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GHF2014 – PS33 – Global Health Education: What are the Priorities for the Global Health Curriculum?

14:00
15:30
PS33 THURSDAY, 17 APRIL 2014 ROOM: 13 ICON_Fishbowl
Global Health Education:
What are the Priorities for the Global Health Curriculum?

MODERATOR:
Prof. André-Jacques Neusy
Chief executive officer, Training for Health Equity Network , Belgium
SPEAKERS:
Ms. Kristina Graff
Director of Global Health Programs, Woodrow Wilson School of Public and International Affairs, Princeton University, United States
Abstract: Princeton’s University Global Health Program: Research and Teaching at the Nexus of Science, Policy and Social Science
Dr. David Beran
Researcher and Lecturer, Division of Tropical and Humanitarian Medicine, University of Geneva, Switzerland
Mr. Clément Graindorges
Medical Student, Faculty of Medicine, University of Geneva, Switzerland
Ms. Carol Savatier
Medical Student, Faculty of Medicine, University of Geneva, Switzerland
Ms. Eloïse Magnenat
Medical Student, Faculty of Medicine, University of Geneva, Switzerland
OUTLINE:
PROFILES:

AJ Neusy_squareProf. André-Jacques Neusy

André-Jacques Neusy, MD, DTM&H, is Chief Executive Officer and co-founder of Training for Health Equity Network (THEnet). THEnet is a global network of socially accountable schools of health sciences and medicine that aims to produce health equity through optimizing the health workforce, contributing to quality health systems and influencing the determinants of health, particularly in disadvantaged communities.

Dr. Neusy is a retired Professor of Medicine at New York University School of Medicine where he founded and directed the Center for Global Health until 2007. He is a visiting professor in several universities around the world.

Dr. Neusy earned his medical degree at the Free Univ. of Brussels and a Doctorate in Tropical Medicine and Hygiene at the Institute of Tropical Medicine of Antwerp-Belgium. He completed his postdoctoral medical training at New York University Medical Center, joined its faculty in 1974 and became the director of the nephrology section at NYU-Bellevue Hospital Center in 1984.

Dr. Neusy frequently consults on health workforce development for academic institutions, governments and international organizations. He was a past president of the Global Health Education Consortium (GHEC), a consortium of more than 80 North American Universities that have global health programs. Dr. Neusy is an ambassador of US-based Freedom from Hunger. He serves on scientific and health committees of various organizations including the International Society for Urban Health, the American Near East Refugee Association, Capacity-Plus, and the Global Forum on Health Professional Education for the 21st Century at the Institute of Medicine, National Academies of Sciences.

Graff PhotoMs. Kristina Graff

Kristina Graff is Director of Global Health Programs at Princeton University’s Woodrow Wilson School of Public and International Affairs, responsible for overseeing and expanding a broad array of domestic and international research and teaching initiatives. She previously served as the Director of Special Initiatives at the New York City Department of Health’s Bureau of Maternal, Infant and Reproductive Health, where she advanced new programs in teen pregnancy prevention, breastfeeding promotion, sex education and support for high-risk mothers and their infants. On the international front she worked on policy, advocacy and service delivery programs to improve women’s health in developing countries through positions at Women’s Dignity Project and EngenderHealth, and through consultancies with the United Nations Population Fund, Family Care International, and Population Action International. Kristina received her Master in Public Affairs from Princeton University’s Woodrow Wilson School, and she completed her bachelor’s degree at Duke University.

Beran190Dr. David Beran

David Beran is a Researcher and Lecturer at the University of Geneva within the Division of International and Humanitarian Medicine at the Faculty of Medicine.

David is a Swiss national who grew up in Geneva. He holds a BSc in Management with an Emphasis in Marketing. Following his first degree, he worked for a leading Swiss Biotech Company in both Health Policy and Government Relations and Public Relations. He then obtained his MSc in Public Health at the London School of Hygiene and Tropical Medicine. For his Masters’ dissertation, David worked at the WHO looking at ways of preventing Type 2 diabetes in children. David has recently completed his PhD looking at the needs of people with Type 1 diabetes in 13 countries at University College London (UCL).

Before joining the University of Geneva, David was the Project Coordinator of the International Insulin Foundation (IIF) since its establishment in November 2002 until September 2011. As of September 2011 David became Advisor to the Board of Trustees. In parallel to his role at the IIF, David was also based at the Centre for International Health and Development, Institute of Child Health, UCL, where he was a Senior Research Fellow, with both teaching and research responsibilities in the areas of health management, access to medicines, diabetes, chronic diseases and health systems in developing countries.

Dr. Marie-Claude Bottineau

PS12_Dr_Marie_BottineauDr. Marie-Claude Bottineau

Pediatrician, Neonatology, Pediatrics Intensive Care, MSF CH, Geneva, Switzerland

Dr. Bottineau is a French Pediatrician with a DESS in Neonatology, a competency in Pediatrics Intensive Care and a Master Degree in Public Health and Tropical Medicine. She did the first part of her carrier working in General and University Hospitals in France as Pediatrician in Pediatrics, Pediatrics and Neonatal Intensive Care in Nantes, Nancy, Le Havre and Paris and her Tropical Medicine Degree in Pitié Salpêtrière Hospital, Paris, with Pr Gentilini and Pr Duflo. She also studied Bio-Ethics in Paris as free auditor getting an equivalence of Master Degree.

