We used a modified acid-fast stain to detect Cryptosporidium oocysts in unconcentrated stools from 824 Haitian children less than 2 years of age with acute diarrhea. Oocysts were identified in stools from 17.5% of 291 children seen at a rural dispensary and in 16.3% of stools from 533 children in an urban hospital. Children with cryptosporidiosis were identified throughout a 22-month period from October 1982 to July 1984, without seasonal predilection. Cryptosporidiosis was twice as common in infants greater than 6 months of age than in younger infants. Cryptosporidium oocysts were rarely found in stools of infants receiving only breast milk. The clinical presentation of children with cryptosporidiosis was similar to other patients with diarrhea who did not have cryptosporidiosis. No asymptomatic Cryptosporidium infections were detected among 71 family members of 31 children with cryptosporidiosis. Three of the 71 family members less than 3 years of age were found to have diarrhea and Cryptosporidium oocysts. In follow-up studies of 31 patients, oocysts persisted in stools for a mean of 14 days (range 5-31 days). Duration of oocyst excretion was directly correlated with duration of diarrhea. These findings suggest that Cryptosporidium is an important cause of acute self-limited diarrheal illness to Haitian children.

Two hundred twenty-nine patients in Haiti with the acquired immunodeficiency syndrome were studied between 1979 and 1984. The clinical spectrum of the syndrome in Haitians was similar in most aspects to that in patients with the disease in the United States. However, in contrast to findings in the United States, accepted risk factors (bisexuality, blood transfusions, intravenous drug abuse) were identified in only 43% of Haitian patients. Patients in Haiti with and without these risk factors were similar to each other but differed from age- and sex-matched siblings and friends in the number of heterosexual contacts and receipt of intramuscular injections. These latter activities were commoner in patients than in their siblings and friends, and represent potential modes of transmission of infection with the human T-lymphotropic virus type III.

SETTING AIDS and tuberculosis center in Port-au-Prince, Haiti. OBJECTIVE To measure the effectiveness of tuberculosis retreatment with the standard regimen (2HRZES/1HRZE/5HRE) in HIV-infected adults. DESIGN Cohort study. RESULTS Of 1,318 HIV-infected patients with access to antiretroviral therapy following World Health Organization guidelines, 56 were diagnosed with recurrent pulmonary tuberculosis and retreated with the standard regimen. Ten patients (18%) died during retreatment, 3 patients (5%) defaulted, and 2 patients (4%) failed. Forty-one patients (73%) had a good retreatment outcome (cure, treatment completed). Of these, 8 patients (20%) died during follow-up, 5 patients (12%) were lost, and 5 patients (12%) had a second recurrence of tuberculosis. Only 26 (46%) of the 56 patients remained alive, in-care, and TB-free after a median of 36 months follow-up. CONCLUSION HIV-infected patients treated for recurrent tuberculosis with the standard retreatment regimen have a high mortality and poor long-term outcomes.

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