Tag Archives: developing countries

Climate Change, Perspectives from Nepal

As a molecular biologist, my mind is frequently focused highly at the microscopic level.   I rarely consider the impact of large-scale environmental or cultural events on the very small molecules or microorganisms which coexist along side us.  Since reading Influence of environmental factors on the presence of Vibrio cholerae in the marine environment: a climate link, I now have an appreciation for the link between infectious diseases and the ecosystem; that is, how the visible affects the invisible or will eventually affect the visible.

 

The interaction between the weather and infectious disease status is an important area of research.  Many examples throughout history show how weather pattern changes and natural disasters lead to catastrophic disease outbreaks.  One recent example is the current outbreak of chloera in Haiti which occurred following the earthquake of 2010 (Kelvin AA JIDC 2011).  The earthquake, which devastated the country’s already weak water sanitization system, created a habitable environment for the colonization of the Cholera bacterium and facilitated the spread of the disease.  Perhaps my favorite article which reviews the interaction between climate change/weather and infectious disease outbreaks is an article by V. Sedas.  In this article, Sedas reviews how environmental factors have significant influence on the outbreak potential and pathogenesis of V. cholerae and other disease causing agents (Seda VT JIDC 2007).  As the fecal-oral transmission route of V. cholera relies heavily on the ecology of the native water supply, seasonal water cycles have been shown to affect the emergence and re-emergence of V. cholerae, thereby affecting the health of local populations (Seda VT JIDC 2007).  This article I highly recommend reading.

In this JIDC Postcard, Yadav Prasad Joshi reflects on how anthropocentric climate change is influencing health, lifestyle and ecosystems globally.  Yadav Prasad Joshi is a PhD student from Nepal and his post provides an invaluable perspective on climate change.

Alyson

Climate Change, Perspectives from Nepal

Have you ever thought about what might be considered the worst event to affect this planet? From wars to terrorism to nuclear emissions, the list is long, but few people would point out the events of climate change. Tsunamis, floods, heat waves, glacial melting and threats to biodiversity are all disasters that affect not only the people in the regions experiencing them, but everyone worldwide.

Weather and climate play a significant role in people’s health. Changes in climate affect average weather conditions. Warmer average temperatures will likely lead to hotter days and more frequent and longer heat waves, which could increase the number of heat related illnesses and deaths. Increases in the frequency or severity of extreme weather events such as storms could accelerate the risk of dangerous flooding, high winds, and other direct threats to people and property. Warmer temperatures could increase the concentrations of unhealthy air and water pollutants. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases.

Global climate change has become one of the most visible environmental concerns (Bioterrorism) of the 21st century.  Climate change has brought about severe and possibly permanent alterations to our planet’s geological, biological and ecological systems. The Intergovernmental Panel on Climate Change (IPCC) now contends that “there is new and stronger evidence that most of the warming observed over the last 50 years is attributable to human activities”.1 These changes have led to the emergence of large-scale environmental hazards to human health, such as ozone depletion, the greenhouse effect, acid rain, loss of biodiversity, stresses to food-producing systems and the global spread of infectious diseases.1,2 The World Health Organization(WHO) estimates that 160,000 deaths, since 1950, are directly attributable to climate change.3

During the last 100 years, human activities related to the burning of fossil fuels, deforestation and agriculture have led to a 35% increase in CO2 levels in the atmosphere, causing increased trapping of heat and warming of the earth’s atmosphere. Eleven of the last 12 years (1995-2006) rank among the 12 warmest years in the instrumental record of global surface temperature. The IPCC reports that the global average sea level rose at an average rate of 1.8 mm per year from 1961 to 2003. The total rise in the sea level during the 20th century was estimated to be 0.17 metres and projected increase in temperature range is 1.8oC to 4.0oC by the end of this century .1,4

Slide2

These IPCC reports changes point to the drastic effects that climate change could have onlife in tropical counties and islands such as Vietnam, Mongolia, Laos, Philippines, Papua New Guinea, Nauru, Micronesia, and Tonga among others. Some of these Islands are only two to three metres above sea level and by viewing this trend of climate change, it is very difficult to predict the future of these countries.  The most common observed phenomena are increasing sea level, acidification, alteration in weather conditions, droughts, cyclones, extreme ENSO (El Nino Southern Oscillation) and EI Nino effects, etc.

Climate change has dramatically and negatively affected human health in the form of increased  burden of diseases of all types, in particular vector-borne illnesses such as dengue and malaria. Changes in climate increase the temperature, which in turn accelerates the multiplication of vectors by breeding, causes droughts which kill crops in some areas or floods which cause cholera in others, thus contributing either directly or indirectly to other diseases such as malnutrition and water-borne, air-borne, and food-borne diseases.

Slide3

Climate change associated with increasingly frequent and severe weather events and causes extensive infrastructure damage, economic slowdown, and interruptions of medical and psychiatric care, all which are likely to affect mental health in several ways. These events, and the lifestyle changes that can result, are associated with increased mental health burdens.5

Basically, there are two ways to  contend with climate change: adaptation and mitigation. The former is as a short-term solution that addresses only how to protect ourselves from adverse condition, whereas the latter is  a long-term process. Therefore, both should run simultaneously. Research area in the sectors of climate change should be highly prioritized and awareness program should be initiated from local levels. For all these activities, governments of all nations should responsible, and develop and implement proper national action plans for climate change.

