Day 3 :
Mahavir Super Specialty Hospital, India
Time : 08:30-08:55
Ashok Kapse is a consulting Pediatrician practicing in the city of Surat in the Gujrat state of India, besides owning a private pediatric hospital and he is also head of the pediatric department at a prestigious Mahavir super specialty hospital. After finishing graduation (MBBS) Kapse did MD in Pediatrics, initially he worked as professor of Pediatrics at Medical College Surat later he opted out for private practice however pursued academic interest. He developed special interest and skill in infectious diseases. Working along with CDC Atlanta he evolved simple clinical approach for diagnosis and management of Dengue illnesses particularly in resource limited situations. Last year for his dengue work he was felicitated with health excellence award. A popular and a sought after speaker Ashok Kapse is a recipient of many oration awards, he has delivered hundreds of lectures on Dengue, Malaria, Typhoid and antibiotic uses across the India. Recently he has acquired a tremendous interest and insight in the role of Vitamin D in human health, functioning along with International council he has been actively working towards vitamin D promotion across the world and he has addressed conferences at Thailand, Finland, China, UAE, and Spain. Kapse has decorated many a posts in medical fields: President of Surat city branch of Indian academy of pediatrics (IAP), president of Gujarat State branch of IAP, National president of Infectious diseases branch of IAP are few of them. Kapse is an avid clinical photographer his photos figure into various books and atlases including the prestigious atlas of infectious diseases published by American Academy of Pediatrics. He has published umpteen articles in peer reviewed journals.
Serious bacterial infections may have a poor outcome unless they are treated promptly and adequately. Early and aggressive antibiotic treatment is the cornerstone of proper management. Unfortunately initiation of treatment is almost always empirical and is also the principal determinant of patient’s outcome, therefore choosing adequate antibiotic therapy is of vital importance. Choice of antibiotic therapy is generally affected by four important variables namely: microbes, drug, patient and treating doctor. Local Microbiological Data should be used for deciding initial empiric therapy. In the want of microbiological aid it is prudent to cover all serious pathogens; due attention should be given to prevailing resistant pathogens in local area. Scale down to narrowest possible effective antibiotic once culture is available; value the pharmacokinetic properties like bioavailability, volume of distribution and effective tissue penetration while choosing antibiotic therapy. Route of drug administration, penetration at site of infection, overcoming certain physical barriers, optimal dose and optimal duration are some of the important factors in determining antibiotic therapy.Development of antibiotic resistant is a key factor in choosing an antibiotic therapy. Contrary to commonly held view antibiotic resistant development is more a characteristic of an individual drug rather than a group therefore choosing a proper molecule will go a long way in warding off the antibiotic resistance. Patients immune status has a strong bearing on disease outcome, a through inquiry pertaining to immune status is vital in all cases; only bactericidal antibiotics should be used in an immune compromised patient. Many organisms’ elaborate potent toxins, neutralization of these toxins assume vital importance while treating such organisms. Many a times laboratory aid is grossly insufficient in developing world and therefore treatment is decided empirically, under such circumstances treating doctor’s knowledge and attitude assumes supreme importance. Constant learning, delearning and relearning is the essence of proper management in such conditions.
- Track 05: Epidemiology of Emerging and Re-emerging diseases
Track 11: Plant Disease Modelling and Parameter Estimation
Track 12: Public Awareness
Track 13: Ebola and Current Research
Track 14: Common Infectious Diseases
Track 15: Infectious Diseases in pregnancy
Track 16: Tropical Infectious Diseases
Track 18: Communicable and Contagious Infectious Diseases
Irina Magdalena Dumitru
Amr Hussein Mahmoud Ismail
Ovidius University Constanta, Romania
Cairo University, Egypt
Ovidius University Constanta, Romania
Time : 08:55-09:15
Irina Magdalena Dumitru MD, PhD is an Associate Professor at “Ovidius” University, Constanta, Romania and also she is a Faculty of Medicine. She is Senior Specialist in Infectious Diseases at Clinical Infectious Diseases Hospital, Constanta. She is a Director of research and development (2006 – 2010) at Clinical Infectious Diseases Hospital, Constanta, in present she is a Director of Research Department at Ovidius” University” Constanta. In recent years she has focused on the parasitological, tropical diseases, chronic hepatitis and HIV/AIDS research. In present she is an NCP Health Romania for Horizon 2020 program. She had involved in many research projects, clinical trials and have published numerous scientific articles (more than 95 papers and chapters in medical science journals and books). She is the president of the Romanian Association of Parasitology, Constanta and member of many scientific societies (EACS, IAS, BENA, Romanian Association of Infectious Diseases, Romanian Association of Study Liver and Romanian Society of Microbiology).
