water- related-diseases workshop · 2016-06-22 · european – southeast-asian experts water...

European – Southeast-Asian Experts Water related diseases Workshop:

Vientiane, 15th

-16th

February 2016

1

A European - Southeast-Asian Experts workshop

Conference Center of CICML

Vientiane, Lao PDR

15th and 16th February 2016

Water- related-diseases Workshop


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-16th

February 2016

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Table of Content

WORKSHOP CONTEXT ......................................................................................................................... 3

1. PRESENTATION OF THE WORKSHOP AND OBJECTIVES ............................................................... 3

2. WORKSHOP PROCEEDINGS ......................................................................................................... 4

2.1 AGENDA ............................................................................................................................... 4

2.2 GROUP WORK - METHODOLOGY ........................................................................................ 7

2.2.2 Questionnaire – state of the art ...................................................................................... 7

2.2.3 Groups Works .................................................................................................................. 7

3. WORKSHOP OUTPUTS ................................................................................................................. 9

4. WORKSHOP CONCLUDING REMARKS ........................................................................................ 12

5. ANNEXES .................................................................................................................................... 14

ANNEXE 1 : PRESENTATIONS OF EACH SPEAKER ........................................................................... 15

ANNEX 2 : LIST OF CURRENT RESEARCH PROJECT ON WATER AT THE INTERFACE OF HEALTH,

ECONOMICS AND ENVIRONMENT IN SOUTH-EAST ASIA (SYNTHESIS OF QUESTIONAIRES) ......... 25

ANNEX 4 : LIST OF PARTICIPANTS .................................................................................................. 30


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WORKSHOP CONTEXT

Population within SEA is growing at an exponential rate, with rapid urbanization and rapidly

degrading key ecosystems with huge impact on the most vulnerable populations. Clean

fresh-water is essential to maintain the production of adequate food supply for the human

and animal population. Climate change, environmental disturbances – e.g. dam building,

irrigation, wetland modification - globalisation of trade, loss of biodiversity are important

drivers of infectious and parasitic diseases including water-related diseases in SEA and could

have a negative impact on the health systems. Water pollution can severely reduce

biodiversity in aquatic and terrestrial ecosystems, and facilitate the spread of serious human

and zoonotic diseases. Water management and the risks and benefits to human health are

complex environmental health challenges, and should be tackled through fully

interdisciplinary research in order to promote systems model approach.

The CIRAD (French agricultural Research Center for International Development), in

collaboration with the Centre Merieux of Laos, National Institute of Health Laos and Pasteur

Institute of Laos, have organized a "Water-related diseases workshop", which was held

from 15th

to 16th

of February 2016 in Vientiane, Lao PDR. This workshop, in the framework

of FP7 European SEA-EU-NET programme, merged 3 topics: Health, Water-Management

and Food Security.

1. PRESENTATION OF THE WORKSHOP AND OBJECTIVES

This expert workshop gathered 25 participants and managed to obtain the following

objectives:

i) To share information (programs and projects) and scientific knowledge on water-related

diseases.

ii) To stimulate EU-SEA cooperation by promoting exchanges between EU and ASEAN

experts, and build up coordinated international projects

iii) To develop networking on water related diseases


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Expected outputs

- A policy note to be published late 2016

- Teaming up and building of consortia proposals to addresss calls

The main themes/sessions of the workshop were organized by important diseases

(Leptospirosis, Cryptosporidium, vector-borne, Opistorchis and other flukes, ...) and by topics

(water management, biodiversity, climate change, antimicrobial resistance, ...), as we

wanted to promote a multisectorial and interdisciplinary approach.

Workshop speakers and participants

The workshop gathered 25 experts, 11 experts from SEA, and 14 experts from EU/Int.