Who is responsible for these overall hazardous conditions caused by climate change? The answer is human beings. Now the time has come to protect our lovely earth and to think about what we are leaving for our future generations. It is not the time to look for blame for problems such as increasing CO2 concentrations, clear-cutting of the forests and so on. t This is the time  for  all nations and human beings to unite with integrity to save the earth and protect the earth for our progeny.

It is my hope that every human will commit to protecting our planet from changing climate and its disastrous effects on human health.

More opinions in this context are highly welcomed. For further information, please contact the author at yadavjoshi@gmail.com

References

  1. McMichael AJ (2003) Global Climate Change and Health: An Old Story Writ Large. A. J. McMichael et al. editors. World Health Organization Geneva. 1-17.
  2. Sahney, S, Benton MJ, Ferry PA (2010) Links between the global taxonomic diversity and expansion of vertebrates on the land, Biology letters 6: 544-547. Available at: http://rsbl.royalsocietypublishing.org/content/6/4/544.full.
  3. McMichael AJ, Woodruff R, Hales S (2006) Climate change and human health: Present and future risks. Lancet  367: 859-869.

4. Climate change and health in Cambodia (2008) A vulnerability and adaptation assessment, WHO/MoH.

5. Roth P ( 2010) Climate change and health: mental health effects, News and views on climate, public health and environment. Available at: http://climatechangehealth.com/tag/ptsd. Accessed on: 1 March 2010.

Slide1Mr. Yadav Prasad Joshi is Nepalese and graduated from Tribhuvan University, Nepal, in Zoology and Psychology. He is extremely interested in infectious diseases and climate change. He joined the JIDC in 2007 as a Reviewer and Editorial Board member in 2012. Mr. Yadav Prasad Joshi has more than 10 years’ teaching experience in biological science to college, university, and medical students. He  participates equally in research activities, seminars, and book writing.  He has done research in tuberculosis, malaria, and many other public health issues.

Currently, he is a PhD student at Sungkyunkwan University, South Korea, in the department of Social and Preventative Medicine. His research topic is climate change and health.

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Filed under Cholera, Countries, Environmental Issues, Environmental Postcard, Infectious Disease, Nepal, Postcards

Marie Anne and the WHO investigate Cholera in Sierra Leone

I believe accurate reporting of infectious diseases, including diarrhoeal diseases, to be a significant issue of consideration in both developed and developing nations.  Accurate reporting by the individual, as well as by medical and government institutions, is imperative for analysis of infectious disease epidemiology. With accurate reporting, especially of cholera cases and cholera typing, appropriate therapeutic and preventative measures can be put in place. 

Here, Marie Anne Chattaway, a microbiologist from the UK, describes her experiences working with the WHO in Sierra Leone establishing an Enteric Bacteria Laboratory in Sierra Leone.  Their goal was to aid cholera diagnosis and reporting in this region.  I can’t thank Marie Anne (marie.chattaway@hpa.org.uk) enough for sharing her project.  I wish her and the taskforce every success in the future.

Thank you to Marie Anne, WHO and Sierra Leone.      

Alyson

Marie Anne and Cholera in Sierra Leone

Slide1

Picture 1: Map of Sierra Leone

I first became interested in developing countries when I started to volunteer for JIDC (The Journal of Infection in Developing Countries) a couple of years ago as a scientific editor and reviewer where the focus was mentoring scientists to publish their research in a scientific journal. I have been working with enteric pathogens for over five years at the Health Protection Agency of the UK and now realise just how much of an impact bacterial enteric infection has in developing countries. Until now, I had only managed to help from the UK, but the outbreak in Sierra Leone provided me with an opportunity to really use my microbiological skills where it was needed the most.

Cholera outbreak in Sierra Leone

Sierra Leone (Picture 1) has recently battled its worst cholera outbreak in 15 years. In

Picture 2: Crowded housing at risk of cholera

Picture 2: Crowded housing at risk of cholera

July and August 2012, the epidemic rapidly spread to all but one of Sierra Leone’s 13 districts. With a combination of crowded housing (Picture 2), unsafe water supplies, poor sanitation and the rainy season ahead, intervention was paramount. On 16 August 2012, the Sierra Leone government declared the outbreak to be a public health emergency, and established the Presidential Taskforce on Cholera. As of 2 October 2012, there had been 20,736 cases, including 280 deaths (case fatality rate or CFR=1.35%). The western area of the country where the capital city of Freetown is located was the most affected area with more than 50% of total cases. Initial training and some supplies were provided to the Central Public Health Reference Laboratory (CPHRL), Lakka and Connaught Hospital, in Freetown by the World Health Organization (WHO) and International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B).  The Global Outbreak Alert Response Network (GOARN) later requested a microbiologist to further evaluate laboratory facilities and provide technical advice and assistance to strengthen laboratory services for detection of cholera cases, capacity for confirmation by laboratory identification and for conducting differential diagnosis for main enteric pathogens (e.g., Vibrio cholera, Shigella, Salmonella, E. coli). The Health Protection Agency (HPA), UK, sent a microbiologist from the Gastrointestinal Bacteria Reference Unit (GBRU) to undertake this task from 10 October to 8 November 2012.

