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DGIS -ITG IMT A. von HUMBOLDT (IMTAvH) Lima, Peru Institutional strengthening & collaboration

DGIS -ITG IMT A. von HUMBOLDT (IMTAvH) Lima, Peru Institutional strengthening & collaboration. Lima & UPCH. Lima, massive rural immigration in 1970-1980: 2 10 M Universidad Peruana Cayetano Heredia National General Hospital (4th line)

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DGIS -ITG IMT A. von HUMBOLDT (IMTAvH) Lima, Peru Institutional strengthening & collaboration

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  1. DGIS -ITG IMT A. von HUMBOLDT (IMTAvH) Lima, Peru Institutional strengthening & collaboration

  2. Lima & UPCH • Lima, massive rural immigration • in 1970-1980: 2 10 M • Universidad Peruana Cayetano Heredia • National General Hospital (4th line) • Northern Lima, 3 million inhabitants

  3. UNIVERSIDAD PERUANACAYETANO HEREDIAFacultades Facultad de Medicina “Alberto Hurtado” Facultad de Ciencias y Filisofía Facultad de Estomatología Facultad de Veterinaria y Zootecnia Facultad de Educación Facultad de Enfermería Facultad de Salud Pública y Administración “Carlos Vidal Layseca” Facultad de Psicología • Private University, founded 1962 • 8 Facs, 6.500 students • Hospital: 420 beds, training in 28 • medical specialities, 900 students • 3 Research Institutes, • including IMT AvH

  4. IMTAvH (1968) • Clinics for Tropical and Infectious Diseases • 150 consultations /day, 36 beds, • 9 infectiologists, 3 dermatologists • 7 labs • 9 courses, pre- & post-graduate incl. Gorgas Course

  5. IMTAvH- ITG 1987 Spin-off from DGIS/IMTA cooperation with Bolivia  joint research project EC-STD (INCO) Leishmaniases 1988 Collaboration for Mycobacterioses Françoise Portaels / Humberto Guerra 1987 Collaboration for Mycoses Danielle Swinne / Betty Bustamante 1989 Memorandum of Understanding (MoU) 1996 Collaboration in Malnutrition (P. Kolsteren)  joint EC-INCO project Antwerp -Lima - Cochabamba 1996 MoU expanded + Nutrition, Public Health, STD 1998 Framework Programme DGIS-ITG-IMTAvH "International Strenthening & Collaboration"

  6. COLLABORATION • 5 topics 12 partners 4 ITMA departments • Leishmaniases *Jorge Arevalo Parasitology • cut., muco-cut. Alejandro Llanos- • Cuentas, MD • *Jean-Claude Dujardin, • D Sc • Mycobacterioses Humberto Guerra, MD Microbiology • TB, MDR-TB, Buruli Françoise Portaels, D Sc • Mycoses Betty Bustamante, MD Clinical Sciences & Sporotrichosis Danielle Swinne, D Sc Institute of Public Health Brussels • Malnutrition Iris Pecho Public Health Micronutrients, Anna Prada • co-infections Patrick Kolsteren • Clinical Research Eduardo Gotuzzo Clinical Sciences (since 2000) Tine Verdonck • HIV/TB, skin ulcer • * Coordination: 2 local coordinators (JA/Lima, JDC/Antwerp) + 1 promotor (DLR/Antwerp)

  7. SYNERGY BETWEEN TOPICS • Clinical epidemiologyofHIV/TB andskin ulcer • Molecular tools for diagnosis and epidemiology • INSTITUTIONAL STRENGTHENING • Human Resources: tech training, M Sc, PhD • Centralized equipment for cryobanking & molecular biology • Computerized management of reference collections: clinical specimens, pathogens, sera • DistanceLearning: CD- ROM Trop. Med. cfr Erwin Van den Ende

  8. DGIS INPUT, BUDGETARY

  9. BREAKDOWN 2000 BUDGET 12 M 4

  10. QUALITY CONTROL • 2001  Administrative management: 2nd back-up site visit (LS + JVL) •  External evaluation: 1 Lat-Am + 1 EU experts • 2002  New 5-yr Master Plan to be identified by IMTAvH • institutional priorities • QC indicators • sustainability • DGIS PROGRAMME •  Strengthens institutional sustainability •  reference and teaching capacity •  competitivity in research fund raising: EC-INCO, WHO/TDR, NIH…

  11. Major achievements (equipment) • Improvement of basic laboratory facilities • Common facilities for sample storage (-70°C) • Bio-Safety • Common laboratory facilities for molecular biology

  12. Major achievements (training) • Clinical research: 2 MDs • Leishmania: 2 PhD, 4 MSc, 2 MSc • Mycology: 1 MSc • Mycobacteriology: 5 Medical students, 1 MSc • Nutrition: 2 experts, multidisciplinary team • Common activities: management biological samples

  13. Major achievements (science) Clinical research: • TB: many patients with MDR, frequent co-infection PCP-TB • Skin ulcer (differential diagnosis): predictive value of clinical and epidemiological information; mostly due to Leishmania, PCR without biopsy (scrap) • Translation of CD-Rom on Tropical Medicine in spanish (+/- 75% achieved)

  14. Major achievements (science) Leishmania: • PCR identification of Leishmania species directly in biopsies (first in the world): prognosis and epidemiological surveillance • Development of methodologies for analysis of differential gene expression (virulence, drug resistance) • Opening of a research line on the influence of vit A on disease progress

  15. Major achievements (science) Mycobacteriology: • Implementation of phage-based methodology for identification of Mycobact. infection and determination of drug-resistance • Detection of resistance to second line drugs in the general population of TB patients and in patients with MDR-TB (16% kanamycin, 10% ofloxacin) • Detection of autochtonous cases of Buruli ulcer

  16. Major achievements (science) Mycology: • possibility to be regional/national reference centre • initiation of studies on molecular epidemiology of fungi Nutrition: • 71% anemia < 5 years: despite good quality of iron-enriched bread, this is not provided to children; search for alternative strategies. • Effect of nutritional supplements on parasitoses

  17. Output (publications) • Leishmania: 1 PhD thesis, 1 MSc thesis, 3 papers • Mycology: 3 papers • Mycobacteriology: 1 manual, 1 paper, 5 abstracts in proceedings • Nutrition: reports, papers in the pipeline • Clinical research: 1 paper in preparation

  18. Output (projects) • Leishmania: 2 TDR, 1 INCO-Dev (Drug resistance), 1 QOL (epidemiological surveillance) • Mycology: 2 clinical trials • Mycobacteriology: 1 INCO-Dev (concerted action), 1 submission to TDR • Nutrition: 1 INCO-Dev, 1 USAID • Clinical research: 2 submissions to TDR

  19. Ref. Sample collection Role of nutritional status Molecular diagnosis and epidemiology Synergy Clinical research Tropical and Infectious diseases Leishmaniases Mycoses Mycobacterioses HIV/AIDS

  20. Prospects • Clinical trials • Reference centre for molecular diagnosis and epidemiology of pathogens (inter-regional course) • Immunology (starting from HTLV/Strongyloides)? • …(Cysticercose, neuro-)

  21. DGIS Institutional strengthening Stability, continuity, pilot studies for competitivity in research projects (EC-INCO, WHO-TDR, NIH..)

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