Experts, from the public health sector, animal health sector, and environment (water, climate,

biodiversity, antimicrobial resistance), and wildlife sector were invited (cf. list of participants in

Annex 3), chosen by Dr Serge Morand (CNRS / CIRAD), Dr François Roger (CIRAD) and Dr Flavie

Goutard (CNRS / CIRAD)

2. WORKSHOP PROCEEDINGS

2.1 AGENDA

Monday 15 February

08:00 Registration

08:30 Opening Speech:

Dr Phimpha Paboriboune (DS Centre Mérieux, Laos)

09:00 Keynote Speaker:

E. Boelee: Management of water and related diseases

09:30 Session 1


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A. Aebischer: Giardiasis in the perspective of water-borne parasitic infections

S. Caccio: Cryptosporidium, the paradigm of a waterborne pathogen

D. Dance / A. Pierret: Land use and soil type determine the presence of the

pathogen Burkholderia pseudomallei in tropical rivers

10:30 Break

11:00 Session 2

P. Echaubard: Liver flukes sustainable control in SEA, frontiers in ecology and global health

Y. Suputtamongkol: Human Leptospirosis: An Update

J. Ledieu: Remote sensing flooding indicator and leptospirosis in Cambodia

K. Nakhapakorn: Climate change impacts on Dengue Fever in Thailand Using Geo-

information Technology

12:30 Lunch

14:00 C. Khoury: SEA-EU-NET presentation

14:20

Group Work

15:30 Break

16:00 Group restitution / Discussion

19:00 Diner

Tuesday 16 February

09:00 Keynote Speaker:

B. McMahon: Antimicrobials Resistance: Wildlife & the Environment


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09:30 Session 3

Y. Trisurat: Watershed management

S. Sayasone: Health geography

D. Jourdain: Ecosystemic services

10:30 Break

11:00 Session 4

A. Ribas: Edibles frogs

S. Morand: Biodiversity

N. Peng Bun: Aquaculture / Fishing

U. Suntornratana: Fishing and health related problems

12:30 Lunch

14:00 F. Goutard: GREASE presentation

14:20

Group Work

15:30 Break

16:00 Group restitution / Discussion

19:00 Diner


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2.2 GROUP WORK - METHODOLOGY

2.2.2 Questionnaire – state of the art

In order to summarize the different research initiatives that are currently implemented in SEA, a

questionnaire (see attached in annex) have been prepared and sent to each participant 2 weeks prior

the meeting, which describes current research Project on Water at the Interface of Health,

Economics and Environment IN SOUTH-EAST ASIA

The objective was to start the workshop with a state of art of the existing projects in SEA which are

covering these thematic, in order to identify during the workshop the gaps in research for future

collaborative projects.

2.2.3 Groups Works

3 groups of 8 experts were set up, and a brainstorming protocol was proposed, with facilitators

and rapporteurs identified for each group :


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Brainstorming protocol

1. Identify gaps and needs: Ask each expert to write 3 most important gaps/needs in research

according to his point of view (1 per post it note)

2. Categorize the gaps/needs : Ask each expert to stick his post it note on the board and to group it

according to the topics identified by the previous person

3. Identification of potential topics : Ask experts to work by group of 3 to brainstorm on research

topics which could be developed based on the gaps/needs identified in steps 1 and 2

4. Identification of research topics based on a template - Ask participants to work by 2/3 on 1

topic and to fill in a appropriate template (title / objectives/ research area/ Potential relevance

or utility of expected research output to the region) – see in annex

Next day

5. Topic Development by group: Ask each group to develop their topic (why this topic, which

components or workpackages; Present and brainstorm with the whole group on the relative

importance of this topic.

6. Topic synthesis: Discuss with the whole group and synthesize the information of the whole

topics arising from the session.


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3. WORKSHOP OUTPUTS

Several research issues have risen from the workshop:

Research issue Objectives

Potential relevance

or utility of expected

research, output to the

region

Water – health related

issues in SEA

Understanding the impact of regional

dynamic changes on water health related

issues and risks

How to increase awareness about water

diseases health risks from local to global

priorities

Transversal evaluation of water health

related diseases burden and

management needs: from local to

international priorities (bottom up

approach);

Promote communication : from local to

national to international; from scientific

N/S (interventions, choice of

Key words : AMR

resistance, impact

assessment; ethics, laws,

knowledge transfer,

governance, participatory

approaches, dynamic

changes


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methodologie)