In parallel, she was doing some regular missions around the world with several Humanitarian Organizations including MSF- France in Kosovo; Vietnam (Ho-Chi-Minh); Madagascar (Antananarivo); Nicaragua (Leon and Managua), during civil war; Nepal (Pokhara-Jomoson); India (Calcutta, slums of Howrah-Pilkhana) and Cameroon (Mpoundou, Abong-Mbang district).

From 1990 to 1996, she dedicated her carrier to the humanitarian action working exclusively in expatriation in different humanitarian contexts of which in Benin with Terre Des Hommes-Lausanne and in Angola with MSF-France (Uige and Benguela provinces during civil war).

After an urgent medical repatriation in December 1995, time for recovering, few months in HQ MSF-France in Paris and few years in Robert Debré Hospital (Pediatrics Emergencies and Neonatal SMUR), she was to the United States in order to complete her Master Degree in Public Health (2000). Then, she worked 2 years as Public Health Medical Specialist at CRED (Center for Research on the Epidemiology of Disasters), UCL, Brussels, Belgium. At the same time she made several missions to Cambodia for the Belgium Cooperation and some consultancies as Evaluator within the European Commission for INCO-DEV and INCO-MED programs.

From 2001 to 2003 she made regular consultancies for WHO Geneva in Switzerland (Geneva) on GAVI (Global Alliance for Vaccines & Immunizations); Chad (Tanjile), Mali (Bamako) and Indonesia (Djakarta, Bali and Iles de la Sonde) on Maternal and Neonatal Tetanus Elimination (MNTE) including Lot Quality Assurance Surveys (LQAS).

From January 2003 to July 2007 she worked as UNHCR Senior Regional Health/Nutrition/HIV – AIDS Co-ordinator for West Africa based in Sierra Leone (Freetown) and Ghana (Accra), then the Great Lakes Region based in Burundi (Bujumbura) and at least Chad – Darfour Emergency, based in Chad (Abéché).

Mid July 2007, she was appointed as Pediatrics Referent in MSF-CH to develop pediatrics vision, policy and strategic approach and to give adequate support to pediatrics fields. In April 2011, she took the coordination and leadership of the MSF International Pediatrics Working Group and early 2014 the coordination of the Mother, Neonatal and Child pool including nutrition.

She taught extensively (H.E.L.P Course, in MSF, UNHCR, Universities...) and participated actively in international congresses making some abstracts, publications, posters, and/or oral communications.

She contributed for many years to the work of Amnesty International against Torture, acting with the Medical Commission. After different professional affiliations, she is currently active member of the Target Advisory Group (TAG) of the International Pediatrics Association (IPA) on Children in Humanitarian Disasters, of the Partnership for Maternal, Newborn and Child Health (PMNCH) (WHO, UNICEF, Save The Children...) and of the Group of Tropical Pediatrics (Société Francaise de Pédiatrie).

She got certificates of recognition from CDC Atlanta, H.E.L.P Course and the UNAM of Nicaragua for her action in emergency settings and/or her contribution to the teaching.

Dr. David Beran

Beran190Dr. David Beran

Researcher and Lecturer, Division of Tropical and Humanitarian Medicine, University of Geneva, Switzerland

David is a Swiss national who grew up in Geneva. He holds a BSc in Management with an Emphasis in Marketing. Following his first degree, he worked for a leading Swiss Biotech Company in both Health Policy and Government Relations and Public Relations. He then obtained his MSc in Public Health at the London School of Hygiene and Tropical Medicine. For his Masters’ dissertation, David worked at the WHO looking at ways of preventing Type 2 diabetes in children. David has recently completed his PhD looking at the needs of people with Type 1 diabetes in 13 countries at University College London (UCL).

Previously David was the Project Coordinator of the International Insulin Foundation (IIF) since its establishment in November 2002 until September 2011. As of September 2011 David became Advisor to the Board of Trustees. In parallel to his role at the IIF, David was also based at the Centre for International Health and Development, Institute of Child Health, UCL, where he was a Senior Research Fellow, with both teaching and research responsibilities in the areas of health management, access to medicines, diabetes, chronic diseases and health systems in developing countries.

