Research
Are there any changes in burden and management of communicable diseases in areas affected by Cyclone Nargis?
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* Corresponding author: Jaranit Kaewkungwal jaranitk@biophics.org
1 Medical Care Division, Department of Health, Ministry of Health, Nay Pyi Taw, Myanmar
2 Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
3 Permanent Secretary Office, Ministry of Public Health, Nonthaburi, Thailand
4 Relief and Community Health Bureau, Red Cross Society, Bangkok, Thailand
5 Inter-agency Coordination and Emergency and Humanitrian Action, WHO Office, Nonthaburi, Thailand
6 Central Epidemiological Unit, Department of Health, Ministry of Health, Nay Pyi Taw, Myanmar
7 Health Information Division, Department of Health Planning, Ministry of Health, Nay pyi Taw, Myanmar
Conflict and Health 2011, 5:9 doi:10.1186/1752-1505-5-9
Published: 28 June 2011Abstract
Background
This study aims to assess the situation of communicable diseases under national surveillance in the Cyclone Nargis-affected areas in Myanmar (Burma) before and after the incident.
Methods
Monthly data during 2007, 2008 and 2009 from the routine reporting system for disease surveillance of the Myanmar Ministry of Health (MMOH) were reviewed and compared with weekly reporting from the Early Warning and Rapid Response (EWAR) system. Data from some UN agencies, NGOs and Tri-Partite Core Group (TCG) periodic reviews were also extracted for comparisons with indicators from Sphere and the Inter-Agency Standing Committee.
Results
Compared to 2007 and 2009, large and atypical increases in diarrheal disease and especially dysentery cases occurred in 2008 following Cyclone Nargis. A seasonal increase in ARI reached levels higher than usual in the months of 2008 post-Nargis. The number of malaria cases post-Nargis also increased, but it was less clear if this reflected normal seasonal patterns or was specifically associated with the disaster event. There was no significant change in the occurrence of other communicable diseases in Nargis-affected areas. Except for a small decrease in mortality for diarrheal diseases and ARI in 2008 in Nargis-affected areas, population-based mortality rates for all other communicable diseases showed no significant change in 2008 in these areas, compared to 2007 and 2009. Tuberculosis control programs reached their targets of 70% case detection and 85% treatment success rates in 2007 and 2008. Vaccination coverage rates for DPT 3rd dose and measles remained at high though measles coverage still did not reach the Sphere target of 95% even by 2009. Sanitary latrine coverage in the Nargis-affected area dropped sharply to 50% in the months of 2008 following the incident but then rose to 72% in 2009.
Conclusion
While the incidence of diarrhea, dysentery and ARI increased post-Nargis in areas affected by the incident, the incidence rate for other diseases and mortality rates did not increase, and normal disease patterns resumed by 2009. This suggests that health services as well as prevention and control measures provided to the Nargis-affected population mitigated what could have been a far more severe health impact.