Travel to Freetown

The HPA was already involved with the cholera outbreak with a focus on epidemiology and case management; Sarika Desai and William Welfare from the HPA had already been deployed as WHO consultants. The specific request for a microbiologist to go to Sierra Leone for the month came later and though I had volunteered to go, in the end I had only 24 hours’ notice that I was on the flight the next day and that urgent supplies were needed. Needless to say, my two large suitcases were filled with consumables as well as clothes, a ridiculous amount of a range of pharmaceutical products (which I did end up using – unfortunately), and insect repellent (the insects still got me, though). I’m not sure what part of the journey was the worst: the bad turbulence on the plane with the woman behind me screaming; the small speedboat trip across the sea in the pitch black;  the jolting of the spine across the dirt tracks in the jeep;, or the sickness on arriving when adapting to the humidity and heat (as you know, we English are used to the cold). Either way, I did make it in one piece and was so happy that I didn’t crash in the plane and impressed by the stunning views (Picture 3) that actually I didn’t mind the bumpy roads.

Picture 3: One of the many stunning views in Freetown

Picture 3: One of the many stunning views in Freetown

Assessment of the laboratory

I was fortunate that there was a dedicated laboratory which had been selected to develop testing based at the Central Public Health Reference Laboratory (CPHRL) in Lakka. It was an hour away from the WHO office. Prior to intervention the department was faced with challenges of the lack of supplies, shortage of available trained staff, poor processing systems, and inadequate Health and Safety protocols in the enteric bacteria section of the CPHRL. The icddr-b had done a fantastic emergency response but further work was now required to establish and maintain an enteric bacteria laboratory in Sierra Leone.

Establishing an Enteric Bacteria Laboratory in Sierra Leone

Before training could even begin, a supplies stock system with the support of the WHO, HPA, CDC and Ministry of Health and Sanitation (MoHS) was set up to receive the required equipment and supplies. Molly Freemen from the Enteric Diseases Laboratory Branch of the CDC joined me for 11 days and the collaboration of all these organisations enabled the success of this mission. Intense training of multiple staff was necessary to maintain function after I left and the staff worked incredibly hard, even coming in at weekends and public holidays. A quality accredited process was set up, including the design of request forms for necessary information, the development of protocols for taking samples, receiving and logging the samples into CPHRL, and testing and recording results on the enteric result database for reporting (Picture 4). A surveillance link was also set up

Picture 4: Left to Right: Musu Abu entering laboratory results with Marie Anne Chattaway

Picture 4: Left to Right: Musu Abu entering laboratory results with Marie Anne Chattaway

so that regular weekly reporting of confirmed enteric pathogens is fed back. The two weeks of practical (Picture 5) and theoretical training was followed by intense three-day theory and practical competency testing. Staff were then certificated in “Isolation and identification of Vibrio cholerae, Salmonella typhi, non-typhoida, lSalmonella, Shigella sp. and E. coli O157” and “Health and Safety and Quality Systems in the enteric bacteria laboratory” (Picture 6).

Picture 6: Left to Right: Musu Abu, Fay Rhodes and Marie Anne Chattaway in Enteric Bacteriology, Quality and Health & Safety training

Picture 5: Left to Right: Musu Abu, Fay Rhodes and Marie Anne Chattaway in Enteric Bacteriology, Quality and Health & Safety training

Challenges and future Work

To sustain the new laboratory service, there is still much work to be done.  The supply system must be managed to ensure stock is available when needed.  Regular testing at the laboratory and reporting of results are essential for monitoring the cholera situation in the country. The biggest challenge will be the organisation and implementation of regular sample collection and transport to CPHRL.  Without regular samples from the districts, the testing competency and surveillance cannot be maintained. The impact of this part of the international response has been considerable; there is now a system for detecting and confirming cholera and other enteric pathogens within Sierra Leone.  If this laboratory component of surveillance is sustained it will lead to a better understanding of the incidence of cholera in the country and provide earlier recognition should the infection become epidemic again, thus enabling a rapid response.

Picture 6: Left to Right: Molly Freeman, Ahmed Foray Samba, Musu Abu, Slyvester Kamanda, Dr Abdual Kamara, Fay Rhodes and Marie Anne Chattaway. Other staff who participated and not in this photo include Eric Sefoi and Doris Harding.

Picture 6: Left to Right: Molly Freeman, Ahmed Foray Samba, Musu Abu, Slyvester Kamanda, Dr Abdual Kamara, Fay Rhodes and Marie Anne Chattaway. Other staff who participated and not in this photo include Eric Sefoi and Doris Harding.

Would I recommend this experience

Absolutely! It was an amazing experience, from networking and collaborating on an international scale with the most amazing and interesting people to experiencing the culture. I felt a real sense of achievement seeing how I can personally make a difference. It is hard work, working long hours with little breaks in sometimes difficult conditions, but the end result was worth any hardship. My favourite challenge was when I first opened the incubator to find lots of small ants favouring the Trypticase Soy agarplates. At first I didn’t think much of it, but when I looked at the plates carefully I saw tiny ant footsteps left by the insects that had walked on a cholera plate just after it had been inoculated. The ants had walked across the plate, dragging the bacteria with it (Picture 7). It is possible that perhaps there is a vector influence with the spread of some diseases that we wouldn’t normally consider!

By Marie Anne Chattaway

**Pictures taken by Marie Anne Chattaway, HPA.

Picture 8: Ant trail spreading cholera on a Trypticase Soy Agar plate (see line from top of plate to the bottom across the middle).

Picture 7: Ant trail spreading cholera on a Trypticase Soy Agar plate (see line from top of plate to the bottom across the middle).