GHF2014 – PS12 – Integrating Neonatal Care in Low Income Countries: the Big Place of the Very Small Babies

16:00
17:30
PS12 TUESDAY, 15 APRIL 2014 ROOM: LEMAN
ICON_Fishbowl
Integrating Neonatal Care in Low Income Countries:
the Big Place of the Very Small Babies

MODERATOR:
Dr. Marie-Claude Bottineau
MD, MPH & TM 
Pediatrician, Neonatology, Pediatrics Intensive Care, MSF CH, Geneva, Switzerland
SPEAKERS:
Dr. Anne Pittet, Pediatrician, Hôpital de l’Enfance à Lausanne and MSF CH, Geneva, Switzerland
Dr. Jean-Marie Choffat, Pediatrician, CHUV, Lausanne, Switzerland
OUTLINE:
 Worldwide experience on the way to promote neonatal care in remote settings, humanitarian emergencies, post emergency programs, LIC… including policy and strategic planning, implementation, integration into MoH structures, task shifting, training course and handover.
PROFILES:

PS12_Dr_Marie_BottineauDr. Marie-Claude BOTTINEAU is a French Pediatrician with a DESS in Neonatology, a competency in Pediatrics Intensive Care and a Master Degree in Public Health and Tropical Medicine. She did the first part of her carrier working in General and University Hospitals in France as Pediatrician in Pediatrics, Pediatrics and Neonatal Intensive Care in Nantes, Nancy, Le Havre and Paris and her Tropical Medicine Degree in Pitié Salpêtrière Hospital, Paris, with Pr Gentilini and Pr Duflo. She also studied Bio-Ethics in Paris as free auditor getting an equivalence of Master Degree.

In parallel, she was doing some regular missions around the world with several Humanitarian Organizations including MSF- France in Kosovo; Vietnam (Ho-Chi-Minh); Madagascar (Antananarivo); Nicaragua (Leon and Managua), during civil war; Nepal (Pokhara-Jomoson); India (Calcutta, slums of Howrah-Pilkhana) and Cameroon (Mpoundou, Abong-Mbang district).

From 1990 to 1996, she dedicated her carrier to the humanitarian action working exclusively in expatriation in different humanitarian contexts of which in Benin with Terre Des Hommes-Lausanne and in Angola with MSF-France (Uige and Benguela provinces during civil war).

After an urgent medical repatriation in December 1995, time for recovering, few months in HQ MSF-France in Paris and few years in Robert Debré Hospital (Pediatrics Emergencies and Neonatal SMUR), she was to the United States in order to complete her Master Degree in Public Health (2000). Then, she worked 2 years as Public Health Medical Specialist at CRED (Center for Research on the Epidemiology of Disasters), UCL, Brussels, Belgium. At the same time she made several missions to Cambodia for the Belgium Cooperation and some consultancies as Evaluator within the European Commission for INCO-DEV and INCO-MED programs.

From 2001 to 2003 she made regular consultancies for WHO Geneva in Switzerland (Geneva) on GAVI (Global Alliance for Vaccines & Immunizations); Chad (Tanjile), Mali (Bamako) and Indonesia (Djakarta, Bali and Iles de la Sonde) on Maternal and Neonatal Tetanus Elimination (MNTE) including Lot Quality Assurance Surveys (LQAS).

From January 2003 to July 2007 she worked as UNHCR Senior Regional Health/Nutrition/HIV – AIDS Co-ordinator for West Africa based in Sierra Leone (Freetown) and Ghana (Accra), then the Great Lakes Region based in Burundi (Bujumbura) and at least Chad – Darfour Emergency, based in Chad (Abéché).

Mid July 2007, she was appointed as Pediatrics Referent in MSF-CH to develop pediatrics vision, policy and strategic approach and to give adequate support to pediatrics fields. In April 2011, she took the coordination and leadership of the MSF International Pediatrics Working Group and early 2014 the coordination of the Mother, Neonatal and Child pool including nutrition.

She taught extensively (H.E.L.P Course, in MSF, UNHCR, Universities...) and participated actively in international congresses making some abstracts, publications, posters, and/or oral communications.

She contributed for many years to the work of Amnesty International against Torture, acting with the Medical Commission. After different professional affiliations, she is currently active member of the Target Advisory Group (TAG) of the International Pediatrics Association (IPA) on Children in Humanitarian Disasters, of the Partnership for Maternal, Newborn and Child Health (PMNCH) (WHO, UNICEF, Save The Children...) and of the Group of Tropical Pediatrics (Société Francaise de Pédiatrie).

She got certificates of recognition from CDC Atlanta, H.E.L.P Course and the UNAM of Nicaragua for her action in emergency settings and/or her contribution to the teaching.

 

OLYMPUS DIGITAL CAMERADr. Anne Pittet

After a pediatric specialization in Switzerland, I joined MSF OCG in 1999 for several field missions in Africa and Asia. I participated also to clinical studies in South Sudan and Myanmar. In 2005 I worked one year in Vietnam to help in the development of a neonatal project and I continue to follow up these activities.

Since 2006 I’m working 6 months a year with MSF and 6 months a year in the Pediatric Department of the University Hospital of Lausanne. Since 2011 I work with the Medical Department of MSF in Geneva and the Training Unit, performing formal training sessions, coaching, supervision and field visits in different countries of Africa, Asia and Haïti.

