***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND More than 500 studies were conducted in Haiti following the January 12 of 2010 earthquake , yet few of them assessed mental health of the population . To our knowledge , none targeted the effectiveness of various methods used to treat survivors , whether adults or children METHOD Our study aim ed to assess one year after the disaster , the effect of a specific psycho-social support offered to relocated children in Port-au-Prince compared with a control group . RESULTS The two groups were homogeneous in the intensity of the peritraumatic distress they experienced . We were unable to show a significant difference between both in the average scores for PTSD , nor for depression , nor in three out of the four sub-scales of the Child Behavior Check-List . In case children , 68 % and 40.9 % , respectively , and 50 % and 20.5 % of the control group , reported severe levels of the symptoms of PTSD and depression . These surprising results can be explained by the absence of equivalence in the two groups from a socio-demographic point of view and because subjects were not r and omly selected in the recruitment process . CONCLUSION This study has not made it possible to indicate the effectiveness of a specific psycho-social support offered to children in the aftermath of the disaster . On the other h and , the sample illustrates the high prevalence ( more than 50 % for PTSD ) of severe post-traumatic stress in this group of school-age children , one year after the earthquake . These results indicate that serious attention should be paid to the mental health aspects in reconstruction program for the country Anemia diminishes oxygen transport in the body , result ing in potentially irreversible growth and developmental consequences for children . Limited evidence for determinants of anemia exists for school-aged children . We conducted a cluster r and omized controlled trial in Haiti from 2012 to 2013 to test the efficacy of a fortified school snack .  Children ( N = 1,047 ) aged 3 - 13 years were followed longitudinally at three time points for hemoglobin ( Hb ) concentrations , anthropometry , and bioelectrical impedance measures . Dietary intakes , infectious disease morbidities , and socioeconomic and demographic factors were collected at baseline and endline . Longitudinal regression modeling with generalized least squares and logit models with r and om effects identified anemia risk factors beyond the intervention effect . At baseline , 70.6 % of children were anemic and 2.6 % were severely anemic . Stunting increased the odds of developing anemia ( adjusted odds ratio [ OR ] : 1.48 , 95 % confidence interval [ CI ] : 1.05 - 2.08 ) and severe anemia ( adjusted OR : 2.47 , 95 % CI : 1.30 - 4.71 ) . Parent-reported vitamin A supplementation and deworming were positively associated with Hb concentrations , whereas fever and poultry ownership showed a negative relationship with Hb concentration and increased odds of severe anemia , respectively . Further research should explore the full spectrum of anemia etiologies in school children , including genetic causes The Jolivert Safe Water for Families program has sold sodium hypochlorite solution ( chlorine ) and conducted household visits in rural Haiti since 2002 . To assess the impact of the program on diarrheal disease , in 2010 we conducted a survey and water quality testing in 201 program participants and 425 control households selected at r and om . Fifty-six percent of participants ( versus 10 % of controls ) had free chlorine residuals between 0.2 and 2.0 mg/L , indicating correct water treatment . Using intention-to-treat analysis , we found that significantly fewer children < 5 in participant households had an episode of diarrhea in the previous 48 hours ( 32 % versus 52 % ; P < 0.001 ) with 59 % reduced odds ( odds ratio = 0.41 , 95 % confidence interval = 0.21–0.79 ) . Treatment-on-treated estimates of the odds of diarrhea indicated larger program effects for participants who met more stringent verifications of participation . Diarrheal disease reduction in this long-term program was comparable with that seen in short-term r and omized , controlled interventions , suggesting that household chlorination can be an effective long-term water treatment strategy OBJECTIVES To measure trauma-related distress and evaluate the feasibility , acceptability , and preliminary efficacy of an 8-week yoga intervention ( YI ) in reducing trauma-related symptoms and emotional and behavioral difficulties ( EBD ) among children living in orphanages in Haiti . DESIGN Case comparison with r and om assignment to YI or aerobic dance