Day 1 :
Alice Alma C Bungay
University of the Philippines, Philippines
Keynote: Evaluating the current status of laboratory diagnosis of fungal infections in the Philippines: Future needs
Fungal infections represent the invasion of tissues by one or more species of fungi which can range from superficial infections to cutaneous and subcutaneous infections, to serious deep tissue, blood, lung or systemic diseases. For almost five decades, the worldwide incidence of fungal infections has increased dramatically. Several factors have contributed significantly to this increase which includes indiscriminate and widespread use of broad-spectrum antibiotics to suppress or kill bacteria, use of corticosteroids, anti-cancer drugs and invasive surgical procedures, among others. The complex interplay between host and microbe is especially evident in the pathogenesis of fungal diseases. In the ecology of organisms as well as host-microbe interactions, fungi which were once classified as saprobic organisms or commensals in their respective ecological niches have now been recognized as opportunistic pathogens or disease-causing agents which possess latent capabilities to cause life-threatening infections in immune-deficient hosts, particularly Acquired Immune Deficiency Syndrome (AIDS) patients. There are also great similarities between fungal cells and animal cells since they are both eukaryotes, which significantly complicate therapeutic approaches to fight fungal diseases which frequently occur in hosts with compromised immunity. Certain fungi, like Candida albicans are particularly commensals, forming part of the normal flora while others like Cryptococcus neoformans, are environmental opportunists that take advantage of the abrogated host’s system. Some fungi are dimorphic in nature occurring as mold forms in the environment transforming into yeast phase in tissues which are able to produce infections even in healthy hosts. They cause diseases called endemic mycoses, which are group of diseases caused by diverse fungi that share common characteristics. In the Asia-Pacific region, the epidemiology of fungal infections is not well described and the information regarding incidence is lacking. There were several researchers who conducted reviews of fungal infections in the region. Surveys conducted showed rising incidence of fungal diseases. The occurrences of such fungal infections in the Asia-Pacific region do exist and pose significant impact or threat on public health. Although the means of diagnosing and treating fungal infections have greatly improved over the last decade, fungi still represent a serious threat to the health of immunocompromised and immunodeficient patients. In addition to the more commonly encountered fungi, recent years have also seen the emergence of life-threatening infections that had been previously seen in clinical practice. Many of these fungi are difficult to detect and treat and their emergence as serious agents of disease among specific patient cohorts presents new challenges to the delivery of safe and effective antifungal therapy. As an offshoot of the Fulbright Visiting Scholar Program where several diagnostic methods were studied and done at Duke University Medical Center, this study will discuss more on the growing concern about opportunistic fungal infections, epidemiology and diagnostic procedures applicable in the Philippines. Mycological methods would include sample/specimen collection, use of appropriate culture media, diagnostic methods, virulence tests using animal models and histopathologic techniques.
- Tropical Diseases | Respiratory and Pulmonary Infectious Diseases | Veterinary Infectious Diseases | Infectious Diseases and Cancer | Microbial InfectionsTropical Diseases | Respiratory and Pulmonary Infectious Diseases | Veterinary Infectious Diseases | Infectious Diseases and Cancer | Microbial Infections
Anita P D Nugroho
Sulianti Saroso Infectious Disease Hospital, Indonesia
Title: Surveillance of under investigated Middle East respiratory syndrome coronavirus cases in the framework of public health emergency of international concern at Sulianti Saroso Infectious Diseases Hospital period from 2014-2018
Anita P D Nugroho has her expertise in surveillance and research in epidemiology field. She has completed her Master of Health at University of Respati, Indonesia. She has worked at Sulianti Saroso Infectious Diseases Hospital since 2001 and from 2014 as an Epidemiology Staff at Directorate of Infectious and Communicable Diseases Research.
Middle East Respiratory Syndrome Corona Virus (MERS-CoV) is a new strain of the corona virus, approximately 80% of human cases reported by Saudi Arabia Kingdom. Cases identified outside the Middle East are people who were infected in the Middle East and travelled to areas outside the Middle East. In Public Health Emergency of International Concern (PHEIC), MERS case requires assessment of risk to human health, risk of international spread of disease and risk of interference with international travel. Early detection of MERS case is through surveillance at the entrance of the country and regional surveillance. Indonesia is the country with the majority Muslim population has a high history travel to Saudi Arabia for Hajj and Umrah. Sulianti Saroso Infectious Diseases Hospital (SSIDH) is national referral hospital for infectious and communicable diseases in Indonesia has task to organize management and surveillance of infectious diseases including new emerging, re-emerging and tropical disease. For MERS case, SSIDH implementing case management and surveillance case for under investigated MERS cases hospitalized. The objective of the study is to describe disease under investigated MERS cases whose hospitalized period 2014-2018. The method includes the passive surveillance. The results of the study are the trend of under investigated MERS cases hospitalized has decreased. The number of hospitalized cases based on sex was 52% for male, 82% was 45 years old above. Based on travel history was 66.7% for Umrah, region origin were 31% cases from areas outside Jakarta. Most patients referenced from hospital and final diagnosis was pneumonia (66%). The laboratory results for all cases period 2014-2018 were negative MERS-CoV. This study concluded that there are no positive of MERS-CoV, most of under investigated MERS cases with pneumonia. Sustainable surveillance is needed as early warning for emerging and reemerging diseases especially MERS.