Improving self/community

resilience in changing SE

Asian environments

Improve individual and social health

resilience

Individual and evolutionary medicine

Ecological community health, maintaining

equity / sustainability

Health threats: infectious

diseases, antimicrobial

resistance,

noncommunicable

diseases

Platform for transfer,

innovation and knowledge

sharing in environment

and health

To enhance and facilitate research

transfer from environmental (climate,

soil, water),

ecological (biodiversity, living resources)

and health (human, veterinary) sciences;

To develop innovative tools to facilitate

transfer / translation research toward

public and

private sectors;

To develop systems for open data and

knowledge representation

Public sector: smart

governance

Private sectors: support of

new sustainable activities

integrated surveillance of

AMR

Mechanisms, surveying systems by

sentinel organism until action (control

and prevention) in environmental

management and agriculture practices

Key Words: Wildlife, domestic animal,

humans, interaction, AMR, sentinels

Action research on the

health impacts of water

contact interventions

- test multi-barrier approach (e.g.

protective clothing, alternative facilities,

bathing

practices/hygiene behavior/education) in

practice and evaluate

- assess ,pact by monitoring widely (e.g.

pathogens [incl. Vibrio, Lepto), vectors,

environmental bacteria, symptoms) and

quantitatively, to see whether instead of

a decrease

of disease, there are multiple benefits

that lead to improved health)

- to develop methodology

Impact in the study sites:

improved health

Generic outcome:

methodologies for

- Identifying appropriate

interventions

- Monitoring health rather

than disease (multiple

pathogens /

symptoms /health


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ASSESSING THE HEALTH

CONSEQUENCES OF

WATERSCAPE

MODIFICATIONS IN GMS

1- CHARACTERIZING WATERSCAPE

MODIFICATIONS (selecting specific

relevant areas)

- Irrigation practices (traditional vs

commercial; local scale)

- Dams (regional scale)

This include assessing landscape

connectivity/fragmentation (GIS), water

movement including

flooding regimes, water quality (i.e.

safety ; agrochemicals), freshwater

communities structure

and function (emphasis on snails and

parasite transmission dynamics),

vegetation cover

(medicinal plants?)

2- HEALTH ASSESSMENT

- ID surveillance (lepto, melioidiosis, Liver

flukes)

- Food safety/nutrition (fisheries, plants)

- Psychosocial dimensions of health in a

context of livelihood transitions (sense

ofcoherence; medical anthropo, etc.)

Research to policy/wise

governance

Community empowerment

through co-creation of

“best practices

information package on

water management and

health outcomes”

Creation of

methodology/protocols

for ID surveillance,

modelling

impacts of irrigation

practices on ID

transmission

Together these

deliverables can be

combined in a Health

Assessment

Package

Water safety: AMR and

infectious diseases

surveillance in water along

the Mekong

- to assess role of water sources in the

spread of infectious diseases

(Cryptospora, B.

pseudomallei) + AMR organisms (E.coli,

Klebsiella, Campylobacter) + other

potential sources

(Med: hospital + Agri: farming)

- to develop standards to assess water

quality + risk factors related to pathogen

+ AMR

- to identify sources and develop tools for

health interventions

Provide scientific data for

informal policy decisions

PH

Establish surveillance

standards and networks

for quick mobilisation of

interventions

Public engagement

opportunities

Better animal health

management

Improved waste water

management


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4. WORKSHOP CONCLUDING REMARKS

This workshop has allowed to successfully pointing out some research issues :

On AMR:

The experts group identified that a lot of researchers in SEA are already working on the molecular

and ecological mechanisms of AMR emergence through descriptive study. There is a need to develop

more analytical studies in order to understand the mechanisms of resistance transmission between

different compartment (animals, human and environment), the role of water and waste (farm or

hospital) as a vector of transmission and to propose more practical recommendations for

antimicrobial management at farms and hospitals. The group proposed to investigate key risk factors

of AMR emergence and spread in varied farming systems in SEA, characterising these systems in

relation to practices -crucially antimicrobials usage- and their contribution to AMR and risk of human

infection. The idea will be to focus on key indicator bacteria, modelling and epidemiological tools,

such as contact networks, risk estimation and case-control studies, to assess the risk of AMR

transmission between compartments. The impact of changes in farming practices at farm level could

be assessed and One Health surveillance system could be tested. The results of these interventions

studies could then help in the design of efficient and adapted policies and recommendations for AMR

control/surveillance.

