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Importance of Cholera and Other Etiologies of Acute Diarrhea in Post-Earthquake Port-au-Prince, Haiti

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  • Les Centres GHESKIO, Port-au-Prince, Haiti; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York

We estimated the proportion of diarrhea attributable to cholera and other pathogens during the rainy and dry seasons in patients seen in two urban health settings: a cholera treatment center (CTC) and oral rehydration points (ORPs). During April 1, 2011–November 30, 2012, stool samples were collected from 1,206 of 10,845 patients who came to the GHESKIO CTC or to the community ORPs with acute diarrhea, cultured for Vibrio cholerae, and tested by multiplex polymerase reaction. Vibrio cholerae was isolated from 409 (41.8%, 95% confidence interval [CI] = 38.7–44.9%) of the 979 specimens from the CTC and in 45 (19.8%, 95% CI = 14.8–25.6%) of the 227 specimens from the ORPs. Frequencies varied from 21.4% (95% CI = 16.6–26.7%) during the dry season to 46.8% (95% CI = 42.9–50.7%) in the rainy season. Shigella, enterotoxigenic Escherichia coli, rotavirus, and Cryptosporidium were frequent causes of diarrhea in children less than five years of age.

Author Notes

* Address correspondence to Macarthur Charles, Les Centres GHESKIO, Port-au-Prince, Haiti. E-mail: mcharles@gheskio.org

Financial support: This study was supported by the United Nations Children's Fund cholera grant “Renforcement et Maintien des Activités dans le Cadre de la Réponse pour le Cholera,” the Centers for Disease Control and Prevention (5U2GGH000545-02), and an International Clinical, Operational and Health Services Research Training Award.

Authors' addresses: Macarthur Charles, Glavdia G. Delva, Jethro Boutin, Karine Severe, Mireille Peck, and Marie Marcelle Mabou, Les Centres GHESKIO, Port-au-Prince, Haiti, E-mails: mcharles@gheskio.org, delvagreatdia@gmail.com, jetbou@gmail.com, karinesevere@gheskio.org, mireillespeck@yahoo.com, and mmabou@gheskio.org. Peter F. Wright, Division of Infectious Disease and International Health, Dartmouth Medical School, Hanover, NH, E-mail: peter.f.wright@dartmouth.edu. Jean W. Pape, Weill Medical College of Cornell University, New York, NY, E-mail: jwpape@gheskio.org.

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