| Issue/Objective |
Natural disasters such as earthquakes exacerbate the risk of infectious disease by disrupting healthcare systems, displacing populations, and creating overcrowded living conditions. This case-study examines country-level responses to the airborne infectious disease, tuberculosis (TB) following major earthquakes in two countries, Haiti (2010) and Japan (2011), to inform post-disaster public health responses.
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| Methodology/Approach |
A targeted literature review was undertaken to retrieve peer-reviewed articles from PubMed, Embase, and reports from the World Health Organization, Haitian, and Japanese government websites. A "lessons learned" approach was applied to understand how baseline structural and health system differences shape responses to TB in the aftermath of a disaster. Content analysis focussed on social and structural determinants of health, continuity of TB diagnostics and treatment, shelter structures, and health workforce and volunteer capacity. |
| Results |
Japan and Haiti both faced elevated TB risks due to displacement and overcrowding, but differential capacities for disaster preparedness precipitated vastly disparate population-level outcomes. In Japan, TB diagnostic and treatment activities resumed within weeks of the Great East Japan Earthquake, due to robust centralized surveillance systems, rapid dissemination of disaster-centred protocols, and restoration of public health services by local providers within makeshift clinics and shelters. In contrast, Haiti's response was characterized by prolonged disruptions to an already weak healthcare system, destruction of TB treatment facilities and case reporting and monitoring systems, a heavy reliance on non-governmental (including international) organizations, and fragmented service delivery by varied actors. Differences were observed in TB treatment continuity, with people in Japan successfully traced, monitored, and maintained on therapy, whereas in Haiti there were extended access barriers related to cost and infrastructural instability. TB rates in Japan remained stable in the years following. In Haiti, case notification rates increased, but it is unclear if this was due to improved case detection or an actual rise in cases. |
| Discussion/Conclusion |
This targeted review highlights the need for context-specific TB guidelines in post-disaster settings, emphasizing strengthened and coordinated surveillance and response systems that are adapted to countries' infrastructural strengths and plug extant gaps that are likely to widen during a disaster. |
| Presenters and Affiliations |
Hanna Lum-Gerry York University |