University of Sarajevo, Bosnia and Herzegovina
Title: Tropical diseases-challenge for Bosnia and Herzegovina
Zarema Obradovic is currently working as a Professor of Epidemiology, Faculty for Health Studies, University of Sarajevo, Bosnia and Herzegovina. He has completed his PhD in Epidemiology and published over 220 scientific papers in different publication, medical journals, national and international symposiums and congresses. He serves as the President of Association of Epidemiologists of FB&H, Member of Bosnian-Herzegovinian American Academy of Arts and Sciences (BHAAAS), Member of International Society of Travel Medicine (ISTM) and also Editorial Board Member for Journal of Health Sciences.
According to WHO tropical diseases encompass all diseases that occur solely, or principally, in the tropics. In practice, the term is often taken to refer to infectious diseases that thrive in hot, humid conditions, such as malaria, leishmaniasis, schistosomiasis, onchocerciasis, lymphatic filariasis, Chagas disease, African trypanosomiasis and dengue. How to connect tropical diseases and Bosnia and Herzegovina? This is a small country in the heart of Europe, with a predominantly continental climate and only in the southern regions, along the Adriatic coast, the climate is Mediterranean, similar to the tropical. However, tropical diseases becoming more significant for several reasons: Increasing number of B&H travelers traveling to the tropics, increasing number of travelers arriving to B&H from the tropics countries, the globalization of all kinds of goods and climate change and habitat change for vectors (reservoirs and disease carriers). In the past, until 1970, there was indigenous malaria in B&H, then it was eradicated, but we have anopheles, disease transmitters and imported cases of malaria as reservoirs of the disease, which means we have a risk for occurrence new malaria cases. We have also some sporadically cases of leishmaniasis. The common fact is that tropical diseases are significant for B&H and therefore we need to do more to educate health professionals how to prevent, to recognize and treat patients with tropical diseases. It is also important to make the general population aware of these diseases and the measures to prevent them.
Sulianti Saroso Infectious Disease Hospital, Indonesia
Title: Surveillance report of rabies transmitting animal bite case at Sulianti Saroso Infectious Diseases Hospital in 2015-2018
Jamiatul Hoer has expertise in surveillance and research in epidemiology field. He has completed his Bachelor of Public Health and worked at Sulianti Saroso Infectious Diseases Hospital as an Epidemiology Staff at Directorate of Infectious and Communicable Diseases Research.
Rabies is an infectious acute disease in the central nervous system (brain) caused by the rabies virus. It is transmitted through mucosal exposure to infected animals, such as rabid dogs, cats, apes/monkeys and sometimes other species. Dogs were the most common rabies-transmitting animals in Indonesia, followed by cats and apes/monkeys. To support rabies-free program in Indonesia by 2020, rabies surveillance is needed to find out the distribution and cases enhancement. The aim of this study is to provide a comprehensive picture of rabies-transmitting animals bite cases during 2015-2018 at Sulianti Saroso Infectious Disease Hospital. This report used the passive and active surveillance method by retrieving data from emergency installation unit register book and hospital data system. The results showed that the rabies-transmitting animal’s bite cases from 2015 to 2018 has increased while for VAR used has decreased. By age, most cases occur at 20-64 years, both men and women. Most types of rabies-transmitting animals were dogs. The biggest patient domicile is from the North Jakarta area. From 2015-2018, the number of cases of rabies-transmitting animals bites cases increased and the use of VAR decreased.
Ali A Ghweil
South Valley University, Egypt
Title: Reactivation of herpes virus in patients with hepatitis C treated with direct-acting antiviral agents
Ghweil Ali Abdelrahman was a Resident of (Tropical medicine and Gastroenterology) for three years. He worked as a Clinical demonstrator and assistant lecturer of Tropical medicine and Gastroenterology, Sohag University. He was working as a Lecturer of Tropical medicine and Gastroenterology, South Valley University. Currently, he is the Head of Tropical Medicine and Gastroenterology department, South Valley University. He is also a member of the European Society of Liver Diseases (EASL).
