title: Are there any changes in burden and management of communicable diseases in areas affected by Cyclone Nargis?
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. jaranitk@biophics.org.
authors.forename: Nyan Win
authors.initials: NW
authors.lastname: Myint
authors.forename: Jaranit
authors.initials: J
authors.lastname: Kaewkungwal
authors.forename: Pratap
authors.initials: P
authors.lastname: Singhasivanon
authors.forename: Kamron
authors.initials: K
authors.lastname: Chaisiri
authors.forename: Pornpet
authors.initials: P
authors.lastname: Panjapiyakul
authors.forename: Pichit
authors.initials: P
authors.lastname: Siriwan
authors.forename: Arun K
authors.initials: AK
authors.lastname: Mallik
authors.forename: Soe Lwin
authors.initials: SL
authors.lastname: Nyein
authors.forename: Thet Thet
authors.initials: TT
authors.lastname: Mu