control ( DC ) plus a nonr and omized wait-list control ( WLC ) group . SETTING Two orphanages for children in Haiti . PARTICIPANTS 76 children age 7 to 17 years . INTERVENTION The YI included yoga postures , breathing exercises , and meditation . The DC group learned a series of dance routines . The WLC group received services as usual in the institutional setting . After completion of data collection , the WLC group received both yoga and dance classes for 8 weeks . OUTCOME MEASURES The UCLA PTSD Reaction Index and the Strengths and Difficulties Question naire were used to indicate trauma-related symptoms and EBD , respectively . A within-subject analysis was conducted to compare pre- and post-treatment scores . A post-treatment yoga experience question naire evaluated acceptability of the YI . RESULTS Analyses of variance revealed a significant effect ( F[2,28]=3.30 ; p=0.05 ) of the YI on the trauma-related symptom scores . Regression analyses showed that participation in either 8 weeks of yoga or dance classes suggested a reduction in trauma-related symptoms and EBD , although this finding was not statistically significant ( p>0.05 ) . Respondents reported satisfaction with the yoga program and improved well-being . CONCLUSIONS Children with trauma-related distress showed improvements in symptoms after participation in an 8-week yoga program compared to controls . Yoga is a feasible and acceptable activity with self-reported benefits to child mental and physical health . Additional research is needed to further evaluate the effect of yoga to relieve trauma-related distress and promote well-being among children Background Studies of the immunogenicity of the killed bivalent whole cell oral cholera vaccine , Shanchol , have been performed in historically cholera-endemic areas of Asia . There is a need to assess the immunogenicity of the vaccine in Haiti and other population s without historical exposure to Vibrio cholerae . Methodology /Principal Findings We measured immune responses after administration of Shanchol , in 25 adults , 51 older children ( 6–17 years ) , and 47 younger children ( 1–5 years ) in Haiti , where cholera was introduced in 2010 . A≥4-fold increase in vibriocidal antibody titer against V. cholerae O1 Ogawa was observed in 91 % of adults , 74 % of older children , and 73 % of younger children after two doses of Shanchol ; similar responses were observed against the Inaba serotype . A≥2-fold increase in serum O-antigen specific polysaccharide IgA antibody levels against V. cholerae O1 Ogawa was observed in 59 % of adults , 45 % of older children , and 61 % of younger children ; similar responses were observed against the Inaba serotype . We compared immune responses in Haitian individuals with age- and blood group-matched individuals from Bangladesh , a historically cholera-endemic area .  The geometric mean vibriocidal titers after the first dose of vaccine were lower in Haitian than in Bangladeshi vaccinees . However , the mean vibriocidal titers did not differ between the two groups after the second dose of the vaccine . Conclusions / Significance A killed bivalent whole cell oral cholera vaccine , Shanchol , is highly immunogenic in Haitian adults and children . A two-dose regimen may be important in Haiti , and other population s lacking previous repeated exposures to V. cholerae Background Recent commentary on the health consequences of natural disasters has suggested a dearth of research on underst and ing the antecedents prior to the disaster that are associated with health consequences after the disaster . Utilizing data from a two-wave panel survey of Port-au-Prince , Haiti , conducted just prior to and six weeks after the January 2010 earthquake , we test factors prior to the quake hypothesized to be associated with food insecurity after the quake . Methods Using r and om Global Positioning System ( GPS ) sampling , we re-interviewed 93.1 % ( N = 1732 ) of the original 1,800 households interviewed in 2009 . Respondents were queried with regard to mortalities , injuries , food security , housing , and other factors after the quake . Findings Child food insecurity was found to be common on all three indices of food security ( 17.2%–22.6 % ) . Additionally , only 36.5 % of school-aged children were attending school prior to the quake . Findings suggest that prior schooling was associated with a substantial reduction on food insecurity indices ( OR 0.62–0.75 ) . Findings further suggest that several household characteristics were associated with food insecurity for children . Prior chronic/acute illnesses , poor living conditions , remittances from abroad , primary respondent mental health , and histories of criminal and other human rights violations committed against family members prior to the quake were associated with food insecurity after the earthquake . Earned household income after the quake was only associated with one of the measures of food insecurity . Interpretation Food insecurity for children  was common after the quake . Those households vulnerable on multiple dimensions prior to the quake were also vulnerable to food insecurity after the quake . Remittances from abroad were leading protective factors for food security . Because Haiti is well known for the potentiality of both hurricanes and earthquakes , reconstruction and redevelopment should focus on ameliorating potential vulnerabilities to poor outcomes in these natural disasters BACKGROUND On January 12 , 2010 , Haiti experienced the western hemisphere 's worst-ever natural disaster . Within 24 hours , the United States Naval Ship Comfort received orders to respond , and a group of more than 500 physicians , nurses , and staff undertook the largest and most rapid triage and treatment since the inception of hospital ships . METHODS These data represent pediatric surgical patients treated aboard the United States Naval Ship Comfort between January 19 and February 27 , 2010 . Prospect i ve data bases managed by patient administration , radiology , blood bank , laboratory services , and surgical services were combined to create an overall patient care data base that was retrospectively review ed for this analysis . RESULTS Two hundred thirty-seven pediatric surgical patients were treated , representing 27 % of the total patient population . These patients underwent a total of 213 operations composed of 243 unique procedures . Orthopedic procedures represented 71 % of the total caseload . Patients returned to the operating room up to 11 times and required up to 28 days for completion of surgical management . CONCLUSIONS This represents the largest cohort of pediatric surgical patients in an earthquake response . Our analysis provides a model for anticipating surgical caseload , injury patterns , and duration of surgical course in preparing for future disaster response missions . Moreover , we propose a 3-phased response to disaster medicine that has not been previously described BACKGROUND In Haiti and other countries , large-scale investments in school feeding programs have been made with marginal evidence of nutrition outcomes . OBJECTIVE We aim ed to examine the effectiveness of a fortified ready-to-use supplementary food ( RUSF ) , Mamba , on reduced anemia and improved body composition in school-aged children compared to an unfortified cereal bar , Tablet Yo , and control groups . METHODS A cluster , r and omized trial with children ages 3 - 13 y ( n = 1167 ) was conducted in the north of Haiti . Six schools were matched and r and omized to the control group , Tablet Yo group ( 42 g , 165 kcal ) , or Mamba group ( 50 g , 260 kcal , and > 75 % of the RDA for critical micronutrients ) . Children in the supplementation groups received the snack daily for 100 d , and all were followed longitudinally for hemoglobin concentrations , anthropometry , and bioelectrical impedance measures : baseline ( December 2012 ) , midline ( March 2013 ) , and endline ( June 2013 ) . Parent surveys were conducted at baseline and endline to examine secondary outcomes of morbidities and dietary intakes . Longitudinal regression modeling using generalized least squares and logit with r and om effects tested the main effects . RESULTS At baseline,14.0 % of children were stunted , 14.5 % underweight , 9.1 % thin , and 73 % anemic . Fat mass percentage ( mean ± SD ) was 8.1 % ± 4.3 % for boys and 12.5 % ± 4.4 % for girls . In longitudinal modeling , Mamba supplementation  increased body mass index z score ( regression coefficient ± SEE ) 0.25 ± 0.06 , fat mass 0.45 ± 0.14 kg , and percentage fat mass 1.28 % ± 0.27 % compared with control at each time point ( P < 0.001 ) . Among boys , Mamba increased fat mass ( regression coefficient ± SEE ) 0.73 ± 0.19 kg and fat-free mass 0.62 ± 0.34 kg compared with control ( P < 0.001 ) . Mamba reduced the odds of developing anemia by 28 % compared to control ( adjusted OR : 
    Output:
    
Infectious diseases were a significant cause of morbidity and mortality among children following the earthquake , with cholera being one of the most important etiologies .
The literature also revealed that large numbers of children in Haiti have significant symptoms of posttraumatic stress disorder ( PTSD ) , peri-traumatic stress , depression , and anxiety , and that food insecurity and malnutrition continue to be important issues .