Inventory of the epidemiological situation of leprosy in Haiti (2013-2017) for the Five-Year Plan: A first stage toward the implementation of the international strategy to combat leprosy, 2016-2020.

Leprosy is endemic in Haiti and remains a disease misunderstood by the population. In 2018, the national program to fight tuberculosis and leprosy (PNLTL) produced its first strategic plan against leprosy to implement the international strategy of the World Health Organization (WHO). The objective of this study was to describe the epidemiological situation of leprosy in Haiti, to assess its prevalence and morbidity, and to guide the strategies of the national plan. A retrospective study of all cases of leprosy diagnosed in the three centers providing care for this disease in Haiti reviewed the new cases at these centers from January 2013 through December 2017. In all, 232 new patients were recorded, or 49 new cases a year. Multibacillary leprosy was predominant: 86%, compared with the international mean of 60 %. Children accounted for 14 % of the new cases (7.5 % internationally), a finding that is evidence of active community transmission. Of the new cases in 2017, 8 %, including one child, had grade 2 impairments. Nearly all the leprosy cases - 94 % (218/232) - came from the two districts with treatment centers (West and Artibonite). Efforts must continue to implement the international strategy to fight leprosy to ensure a reduction by 2020 in the rate of grade 2 impairments among new cases and the number of new cases among children.

La gestión por procesos en el tratamiento del dolor / Process managetnent in pain treatment

El tratamiento del dolor constituye una oportunidad de mejora. Los principios de la gestión por procesos pueden facilitar el diseño,desarrollo y funcionamiento de las Unidades del Dolor. El requisito fundamental es la orientación al paciente, buscando la satisfacciónde sus necesidades y demandas. La identificación de los distintos procesos -de gestión, clave y de apoyo- que se integran en la Unidaddel Dolor permite la elaboración del mapa de procesos de la Unidad, con sus correspondientes fichas de procesos y diagramas de flujoo flujogramas. Esta metodología, que supone una ruptura con las formas de gestión tradicional, puede contribuir a dar personalidad eidentidad a la Unidad asistencial, facilitando eventualmente su certificación en calidad(AU)

The management of pain still needs to be improved. The principles of process management can be applied to the design, development and daily function of a Pain Unit. The main request is its orientation to meet the needs and demands of patients. The identification of the different processes within the Unit allow for the design of its process mapping and the development of process files and flowcharts. This methodology of work may break away with traditional management schemes, but can contribute to better define the identity of the Pain Unit and eventually facilitate its certification in quality (AU)