Background: Although research on the microbiome is considered an emerging science, scientists already have made tremendous progress in understanding the microbial makeup of the microbiome and associating microbiome diversity with human disease. Moreover, they are beginning to make headway in understanding how the microbiome impacts human health and disease. They are recognizing the integral role of the microbiome in human physiology, health, and disease, with microbes playing critical roles in many host metabolic pathways. The objective of the study was to assess the effectiveness of intestinal microbiome transplantation in patients diagnosed with Clostridium difficile colitis.
Material and Methods: Intestinal microbiome transplant was performed in 36 patients diagnosed with Pseudomembranous colitis in Clinic of Infectious Diseases and Clinic of Gastroenterology between 01.01.2014 - 31.12.2014.
Results: Patient age ranged from 42-79 years with a median of 60.2 years, predominantly male (68%). Most patients were presented to multiple recurrences (32 cases), 4 patients did not respond to conventional therapy with metronidazole and vancomycin. All of these patients had at the time of transplantation, mild to moderate clinical forms of the disease. The evolution of the patients was favorable in all cases, the cure rate was 100%. No recurrences were reported after 10 weeks of surveillance in these patients.
Conclusions: Intestinal microbiome transplantation is a safe method with good results in the short term but also long-term prevention of recurrence in patients with pseudomembranous colitis.
Stef Stienstra is a Strategic and creative consultant in biomedical science, with a parallel career as a Commander of the reserve of the Royal Dutch Navy. For the Dutch Armed Forces he has responsibility for the counter measures in CBNRe threats and (medical) consequence management both in a military and a civilian (terrorism) setting. He is strategic functional specialist for “Health & Environment” of the 1-Civil-Military-Interaction Command (1-CMI) of the Dutch Armed Forces and for 2015 also in the NATO Response Force (NRF), which is in 2015 the responsibility of the 1-German-Netherlands-Corps (1-GNC). He was the director of the 2014 World Congress of CBRNe Science & Consequence Management in Tbilisi, Georgia. In his civil career he works internationally as consultant or as scientific supervisory board member for several medical and biotech companies, merely involved in biodefense. He is also visiting professor for Punjab University in Pakistan and Rhein-Waal University in Germany. He has finished his studies in Medicine and in Biochemistry at the University of Groningen in The Netherlands and has extensive practical experience in cell biology, immunohaematology, biodefense and transfusion medicine. His natural business acumen and negotiation competence helps to initiate new successful businesses, often created out of unexpected combinations of technologies. His good understanding of abstract science combined with excellent skills in the communication of scientific matters to non-specialists, helps him with strategic consulting at top level management.
Introduction : Sharing security threat information is a challenge for governments and their agencies. Especially in biotechnology and microbiology the agencies do not know how to classify information on potential bio-threats.
Methodology: An example is the delay of the publication of the transmissibility of H5N1 avian influenza virus in Science by the Erasmus Medical Centre in Rotterdam, The Netherlands in 2012 as various organizations wanted to investigate whether the details could be misused. The study showed that only a small number of mutations would make it possible to change the H5N1 virus so it could spread through the air. Dangerous, but this information is also useful to develop new therapies and/or vaccines.
Discussion: The knowledge of these natural mutation mechanisms could be misused to weaponize micro-organisms. It enables the engineering of the lethality, like it is done with some anthrax strains. Should these laboratory techniques be classified? Academics want to publish for the progress of science to find useful applications. The Rotterdam scientists were really annoyed when their research was blocked for publication and feared that other groups would be firstin publishing a part of their obtained experimental results.
Conclusion: Biosafety is already common practice in micro-biology, but biosecurity is often still questionable. A ‘Code of Conduct’, like the Dutch Academy of Science has developed, would help; especially for the so-called insider risk. Educational programs for the identification and assessment of risks and threats to security have to be developed to give scientists bio-threat awareness and for government officials to rationalize the real threat, without damaging the progress of science.