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Filed under Countries, Infectious Disease, Postcards, Sierra Leone, Vibrio cholera

Introducing DR. Ana Carolina Ritter, PhD! Moving from PhD student to Post Doctoral Fellow

So you can’t wait to finish your PhD.  The years have been slowly slugging by.  It seems you have been at it for eternity…  And then BAM!!! You are done.  It seems it has come all at once.  So what comes next? What comes after the PhD is completed?  And importantly, now that you have finished (which is what you have been waiting for), it may be hard to know how to move on or what to do next.  I HAVE BEEN THERE. And so has Ana Carolina.

Ana last wrote of her interesting PhD research on Salmonella, telling us how she was able to study and conduct her lab work in both Italy and in her native Brazil.  Now Ana updates us with her exciting news that she has received her PhD.  She also shares how she navigated the difficult road from PhD to landing a postdoctoral fellowship in Bologna, Italy.

Good Luck Ana!

Alyson

Italy, I’m coming!

Hello! Good news, I’m going back to Italy … To do the postdoctoral research, this time in Bologna!

In my last blog post, I wrote a little bit about my experience completing part of my PhD at the University of Sassari… Since then, I have completed my PhD and the desire to return to Italy increased!

AnaPhD Talk

Ana’s PhD Seminar in Brazil

Therefore, while completing my doctorate, I sought out a group conducting strong research in food microbiology in Italy to do my postdoctoral research. After searching through PubMed, I found some papers published by the group led by Professor Maria Elisabetta Guerzoni.  I was very interested in the research they perform at the University of Bologna, more precisely in the Distal.  I contacted Professor Guerzoni and we were extremely well matched.

Upon receipt of her acceptance, I applied for a scholarship from a Brazilian funding agency for research, called “National Counsel of Technological and Scientific Development” (CNPq)1.  I outlined a project where I proposed working with new technology for disinfection of food, called Gas plasma2.  In late September I received a positive response from the Brazilian government, and will embark for Bologna in January 2013! Very cool huh?

Currently, it is exciting times for research in Brazil as the government is supporting researchers in bringing new technologies to Brazil by funding global travel for scientific education.  This initiative supports the development of competent professionals, through the granting of many scholarships to enable researchers to study in top universities worldwide.

I’m very excited as I am going through a new experience both in my personal life and academic life. And I hope that this partnership with the University of Bologna allows me to publish work as was the case happened with the University of Sassari3… And of course, I’ll be closer the Central Office of JIDC and old friends.

See you!

1: http://www.cienciasemfronteiras.gov.br/web/csf-eng/

2: Ragni, A., Berardinelli,A.,, Vannini, L., Montanari, C, Sirri, F., Guerzoni, M.B., Guarnieri, A. Non-thermal atmospheric gas plasma device for surface decontamination of shell eggs. Journal of Food Engineering 100 (2010) 125–132.

3: Ritter, A. C., Bacciu, D., Santi, L., Silva, W.O.B, Vainstein, M. H., Rubino, S., Uzzau, S., Tondo,E.C. Investigation of rpoS and dps genes in Sodium Hypochlorite Resistance of Salmonella Enteritidis SE86 Isolated from Foodborne Illness Outbreaks in Southern Brazil. Journal of Food Protection. Journal of Food Protection. , v.75, p.437 – 442, 2012.

AnaPhDParty

Ana’s PhD Graduation Celebration

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Filed under Brazil, Countries, Infectious Disease, Postcards, Salmonella

Thank-Science-Giving: The Nobel Prize, Science Now and Science Future

Picture from http://funmike.com/

Every year in early October the Nobel Prize winners are announced.  For those of us in Canada, this coincides with our Canadian Thanksgiving, which is celebrated the second Monday in October every year.

Call me a NERD but to me this is an appropriate pairing:  Thanksgiving — a time to reflect on what we have in our lives — and the Nobel Prize – a time to reflect on a person’s lifetime of achievement.  Importantly, the contributions of the named Nobel Laureates have often have had an enormous impact on scientific methodology, scientific theory and/or the quality of health and life in general.  For instance, this includes recognition for the discovery of HIV (2008), development of the gene silencing (2006), and discovery of protein ubiquitination (2004).  And where would we be without PCR (Polymerase Chain Reaction)?  The Nobel Prize for Chemistry was awarded to Kary Mullia and Michael Smith in 1993 for their discovery and work on PCR.

The achievements recognized in this year’s awards resonate through many aspects of our lives, from the optimism for the possibilities offered by therapeutic stem cells to the stabilization of the global economy.  Hopefully the dividends from these discoveries will be evident in the years to come.

If you knew me during the first couple of years of my PhD, then you heard me talk endlessly about Robert Lefkowitz and the biology of the trimeric G-protein protein couple receptors (GPCR) chemokine receptors.  I am sure all of Queen’s University heard my ramblings — I was GPCR OBSESSED.  Without Dr. Lefkowitz’s work, I probably would not have a PhD today, and for his work on GPCRs I am grateful.  Specifically Dr. Lefkowitz has made a significant impact on the field of drug development by elucidating the signalling, activation and desensitization of GPCRs which has been applied for the treatment of conditions such as ulcers and hypertension.  Therefore, I was super pumped to hear of the Nobel Prize in Chemistry this year going to Dr. Lefkowitz and Brain K. Kobilka”for studies of G-protein-coupled receptors“. 

The announcement for the Chemistry Nobel Prize on GPCRs got me thinking, “Who will win next year?  What researcher, technology or development has impacted the other areas of my scientific career or science and society in general significantly enough to be deserving of the NEXT Nobel Prize?”