GHF2014 – PS10 – Empowering Diabetic Patients: Healthcare is not enough

14:00
15:30
PS10 TUESDAY, 15 APRIL 2014 ROOM: 13 ICON_Fishbowl
Empowering Diabetic Patients:
Healthcare is not enough

MODERATOR:
Dr. Gregoire Lagger
Division of therapeutic patient education for chronic diseases, Geneva University Hospitals, University of Geneva, Switzerland
SPEAKERS:
Utilizing Nurses as Diabetic Educators: Sri Lankan Experience
Dr. Manuj Weerasinghe, Senior Lecturer, Department of Community Medicine, University of Colombo, Sri Lanka
Integrating Non-Medical Needs for Chronic Diseases: the Example of Type 1 Diabetes
Dr. David Beran, Researcher and Lecturer, Division of Tropical and Humanitarian Medicine, University of Geneva, Switzerland
Integrating Artistic Programs in Diabetes Education and Self Management in Madagascar
Dr.Tojosoa Rajaonarison, Director of artistic programs, Madagascar Diabetes Association (A.MA.DIA), Madagascar
OUTLINE:
PROFILES:

Gregoire_Lagger_squareDr. Gregoire Lagger

Grégoire Lagger is Doctor of Science. Since 2005 he is a teacher-researcher in Therapeutic Education at the Faculty of Medicine and University Hospitals of Geneva. His current research topics focus on the patients' motivation to learn and change their behavior and remission of type 2 diabetes.

 

Weerasinghe Profile PhotoDr. Manuj Weerasinghe

Dr. Manuj Weerasinghe obtained MBBS degree at the Faculty of Medicine, University of Colombo (1998) and completed internship in internal medicine and Obstetrics and Gynecology at Colombo South Teaching Hospital. Then he shifted to the field of public health and obtained degrees of Masters of Science (2002) and Doctor of Medicine in Community Medicine (MD) from the Postgraduate Institute of Medicine, Colombo (2005). He won a fellowship to the Graduate School of Public Health University of Pittsburgh, USA on health policy and health programme evaluation during 2006/2007 period.

At present he serves as a Senior Lecturer in the Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka. Dr. Weerasinghe facilitates both undergraduate and postgraduate learning in the university and functions as an examiner at both levels.  He also serves in advisory capacity for several committees in Ministry of Health, Sri Lanka. He has served as a council member of the Sri Lanka Medical Association, Sri Lanka Association for Advancement of Science and College of Community Physicians of Sri Lanka.

Dr-Tojosoa-RajaonarisonDr.Tojosoa Rajaonarison

Dr. Tojosa Rajaonarison has been working in the Madagascar Diabetes Association (AMADIA) as a dentist for 9 years.

She has been designated Director of Artistic programs in the AMADIA since 2010. They have done 12 painting workshops sessions: 4 specific sessions for children, 1 specific session for the AMADIA health caregivers and 7 sessions for adults.

In 2011 Dr. Rajaonarison did training in Therapeutic Education and Art-therapy in Grimentz- Switzerland and she was trained in Therapeutic Education by the Foundation for Research and Training in Patient Education Team in Madagascar in 2010.

Beran190Dr. David Beran

Dr. David Beran is a Researcher and Lecturer at the University of Geneva within the Division of International and Humanitarian Medicine at the Faculty of Medicine.

David is a Swiss national who grew up in Geneva. He holds a BSc in Management with an Emphasis in Marketing. Following his first degree, he worked for a leading Swiss Biotech Company in both Health Policy and Government Relations and Public Relations. He then obtained his MSc in Public Health at the London School of Hygiene and Tropical Medicine. For his Masters’ dissertation, David worked at the WHO looking at ways of preventing Type 2 diabetes in children. David has recently completed his PhD looking at the needs of people with Type 1 diabetes in 13 countries at University College London (UCL).

Previously David was the Project Coordinator of the International Insulin Foundation (IIF) since its establishment in November 2002 until September 2011. As of September 2011 David became Advisor to the Board of Trustees. In parallel to his role at the IIF, David was also based at the Centre for International Health and Development, Institute of Child Health, UCL, where he was a Senior Research Fellow, with both teaching and research responsibilities in the areas of health management, access to medicines, diabetes, chronic diseases and health systems in developing countries.

GHF2014 – PS07 – Improving Maternal and Child Health Services

14:00
15:30
PS07 TUESDAY, 15 APRIL 2014 ROOM: LEMAN ICON_Fishbowl
Improving Maternal and Child Health Services
MODERATOR:
Dr. Anayda Portela, Department of Maternal, Newborn, Child and Adolescent Health (MCA), World Health Organization, Switzerland
SPEAKERS:
Maternal Health Workforce Management in Vietnamese Health Communes
Mrs. Thi Hoai Thu Nguyen, PhD student, Faculty of Health Management, Hanoi School of Public Health, Vietnam
Integrating Community Participation in Maternal and Newborn Health Services: Burkina Faso
Integrating Health Promotion to Improve Maternal and Newborn Health in El Salvador
Ms. Janet Perkins, Health Programme Officer, Health Department, Enfants du Monde, Switzerland
Linking Health And Educations Measures To Improve Early Childhood Development Programmes: Kyrgyzstan
Dr. Anara Doolotova, Health Programme Officer, Health Department, Aga Khan Foundation, Kyrgyzstan
New Model of Formative Supervision to Improve Health Outcomes in Ukraine
Mr. Martin Raab, Senior Public Health Specialist and Project Manager, Head of the Unit, Health Technology & Telemedicine Unit, Swiss Center for International Health, Swiss Tropical and Public Health Institute, Switzerland
OUTLINE:
PROFILES:

Nguyen Profile PhotoMrs. Thi Hoai Thu Nguyen

Nguyen, Thi Hoai Thu (MSc) is a lecturer in the Hanoi School of Public Health and is a PhD student of the Queensland University of Technology. Her research encompasses issues related to health system governance. Her recent research includes multi-partner research in the three Asian countries including Vietnam, HESVIC (Health systems stewardship and regulation in Vietnam, India and China) funded by the European Commission.