Amr Ismail MBBCh, MSc, MD, MACP, FISQua, FABAM, CHPI, Consultant Dermatologist received on 1998 his Doctorate of Dermatology from Cairo University and Faculty of Medicine, Egypt. Fellow of the American Board of Aesthetic Medicine (ABAM), USA. Fellow of International Society for Quality in Healthcare (ISQua), Ireland. Certified Professional Health Performance Improvement, AIHQ, USA. Member of American College of Health Executives (ACHE), USA. Member of American College of Physicians (ACP).
Hand-foot-mouth disease (HFMD) or vesicular stomatitis with exanthem is a common childhood condition. The most common causes are non-polio enteroviruses such as Coxsackie virus A16 (CAV 16) and Enterovirus 71 (EV 71). EV 71 is a common ribonucleic acid (RNA) virus that is found worldwide. EV 71 associated HFMD is considered benign and selflimited but complications may include encephalitisand myocarditis. Most deaths occur as a result of pulmonary edema or hemorrhage.
Prevention and Control Measures: Decisions on public health interventions to prevent and control HFMD must be made despite the lack of definitive scientific and technical evidence. During outbreaks, adequate and functioning surveillance systems,improved sanitation and goodhygiene,are important preventive measures. Moreover, promoted network specific for HFMD,improving infection control measures, clinical case management, closure of schools, and supportive legislation to facilitate public health interventions.
Treatment: No specific antiviral agent is available for therapy or prophylaxis of EV 71 infection. Treatment is supportive and focuses on management of complications. Intravenous administration of immune globulin may have a use in preventing severe disease in immunocompromised patients.
Future Considerations: Several vaccines for HFMD are currently under development.
Harbin Medical University, China
Time : 10:00-10:20
Mingli Jiao completed her PhD at the Public Health School, Harbin Medical University (HMU), in Harbin, China—site of the 1911 pneumonic plague outbreak (it was called Fujiadian, Manchuria). The surgeon general at that time, Wu lien-teh, was the first president of HMU. Mingli Jiao studied at the University of Washington and at the Johns Hopkins Bloomberg School of Public Health as a visiting scholar. She is the vice director of Health Policy and Hospital Management Center in HMU.
Many epidemics have taken place in the 20th century, such as Spanish flu, HIV/AIDS, SARS, bird flu, and the recent wave of the Ebola in Western Africa. Facing these ‘emerging and re-emerging diseases’, our historical experience battling against epidemics may provide us a new perspective. And China’s effective experience, as an underdeveloped country, may be more useful for low and middle-income countries. We reviewed the pneumonic plague epidemic outbreak in China’s northeast from October 1910 to April 1911 and this plague has been called the worst epidemic of the 20th century, since it took more than 60,000 lives. The recent outbreak of Ebola in West Africa presents many similarities—such as in issues of economy, culture, health systems, and other background environments—with the plague that happened in Northeast China (Manchuria). Manchuria has suffered wars, poverty and inadequate health infrastructure just like the West Africa of today. It is also similar that the particularly devastating courses of these epidemics are attributed to biologic characteristics of the virus. It is more likely that these are the result of the combination of dysfunctional health systems, international indifference, high population mobility, local customs, densely populated capitals, and lack of trust in authorities after years of armed conflict. Summarizing the successful experiences in fighting the pneumonic plague in Northeast China a hundred years ago has importance in dealing with the current Ebola diffusion in West Africa. In addition, China’s social motivation and quarantine experience during the 2003 SARS control may help stop Ebola.
Charles Universirty in Prague, Czech Republic
Time : 10:20-10:40
Aysheshm Kassahun is a PhD student at Charles university in Prague, department of Parasitology. He is evolved in various activities focusing on leishmaniasis researches. He published more than 10 papers in a peer-reviewed journals through his postgraduate studies.
