiency virus (HIV), severity of cholera was not greater with HIV infection. This study documents the correlation of cholera waves with rainfall and its reduction in settings with improved sanitary conditions and potable water when newly introduced cholera affects all ages equally so that interventions must be directed throughout the population.