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INFECTIOUS AND TROPICAL DISEASES CONTROL IN CUBA A NECESSARY INTRODUCTION. PROF. G. KOURI INSTITUTO DE MEDICINA TROPICAL “PEDRO KOURÍ”. THE WORLD´S BURDEN OF INFECTIOUS DISEASES INFECTIOUS DISEASES ARE NOW THE WORLD´S BIGGEST KILLER OF CHILDREN AND YOUNG ADULTS.
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INFECTIOUS AND TROPICAL DISEASES CONTROL IN CUBA A NECESSARY INTRODUCTION PROF. G. KOURI INSTITUTO DE MEDICINA TROPICAL “PEDRO KOURÍ”
THE WORLD´S BURDEN OF INFECTIOUS DISEASES INFECTIOUS DISEASES ARE NOW THE WORLD´S BIGGEST KILLER OF CHILDREN AND YOUNG ADULTS. MORE THAN 13 MILLIONDEATHS A YEAR(221/100 0000INHABITANTS) - ONE IN TWO DEATHS IN THE THIRD WORLD. WHO REPORT ON INF. DIS.
(II) OVER THE NEXT HOUR ALONE 1 500 PEOPLE WILL DIE OF AN INFECTIOUS DISEASE OVER HALF OF THEM CHILDREN UNDER FIVE YEARS. WHO REPORT ON INF. DIS./
INFECTIOUS DISEASES REPRESENTS: • 45% OF DEATHS IN LOW INCOME COUNTRIES (ASIA AND AFRICA). • 63% OF DEATHS IN CHILDREN • (0-4 YEARS) WORLDWIDE. • 48% OF PREMATURE DEATHS • (0 - 44 YEARS), WORLDWIDE WHO REPORT ON INF. DIS.
LEADING INFECTIOUS KILLERS • MILLIONS OF DEATHS WORLWIDE • ALL AGES • ACUTE RESPIRATORY INFECTIONS: 3.5 • AIDS: 2.3 • DIARROEHAL DISEASES: 2.2 • TUBERCULOSIS: 1.5 • MALARIA: 1.3 • MEASLES: 0.9 WHO REPORT ON INF. DIS,
IT IS ESTIMATED THAT THE MAJORITY OF DEATHS FROM INFECTIOUS DISEASES CAN BE PREVENTED WITH EXISTING COST-EFFECTIVE STRATEGIES WHO REPORT ON INFEC. DIS.
IN THE WORLD, ONE THIRD OF THE POPULATION LACKS ACCESS TO THE ESSENTIAL DRUGS WHO REPORT ON INFECTIOUS DISEASES
TODAY THE POOREST COUNTRIES ARE PAYING A HEAVY PRICE FOR THE WORLD´S COMPLACENCY AND NEGLECT WHO REPORT ON INFECTIOUS DISEASES
20% OF THE WORLD POPULATION (1 300 MILL.) LIVE IN ABSOLUTE POVERTY • (LESS THAN $1 USD/DAY) • SURVIVING WITH LESS THAN $2 USD/DAY IS A REALITY FOR ALMOST HALF THE PEOPLE ON THE PLANET . • THESE FIGURES ARE STILL RISING WHO DIRECTOR GENERAL REPORT DEC/99
A VICIOUS CICLE OF POVERTY DIEASE AND DEATH Poverty Low Productivity Disease Death and Disability KOURI G, LLOP A, ROGES G
INCIDENCE AND CONTROL OF TROPICAL DISEASES IN CUBA INSTITUTE OF TROPICAL MEDICINE “PEDRO Kourí” HAVANA - CUBA YEAR 2004
THE SO-CALLED TROPICAL DISEASES ARE NOT A HEALTH PROBLEM IN CUBA IN THE YEAR 2005
FACTS AND FIGURES 1959 - 2004
11.2 MILLON INHABITANTS >70 000 M.D. WELL DEVELOPED PRIMARYHEALTH CARE SUB - SYSTEM
FROM 1959 THE CUBAN NATIONAL HEALTH SYSTEM WAS STABLISHED ACCESIBLE UNIVERSAL FREE 100% OF URBAN AND RURAL POPULATION IS PROTECTED
MAIN MORTALITY CAUSES IN CUBA • HEART DISEASES • CANCER • CEREBROVASCULAR DISEASES • INFLUENZA AND PNEUMONIA • ACCIDENTS
IMMUNIZATION PROGRAME IN CUBA(100%), YEAR 2003 BCG POLIO MEASLES MENINGO B RUBELLA MENINGO C MUMPS DIPHTERIA HEMOPHILUS B TETANUS HEPATITIS B PERTUSIS LEPTOSPIROSIS ** CURRENTLY THE VACCINATION AGAINST INFLUENZA IS LIMITED TO THE ELDERLY IN THE WORLD “ONE IN FIVE CHILDREN ” ARE NOT FULLY INMUNIZED BY THEIR FIRST BIRTHDAY (WHO REPORT ON INF. DIS..)