I believe a new tone has been set for global science and health care. Specifically, the work by  Grand Challenges Canada is leading the way for global scientific development.  Their platform encompasses the utilization of scientific innovation to improve health care and build scientific discovery in low-income countries.  Grand Challenges Canada has received global attention by Scientific and Global Health Organizations including the prestigious scientific publication Nature, the Bill and Melinda Gates Foundation, and USAID.  Grand Challenges Canada has implemented programs for solving health-care challenges through the following in initiatives:  Stars in Global Health, Saving Lives at Birth, Saving Brains, and Global Mental Health.  Importantly, the Stars in Global Health programme supports collaborations between Canada and lower income countries  for the development of scientific innovations for resolving global health challenges.  Essentially, its aim is to utilize scientific discovery to directly improve the health problems in lower income countries. I believe that the work being conducted requires both scientific and health-care novelty and knowledge and will have a significant global impact.  To me, I can’t think of anything more fabulous than using science, scientific initiatives and global collaborations to directly solve world issues and I feel these efforts should be recognized.

Now I ask YOU.  What researcher or what technology do you see as deserving of a Nobel Prize?  Or what innovation do you see as having a significant impact on science or society in the next 10 years?  What Scientific Discovery are you personally thankful for? I would love to know your thoughts…

Alyson

This year the awards were as follows:

My Post on The Book The Grandest Challenge by Dr. Abdallah S. Daar and Dr. Peter A. Singer can be read here

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Filed under News, Science Thoughts

TB Talk: Good news for Mycobacteriologists in developing countries by Amber

Staying with the Theme of the month TB, here is Amber’s pick for January 2012.  Her pick comes from the November 2011 Issue of JIDC entitled “The stability of human, bovine and avian tuberculin purified protein derivative (PPD),” by Maes et al.  With the challenges in the current state of Global TB, this is a great article that tackles a controversial issue in the TB field, TB diagnosis.

Alyson

 

TB Talk: Good news for Mycobacteriologists in developing countries

Has the WHO’s stop TB strategy made progress?  Is TB completely eradicated? Has there been groundbreaking research in anti-TB drug development? hmmmm………

Unfortunately, the answers to these questions are not entirely positive, but an interesting piece of research that was published in the November issue of JIDC shows that we are on the right track in these areas. “The stability of human, bovine and avian tuberculin purified protein derivative (PPD)” by Maes et al. describes the antigenic stability of the purified protein derivatives (PPDs) of Mycobacterium when exposed to extreme temperature variations. PPDs are used for the tuberculin skin test, which is the only reliable method for the diagnosis of latent TB infection (LTBI). Although new TB-specific detection methods based on interferon gamma release have been introduced recently as an alternative test, due to its cost effectiveness and easy applicability, the tuberculin test is still widely used. However, concerns are raised about the traditional test’s low specificity and instability during long storage and transportation in the field.

Maes et al. evaluated the antigenic stability of human and bovine preparations of tuberculin PPDs which were exposed at different temperatures in TB-sensitized guinea pigs and Gertrudis cows respectively.   By comparing the stability of PPD preparations stored at 37oC for one month or at 100oC for an hour to those which were stored in standardized conditions, the research team demonstrated that undoubtedly clears the air about the clinical use of tuberculin skin test particularly in developing countries where it is hard to comply with the standard storage conditions.  The main conclusion was that the tuberculin PPD remained stable and was able to be stored or transported for long periods without refrigeration even in unfavorable temperatures.1

LTBI significantly contributes to the high incidence rate of TB disease in developing countries. Serious TB control measures have been taken up by the WHO; however, the efforts are largely affected by the poor or late diagnosis of LTBI cases which results in the delayed treatment and consequently the eventual development of active TB disease.  In this situation, I would say that the investigation by Maes et al is definitely encouraging for TB-sicians or TB-tists from developing countries.

Isn’t it good!!!  Oh I think you need more . . .  this was just an appetizer . . .

JIDC has a lot to offer you.  Check out the special January issue dedicated to TB and I will be back with more interesting reviews 😉

Talk talk . . . TB talk!

-Amber

Reference List

 

  (1)    Maes M, Gimenez JF, D’Alessandro A, De Waard JH. The stability of human, bovine and avian tuberculin purified protein derivative (PPD). J Infect Dev Ctries 2011;5:781-785.

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Filed under Amber, Infectious Disease, People, Tuberculosis

Goodbye 2011 and Hello New Science Year 2012: JIDC Postcards 2011- a Wrap-up

Good Bye 2011.  Hello New Science Year! Its 2012!  I hope everyone had a fabulous 2011 and rang in 2012 with a (big) bang!

There is so much a new year brings, especially in science. A new year with many possibilities. New conferences to attend (yeah!). Papers to publish. Exciting projects to start.  And new posts to write for the JIDC Blog!

To move forward in a guided direction I often feel we need to review the past.  What conferences were attended?  Were they beneficial? What papers were we able to publish last year? Were they well received? What are the stages of the current projects? Are they close to a publication? Are they close to completion?

And here at the JIDC Blog, what were the posts on the Blog over the last year?  Were they helpful to readers and authors? Did they promote scientific discussion? Were the Blog and the Blog Posts a good resource for research information? – This was my main goal when starting the JIDC Blog.  My hope was that the Blog would be useful to JIDC readers and authors alike as an information resource as well as a point for discussions.  I also hoped that it would be a valuable tool for non-JIDC members and help educate new people about JIDC.