On Water :

From the different presentation given during the meeting, the need of assessing the health

consequences of water modification in the great Mekong Bassin received the full attention of the

researchers and expert. They proposed first to characterize the waterscape modifications. This could

include the assessment of landscape connectivity/fragmentation, the water movement including

flooding regimes, water quality (i.e. safety ; agrochemicals), the freshwater communities structure

and function (emphasis on snails and parasite transmission dynamics), the irrigation practices (local

level) and the dam impacts (at regional level). Then the most important diseases link with

waterscape modification, in term of health impact, economics importance, livelihood, side effects

should be identified and prioritized. The objectives will be to develop statistical or mathematical

models to test changing scenario and then assess the impact of the changes on the system before

setting up interventions.


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A draft policy note was prepared during the conclusion session with the experts present:

Issues about changes in water system dynamic (especially in the area of the Mekong basin) and the

impact of human actions (agricultural and cultural/behaviour practices), climate changes and socio-

economic context evolution, are complex questions that need integrated framework (One Health,

Ecohealth or Global Health). Some tools have been developed by researcher to addresses these

issues but innovation are still required.

The first challenge identified during this meeting was the lack of proper mechanism or tools to

implement surveillance on water related health issues: experts highlighted the fact that few methods

exist to implement surveillance on water or related environment. Questions remain about what to

detect and at which threshold, for which action (simple monitoring or action from environmental

data) and how to share and use these data. Methodological issue of scale (geographic, and time)

between water systems, agriculture systems and public health were as well identified as very

important in order to be able to integrate the data and to make relation between the water system

and the food system (e.g. for antimicrobial resistance in the environment). Surveillance and

monitoring data are required to implement tailor-made intervention and to be able to make trade off

decisions between economic benefits and health consequences or local, national, international issues

(transboundary issues).

When considering water-borne diseases in SEA, several questions still remains, very limited

information exist on the impact of these diseases on the health and the livelihood of the local

communities and there is poor knowledge about the different biodiversity of the pathogens and their

associated virulence. There is no standardisation about methods of detections. One suggestion will

be to use syndromic surveillance (diarrhoea, liver disease syndrome, chronic fever, encephalitis) for

detection and estimation of their prevalence, and to try to develop some indicators about factors

associated with syndrome and pathogens.

Integrated research project will be needed to answer these questions, with the involvement of

environmental experts, forestry, public health and agriculture specialists. The problem is how to

involved different sectors in an OH or Ecohealth approaches, how to work on a small interface

between the different discipline and how to show the benefits of an ecosystem approach. Water

management is a multi-country, multi-cultural and multi-sites issue which needs the involvement of

the right experts but as well the enrolments of local communities that will bring their knowledge

about local resources management, and cultural diversity. Traditional knowledge need to be

identified thought the help of sociological surveys in order to be a source of innovation in the field of

water resource management and health.


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5. ANNEXES

ANNEXE 1 : PRESENTATIONS OF EACH SPEAKER

ANNEX 2 : LIST OF current research Project on Water at the Interface of Health, Economics and

Environment IN SOUTH-EAST ASIA (SYNTHESIS OF QUESTIONAIRES)

ANNEX 4 : LIST OF PARTICIPANTS


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ANNEXE 1 : PRESENTATIONS OF EACH SPEAKER

Keynote Speaker

Management of water and related diseases Presentation Eline Boelee (Water Health)

ABSTRACT

Several infectious diseases are related to water in many different ways. Various types of

disease agents and vectors lead to complicated and highly specific modes of transmission,

influenced by water use, quality and management. Water supply for people, animals, food or

energy is usually managed by separate sectors that are not always aware of the positive or

negative health impacts of their infrastructure and its operation. The main exception to this

is safe domestic water supply, often promoted as a key intervention for the prevention of

water-borne diseases, especially when coupled with sanitation and hygiene. Contrarily,

where water management for irrigation or power generation leads to increased transmission

of malaria or other water-related diseases, this tends to be considered as inevitable side

effect, if recognized at all.

