Grand Anse Departement: Malaria, Syphilis, and HIV Surveillance

A well equipped and experienced ground team reports the following laboratory results obtained during the month of June in Grand Anse Departement:

• Of 148 patients screened for malaria using RDT, 16% were positive
• Of 92 patients screened for syphilis, 13% were positive (historical average 12%)- unknown whether statistically significant
• 159 patients were screened for HIV, of which 4% were positive (historical average 6%)- unknown whether statistically significant

MSPP's representative for the National Laboratory, Alexandre Existe, continues to advance requests for malarial smear evaluation to be performed only at the National Laboratory in PAP as the criteria upon which to activate public health response.  Meanwhile, responders continue to use RDTs as a basis for clinical treatment.  Given the implied time delay, the MSPP course of action appears impractical and does not represent an effective model for rapid surveillance and response for malaria under the current conditions in Haiti.  There remains a strong impression that timely warning information is not being shared by MSPP, PAHO, and CDC, which continues to affect trust among responders on the ground.  The question of "what's in it for them [the responders]" continues to be unanswered operationally.

HEAS has already reported substantial time delays and failures in sharing information with the responder community in Haiti due to breakdowns in trust between MSPP and the NGO community and promotion of standards not practical under current operational conditions.  Recent communications from MSPP at Health Cluster meetings include continued admonishment to report outbreaks exclusively to MSPP staff.  Meanwhile, infectious disease events are managed locally and without report to MSPP or its partner public health organizations.  Thus far, the majority of infectious disease events and potential crises have been reported anonymously through social networks of trust, to include the HEAS.  As the tone of communications from MSPP becomes more stringent in an environment where trust has already been eroded, along with lack of demonstrated transparency to share timely information, it remains apparent syndromic surveillance and traditional epidemiology has failed to produce an effective early warning capability in Haiti.

Comments

[mark smith]

The sexually transmitted diseases are getting very high especially the dreaded HIV. I hope this study will make the people more aware than ever especially for us parents.

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