Tuberculosis in Haiti

Tuberculosis, or TB, is one of Haiti’s greatest infectious causes of mortality in both youth and adults and has been termed a priority country by the Pan American Health Organization for TB control. TB is a highly contagious disease that may be transmitted from person to person via small droplets produced by coughing. Inhalation of these droplets often cause the disease to appear. Unfortunately, as much as 40% of these cases go undiagnosed and the WHO fears that there is an increase in TB drug resistance. In 2010, a massive earthquake devastated the region and it lost much of its health infrastructure. People were stay in close-knit tent camps that cause an increase in the risk and infection of tuberculosis among the population. The delay in care created an increase in the spread of the disease.

Tuberculosis in a public health problem of global magnitude. A particular social stigma that infected individuals “don’t want to be labeled” severely handicaps efforts to control the disease. As described by a local, “When a Haitian gets sick, he is afraid to disclose it. He doesn’t want others to find out.” This is not only a social stigma, but it may be a cultural stigma if it is shameful to be infected with TB. The stigma is also economic because many Haitians with the disease feel labelled as poor.

In response to this endemic disease among Haitians, the Center for Disease Control (CDC) worked with other foundations to strengthen laboratories and laboratory practices with new microscopes and training for technicians. The also built a new TB laboratory in 2011 and established TB culture and drug susceptibility testing at the laboratory.

As for continuing research on this subject, only one name pops to the top. Dr. Paul Farmer is one of the leading medical anthropologists working on the issue of tuberculosis in Haiti. His approach to solving this problem is to research implementation methods and the innovation of care delivery models. Farmer states that operations research, using observational methods, are often the most appropriate means in such impoverished settings. He takes all cultural, social, political, and economic factors into account when determining how best to move forward and move treatment plans forward with limited resources.

http://globalhealth.thelancet.com/2013/07/08/clinical-trials-and-global-health-equity

 

Centers for Disease Control and Prevention. “DTBE in Haiti.” Accessed August 4, 2014. http://www.cdc.gov/tb/topic/globaltb/haiti.htm

IRIN. “HAITI: Combating TB in Port-au-Prince’s tent cities.” Accessed August 4, 2014. http://www.irinnews.org/report/91113/haiti-combating-tb-in-port-au-prince-s-tent-cities

The Crudem Foundation. “Tuberculosis in Haiti.” Accessed August 4, 2014. http://crudem.org/tuberculosis-in-haiti/

University of South Florida College of Public Health. “Stigma and Tuberculosis among Haitian Populations.” Accessed August 4, 2014. http://health.usf.edu/publichealth/cophinternational/pdf/Haiti-Stigma%20and%20Tuberculosis%20among%20Haitian%20Populations.pdf

This Post Has 1 Comment

  1. Justin Blazejewski says:

    From reading the articles cited, it is clear that Tuberculosis in Haiti is a global health problem for concern and in need of continuous research such as Dr. Paul Farmer has since been working on. Tuberculosis falls into the infectious disease category of global health issues in relation to lecture 6.1 from this week’s material.
    Dr. Farmer’s attempt toward Tuberculosis treatment was defined as a “rigorous observational study” relating to anthropology methods in that he has researched implementation methods and the innovation of care delivery methods. With that, Farmer and his colleagues achieved success by identifying goals and objectives, primary constraints and barriers to achieving treatment, and formulated research questions to provide insight on how to overcome the obstacles at hand. With that, come a number of questions regarding when to before initiating Antiretroviral Therapy (ART). These questions relate to identifying co-infected persons in a timely manor, speeds of enrolling patients for care, and providing the community for an environment which allows better adherence and prevention toward to spread of drug-resistant Tuberculosis.
    Farmer adds that any research endeavor should strive to address the disparities at risk that constitute the backdrop of global health along with the disparities of training and opportunity that explain why research capacity is heavily concentrated far from the setting in which the burden of these pathologies is concentrated.
    I found that applying Farmer’s anthropology to such a topic as Tuberculosis did benefit my understanding of the disease as a global health problem. Research in this manner addressed constraints and needs of health programs in high poverty settings such as that in Haiti. The approach also proved that planning questions relating to spreading information for those threatened by such a disease can and often will play a key role toward the wellbeing and survival of those whom have not yet benefited from proven intervention versus solely obtaining information based on clinical trial.

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