Leishmaniasis represents an important public health problem in Ethiopia with heterogeneous clinical manifestations ranging from self healing cutaneous form (CL), mutilating mucocutaneous (MCL) and metastasizing diffused lesions (DCL) to a life-threatening visceral leishamaniasis (VL). Leishmania aethiopica is a usual etiological agent of CL while L. donovani is considered the sole agent of VL in the country. The main transmission mode of these protozoan parasites is by the bite of infected female phlebotomine sand fly in the genus Phlebotomus. Even though Ethiopian CL is believed to be zoonotic with rock hyraxes as main reservoirs of the parasite, the transmission cycle of VL remains unclear and traditionally believed to be anthroponotic. As part of a study on the ecology and transmission dynamics of VL in Ethiopia, we investigated the role of domestic (E.g cattles, dogs) and wild (e.g rodents) animals in leishmaniasis cycle at endemic and non-endemic settings. Molecular techniques targeting two genes (kDNA and ITS1) of the parasite were used to determine natural infection. Moreover, serological procedures (anti-L. donovani IgG and anti-sand fly saliva antibodies in peripheral blood) were used as a marker of exposure to the parasite and probable vectors. Our findings could open insight in the involvement of animals for epidemiology of Ethiopian leishmaniasis at certain sort of reservoir system or as potential blood source for sand fly vectors.
Azerbaijan National Academy of Sciences, Azerbaijan
Title: Serological and molecular detection of melon (cucumis melo l.) infecting viruses in Azerbaijan
Time : 11:00-11:20
Nargiz Sultanova received B.Sc. in Biological Sciences at the Baku State University (September 1999-Jule 2003) and has completed her Master in Molecular biology at the Baku State University in Azerbaijan (September 2003 - July 2005). She completed her PhD in 2014 at the Institute of Botany, Azerbaijan National Academy of Sciences. She has worked with both theoretical and applied molecular biology, including virology, plant biology, plant biochemistry and plant pathology. She now serves as a senior researcher at the Bioadaptation laboratory at the Institute of Botany in Azerbaijan. She is author of more 47 scientific journal papers, published in a wide range of journals that covers a broad range of research areas.
Azerbaijan has a great potential for production of most important cucurbit crops. Being dangerous diseases, viruses with DNA and RNA genomes lead to reduced plant quality and yield. Until now more than 35 viruses have been found in cucurbit plants around the world. The main objective of this study is phytopathological monitoring, detection and identification of main viruses which infect vegetables (squash, melon, watermelon) grown in greenhouse and natural conditions with visual, serological and molecular methods. For this purpose during on a preliminary assesment 52 different cucurbite samples were collected taking into consideration viral diseases potensial symptoms. The collected plant samples were diagnosed using field tests (AgriStrip BIOREBA AG, Switzerland) that allows analyses a large number of samples at the same time based on immunochromato test. Extracts were obtained from leaf samples which showed positive results for checked virus and analyzed with DAS-ELISA method (BIOREBA AG, Switzerland). Samples were considered to be positive if the A405 nm values were more than three times those of the healthy control. The consentration of virus samples has been identified spectrophotometrically on the bases of optical absorption of enzymatic reaction products at 405 nm in comparison with negative control samples with at least three times more values have been considered positive for tested disease. As a result of serological tests, melon necrotic spot virus (MNSV) belonging to carmovirus have been found in two melon (Cucumis melo L.) samples, Zucchini Yellow Mosaic Virus (ZYMV) belonging to potyvirus in three melon samples, Squash mosaic virus (SqMV) belonging to three melon samples and in two samples SqMV + ZYMV, ZYMV+ CMV (Cucumber mosaic virus) as a mixed virus infections. Serologycal methods show that 54.6% disease level has been identified for the ZYMV virus. For identification of ZYMV, total RNA extracts were separated using TRI-Reagent (Sigma Chemical, St Louis, MO, USA) from leaves of infected plants that were positive in DAS-ELISA. Extracted total RNA samples have been amplified by RT-PCR method with ZYMV-CP-5’ (5’-GGTTCATGTCCCACCAAGC-3’) and ZYMV-CP-3’ (5’-ATGTCGAGTATCACATTTCC-3’) spesific primers. Amplified PCR products were electrophoresed in Tris-acetate-EDTA buffer through 1.5% (w/v) agarose gel, stained with ethidum bromide (1.5 μg) and viewed with a UV transilluminator. ~600 bp amplicons were observed in all samples which confirm the presence of ZYMV.
University of Nigeria, Nigeria
Title: Determinants of treatment delays among pulmonary tuberculosis patients in Enugu metropolis, South-East, Nigeria
Time : 11:20-11:40
Omotowo IB obtained MBBS from University of Ilorin, Nigeria in 1987. He completed MPH from University of Nigeria, Nsukka in 2006, and FWACP from West African College of Physicians in 2009. He worked as a Medical Advisor for German Leprosy and Tuberculosis Relief Association from 2010 to 2012. He is a lecturer at the Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus since August, 2012. He is the MBBS Coordinator in the department since then. He has published some papers in both local and international journals. His interests are infectious and non-communicable diseases.