Prevention and control of water-related diseases are usually driven by the public health

sector and primarily destined at the disease or pathogen itself and less at its vectors or

transmission. Theoretically, wherever water is artificially managed, this could be done in

such a way that it has hampers transmission or spread of water-related diseases. For

instance, breeding of mosquito larvae and intermediate host snails is often disrupted when

water levels fluctuate or flow velocity is high. This may reduce disease transmission and

become complementary to public health interventions. In practice, few recent examples are

available of this environmental control.

Existing tools for impact assessment may not be adequate to determine the health risks

associated with water management interventions across scales from farm to landscape

levels, let alone help the development of remedial measures. Trans-disciplinary research can

increase awareness of the interlinkages among the health, water and agricultural sectors.

Concepts such as One Health and EcoHealth may be helpful to identify risks and

opportunities for preventing or reducing water-related diseases and benefitting human

health.


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Giardiasis in the perspective of water-borne parasitic infections

Toni Aebischer, Robert Koch-Institute, Berlin, Germany

ABSTRACT

Giardiasis is a major cause of diarrheic disease in humans worldwide. The causative agents

Giardia duodenalis protozoan parasites belong to mainly two distinct genetic groups

(referred to as G. duodenalis assemblages A and B), which appear to have a comparatively

broad host range and can be detected in animals as well. Thus, from an epidemiologist point

of view the infection, the organism may circulate through anthroponotic as well as through

zoonotic cycles. The infection can be contracted by a number of different routes but the

relevance of a particular route is to differ depending on the epidemiological setting.

Of these routes, consumption of contaminated water is thought to be a major way of

transmission. I will report on recent analyses that took a look at the correlation of

microbiologically qualified water supply and prevalence of infection. I will also refer to

existing guidelines to the monitoring of Giardia spp. contamination in water sources and

food items, respectively.

To analyse relevant infection cycles properly, genotyping by molecular methods is required.

Thus, an overview over current molecular typing approaches will be presented. Application

and usefulness of such an approach will be illustrated using recent examples of our own

published and unpublished work. This will cover the analysis of field samples, the suitability

of current methods to investigate outbreaks of giardiasis, and, the characterization of clinical

samples from patients with chronic infections. Our efforts aim at developing also a workflow

to test for drug sensitivity since therapy refractory infections occur comparatively frequently

and, depending on country, contribute significantly of disease burden.


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Cryptosporidium: the paradigm of a waterborne pathogen

Simone M. Cacciò,

European Union reference laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy

ABSTRACT

Cryptosporidium has emerged as a significant cause of diarrheal disease, with particularly

severe health consequences for very young children living in endemic areas. Two species,

the zoonotic C. parvum and the anthroponotic C. hominis, are responsible for the vast

majority of human cases, but many other species are known to infect wild and domestic

animals. Infected hosts can shed very large number of oocysts with their faeces and, as a

result, contamination of water with oocysts from animal waste, run-off from contaminated

land, or from anthroponotic sources commonly occur globally. The remarkable robustness of

the oocysts accounts for their ability to withstand environmental stress and to persist for

months in aquatic environments, particularly in cold water, while retaining their infectivity.

Furthermore, oocysts are resistant to chlorine disinfection at the concentrations typically

applied during water treatment. Finally, few oocysts are sufficient to cause infection. Under

these circumstances, it is easy to understand the important role played by water in the

complex epidemiology of cryptosporidiosis. Over the last decades, many waterborne

outbreaks have occurred, sometimes involving very large number of individuals. However,

new regulations, better water treatment and operational improvements have contributed to

a decline in the number of outbreaks caused by drinking water. During the same period, an

increase in the number of outbreaks due to recreational water, particularly swimming pools,

has been observed. Here, I will review the current knowledge on waterborne

cryptosporidiosis, with special emphasis on the epidemiological context of South East Asia.