PS07_PerkinsMs. Janet Perkins

Janet Perkins is a Programme Officer in the Health Department of Enfants du Monde, a nongovernmental organization based in Geneva, Switzerland, where she provides technical support to maternal and newborn health projects in Bangladesh, Burkina Faso, El Salvador and Haiti. She also works as a consultant to the World Health Organization. She obtained her MPH at the University of Texas Houston Health Science Center in 2008.  She has previously worked with governmental and non-governmental organizations on health promotion in Houston, Texas, U.S.A.

Doolotova PhotoDr. Anara Doolotova

Dr. Doolotova has been working in the public health sector in Central Asia for almost 30 years after graduating from the Kyrgyz Medical State University in Kyrgyzstan.  In 1995, she graduated from the Kyrgyz Research Obstetrics and Pediatrics Institute and obtained my PhD in Medical Science (PhD). Additionally, she successfully completed her non-degree Hubert Humphrey fellowship in public health policy and management for mid-level professionals at the Johns Hopkins University (2007 to 2008) in Baltimore, USA.

She has six years of project management experience, four of which she spent in Kyrgyzstan implementing the Project HOPE, a USAID program on child survival. She spent two years in Tajikistan implementing the Water Sanitation of Mission East project, which was funded by Denmark, EU. Also, she worked for almost two years as the Regional Monitoring & Evaluation Coordinator in Kyrgyzstan, Tajikistan and Turkmenistan with Creative Associates, implementing the Quality Learning Project. Currently, Dr. Doolotova is working as the Health Program Officer of Aga Khan Foundation coordinating the health programs, strategy development and fundraising. From 2011 she has been working as a focal point of Central Asia Health Systems strengthening project (CAHSS) in two regions of Kyrgyzstan. CAHSS aims to strengthen health systems to improve the health of men and women, particularly women of reproductive age, newborns and children under five in target areas of Pakistan, Afghanistan, Tajikistan and Kyrgyz Republic. The project is funded by DFAID.

GHF2014 – PS02 – Integrated Management of Childhood Illness: Where Do We Stand?

10:45
12:15
PS02 TUESDAY, 15 APRIL 2014 ROOM: LEMAN ICON_Fishbowl
Integrated Management of Childhood Illnesses:
Where Do We Stand?

MODERATOR:
Dr. Lulu Muhe, Department of Maternal, Newborn, Child and Adolescent Health (MCA), World Health Organization, Switzerland
SPEAKERS:
Performance of Community Health Workers in Community Case Management: Uganda
Dr. Agnes Nanyonjo, Research Officer-Public Health, Malaria Consortium Uganda Technical Country Office, Uganda
Dr. Eric A. F. Simões, Professor of Paediatrics, School of Medicine, Department of Paediatrics University of Colorado, Anschutz Medical Campus, United States
OUTLINE:
The aim of the IMCI strategy introduced in 1996 was to contribute to the reduction of child mortality through appropriate management of major causes of child death including pneumonia, diarrhoea, malaria and malnutrition, improved caregiver knowledge and home care practices during illness, and prevention of illness. As we approach the 2015, what has been the contribution of IMCI in the global progress towards achieving MDG 4. Is the IMCI model still fit for purpose in addressing child survival and the emerging epidemic of non-communicable diseases beyond the 2015?
PROFILES:

Nanyonjo Profile PhotoDr. Agnes Nanyonjo

Dr. Nanyonjo is a Research officer-Public Health working with Malaria consortium Uganda. She completed her undergraduate studies from Makerere university Uganda with a bachelor of medicine and bachelor of surgery degree. She specialized in public health from Umeå university Sweden. She is a doctoral student at Karolinska institute.  She has experience working community case management of childhood diseases, HIV/AIDS and sexual and reproductive health of young people.

Eric_Simoes_squareDr. Eric A. F. Simões

Eric Simoes is a Professor of Paediatrics at the School of Medicine Department of Paediatrics University of Colorado Anschutz Medical Campus.

Eric A. F. Simoes, MB, BS, DCH, MD, earned his medical degree from the University of Madras, India, in 1984. He completed paediatric infectious diseases fellowship training at the University of Colorado School of Medicine in 1989, at which time he joined the faculty of the Department of Paediatrics and Children's Hospital Colorado. From 1995 to 1999, he directed the Paediatric Infectious Diseases Fellowship Program. Since 2001 he also has had an appointment as Professor of Paediatric Infectious Diseases and Tropical Child Health with the Department of Paediatrics, Obstetrics, and Gynaecology at the Imperial College of Science and Technology in London, UK.