So shall we review?

There is a blog tradition that I have only just learned about.  The tradition is that the first post of the New Year should be a listing of all the first sentences from the first post of every month from the previous year.

Below is a listing of all of the first Posts of every month in 2011 and the first sentences from each.  I have also added my personal notes from each post.

Here we go…

June 2011 — JIDC Postcards: The JIDC Blog

Hi, and welcome to JIDC’s blog. 

I was sooo excited…and nervous to introduce the Blog to the JIDC community and the world.  Would anyone read it? Would anyone like it?  Would it be a Blog that we could be proud of? Only you can answer these questions for me. 

 

July 2011 – Olga:  From Mozambique to Brazil

A Challenge!! An Opportunity!!

My name is Olga André Chichava, and I’m a young biologist fromMozambique!

I absolutely loved this post from Olga. Her story gave an incredible view into the life of a research student who is also a mother.  I was inspired to see her courage to move to a foreign country and her drive to build her masters project.   She shared her passion for research as well as life with us. This post was featured on the headlines of Microbiology Daily, I was so proud. Also, this post is the most popular post on the Blog.

 

August 2011 – Milliedes in Kashmir,India

Insects have been found in Marrhama, a village in Blok Trehgam in the District of Kupwara Jammu and Kashmir, India. The main water source used for drinking purposes is badly affected by the insects.

This post from Dr. Kadri highlighted problems that affect regional areas which can easily go unnoticed to the rest of the world.  I am so glad that he shared this experience so that more people can be aware of such difficulties that face communities. This is the second most popular post of all time on the Blog and I am happy that it has reached so many people!

 

September 2011 – The First Annual Conference on Drug Therapy in TB Infection

The Africa Health Research Organization, AHRO, presents the International Conference on Drug Therapy in TB Infection

What: First International Conference on Drug Therapy in TB Infection
When: 6-7 January 2012
Where: Edinburgh Scotland
Who: Presented by AHRO,Africa Health Research Organization

It was great to post about this conference.  Since the conference was just completed, I hope that everything went well and it was a successful event.  Also, I would love to hear a roundup of the conference by anyone who attended.  Please contact me if you are interested in writing a Blog Post describing this meeting.

 

October 2011 – And the winner is…! JIDC Open Access Week#4

And the winner is….I just couldn’t help it.  I have enjoyed Open Access Week and the JIDC T-shirt give-away that I could not just draw only 1 name.  So I picked 6!

Ooooo this was an exciting one.  I was incredibly happy to share JIDC and the JIDC T-shirts with readers and authors! If you are a winner and you haven’t contacted me and would still like at T-shirt, please let me know.

 

November 2011 – Publishing a Scientific Article in JIDC

How do I publish a scientific paper?…This question is asked by all young scientists. 

How do you write a scientific paper? There are so many directions one can take when putting their research together. I hope this helped authors organize themselves when preparing manuscripts for JIDC.  In addition to this Post, if you have other specific questions about writing a paper or you have a particular writing topic you would like to see a post about, please don’t hesitate to let me know.  I am currently preparing a post how I write a scientific paper to share with you.

 

December 2011 – ReR – MedToday!

Memento te hominem esse. – Remember that you are human.

What an important point that is! Remember you are human. We are all vulnerable and delicate aren’t we? I am so happy to have posted the special work of ReR-MedToday! The importance of support during times of ill health can’t be overstated. I am sure the families touched by this organization are forever grateful.

 

Thats a Wrap! 

So that’s the JIDC Blog for 2011.  I hope 2012 brings just as fabulous Posts and discussions as 2011 did.

I would like to thank everyone who contributed to the Posts and Discussion of the 2011 JIDC Blog!  In no particular order, BIG THANKS to:

IRIN and Jane Summ

Olga Andre Chichava

Prof. Jorg Heukelbach

Anna Carolina Ritter

Laboratory of Food Microbiology of the ICTA/UFRGS

Federal University of Rio Grande do Sul

Dr. Vinod Singh

USAID

David Dorherty

Joanne Wong

Dr. S.M. Kadri

Open Access and Open Access Week

SPARC

PLoS

Donna Okubo

Dr. Amber Farooqui

Jain et al., JIDC 2011

Dr. Abubaker Yaro

Annals of Tropical Medicine and Public Health

1st International Conference on Drug Therapy in TB Infection

The Grandest Challenge

Dr. Abdallah S. Daar

Dr. Peter A. Singer

Sun et al., JIDC 2011

Amedei et al., JIDC 2011

Elios et al., JIDC 2011

Jeff Coombs

Tracy Zao

Ashish Chandra Shrestha

Sara Norris

Christopher Logue

Sunita Pareek

Marie Anne Chattaway

Chimwemwe Mandalasi

Jane-Francis Akoachere

University of Buea, Cameroon

Nikki Kelvin

Tribaldos et al., JIDC 2011

Dr. Lorelei Silverman

Dr. Rosalind Silverman

Models of Human Diseases

Loredana

University Hospital of Hue, Vietnam

University of Sassari

Dr. Le Van An

Dr. Tran

Prof. Piero Cappuccinelli

Remi Eryk Raitza

ReR-MedToday!

SmileKenya

Drake Current

Current Family

Dr. Myo Nyein Aung

School of Tropical Medicine, Mahidol University, Bangkok

And a spceial thanks to Prof. Salvatore Rubino for his support of the Blog!

