@article{fdi:010070588,
  title = {{T}he dry season in {H}a{\¨ie}ti : a window of opportunity to eliminate cholera},
  author = {{R}ebaudet, {S}. and {G}azin, {P}ierre and {B}arrais, {R}. and {M}oore, {S}. and {R}ossignol, {E}. and {B}arthelemy, {N}. and {G}audart, {J}. and {B}oncy, {J}. and {M}agloire, {R}. and {P}iarroux, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{BACKGROUND}:{S}ince the beginning of the cholera epidemic in {H}aiti, attack rates have varied drastically with alternating peak and lull phases, which were partly associated with the fluctuating dry, rainy and cyclonic seasons. {A}ccording to a study conducted in 2012, the toxigenic {V}. cholerae {O}1 strain responsible for the outbreak did not settle at a significant level in the {H}aitian aquatic environment. {T}herefore, we hypothesize that some areas of lingering cholera transmission during the dry season could play an important role in the re-emergence of outbreaks during the rainy season. {O}ur objective was therefore to describe the dynamics of cholera and assess the fight against the disease during the dry season. {METHODS}:{A} field study was conducted from {F}ebruary 19 to {M}arch 29, 2013. {A}fter identifying the affected communes by analyzing the national cholera database, we visited corresponding health facilities to identify patient origins. {W}e then conducted a field assessment of these foci to confirm the presence of cholera, assess factors associated with transmission and examine the activities implemented to control the epidemic since the beginning of the current dry season. {RESULTS}:{W}e found that the great majority of {H}aitian communes (109/140) presented no sign of cholera transmission in {F}ebruary and {M}arch 2013. {S}uspected cases were concentrated in a small number of urban and rural areas, almost all of which were located in the northern half of the country and often in inland locales. {I}n these areas, community health activities appeared insufficient and were often inappropriately targeted. {O}ut of 49 analyzed foci, only 10 had benefited from at least one intervention involving the distribution of water treatment products together with an awareness campaign since {D}ecember 2012. {CONCLUSION}:{C}holera continues to affect {H}aiti as observed in early 2013; however, activities implemented to interrupt cholera transmission appear insufficient and poorly suited. {T}his deficiency in the fight against cholera, especially at a period when transmission is weak, may explain the persistence of cholera even in the absence of significant aquatic reservoirs in {H}aiti.},
  keywords = {{EPIDEMIOLOGIE} ; {INFECTION} ; {TRANSMISSION} ; {LUTTE} ; {SAISON} {SECHE} ; {CHOLERA} ; {HAITI}},
  booktitle = {},
  journal = {{PLOS} {C}urrents. {O}utbreaks},
  volume = {{J}un 10},
  numero = {},
  pages = {9  [en ligne]},
  ISSN = {2157-3999},
  year = {2013},
  DOI = {10.1371/currents.outbreaks.2193a0ec4401d9526203af12e5024ddc},
  URL = {https://www.documentation.ird.fr/hor/fdi:010070588},
}