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Land use and soil type determine the presence of the pathogen

Burkholderia pseudomallei in tropical rivers


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Liver flukes sustainable control in SEA frontiers in ecology and global health

Pierre Echaubard 1

WHO Collaborating Centre for Research and Control of Opisthorchiasis, Tropical Disease Research laboratory,

Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. 2

Department of Biology, Laurentian University, Sudbury, Ontario, Canada P3E 2C6 3

Global Health Asia, Faculty of Public Health, Mahidol University, Bangkok, Thailand

ABSTRACT

Wetland ecosystems (rivers, lakes marshes rice fields, coastal areas) are settings that

determine human health and well-being through a number of characteristic influences, such

as: a source of hydration and safe water; a source of nutrition; sites of exposure to pollution

or toxicants; sites of exposure to infectious diseases; settings for mental health and psycho-

social well-being; places from which people derive their livelihood; places that enrich

people’s lives, enable them to cope and to help others; and sites from which medicinal

products can be derived. These influences can either enhance or diminish human health

depending on the ecological functioning of wetlands and their capacity to sustainably

provide the products and services we derived from them. It follows then that losses of

wetland components, and disruptions to wetland functions, will have consequences for

human health along any or all of these lines (Horwitz et al., 2012). Seen in this way,

problems in which the environment is considered to have been implicated in health out-

comes cannot be solved by medical approaches to health alone. Rather, broader approaches

are needed, drawing on a wider scientific base, including ecological and social sciences.

Opisthorchis viverrini (Ov), the Southeast Asian liver fluke, is a fish-borne complex life cycle

trematode endemic in rice field ecosystems of Thailand, Lao PDR, Cambodia and southern

parts of Vietnam where an under-estimate of 10 million people are reported to be at risk of

Ov infection. The northeast region of Thailand is known in particular to be a hotspot of Ov

transmission, which despite nationwide public health prevention campaigns led by the

government and private organizations, still present high infection prevalence. The

persistence of high infection rates in the region, we argue, is due to 1) its cultural and

ecological particularities — where wet rice agrarian habitats; centuries old raw food culture

and the parasite complex biology combine to create an ideal transmission arena — and 2)

the biomedical-based research and control interventions ill-equipped both conceptually and

methodologically to apprehend such complex social-ecological issues and provide

sustainable solutions.

Here we review the state of our knowledge regarding the ecology of the Asian liver fluke

transmission. We also discuss the limitations of inductive epistemological and surveillance

type of approaches that have dominated the research initiatives in liver fluke epidemiology,


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highlight the lack of hypothesis driven research and identify a series of themes — ranging

from environment-mediated hosts ecological release to human ecology, landscape

connectivity and management as well as globalization – that have been overlooked despite

their critical influence in shaping transmission dynamics. Finally, we describe an integrative

‘biomedical-ecologic’ research model intended to bridge disciplinary gaps, enhance

collaborative research and education as well as provide a broader human health and

sustainable development framework in the context of the rapidly changing SEA waterscape.


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Human Leptospirosis: An Update

Yupin Suputtamongkol

Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, Thailand

ABSTRACT

Leptospirosis is a widespread and potentially fatal zoonosis that is endemic in many tropical

countries and causes large epidemics after heavy rainfall and flooding. It is caused by the

pathogenic Leptospira spp. Infection results from direct or indirect exposure to infected

reservoir animals, mainly rodents. Leptospirosis typically presents as a nonspecific, acute

febrile illness characterized by fever, myalgia, and headache and may be confused with

other entities such as influenza and dengue fever. In endemic countries, it is one of the most

important cause of acute undifferentiated fever. Severe pulmonary haemorrhage and

multiorgan failure is now recognized as the most common cause of fatal leptospirosis. Early

diagnosis of leptospirosis is largely a clinical diagnosis and relies on a high index of suspicion

based on the patient’s risk factors, exposure history, and presenting signs and symptoms.

Rapid diagnostic tests for leptospirosis are improving, but a negative result should not be

relied on to rule out early infection. For these reasons, empirical therapy should be initiated

as soon as the diagnosis of leptospirosis is suspected.


