Nepalese origin of cholera epidemic in Haiti.

Cholera appeared in Haiti in October 2010 for the first time in recorded history. The causative agent was quickly identified by the Haitian National Public Health Laboratory and the United States Centers for Disease Control and Prevention as Vibrio cholerae serogroup O1, serotype Ogawa, biotype El Tor. Since then, >500 000 government-acknowledged cholera cases and >7000 deaths have occurred, the largest cholera epidemic in the world, with the real death toll probably much higher. Questions of origin have been widely debated with some attributing the onset of the epidemic to climatic factors and others to human transmission. None of the evidence on origin supports climatic factors. Instead, recent epidemiological and molecular-genetic evidence point to the United Nations peacekeeping troops from Nepal as the source of cholera to Haiti, following their troop rotation in early October 2010. Such findings have important policy implications for shaping future international relief efforts.

Encuesta domiciliaria sobre salud y enfermedad en zonas rurales de Bolivia. / Household survey of health and disease in rural areas of Bolivia

La encuesta domiciliaria que aqui se presenta proporciona informacion reciente acerca de los patrones de morbilidad y mortalidad en las zonas rurales de los llanos de Bolivia.Se pretende que los datos ayuden a los planificadores de salud y a otros interesados en mejorar los servicios rurales de salud en esta y otras situaciones comparables

Prevalence and cost of illness episodes in rural Bolivia.

As part of a demonstration project to improve the delivery of health services in rural Bolivia, a household survey of 3372 persons (98% participation) was conducted in the Montero region of eastern Bolivia during the last 3 months of 1977. The population surveyed was relatively young, 52% less than 15 years of age. Spells of illness occurring during the 14 days prior to the survey were reported by 42% of the population. Nearly half (46%) of these symptomatic illnesses, here defined as illness episodes, were respiratory or gastrointestinal problems, and medical assistance was sought for 21% of them. Physicians were consulted by 70% of the persons who sought medical assistance. Only 39% of persons disabled 3 or more days by a symptomatic illness obtained medical assistance. The average expenditure for illness episodes during the preceding 2 weeks was $2.13 per person, 76% for medication, 15% for fees, 5% for transportation, and 4% for other expenses. The results of this survey are intended to aid the Bolivian government in planning more effectively for improved rural health services.