Introduction: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of treatment is essential to achieve an effective tuberculosis control programme.
Objective: To assess the determinants of treatment delays among pulmonary tuberculosis patients in Enugu metropolis, South-East, Nigeria
Methods: This cross sectional study was conducted among 219 pulmonary tuberculosis patients in six randomly selected DOTS centres in the three LGAs in Enugu metropolis. Data was analysed using SPSS version17, and statistical significance of association between variables was assessed using Chi-square test at p<0.05. STATA version 13.1 was used to calculate the positive predictors of TB treatment delays using logistic regression. Ethical clearance was obtained from the Research Ethics Committee of UNTH and informed verbal consent was obtained from the participants.
Results: Overall, 291 respondents took part in the study, 55.7% were males, 84.4% were aged between 16 to 60 years, while their mean age was 35.4 ± 12.6 years. Most of the participants 32.9%, 26.9%, 15.5% are traders, civil servants, and students respectively. Among the respondents, 3.6% knew that mycobacterium tuberculosis is the cause of tuberculosis. Among the participants, only 23.3% presented for first appropriate treatment consultation within 1-30 days of onset of symptoms. The reasons given by the respondents for the delay are: ignorance of necessity treatment (36.1%), Lack of money (24.2%), no health facility close to the house (13.2%), and other reasons 26.5%. Delay in treatment was found to be significantly associated with HIV status (X2 =23.412, df=8, p=0.003), knowledge about the causes of TB (X2=42.322, df=28, p=0.040), TB symptoms experienced (X2=46.857, df=20, p=0.001), occupation (X2=34.217, df=20, p=0.025), and distance of the health facility from the respondents residence (X2=34.908, df=8, p=0.000). The positive predictors of delayed treatment, using logistic regression, were first presentation at: patent medicine dealer (OR 12.3 CI: 3.22-36.23), private hospital (OR 10.6 CI: 5.73-17.94), prayer house (OR 7.2 CI: 2.75-23.64), and traditional healer (OR 11.9 CI: 6.87-32.85)
University of Agriculture, Nigeria
Time : 11:40-12:00
Ebele U Umeh got his Ph.D. from the University of Nigeria, Nsukka. Presently she is a Professor of Microbiology and lectures at the University of Agriculture, Makurdi, Nigeria. She is a member of the University Senate and University Senate Business Committee. She has headed a Department in her University. She supervises Masters and Doctoral research studies in her University, and is an external examiner and visiting lecturer to a number of universities. Some of the courses she teaches include bacteriology, medical microbiology, food microbiology, industrial microbiology, microbial genetics, etc. She has published articles in peer reviewed local and international journals.
Cytomegalovirus (CMV), a member of the herpes family, belongs to a group of viruses referred to as the TORCH complex comprising (Toxoplasmosis, Rubella, Cytomegalovirus and Herpes Simplex). Known to be frequently transmitted to developing fetus, it remains one of the leading causes of congenital viral infections. Although the infection has been detected in Nigerian neonates, its awareness is limited particularly in a growing metropolitan city like Makurdi, Nigeria. In this study, the prevalence of CMV antibodies and their association with some socio-demographic factors in pregnant women was evaluated. Pregnant women (N=375; age range = 15 to 50 years) attending ante-natal clinic in different hospitals in Makurdi were screened for the infection. Five-ml venous blood was collected from each participant for serological studies, and structured questionnaire was used to obtain socio-demographic data. Serum samples were assayed using ELISA technique. The overall prevalence of anti-CMV IgG-antibodies was 93.3% (n=350) and was 3.5% (n=13) for anti-CMV IgM-antibodies.Prevalence of the anti-CMV antibodies was significantly associated with gravidy and marital status (P<0.05): the seroprevalenceof CMV antibodies was higher in women who have had more than one pregnancy. The prevalence of anti-CMV IgG antibodies was highest (100%) in older pregnant women aged 41-50 years, but was lowest (85.0%) in younger ones aged 15-20 years. Risk factors for the disease such as history of blood transfusion, scarification, and multiple sexual partners were important, even though not statistically significant (P>0.05). Women of child-bearing age in the growing metropolitan city of Makurdi, Nigeria need to be educated on precautionary measures that will prevent cytomegalovirus infection.
