Search PubMed⌕ Search

PubMed · 8086913

Fighting for survival.

Abstract

The political crisis in Haiti has had a severe impact on the health of the population. Mortality among Haitians is 13 per 1000, much higher than the Latin American rate of seven per 1000, and the incidence of AIDS, tuberculosis, and malnourishment is increasing among children. Although food and medicine are exempt, United Nations sanctions have had a negative impact on most of the population. In particular the embargo on fuel has limited most people's access to health care. The difficulties of distributing aid and health care without softening the embargo on fuel are immense, and the health of Haitians is not likely to improve until the political crisis is resolved.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

C Chelala. Fighting for survival.. https://doi.org/10.1136/bmj.309.6953.525

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Reiter's syndrome associated with the Acquired Immunodeficiency Syndrome: a case report.

The association of Reiter's Syndrome (RS) with the Acquired Immunodeficiency Syndrome (AIDS) is seldom mentioned in the medical literature. This report illustrates this relationship in a 46 years old male patient suffering from AIDS (CD(4)(+) = 240 cells/mm(3), CD(8)(+) = 1,301 cells/mm(3) and viral load = 330,000 copies/ml), pulmonary tuberculosis (positive catarrhal bacilluscopy), and RS. The diagnosis of RS was based on the combination of dermatological and articular alterations. The patient s cutaneous lesions were characterized by exfoliation and the formation of crusts located on the face, scalp, genitals, hands, and feet; onychodystrophy with opacity; yellowish coloring; and hyperkeratosis of the nails. Articular lesions led to progressive deformity of phalangeal joints of the hands, and intensive arthralgia, mainly of the larger joints (shoulders, elbows, hips and knees). AIDS treatment was administered with anti-retroviral drugs (zidovudine and didanosine); for tuberculosis (isoniazid, rifampicine, and pyrazinamide); and (prednisone and inometacine) for the RS. The patient recovered with the improvement of articular symptoms; however, on the eighth day of treatment, the patient showed significant hemoptysis and hypovolemic shock, and died. The association of RS and HIV infection is reviewed.

Acquired Immunodeficiency Syndrome↗

Monitoring clinical trials: issues and controversies regarding confidentiality.

During phase III clinical trials in life-threatening disease settings, it is important to ensure that the Data Monitoring Committee (DMC) has exclusive access to the interim efficacy and safety data generated by the data analysis centre, in order to minimize the risk of widespread prejudgement of unreliable trial results based on limited data. This prejudgement could adversely impact rates of patient accrual, continued adherence to trial regimens and ability to obtain unbiased and complete assessment of trial outcome measures. This also could result in publications of early results that might be very inconsistent with final study data on the benefit-to-risk profile of the study interventions. Circumstances arise only rarely in which unblinding of interim data beyond the DMC would enhance the ability of the trial to provide reliable results. However, to address the ethical imperative to protect the interests of study participants, the DMC itself should have access to unblinded efficacy and safety results.

Acquired Immunodeficiency Syndrome↗