CDC in Dominican Republic
Dominican Republic at a Glance
- Population: 10,135,000
- Per capita income: $8,110
- Life expectancy at birth women/men: 76/69 yrs
- Infant mortality rate: 23/1000 live births
The Centers for Disease Control and Prevention (CDC) in the Dominican Republic has four disease impact goals: 1) eliminate transmission of HIV from pregnant mothers to babies, 2) prevent new cases of adult HIV among high-risk populations, 3) reduce the prevalence of tuberculosis, and 4) reduce the impact of infectious disease outbreaks. To achieve these goals, CDC works closely with the ministry of health (MoH) and non-governmental partners to conduct epidemiology and surveillance; strengthen laboratory systems; implement HIV prevention; and conduct outbreak response. CDC is a member of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and U.S. Global Health Initiative country teams.
Epidemiology and Surveillance
CDC works with the MoH to strengthen surveillance systems in the Dominican Republic, including a new national electronic reportable disease surveillance system; a project co-funded with CDC’s Global Fund to develop an electronic reporting system for tuberculosis; a project with PAHO/WHO to develop an electronic HIV hospital reporting system; and a sentinel surveillance system for sexually transmitted infections.
CDC is collaborating on several large population surveys: two behavioral surveillance surveys among populations that are at high risk of HIV/AIDS and a demographic health survey.
The Field Epidemiology Training Program (FETP) with 6-month basic, 9-month intermediate and 2-year advanced levels underpins all of CDC’s epidemiology and surveillance portfolio by building human resource capacity within the Ministry of Health at the local and national levels to detect and respond to health threats.
Impact in Dominican Republic
- Launched a national laboratory accreditation program and strengthened laboratory capacity
- Assisted MoH to plan and implement a national strategy for prevention of mother-to-child transmission of HIV and syphilis
- Conducted HIV prevention interventions among men-who-have-sex-with-men, drug users, and mobile populations
- Supported FETP to increase capacity at basic, intermediate, and advanced levels
- Global Disease Detection supported MoH to reduce the impact of the cholera epidemic in 2010/2011
The core of CDC’s laboratory systems strengthening program is the Strengthening Laboratory Management Towards Accreditation (SLMTA) training. Developed by CDC and WHO in the Africa region, and adapted by CDC in the Dominican Republic for the Americas, SLMTA is a highly successful approach that combines a structured continuous quality assessment approach with equipment purchases and servicing to enable MoHs to develop their own laboratory systems strengthening program.
Additional elements of laboratory system strengthening supported by CDC include training of local MoH laboratory supervisors to improve laboratory management and an external quality assessment program with CDC in Atlanta. CDC supports the Dominican Republic in meeting its obligations under the International Health Regulations by helping it develop laboratory capacity for disease surveillance including training laboratory technicians in basic epidemiology and surveillance, installing molecular and genetic testing capacity in the national reference laboratory, and developing a public health laboratory network.
CDC supports community-based HIV prevention and hospital-based HIV prevention programs in the Dominican Republic. The community HIV prevention interventions supported by CDC focus on men-who-have-sex-with-men, people who inject drugs, and mobile populations (construction workers, agricultural workers, street vendors, and truck drivers). These interventions are based on evidence-based Diffusion of Evidence Based Interventions (DEBI) developed by CDC in the United States.
Hospital-based prevention programs include prevention of mother-to-child transmission (PMTCT) and blood safety. CDC has supported the MoH developing a national PMTCT strategy and is working collaboratively with USAID to strengthen PMTCT in 16 key hospitals that account for approximately 80% of all births in the country. Increasing access to safe blood, vital for reducing maternal mortality, includes developing a national voluntary blood donation strategy, equipping six strategically selected regional blood banks, and training medical and technical personnel.
Top Causes of Deaths in Dominican Republic
- Cardiovascular disease 39%
- External causes 20%
- Cancer 16%
- Infectious diseases 8%
- Transport accidents 5%
- Homicide 3%
Emerging Public Health Issues
In addition to routine health strengthening activities, CDC provides support for outbreak detection and response. The cholera outbreak in 2010 prompted a rapid response by CDC, which included establishing a cholera laboratory within 48 hours of the first case reported in Haiti and bringing expert medical and epidemiology assistance from the CDC Regional Office in Guatemala and from CDC Atlanta to assist the MoH in controlling the outbreak. The local field epidemiology residents and graduates were essential to the response.
CDC actively supports bi-national public health efforts between the Dominican Republic and Haiti. Collaborative projects with both MoHs include a bi-national malaria control program and a bi-national tuberculosis control program.
Regionally, CDC works with the CDC Central America Regional Office in Guatemala and the CDC Caribbean Regional Office in Barbados, to coordinate and respond to public health issues in both regions.
CDC office (physical presence)
9 Locally Employed