St. Luke’s Medical Center, Philippines
Time : 12:00-12:20
Maria Luisa G Daroy is a Scientist at the Research and Biotechnology of St. Luke’s Medical Center and Assistant Professor in the MS Molecular Medicine Program of the St. Luke’s College of Medicine-WHQ Memorial. She has published more than 20 papers on dengue, Japanese encephalitis, chikungunya, eye infections, dementia, diabetes, and coronary artery disease. She is Chair of the Board of Examiners of the Philippine Academy for Microbiology and authored a book chapter on Philippine microbiology research. Current researches include dengue, chikungunya, diarrhea, CNS infections, pathogen genomics, plant antivirals, molecular diagnostics, dengue POC, and genetics of CVD, thyroid cancer, and dementia.
Chikungunya fever is an emerging mosquito-borne viral disease in the tropical regions of the globe, including the Philippines. From 2012 to 2014, 126 CHIKV isolates were detected by RT-PCR of the nonstructural protein 1 (nsP1) and/or envelop (E) genes from patient sera. Phylogenetic analysis of partial and full nsP1 and E1 gene segments showed them to belong to the Asian genotype. In 2013, vertical transmission of chikungunya virus infection was confirmed by RT-PCR and cDNA sequence analysis of CHIKV isolates. cDNA sequence analysis using BioEdit software revealed identical sequences of the amplified E1 and nsP1 regions, confirming the vertical transmission of a single strain of CHIKV from mother P. B. to her newly born son, J. M., with overt symptoms of the viral illness manifested in both of them. Further comparison of the sequences from this CHIKV strain with the cDNA of other isolates in GenBank using BLAST showed close similarities with Asian isolates from Thailand, Indonesia, Malaysia, China and Taiwan. Using sequence independent single primer amplification (SISPA) and nextgeneration sequencing we generated a whole genome sequence from a CHIKV isolated in 2013 from Metro Manila by mapping the reads to the curated NCBI Chikungunya reference sequence (NC004162). Complete coding sequence phylogenetic analysis shows it to be most closely related to two strains from Zhejiang and Indonesia, which belong to a subclade in the Asian genotype. The tree also shows two Philippine strains p isolated in 1985 forming a sister clade suggesting lineage persistence of CHIKV in the Philippines.
National Institute of Malaria Research, India
Time : 12:20-12:40
Severe clinical cases exclusively associated with Plasmodium vivax are increasingly being reported worldwide with complications like renal failure, jaundice, acute respiratory distress syndrome, cerebral malaria, seizures, anemia, thrombocytopenia, pulmonary edema, splenic rupture and death. Emergence of P. falciparum like severity in P. vivax and its pathogenesis has been speculated to be linked to increasing chloroquine resistance (CQR). Two main transporters studied with regard to CQR in P. vivax are P. vivax chloroquine resistance transporter, pvcrt-o; and the P. vivax multidrug resistance transporter, pvmdr1 which are orthologous to the pfcrt and pfmdr1 genes respectively. Even though these transporters are not established as molecular markers for CQR, they have a speculated role in CQR of P. vivax. Further, it has been demonstrated that the clinical severity in P. vivax could be associated with increased expression levels of parasite transporter genes likely to be involved in CQR i.e. pvcrt-o and pvmdr1. In this study, relative expression levels of pvcrt-o and pvmdr1 genes were analyzed in severe and non-severe P. vivax cases compared to a non-severe control group. P. vivax positive isolates were classified as severe and non-severe according to the WHO guidelines for severe malaria. Transcription analysis of drug resistance genes was carried out for severe and non-severe P. vivax isolates by real-time PCR normalized to β-tubulin; the endogenous gene. The severe P. vivax isolates were found to have higher expression levels of the drug resistance genes (pvcrt-o and pvmdr1) as compared to the non-severe P. vivax infections. Increased expression levels of CQR transporters in severe infections indicate their role in the changing pathogenesis of P. vivax that can no longer be considered benign. It brings to light how genes linked to the emerging CQR in P. vivax might impart virulence to vivax malaria making them excellent genetic markers for disease severity.
