Médecine tropicale : revue du Corps de santé colonial
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Epidural analgesia is the most effective method for pain relief during labor. This 10-year exploratory descriptive study on factors underlying women's decisions to request or refuse labor epidural analgesia (LEA) was carried out at a level III maternity hospital in Antananarivo, Madagascar. All patients underwent a pre-anesthesia check-up (PAC) between 32 and 34 weeks of amenorrhea. ⋯ No patient had good knowledge about LEA. Nulliparous women that accepted EA had a higher socio-economic level, expected stronger labor pain, were better informed about EA, and expressed greater confidence in medical care. In addition to economic aspects, the main reasons for refusing EA involved fear and family background.
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Cholera, that had been present in rural areas north of Port-au-Prince, Haiti since October 2010, reached the urban area in November. Due to the novelty of the disease in this region, to the lack of health care, clean water, and waste disposal facilities, and to the extensive damage caused by the earthquake on January 12, 2010, that left a large victim population living in camps, a large-scale health disaster was feared. However, after two months, the disease appeared to be relatively well-controlled and treated with a fatality rate of less than 1% in the urban area. Actions implemented by the Ministry of Health long with its efforts to coordinate the intervention of the many humanitarian partners played a role in this outcome.