Reflecting on the 2011 Blog has shown me I have lots more science to cover! It has also spiked my curiosity.  What was your favorite Post of 2011?  What about your Favorite JIDC Postcard? Was there a topic that you enjoyed reading about or a Postcard that you could identify with? Let me know. I love to hear from you!

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Filed under Amber, Countries, Editor's Pick, Environmental Issues, JIDC News, Open Access, People, Postcards, Science Thoughts, Science Tools, Scientific Writing, Wrap-Up

mHealth! Mobiles for Improving Healthcare

In place of a JIDC Postcard this week, the fabulous Derek Ng has written a piece on mHealth.  The potential of mobile phones to deliver health advice and/or information is exciting.   I already see many people using this technology here in Canada.  For instance, many of my pregnant friends receive weekly up-dates on the progression of their pregnancies on their mobile phones.  Although powerful, challenges for implementing these technologies do exist.  In this Blog Post Derek has reviewed the compelling advances in mHealth as well as discussing the challenges. 

What are your thoughts on mHealth and how well do you think it will be accepted in your area?  Are you using mHealth technologies in your area?  Or are you trying to implement a new mHealth technology?  If you have comments or would like to share your experiences in mHealth we would like to hear from you.  Particularly I am interested in the use of mobile devices to track infectious disease outbreaks.  

Alyson

The advent of mobile phones has made it considerably easier for people to communicate regardless of where they were in the world. By the mid-2000s, these phones were becoming increasingly powerful with miniaturized computer chip technology that made it possible for users to complete more complex tasks. The mobile phone has evolved from a device that was essentially a phone that individuals could use away from home to something more resembling a handheld computer – an aptly named “smartphone.” Today, users can perform tasks beyond that of simply calling and texting, such as e-mailing, surfing, video recording, word processing and more. The integration of computer-like capabilities to the phone has also resulted in the development of applications that can be designed to perform specialized tasks. One interesting twist in the mobile world is that of mobile health (mHealth).

What is mHealth?

The World Health Organization (WHO) defines mHealth as “the use of mobile and wireless technologies to support the achievement of health objectives,” where the WHO has published a write-up on mHealth.  The concept of mHealth has already caught on with cell phone applications that assist health-care providers by providing up-to-date lists of drugs, information on diseases and so forth. This has already aided physicians in supplementing their point-of-care service. It is also available on the outpatient or receiving end of health care by providing patients with schedules for medications or how to eat or exercise better. The possibilities appear to be even more promising as mobile technologies are still rapidly advancing. Although we can see real applications and benefits for this technology in industrialized countries, the same remains to be seen for developing countries as well.

How have mobile phones changed the developing world?

Cell phone usage in developing countries has skyrocketed in the past and continues to do so in areas such as South America, Africa and Asia [1]. The technology has helped countries without infrastructure to bypass the need to construct landlines which were previously required for telephony to occur. By constructing modern radio towers instead, these countries can leapfrog the older and more expensive telephone technology, which has resulted in countries that possess a well-established mobile network despite lacking paved roads, electricity or landline internet connections [1]. This situation has allowed for an unprecedented number of individuals who are now connected to each other, as well as the internet. One key aspect about this far-reaching technology is that it has been made very affordable in these areas. For example, China and India have over 800 million cell phone subscribers each, whereas in contrast, Canada has 24 million active cell phone accounts [1]. When I visited China, I spent about 20 Canadian dollars on a prepaid plan that offered me more minutes and data usage than I could use in a month. In Canada, my cell phone plan is often over 50 dollars a month.

Why mHealth?

An advantage of mHealth is that it can be utilized to allow a broad base of users (many of which are already subscribed to a cell phone plan) to be instantly informed on wide range of issues. These topics could range from outbreak detection and notification, drug or therapy adherence (such as that seen in TB treatment), HIV awareness, and so forth. For example, Grand Challenges Canada is promoting innovative ways in which to solve global health issues [2]. Furthermore, the use of mHealth to improve healthcare has been reported in countries such as Kenya and Cameroon [3–8]: some articles of which are Open Access, Implementing medical information systems in developing countries, what works and what doesn’t by Fraser 2010, The Cameroon mobile phone SMS (CAMPS) trial: a protocol for a randomized controlled trial of mobile phone text messaging versus usual care for improving adherence to highly active anti-retroviral therapy by Mbuagbaw et al., 2011, and Global Networking of Cancer and NCD Professionals Using Internet Technologies: The Supercourse and mHealth Applications by Linkov et al., 2010.

Two interesting proposals of the Canadian Rising Stars in Global Health from Grand Challenges Canada we recently came across here at the JIDC were ‘using mobile phone text messaging to reduce maternal and infant death in rural areas in China’[8] and ‘mHealth for Maternal and Newborn Health: Clinical decision support for community health workers in Western Kenya’[9]. The first idea, proposed by Ri-Hua Xie from the Ottawa Hospital Research Institute and University of Ottawa, is to deliver educational material from the World Health Organization to expecting mothers who might not have received the information otherwise. Her proposal aims to reduce both maternal and infant deaths, by connecting healthcare providers to expecting and new mothers in rural areas.  You can watch a video describing her idea here.

The latter proposal by Astrid Christoffersen-Deb at the University of Toronto is in collaboration with Moi University Schoolof medicine inKenya. She would like to provide citizens with a unique barcode and identifying health card, which can be scanned by a community health worker. This provides the workers access to electronic medical records for sending and receiving information to and from medical facilities.  You can watch a video describing Astrid’s idea here.