Health Services Academy, Pakistan
Title: Assessment of knowledge regarding risk factors of Hepatitis C virus transmission and options to avoid them (A comparative analysis)
Time : 12:40-13:00
Samina Naeem Khalid is a medical doctor and has done her Ph.D in Reproductive Endocrinology from Quaid-i-Azam University, Islamabad. She is a trained health professional in IVF/ICSI and has done her Fellowship in Reproductive Medicine from Cleveland Clinic, USA. She is working as an Associate Professor in Department of Reproductive/Maternal & Child Health at Health Services Academy, Islamabad. She is involved in training of Public Health Professionals with Ministry of National Health Services, Regulations and Coordination, Pakistan. She is currently working on a country project with UNFPA on LHW MNCH workload assessment and Human Rights Based Family Planning Service in Pakistan.
Hepatitis C Virus (HCV) is affecting 170 million people annually (WHO, 2012) and Pakistan ranks high in chronic hepatitis. A comparative cross-sectional study of HCV positive (n = 344) and negative (n = 176) respondents at Taluka Hospital (OPD), Rural District, Sindh was done using a structured questionnaire and open ended questions. Analysis was done by cross-tabulation and Chi-square test. Aim of the study was to improve the knowledge of risk factors of HCV transmission. Objectives were to assess the knowledge regarding HCV risk factors and to identify the options to avoid HCV transmission. A total of 520 respondents (66% HCV positive) showed highest infection in 21-30 years ages (39.0%) with more infection in urban population (75.6%) and illiterate group (52.9) having more family deaths due to hepatitis in HCV positive respondents. Majority of HCV positive cases had misperceptions of water (11.3%; P < 0.036), food (10.3%; P = 0.283), heat (10.1%; (P = 0.412), and mosquitoes (9.9%; P < 0.003) as the major factors of transmission. History of more therapeutic injections/ year (60%; P < 0.0001), surgery (80%; P < 0.009), shaving at barber’s shop (64.2%; P < 0.119), sharing tooth brush, razor and miswak, (82%, 77% and 88.1% respectively; P < 0.0001, P < 0.0001, P < 0.0001) was more in HCV positive respondents. Respondents suggested launching auto disable syringes, disposable dental/surgical instruments and registering barber’s shops with a policy to use new blade/razor for each customer. HCV positive population needs health education and awareness to resolve misperceptions.
Quaid I Azam University, Pakistan
Title: Prevalence of inducible clindamycin resistance in Staphylococcal isolates at a tertiary care hospital from Islamabad, Pakistan
Time : 13:00-13:20
Rabaab Zahra has completed her Ph.D from University of Edinburgh, UK and postdoctoral studies from University of Washington, Seattle and University of California, San Diego. She is Assistant Professor at Department of Microbiology, Quaid-i-Azam University.
The emergence of antibiotic resistant Staphylococci is an increasing problem and among available options, clindamycin is an appropriate choice for treating different Staphylococcal infections. The routine antibiotic susceptibility test is not suitable to detect inducible clindamycin resistance. The objective of this study was to investigate the prevalence of clindamycin inducible resistance among clinical isolates of Staphylococci. The clinical isolates included in this study were collected from Pakistan Institute of Medical Sciences (PIMS), Islamabad. Bacterial identification was done by colony morphology and biochemical tests. Kirby-Bauer disc-diffusion method was used to assess the susceptibility pattern of Staphylococci against different antibiotics. The results were interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Double Disk Diffusion test (D-test) was carried out to evaluate the clindamycin inducible resistance. A total of 176 clinical isolates of Staphylococci were collected from different sample source which were blood, pus, urine, sputum, tracheal secretions and tissue fluids. Prevalence of clindamycin inducible resistance among Staphylococci was found to be 7.23%, whereas in Staphylococcus aureus it was 5.12%, and for coagulase negative Staphylococci it was observed to be 9.45%. Resistance rate to other antibiotics were as following: cefoxitin 82.38%, linezolid 62.5%, vancomycin 13.06%, tigecycline 35.79%, tetracycline 58.52%, ciprofloxacin 54.54%, rifampin 35.22%, fosfomycin 92.61%, fusidic acid 84.09%, clindamycin 44.31%, erythromycin 53.97%, gentamicin 54.54%, chloramphenicol 18.74% and for sulfamethoxazole it was 53.40%. Inducible resistance is contributing towards clindamycin failure because clinicians prescribe clindamycin for different Staphylococcal infections without the knowledge of clindamycin inducible resistance. It is suggested that D-test should be included in routine diagnostic tests to avoid clindamycin failure.