Cholera Surveillance Project in Haiti

Cholera Surveillance and Response in Haiti

Between January, 2012 and January, 2014, there were 8,534 cholera deaths and 697,256 overall cholera cases reported by the Haitian Ministry of Public Health (MSPP). Using comparative genomics, several studies provided circumstantial evidence that infectious cholera strains originating in Nepal triggered the outbreak. However, multiple strains appear to have been involved, some of which may have been of local origin, which reflects the need to develop methodology for accurate strain identification in order to track sources of infection.

On February 27, 2013, the Haitian government launched a 10-year cholera elimination plan. The plan aims to limit the transmission of cholera in Haiti by improving access to water, sanitation, hygiene, and health care facilities for 80-90% of the Haitian population. Pivotal to these goals is the development of early warning and rapid response systems, and ongoing cholera awareness campaigns.

UMass Study Funded

Uniting for Health Innovation has funded a study, led by Tim Ford, director of the UMass Institute for Global Health, to work on improvements for cholera surveillance methods in Haiti.  This goal has been broken up into parts:

1) Work with community health organizations in Haiti to incorporate information on cholera into existing trainings and identify and connect potential cholera cases with local health resources,

2) Develop hand-held cholera diagnostic tools that can be used in a resource-limited setting.

Our project aims to:

  • Identify organizations and communities in Haiti that can most effectively participate in cholera surveillance and intervention.
  • Identify specific roles for the UMass team and their collaborators in surveillance and intervention.
  • Identify and optimize new tools for sampling, diagnosis, environmental and clinical decision-making.

Jean Arnaud and Monika Roy, UMass Amherst students who have previous experience in Haiti, traveled there in the summer of 2017 to meet with Midwives for Haiti (MFH), a non-governmental organization with an extensive community health outreach program in the Haiti's Central Plateau.  Arnaud and Roy shadowed members of the MFH team on their community visits, put together cholera-related materials for MFH's existing training program, and helped conduct a cholera awareness training for community members. They also connected with the local public health governmental branch to learn more about their current cholera surveillance and response system.

Arnaud has returned to Haiti to train public health officials on water sampling—a first step to the hand-held metagenomic sequencing the Ford lab is developing for use in Haiti.  While this system is being optimized in the lab, samples have been sent to collaborators for testing. During this testing period, the lab has also hosted a member from the University of Notre Dame Hinche (UNDH) in Haiti to learn about DNA isolation and the idea behind the metagenomic sequencing, as UNDH also has obtained the same instrument as the one Ford's lab is optimizing.

For more info, please see Ford Leading Project to Fight Cholera in Haiti, as well as the published 2018 paper of this work.