Thus far about 80% of all WHO member states offer at least one mHealth service – the majority of which are in higher-income countries[1]. The highest reported rate of mHealth use was in countries inEurope, whereas Africa was least active. The majority or about two-thirds of projects in mHealth are still in a pilot stage, which poses some problems in its widespread implementation.

The challenges in implementing mHealth

However, not everyone is as optimistic about the impact of mobile phones in these countries. In fact, mHealth faces several barriers, despite the many promising ideas outlined earlier. Some issues include the lack of convincing studies that outline a positive benefit for the cost of implementing mHealth. The studies also need to show more evidence that mHealth can improve health outcomes. In countries where funding is already limited, the governments may decide to fund other important health care programs whose outcomes are better established. There is also a lack of standardization because some of the studies have been launched to tackle one specific problem in that one region. The WHO is currently developing a tool kit that may offer a standardized set of guidelines for using mHealth in the future.

The future of mHealth and summary

mHealth offers a promising way to deliver different health care programs and services to the individuals who have traditionally had difficulty accessing such resources. With the increasing capabilities of mobile technology and its penetration into remote and rural areas, we can look forward to emerging fields within mHealth. Ideally such applications (some of which previously mentioned) would benefit both health-care providers and patients alike. Health-care providers may see advanced telehealth technologies for communicating with experts for assistance in complex or difficult procedures outside of sophisticated care facilities, such as in remote or underserviced areas. An extension of this is that it could also allow physicians to more easily follow-up and monitor their patients. Yet another application branching from this is education of citizens for public health purposes.

With any new emerging technology, it is important to assess its benefits and risks. Studies must be made to produce a standardized set of guidelines – an undertaking which is already in progress through the WHO. Following such guidelines, it would also be useful to validate the technology according to the needs of an individual country and its citizens, since disease burdens and health-care services would vary.

While the verification of the benefits of mHealth and whether it is a valuable investment over other health services in countries where resources are already limited are important considerations, there appears to be a potential for mHealth to make a significant impact on health care in the future

Derek Ng

What are your thoughts on mHealth?

Please feel free to leave a comment.

Derek is from Toronto, Canada and is now a second year medical student at the University of Western Ontario.  Comments or questions contact Derek: cng2014@meds.uwo.ca or myself:  akelvin@jidc.org 

Derek on Left

 

Reference List

 

      1.   World Health Organization W (2011) mHealth New horizons for health through mobile technologies.

      2.   2011 July) Grand Challenges Canada. http://www.grandchallenges.ca/.

      3.   Chang LW, Kagaayi J, Arem H, Nakigozi G, Ssempijja V, Serwadda D, Quinn TC, Gray RH, Bollinger RC, Reynolds SJ (2011) Impact of a mHealth Intervention for Peer Health Workers on AIDS Care in Rural Uganda: A Mixed Methods Evaluation of a Cluster-Randomized Trial. AIDS Behav . 10.1007/s10461-011-9995-x [doi].

      4.   Tamrat T, Kachnowski S (2011) Special Delivery: An Analysis of mHealth in Maternal and Newborn Health Programs and Their Outcomes Around the World. Matern Child Health J . 10.1007/s10995-011-0836-3 [doi].

      5.   Mbuagbaw L, Thabane L, Ongolo-Zogo P, Lester RT, Mills E, Volmink J, Yondo D, Essi MJ, Bonono-Momnougui RC, Mba R, Ndongo JS, Nkoa FC, Ondoa HA (2011) The Cameroon mobile phone SMS (CAMPS) trial: a protocol for a randomized controlled trial of mobile phone text messaging versus usual care for improving adherence to highly active anti-retroviral therapy. Trials 12: 5. 1745-6215-12-5 [pii];10.1186/1745-6215-12-5 [doi].

      6.   Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, Jack W, Habyarimana J, Sadatsafavi M, Najafzadeh M, Marra CA, Estambale B, Ngugi E, Ball TB, Thabane L, Gelmon LJ, Kimani J, Ackers M, Plummer FA (2010) Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 376: 1838-1845. S0140-6736(10)61997-6 [pii];10.1016/S0140-6736(10)61997-6 [doi].

      7.   Fraser HS, Blaya J (2010) Implementing medical information systems in developing countries, what works and what doesn’t. AMIA Annu Symp Proc 2010: 232-236.

      8.   Linkov F, Padilla N, Shubnikov E, Laporte R (2010) Global Networking of Cancer and NCD professionals using internet technologies: the Supercourse and mHealth applications. J Prev Med Public Health 43: 472-478. 201011472 [pii];10.3961/jpmph.2010.43.6.472 [doi].

      9.   RI-HUA XIE, Canadian Grand Challenges (2011 July) USING MOBILE PHONE TEXT MESSAGING TO REDUCE MATERNAL AND INFANT DEATHS IN REMOTE AREAS IN CHINA. http://www.grandchallenges.ca/canadianrisingstars_round1grantees/rihuaxie_en/.

    10.   ASTRID CHRISTOFFERSEN-DEB, Canadian Grand Challenges (2011 July) MHEALTH FOR MATERNAL AND NEWBORN HEALTH: CLINICAL DECISION SUPPORT FOR COMMUNITY HEALTH WORKERS IN WESTERN KENYA. http://www.grandchallenges.ca/canadianrisingstars_round1grantees/astridchristoffersendeb_en/.

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Filed under Kenya, mHealth, News, Science Tools