Eric Simoes has published over 170 journal articles, books, book chapters, scholarly reviews, and abstracts. He is widely sought as a speaker, teacher, and consultant, both nationally and abroad. Worked as a Member, Advisory Committee on Acute Respiratory Infections, World Health Organization 1999-2004

Immunization status of young people attending a youth clinic in Geneva, Switzerland

Author(s) Anne Meynard1, Emilien Jeannot2, Lydia Markham3, Claire-Anne Lazarevic 4, Bernard Cerutti 5, Francoise Narring6
Affiliation(s) 1Department of Pediatrics, Geneca University Hospitals, Geneva, Switzerland, 2Institute of social and preventive medicine, Faculty of Medicine, University of Geneva, Institute of social and preventive medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland, 3Private general practice, Private general practice and school health service, Nyon, Switzerland, 4School Health Service , Department of Public instruction Geneva, Geneva, Switzerland, 5Faculty of medicine University of Geneva, Faculty of medicine University of Geneva, Geneva, Switzerland, 6Department of Pediatrics, University hospitals Geneva, Geneva, Switzerland.
Country - ies of focus Switzerland
Relevant to the conference tracks Advocacy and Communication
Summary This study aims to describe immunization status at first visit in a collective of young people coming to an academic youth clinic. Results confirm our hypothesis that many young immigrants have had adequate childhood vaccination especially for tetanus but  are missing Hepatitis B and HPV. Collaboration between nurses in the youth clinic and school health services allows, not only detection of under-vaccinated youth, but quick and effective vaccination .
Background Adolescents are under-vaccinated and have limited access to effective care or preventive services in many regions of the world. Data on immunization status of adolescents or young adults in Switzerland are scarce and little is known about barriers to adequate coverage. Swiss vaccination coverage data shows that children of foreign origin are usually better immunized, but that this difference is lost in adolescence, where the most important factor of adequate vaccination is the presence of a school health vaccination program.
Objectives The objective is to describe the immunization status at first visit and differences in immunization status according to duration of stay in Switzerland and nationality of young people coming to a mulitdisicplinary youth clinic in Geneva
Methodology Immunization status at first visit (medical file, immunization booklets or school health database) was collected retrospectively between January 2010 and June 2011 in all patients coming for a first visit at Geneva University hospital’s multidisicplinary youth clinic. The main outcomes were Tetanus antibody titers one month after a booster of tetanus containing regimen and immunization status at first visit and the comparing of rates between young people of Swiss or foreign origin and for foreigners according to duration of stay in Switzerland.
Results 89% of patients tested for tetanus antibodies had values above 1000 U/l indicating adequate childhood immunization with 29% above 10’000 U/l putting them at risk of hyperimmunization if given usual adult catch up regimens (3 dosis). On the contrary Hepatitis B serology was often negative among the same population in our sample. Finding written information about immunization is significantely higher in youth born in Switzerland regardless of sex and nationality for all vaccines studied (tetanus, measles, hepatitis B and HPV) but is inferior to Swiss vaccination coverage data. Collection of information was highly facilitated by collaboration between academic youth clinic and school health services.
Conclusion In the absence of data, many young people immunized against tetanus or measles might in fact already be well immunized for childhood vaccinations. Effective collaboration between school-health services, primary health care facilities and youth clinics is highly effective in improving adolescent vaccine coverage especially with the help of public heath policies. School health services are usually very well informed about vaccination strategies in countries of immigration and the WHO database can also help to adapt recommendations to migratory flows.  However, they might miss young people at higher risk of being under or over immunized for example those with no booklet, absent from school on the day of immunization campaign, or with no permanent address. In Switzerland, parental consent is required for Hepatitis B or HPV immunization for young people under 16 years of age.Individually adapted catch-up immunization plans for adolescents and young adults regardless of origin or gender can avoid unnecessary and unsafe vaccination, and bring attention to barriers to adolescent vaccination as well as other adolescent health issues. Individual counseling allows targeted screening for silent infectious diseases (STI’s, Hepatitis, Chagas disease or common parasitic infections) but should mainly focus on assessment of protective and risk factors for healthy development of young people.

Variation in Dietary Intake and Pre-eclampsia and Eclampsia in Indian women: Findings from the National Family Health Survey.

