August 06, 2010
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Surveillance system useful after Haiti earthquake, improvements needed for future

CDC. MMWR. 2010;59:933-938.

CDC. MMWR. 2010;59:939-945.

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According to two reports from the CDC, more work needs to be done to improve data reporting, data quality and humanitarian response during crises. Such improvements could increase the longevity of the National Sentinel Site Surveillance System, a program launched after the earthquake hit Haiti earlier this year.

Two weeks after the 7.0-magnitude earthquake, the Ministry of Public Health and Population, the Pan-American Health Organization, CDC and other global agencies instituted the National Sentinel Site Surveillance System to target relief efforts by tracking disease trends, discovering outbreaks and identifying the affected population.

According to one CDC report, from Jan. 25 through April 24, 2010, 42,361 people had reportable conditions. Fifty-four percent of these people were female and 32.6% were <5 years old. The most commonly reported conditions, nationwide, were acute respiratory infection (16.3%), suspected malaria (10.3%) and fever due to an unknown cause (10%). Twelve percent of conditions were due to injuries. The researchers did not identify any epidemics or disease clusters and the number of reports decreased over time.

During this time, the Surveillance System was also making strides to measure outbreak potential and establish control measures among internally displaced persons. According to a second report by the CDC, the Haitian Health Cluster engaged non-governmental organizations assisting large camps, established the Internally Displaced Persons Surveillance System (IDPSS), tracked trends of reportable conditions, conducted epidemiologic and laboratory investigations and established control measures.

Ninety-one non-governmental organizations had reported to the IDPSS at least once by April 24, 2010. No major disease outbreaks occurred through April 24, despite investigations for suspected clusters of typhoid fever and malaria.

According to the researchers, challenges in maintaining the surveillance system included complexities in communication due to the turnover at non-governmental organizations and a “lack of reliable camp population denominator estimates,” causing limitations to the usefulness of the data.

Researchers from both reports stressed the importance of improving data reporting and quality by adding additional surveillance strategies and education to health care providers.

“Improving future humanitarian response requires advance development and distribution of easily adaptable standard surveillance tools, development of an interdisciplinary strategy for an early and reliable population census and development of communication strategies using locally available internet and cellular networks,” the researchers wrote.

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