Borrelia in Brazil – Fact or Fiction? A Collaborative Study with a One Health Approach
1School of Medicine, University of Washington, Seattle USA; 2School of Veterinary Medicine and One Health, One World Brazil-Latin America, University Federal of Viçosa, Minas Gerais Brazil; 3Animal Hospital and PR Agropecuaria Ltda, Porto Seguro, Brazil; 4Hospital Aliança, Infectious Diseases Sector, Salvador Bahia, Brazil,; 5Paul Allen Global Animal Health, Washington State University, Pullman, USA
Members of the Borrelia genus are responsible for two important diseases of animals and humans, namely Lyme borreliosis and relapsing fever. Lyme borreliosis is currently the most common vector-borne disease in both North America and Europe, and causative agents of both diseases are now known to exist in the Middle East, Africa and Asia. Despite reports of similar clinical entities in South America over the last 20 years, laboratory confirmation of the putative etiological agent has proven difficult, presumably due to differences from other known Borrelia. In Brazil, a Lyme-like disease has been described as an emerging zoonosis, with clinical symptoms progressing from skin rash and fever to arthritis, carditis and neurological complications. Although these symptoms are similar to those associated with Lyme borreliosis in North America, the clinical picture in Brazil is also associated with recurring febrile episodes that are more closely related to relapsing fever. Identifying the causative agent has also been problematic due to the fact that current diagnostic tests for Lyme borreliosis have routinely failed. To gain a better understanding of the etiological agent inducing Lyme-like disease in Brazil, blood and tissue samples from symptomatic patients and various wildlife from the states of Minas Gerais and Bahia, Brazil were collected for DNA sequencing and multi-locus sequence typing. Utilizing the One Health concept, results from this study will shed light on the importance of wildlife as reservoirs of emergent diseases, and are expected to allow phylogenetic analysis of the putative pathogenic microorganism in order to identify as either a Lyme borreliosis- or relapsing fever-type agent. This in turn will be instrumental in laying the foundation for further laboratory studies into the biology and pathogenesis of the causative agent, and allow for the development of tests to effectively diagnose the disease in afflicted domestic animals and patients.
A Muslim Mental Health Conference: Community Approaches to Dealing with Disaffection and Extremism
College of Osteopathic Medicine Michigan State University, United States of America
Muslim Immigrant Communities appear to have higher rates of a variety of psychiatric disorders as related to immigrant status and to exposure to traumatic events in the home country. In Muslim cultures, psychiatric disorders tend to not be well recognized and are often highly stigmatized. The Department of Psychiatry at Michigan State University holds a Muslim Mental Health conference yearly. Objectives include:
1) Basic mental health training for Imams and community leaders to help Imams better understand the way psychiatric and behavioral disorders present and to give them basic intervention and referral strategies. Sensitizing leaders in communities will help improve recognition and access to treatment especially for the important group of young adults who have both psychiatric disorders and substance use disorders and who are having difficulty integrating into the community and culture. These young adults are at risk for continued alienation, poor achievement and radicalization.
2) Public lectures to sensitize other community members and those of other faiths to issues in the Muslim community
3) A research day with posters and presentations to create a forum for researchers to discuss and to improve the quality and quantity of research on Muslim Mental Health issues.
A Street Conducive to All Ages
1Malaysian Medical Association, Malaysia; 2Institute for Medical Research, Malaysia; 3KPJ Healthcare University College Nilai, Malaysia
This one-year study aims to make Jalan Pahang in Kuala Lumpur, Malaysia conducive to all ages. This historical locality has undergone tremendous developmental processes since independence in 1958 and today, there are many commercial centres and condominiums. This street is within the strategic zone of the Kuala Lumpur city centre and is part of the KL Structure Plan 2020. While the infrastructure is being built, the necessary maintenance and softer components appear to be side-lined in that the street is unsafe, unaesthetic, unappealing and unhealthy from the daily user and for the older or physically-challenged individual.
The aims incorporate the World Health Organization Healthy City model based on: health-supportive environment; good quality of life; basic sanitation and hygiene needs; and access to health care.
The methodology involved a risk assessment approach through a questionnaire survey on Knowledge, Attitude and Practice of 300 individuals from among the local community. The parameters looked at safety and security concerns, smoke-free, clean and green environment, and the aesthetic aspects of the street.
The outcome produced evidence to be presented to the local authority for them to work on deliverable such as to install adequate facilities such as streetlights, railings, ramps, benches, CCTVs, escalators for the overhead pedestrian bridge, lifts; wash-basins and toilets near the market-place; green and handicap-disabled buses to ply the route; notices to declare the areas in front of the hospitals, institutes and hotel to be smoke-free zones; ample waste disposal facilities; greening of the environment; and increase in enforcement with police patrolling the street.
This study will benefit the local community, enhance the civic-conscious mindset of the public, and reduce the incidence of snatch-thefts. There will be an atmosphere of helpfulness in that the community will communicate in a friendly manner and a well-cultured society will slowly but surely emerge.
A Conceptual Framework for Conducting and Integrated Vulnerability Assessment in Climate Change and Malaria Transmission
Griffith University School of Environment: Centre for Environment and Population Health and Environmental Research Futures Institute, Brisbane, Australia
Climate change will impact on ecosystem regulation of climate-sensitive diseases such as malaria. Also, other important ecological, socioeconomic and sociodemographic factors, such as land use change, gender, age, human immunity, population growth, migration and transportation and levels of economic development have an influence on malaria transmission. A sufficiently accurate determination of risk must include the relative contribution this array of influences at multiple scales including those operating at the local level, as these factors can either mitigate or exacerbate the projected risk from climate impacts alone. It is also important to understand the extent to which affected communities are vulnerable to this risk and their adaptive capacity. Integrated vulnerability assessments involve the consideration of climate and other biophysical and social determinants of malaria transmission in a holistic framework for risk evaluation. A review of research on malaria transmission in the East African region, which is a high-risk area for malaria transmission, revealed only one integrated vulnerability assessment of climate change and malaria. This lack of integrated vulnerability assessments largely reflects the multiple interacting determinants involved, the lack of appropriate data, the need for a multi-disciplinary approach, and the difficulty in conducting the required analyses at multiple temporal and spatial scales. Vulnerability is also context specific and although there are general guidelines on such assessments, there is not one universal method for such studies. Based on the theoretical concepts of climate change, malaria transmission and vulnerability, this paper will present a conceptual framework developed to conduct an integrated vulnerability assessment of climate change impact on malaria transmission in Western Kenya, East Africa. The framework utilises a systems approach, identifies critical stakeholders at regional and community level, and considers the influence of climate change, land use change and other social influences in transmission.