Author(s) Sutapa Agrawal1, Jasmine Fledderjohann2, David Stuckler3, Sukumar Vellakkal 4, Shah Ebrahim 5
Affiliation(s) 1South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, 2Deaprtment of Sociology, University of Oxford, Oxford, United Kingdom, 3Department of Sociology, Oxford University, Oxford, United Kingdom, 4SANCD, PHFI, New Delhi, India, 5Non communicable Disease Epidemiology, LSHTM, London, United Kingdom.
Country - ies of focus India
Relevant to the conference tracks Women and Children
Summary Pre-eclampsia/eclampsia is responsible for upwards of 20% of maternal morbidity and mortality in developing countries. We examine the relationship between food intake and symptoms of pre-eclampsia and eclampsia among Indian women aged 15-49 (n=39,657) for the most recent live birth in the five years preceding the National Family Health Survey-3 (2005-06). Daily consumption of milk, vegetables, chicken/meat and weekly pulses/beans consumption are associated with substantially lower risk of pre-eclampsia. Eclampsia risk is higher among those who consumed fruit and chicken/meat occasionally, and lower among those consuming vegetables daily.
Background Pre-eclampsia and eclampsia pose significant threats to maternal health, particularly in developing countries. In low-and middle-income settings, these two conditions affect approximately 8% of all pregnancies, causing an estimated 15%-20% of maternal morbidity and mortality. Pre­eclampsia is a life threatening complication of pregnancy that typically starts after the 20th week of gestation. Women with pre-eclampsia may present with symptoms such as headache, upper abdominal pain, or visual disturbances and have raised blood pressure, ankle oedema and proteinuria. When pre-eclampsia is left untreated or is severe, giving rise to seizures/convulsions which cannot be attributed to other causes (such as epilepsy), the condition is known as eclampsia. Although several studies have found that micronutrient deficiencies, such as iron, vitamin A, vitamin C, and calcium, contribute to pre-eclampsia risks, few studies have evaluated the potential role of different food types.
Objectives Existing nutritional evidence is highly variable. Dietary patterns may influence maternal antioxidant levels, mediating the link between pre-eclampsia and oxidative stress, an established risk factor. However, consumption of high-energy diets may increase risk of pre-eclampsia by inducing abnormal lipid metabolism, while consumption of dietary fibre may regulate these metabolic processes, thereby reducing risk. However, studies which have attempted to test these links empirically have not been conducted in high burden countries, nor have they employed appropriate multivariate models. To our knowledge, there has not been any previous large-scale report concerning the dietary risk factors for pre-eclampsia and eclampsia in Indian women. Here, we evaluate potential dietary risk factors of pre-eclampsia and eclampsia, using a large representative sample of Indian mothers in the third National Family Health Survey conducted during 2005-06.
Methodology Data were taken from the most recent wave of the National Family Health Survey (NFHS-3, 2005–2006), India’s Demographic and Health Surveys. NFHS-3 collected demographic, socioeconomic and health information from a nationally representative probability sample of 124,385 women aged 15–49. The sample is a multistage cluster sample with an overall response rate of 98%. All states of India are represented in the sample (except the small Union Territories), covering more than 99% of the country’s population. The analysis presented here focuses on 39,657 women in the sample who report being married and who have had a live birth in the five years preceding the survey. The survey was conducted using an interviewer-administered questionnaire in the native language of the respondent. To assess the occurrence of pre-eclampsia, mothers were asked if at any time during their last pregnancy they experienced relevant symptoms, including difficulty with vision during daylight, night blindness, convulsions (not from fever), swelling of the legs, body or face, excessive fatigue, or vaginal bleeding. Women who reported difficulty with vision during daylight, swelling of the legs, body, or face, or excessive fatigue were coded as having symptoms of pre-eclampsia, whereas those who reported experiencing convulsions (not from fever) were coded as symptomatic of eclampsia. Data on blood pressure and proteinuria during pregnancy were not available in the NFHS. Dietary intake variables were based on the self-reported frequency of consumption of milk or curd, green leafy vegetables, fruits, pulses and beans, eggs, fish, chicken or meat, categorised into daily, weekly, occasionally, or never. Potential confounders and covariates were selected on the basis of previous knowledge of their association with pre-eclampsia/eclampsia. We used multiple logistic regression to estimate the association between variation in dietary intake and pre-eclampsia and eclampsia risk after adjusting for maternal factors, biological and lifestyle factors and socio-demographic characteristics of the mothers. Models were adjusted for sampling weights (IIPS & Macro International 2007). All analyses were conducted using the SPSS statistical software package Version 19.
Results Overall 55.6% of mothers reported pre-eclampsia symptoms, and 10.3% reported eclampsia. Table 1 reports the results of our statistical models. After adjusting for maternal, biological, and chronic disease risk factors, as well as socio-demographic characteristics, we found that the risk of pre-eclampsia was significantly lower among women who consumed milk daily (OR:0.88;95%CI:0.81-0.96), green leafy vegetables daily/weekly (OR: 0.69 to 0.76), pulses or beans at least weekly/occasionally (ORs ranges from 0.84 to 0.92), fruits daily (OR:0.92), eggs weekly/occasionally, consumes fish (OR:0.90) or chicken/meat daily or occasionally, with added reference to those who never consumed them. However, a greater risk of pre-eclampsia was found among women consuming fruits weekly/occasionally (OR:1.11), eggs daily (OR:1.23) and fish weekly (OR:1.22). The risk of eclampsia was lower among those consuming green leafy vegetables (ORs ranges from 0.74 to 0.79), consuming fish weekly or occasionally (ORs ranges from 0.44 to 0.62), eggs weekly or occasionally (Ors ranges from 0.61 to 0.76), but was higher among those who consumed fruits (ORs ranges from 1.18 to 1.44), chicken/meat occasionally (OR:1.28;95%CI:1.11-1.48) with reference to those who never consumed them.
Conclusion Our study provides empirical evidence of an association between the frequency of intake of specific food items and prevalence of pre-eclampsia/eclampsia in a large nationally representative sample of Indian women. Findings suggest that variation in the frequency of consumption of specific foods has a substantial effect on the occurrence of symptoms suggestive of pre-eclampsia/eclampsia in this population. The strengths of our study include the large nationally representative study sample and the population-level focus on the predictors of pre-eclampsia and eclampsia. However, due to the general challenges of measuring hypertensive disorders in population-based studies, the information of the symptoms of pre-eclampsia and eclampsia presented here is based on self-reports and should therefore be interpreted with care. Although we adjusted for several confounding variables, we cannot exclude the possibility of residual confounding. In these analyses, the cross-sectional design precludes causal inferences and we were limited to the questions used to elicit lifestyle and dietary information. Few population level studies exist which assess the dietary determinants of pre-eclampsia and eclampsia. This study is important because few others have reported pre-eclampsia/eclampsia prevalence rates based on population-level data. Our study implicates that modifiable risk factors for pre-eclampsia/eclampsia exists and thus there is a need for replication of findings given that the dietary patterns are modifiable. Our study findings may serve as an important call for health care providers to heighten their awareness of the increased population-level risk for pre-eclampsia and eclampsia disease originating in pregnancy. With the target of the Millennium Development Goals in sight, pre-eclampsia/eclampsia should be identified as one of the priority areas in reducing maternal mortality in India. However, further research involving the use of a more comprehensive dietary measure, pre-pregnancy assessment of all the risk factors and ascertainment of dietary intake prior to the development of pre-eclampsia and eclampsia and accuracy of reporting of the symptoms of pre-eclampsia and eclampsia are needed in a developing country setting.