We performed a case-series analysis of reactivation of herpes virus in patients with Hepatitis C Virus (HCV) infection treated with Direct-Acting Antiviral (DAA) agents. Eight cases were detected among 100 treated patients with direct acting antiviral regimens in Qena University Hospital from June 2016 to June 2017. Herpes virus was reactivated in 8 patients who received DAA therapy. None of the cases had risk factor for HZ reactivation. The DAAs used regimens were Sofosbuvir/Daclatasvir in 6 cases and Sofosbuvir/ Ledipasvir in 2 cases. Immune changes that follow HCV clearance might lead to reactivation of other viruses, such as herpes virus. Patients with HCV infection suspected of having herpes virus infection should be treated promptly.
Vinod C Parmar
Parmar Children Hospital, India
Vinod C Parmar had completed his MD and DCH from South Gujarat University, India and Post-graduation in Pediatric Nutrition from Boston University, USA. He is currently working as a Consultant Pediatrician and Dermatologist in Parmar Children Hospital since 39 years.
A birthmark is a marking on the skin present at birth or which appears shortly after birth. Birthmarks vary in size and shape, and can be blue, black, tan, brown, pink, red, purple and even white. Some are smooth, and some are raised and rough, but mostly, birthmarks are painless and harmless. They are not punishment for anything you or your baby did at any point, and don't indicate a latent power. Growing up with a visual birthmark is often emotionally embarrassing and upsetting as peer pressure and name-calling occur which causes self-esteem issues that often persist into adulthood. Some birthmarks may even serve as indicators of underlying health issues. To be extra safe, it's important to have a doctor check your baby's birthmarks, if rapid changes are seen. You do have options when it comes to removal of vascular birthmarks. It is congenital, benign irregularity on the skin, occur anywhere on the skin. They may be caused by overgrowth of blood vessels, melanocytes (as a result of inconsistencies in pigmentation), smooth muscle, fat, fibroblasts, or keratinocytes. Some kids have small marks and others have bigger ones. Some go away on their own, and others stick around whole life. The dermatologist can decide if treatable or just to leave it alone. They are of two types: Pigmented and vascular. If born with a mole, it is considered a birthmark or beauty marks. Moles usually are small, brown spots, sometimes can be larger and of different colors, like pink, skin-colored or black. Some are flat and smooth; some are raised above the skin like a slight bump. If a mole itches or bleeds, than have to be checked out to make sure it is benign.
Sulianti Saroso Infectious Disease Hospital, Indonesia
Title: Surveillance of diphtheria cases, inpatient in Sulianti Saroso Infectious Diseases Hospital from 2015-2018 Herlina, Sulianti
Herlina is currently working as an Epidemiology Staff at Sulianti Saroso Infectious Diseases Hospital and also a Lecturer at UHAMKA Faculty of Pharmacy and Science.
Diphtheria is caused by Corynebacterium diphtheriae and almost all over the world causes an outbreak. This disease mainly attacks children aged 1-12 years. Easy to spread and transmitted by direct contact with droplet. Diphtheria prevention is conducting an immunization program. The objective of the study is to obtain an overview of the epidemiological surveillance of diphtheria inpatients period 2015-2018 at Sulianti Saroso Infectious Diseases Hospital based on person, place and time. The method of this study includes passive surveillance by taking patient data from medical record status. The results showed that the there was an increase in cases of hospitalized diphtheria period 2015-2018. Diphtheria cases in patient based on sex and age from 2015-2018 were children (408 cases) bigger than adult (203 cases) and male (318 cases) bigger than female (293 cases). Based on the origin of referrals were hospital 247 cases; health center 171 cases; come alone 06 cases and clinic 87 cases. Based on domicile, the biggest from outside Jakarta with 236 cases and North Jakarta with 126 cases. Based on laboratory culture confirmation were 2 (2015); 5 (2016); 7 (2017) and 45 (2018). Based on life status (death) were 2 (2016); 3 (2017) and 10 (2018). Diphtheria cases based on epidemiology criteria: Total patients come with suspected diphtheria (sign and symptoms like diphtheria) from 2015-2018 were 611 cases, consist of 211 patients were non-diphtheria (sign and symptoms like diphtheria but final diagnosed not diphtheria) and 400 patient’s diagnosed to probable diphtheria (clinical diphtheria). From probable diphtheria, 69 patients diagnosed to confirmed diphtheria (clinical diphtheria and positive laboratory diphtheria). This study concluded that the diphtheria hospitalized at SSIDH was increased. National preparedness of diphtheria is needed, especially case finding in community to break the chain transmission of diphtheria, strengthening surveillance networking regarding follow-up of the diphtheria patients.