Day 3 :
Keynote Forum
Reza Nassiri
Michigan StateUniversity, USA
Keynote: Outbreak of Chikungunya Virus in the Dominican Republic
Time : 10:00-10:25
Biography:
Dr. Reza Nassiri is Associate Dean of Global Health; Director of Institute of International Health; Professor of Clinical Pharmacology, Professor of Family and Community Medicine, and lecturer in Global Health, Infectious Diseases and Tropical Medicine at Michigan State University College of Osteopathic Medicine. His research interests focuses on Clinical Pharmacology of HIV/AIDS & TB, prevention and control of infectious diseases, neglected tropical diseases, community health, global health, and socio-ethical determinants of health. Prof. Nassiri works on international public health issues and has expertise in global health education, research, policy and governance. He has made contributions in various fields of medical sciences including clinical investigation and health education. One the basis of his extensive experience and expertise in HIV/AIDS and TB, he developed Clinical Research Programs in Brazil, South Africa, Haiti, Dominican Republic and Mexico. The core foci of such programs are socio-cultural, bio-ethical determinant of HIV/AIDS and TB prevention, control and intervention.
Abstract:
Chikungunya fever (CF) is an emerging mosquito-borne viral disease caused by an alphavirus, Chikungunya virus (CHIKV). The disease is transmitted predominantly by Aedesaegypti and Aedesalbopictus mosquitoes, the same species involved in the transmission of dengue. The most common symptoms of Chikungunya virus infection are fever, arthralgia, backache, and headache. Outbreaks have occurred in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans. The socioeconomic factors and public health inadequacies facilitate rapid spread of this viral infection. CHIKV has expanded its geographical range producing new outbreaks including the Caribbean region, and therefore, the Dominican Republic.In December 2013, the Pan American Health Organization issued a warning about indigenous cases of CHIK in Saint Martin,therefore the Ministry of Public Health (MPH) from the Dominican Republic (Pimentel, 2014)released an epidemiological alert in conjunction with the National Plan for Preparedness and Response to CHIK, on January 2014. In February 2014, notifications ofcases with febrile syndrome at the Paniagua Maria Hospital in the municipality of San Gregorio de Nigua, province of San Cristobal, indicated a sustained prevalence. After ruling out other infectious diseases such as dengue, malaria, measles and rubella, the outbreak of CHIKV was then confirmed bythe Center for Disease Control and Prevention (CDC) on April 3rd, 2014.The main commercial port in the country, located in Haina, is supposed to have been the gateway to the virus.The MPH activated the Interagency Committee on Health Surveillance, created the Vice Ministry of Public Health’s Situation Room, where a group of health professionals was assigned to coordinate and assess needs and actions to respond to the epidemic, composed of six working groups: epidemiology, health services, strategic communication, planning and logistics, fast response and vector control. Among the first actions taken, was the development of the Clinical Management Guide for CHIKV (MPH, 2014) and its national distribution among health care networks.In addition, community forums and meetings with provincial and regional hospitals were organized to inform of the epidemic, prevention activities and the need to eliminate mosquito breeding sites, using larvicides in water storage tanks in homes. The General Direction of Epidemiology (DIGEPI) elaborated instruments of recollection and notification of cases and outbreaks, which were presented in a meeting with the National Epidemiology Network. The volume of cases (DIGEPI, 2014) of CHIKV overwhelmed the health services, at all levels, increasing the total health costs during the 9 months of its prevalence, affecting 524,297 cases with six mortality registered. The incubation period was from 2-6 days with clinical symptoms usually appearing 4–7 days post-infection, which included rash, pain in the lower back, joint pain (with or without the presence of swelling), and vomiting, nausea, headaches, chills and fevers. As a complication, rheumatoid arthritis-like symptoms persisted for months. Due to a lack of vaccine and specific medication for the CHIKV, the support care of symptoms was recommended such as taking plenty of fluid, having bed rest, IV fluid in case of dehydration and medications for fever and pain. In conclusion, CF is an emerging vector-borne disease of high public health significance in Dominican Republic. Vector-borne diseases management, control and prevention should include cross-sectoral solutions involving all stakeholders. The One Health approach can greatly enhance communication and collaboration among the stakeholders to control and prevent CF.
Keynote Forum
Jun-qing Wu
Shanghai Institute of Planned Parenthood Research, China.
Keynote: Investigation on Sexual Behavior among Migrant Population in Three Chinese Cities
Time : 10:25-10:50
Biography:
Junqing Wu has completed her Ph.D at the age of 45 years from Fudan University. She is the director of Dept. of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research. She has published more than 200 papers in reputed journals and serving as tutor of Ph.D student of Fudan University.
Abstract:
In order to understand sexual behavior among migrant population in three chinese cities, and to explore its influencing factors. A multi-stage cluster sampling were carried out to select subjects from three cities，including Beijing，Shanghai and Chengdu. Then they would be interviewed by trained investigators with structured questionnaires. 6304 migrants were included in this Investigation, and 4069 migrants had reported first sexual behavior. The oldest of first sexual behavior was 42 years old, the youngest was 12, and the average was 22. About sexual subject, spouse was 74.32%, romantic partner was 23.37%, casual or commercial sex partners were 1.59%, 0.24% respectively. 13.74% was more than one sexual partner. There were differences in the number of sexual partners among migrants from different cities, with different gender, age, marital status, educational background, family monthly income per capita, household categories, the year of working outside, the number of regions they had worked, the main mode of living in current residence, and the number of children. Logistic regression analysis showed that unmarried male migrants from Shanghai, worked in service and entertainment venues, with non-agricultural household, with no child, had lower sexual partners. The study showed that there were unmarried sexual behavior and multiple sexual partners among migrants in three cities. Specific sexual concept education should be carried out, and advocating safe sex, so as to improve the level of migrants’ reproductive health.