Towards The Elimination Of New Pediatric HIV Infections.

Author(s) Olatunji Adetokunboh1.
Affiliation(s) 1Community Health, Stellenbosch University, Cape Town, South Africa.
Country - ies of focus South Africa
Relevant to the conference tracks Infectious Diseases
Summary In 2009, UNAIDS called for the virtual elimination of Mother to Child Transmission. In 2011, the Global Plan started and it covers all low and middle-income countries, but focuses on the 22 countries with the highest estimated numbers of pregnant women living with HIV. The data used were obtained from 2012 progress reports submitted by countries to UNAIDS and Spectrum software 2012 country files were used in monitoring the progress of these countries. From this study, Kenya, Namibia, South Africa, Swaziland and Zambia were the top progressing countries while India, Congo Democratic Republic, Nigeria, Angola, Chad and Mozambique were in the rear.
Background In 2009, the Joint United Nations Programme on HIV/VIGS (UNAIDS) called for the virtual elimination of Mother to Child Transmission, a call that has since been embraced by many agencies, regional coordinating bodies and national governments.
In 2011, at the United Nations General Assembly High Level Meeting on AIDS, global leaders made commitment with a plan towards the elimination of new HIV infections among children by 2015 and to keeping their mothers alive. This plan covers all low and middle-income countries, but focuses on the 22 countries with the highest estimated numbers of pregnant women living with HIV.
Objectives The objective of this study was to access the progress of the priority countries involved in Global Plan towards the elimination of new HIV infections in children and keeping their mothers alive.
Methodology Research question:
What is the progress made by the priority countries towards the elimination of new HIV infections in children and keeping their mothers alive.Methods:
The data used were obtained from 2012 progress reports submitted by countries to UNAIDS and Spectrum software 2012 country files. The study looked at the overall target 1 which is geared towards reducing the number of new HIV infections among children by 90%. The study also looked at Prong 3: Targets 3.1 - reducing mother-to-child transmission of HIV to 5% , Target 3.2 - having 90% of mothers receiving Perinatal antiretroviral therapy or prophylaxis and Target 3.3 - having 90% of breastfeeding infant-mother pairs receiving antiretroviral therapy or prophylaxis. The 2009 data serves as the baseline for this study.
Results For the overall target 1, the countries were categorized into 3 categories with 8 countries achieving rapid decline ( > 30%), 7 countries had moderate decline (20 -30%) while 5 countries had slow or no decline (10%) The percentage difference in reduction of mother-to-child transmission rate (%) (2009-2011), 9 countries (5 - 10%) and 5 countries (90%, 50-90% and < 50% in 3, 12 and 7 countries respectively.
By 2011, the percentages of mother-infant pairs receiving antiretroviral drugs to reduce transmission during breastfeeding were >50%, 21-50% and ≤20% in 3, 6 and 11 countries respectively. From this study, Kenya, Namibia, South Africa, Swaziland and Zambia were the top progressing countries while India, Congo Democratic Republic, Nigeria, Angola, Chad and Mozambique were in the rear. Notably, by 2009 Botswana had achieved some of the targets. Some of the countries did not provide adequate data for proper assessment.
Conclusion There was some level of progress among the priority countries in different areas geared towards reaching the elimination of new HIV infections in children, however some countries are still far behind. The performance in the area of mother - infant pairs receiving antiretroviral drugs is generally not encouraging. There is need for more drastic measures in the slowly progressing countries and keeping pace with the others. This research will be published in open access journals and presented to the research communities.