NATION-WIDE, LABORATORY BASED SURVEILLANCE SYSTEM FOR MOST IMPORTANT INFECTIOUS AND PARASITIC DISEASES
CONTROL ELIMINATION ERADICATION 2004
CUBA, HAS A LONG TRADITION IN THE CONTROL OF INFECTIOUS DISEASES • DURING THE SPANISH COLONY • CHOLERA APPEARD IN CUBA IN 1834, IT WAS ELIMINATED IN 1871 • AT THE BEGINING OF THIS CENTURY • YELLOW FEVER WAS ERADICATED IN 1902 • IN 1915 BUBÓNIC PLAGUE WAS ERADICATED • IN 1923 SMALLPOX WAS ERADICATED • IN 1947 LAST CASE OF BANCROTI FILARIASIS
ELIMINATED AND CONTROLLED INFECTIOUS DISEASE AFTER 1959 • IN 1962 POLIO WAS ERADICATED • IN 1967MALARIA WAS ERADICATED • IN 1972 NEO-NATORUM TETANUS WAS ELIMINATED
ELIMINATED AND CONTROLLED INFECTIOUS DISEASES (II) IN 1979 DIPHTERIA WAS ELIMINATED IN 1993MEASLES WAS ELIMINATED IN 1995 RUBELLA WAS ELIMINATED IN 1995 MUMPS WAS ELIMINATED
NO MORE CONSIDERED A HEALTH PROBLEM IN CUBA: TETANUS, WHOOPING COUGH (LESS THAN 0.1 X 100 000) MENINGOCCOCAL DISEASE DECLINED ITS MORBIDITY IN 93% AND ITS MORTALITY IN 98% HEPATITIS B MORBIDITY IN CHILDREN, LESS THAN 15 YEARS, WAS REDUCED IN 97% HUMAN LEPTOSPIROSIS DECLINED (CUBAN VACCINE)
THE TUBERCULOSIS RATE IS 6.6 X 100 000 AT PRESENT WE ARE PREPARING A PROGRAMME TO ELIMINATE Tb IN CUBA LEPROSY IS NOT A HEALTH PROBLEM
DIARRHEAL DISEASES ARE PREVALENT ALTHOUGH ITS MORTALITY RATE WAS REDUCED MORE THAN 95% BETWEEN 1962 AND 2004
TOTAL HIV-AIDS PATIENTS: 6025 (1985-04)- (0.07%) AMONG THEM AIDS PATIENTS : 4724 AIDS DEATHS: 1222 HIV CARRIERS: 3424
MAIN HEALTH INDEXES IN CUBA
INFANT MORTALITY: 5.8 / 1000 NEWBORNS MATERNAL MORTALITY : 3.8 /10 000 NEWBORNS TOTAL 2.12 /10 000 NEWBORNS (DIRECT) 1.73 / 10 000 NEWBORNS (INDIRECT) INFEC. DISEAS. 0.08 / 10 000NEWB.
LIFE EXPECTANCY: 77 YEARS MEN: 75 YEARS WOMEN:79 YEARS
INFECTIOUS AND PARASITIC DISEASES MORTALITY RATE - CUBA GENERAL MORTALITY RATE:60.3 (IN THE WORLD: 221X100 000)
IN CUBA THE % OF MORTALITY DUE TO INFECTIOUS DISEASES IS ONLY 6.5%
THE NUMBER OF FATAL CASES IN 2004 EXCLUDING INFLUENZA AND PNEUMONIA FOR ALL THE REST OF INF. DIS. WHAS 742 FATALITIES WHICH REPRESENTS 0.9% OF THE TOTAL MORTALITY IN CUBA (IN 1970 : 7,2%)
MAIN CHALLENGES FOR CUBA • ACUTE RESPIRATORY INFECTIONS • HIV/AIDS • OTHER STIs • PREVENT ANTIMICROBIAL RESISTANCE
INSTITUTE OF TROPICAL MEDICINE “PEDRO KOURI”(IPK) MINISTRY OF PUBLIC HEALTH HAVANA CUBA PROF GUSTAVO KOURI MD, PhD ,DrSc VICEPRESIDENT CUBAN ACADEMY OF SCIENCES DIRECTOR GENERAL IPK
PABELLÓN DOMINGO CUBAS, HOSPITAL CALIXTO GARCÍA SEDE DE LA CÁTEDRA DE PARASITOLOGÍA # 20 Y DEL INSTITUTO DE MEDICINA TROPICAL 1937 1000 MTS2
ASCARIASIS OBSTRUCCIÓN INTESTINAL esto ya no existe en Cuba
ASCARIASIS VIAS BILIARES
ULTIMOS CASOS DE FILARIASIS BANCROFTI EN CUBA
ULTIMOS CASOS DE FILARIASIS BANCROFTI EN CUBA
Amebiasis cutánea SE CONFUNDÍA CON CANCER APORTE DE KOURI Antes del tratamiento SE CONFUNDÍA CON CANCER Después del tratamiento
PROPOSAL FOR A NEW BUILDING FOR THE INSTITUTE April / 1939 IT WAS NOT ACCEPTED . LACK OF FUNDS
A NEW PHASE, 1979 - 2004 NEW CHALLENGES