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Remote sensing flooding indicator and leptospirosis in Cambodia

MSc Julia LEDIEN

Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, BP983, Phnom Penh,

Cambodia. jledien@pasteur-kh@org

ABSTRACT

Remote sensing can contribute to early warning for diseases with environmental drivers,

such as flooding for leptospirosis. In this study we assessed the performance of six remotely-

sensed flooding indicators in Cambodia and evaluated their potential in predicting the

spatial distribution of human leptospirosis seroconversions. The performance of the flooding

indicators was assessed by ground truthing. The best indicator, the

Modified Normalized Difference Water Index (MNDWI), was used as an explanatory variable

in a boosted regression tree model of leptospirosis seroconversions. MNDWI was the most

influential explanatory variable in our model (relative influence: 26%), followed by time since

the first flooding of the year (19%) and age (16%). Interestingly, MNDWI thresholds for both

detecting water and predicting the risk of leptospirosis seroconversion were independently

evaluated at -0.3. Value of MNDWI greater than -0.3 were significantly associated with an

increased risk of leptospirosis seroconversion (RR= 1.59 [1.07 – 2.40]). MNDWI may be

useful as a risk indicator for flood driven diseases in South East Asia.


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Climate change impacts on Dengue Fever in Thailand Using Geo-information

Technology

Kanchana Nakhapakorn1, Somwang Kurusarttra

1, Chiit Chansang

2, Supet Jirakajohnkool

3

1Faculty of Environment and Resource Studies, Mahidol University, Salaya, Nakhonpathom Thailand

2Medical Science Department, Ministry of Public Health, Nonthaburi, Thailand

1Faculty of Science and Technology, Thammasart University, Rangsit, Pathumthani, Thailand

ABSTRACT

Dengue haemorrhagic fever is a mosquito-borne viral infection that poses a constant and

serious risk to most tropical regions. As countries become more developed and

environmentally transformed from rural to urban, the human population’s inexorable

growth will change global patterns of the disease and mortality. Furthermore, changes in

climate pattern phenomenon are thought to be a major contributing factor to the disease’s

spread. The aim of the study was to identify the potential risk of dengue fever in relation to

environment factors, in particular, on changes in climatic factors.

Results show that the incidence of dengue increased during the rainy season and reached a

maximum around the peak of rainfall. Pooled data for all the three seasons revealed that

dengue cases were significantly associated with climatic variables. The two most significant

ones were mean minimum bi-weekly temperatures at t-1 (n = 2530, r2

= 0.245, P < 0.001)

and total bi-weekly rainfall during t-2 (n = 2530, r2

= 0.137, P < 0.001). Increases in dengue

cases were positively related to rising temperatures in all seasons. However, increasing

rainfall was weakly associated with dengue cases in summer and winter seasons and not

significantly related during the rainy season.

KEY WORDS: GEOINFORMATION/ DENGUE / CLIMATIC FACTORS


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Keynote Speaker

Antimicrobials Resistance: Wildlife & the Environment

Barry J. McMahon

UCD School of Agriculture & Food Science, Dublin, Ireland

ABSTRACT

Antimicrobial resistance (AMR) is the greatest challenge facing global public health in the

next 20-30 years. The causes have been linked with overuse, and even abuse, of

antimicrobial compounds in veterinary and human medicine but the symptom of the

problem have been far wider than domestic and domiciliated environments. Data will be

presented from wild birds species that were screened for AMR from a range of locations

across Europe and Ireland which are associated with aquatic and marine ecosystems. There

is widespread prevalence of AMR, including ESBL producing bacteria. These data confirm

that AMR is present in range of different locations but the implications of the finding need to

be realised. The major concern is that the symptoms of AMR i.e. widespread AMR in wildlife,

could now become a source of bacteria that are no longer susceptible to available

therapeutic treatment. Indeed, marine and aquatic ecosystems warrant further investigation

in order to minimise the risk of the proliferation of AMR bacteria back into environment

that’s that could cause serious public health problems. It is now time to consider AMR as

modern zoonoses.


Vientiane, 15th

-16th

February 2016

25

ANNEX 2 : LIST OF CURRENT RESEARCH PROJECT ON WATER AT THE INTERFACE OF

HEALTH, ECONOMICS AND ENVIRONMENT IN SOUTH-EAST ASIA (SYNTHESIS OF

QUESTIONAIRES)


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-16th

February 2016

26

Title Leading Location Objectives Areas of research OH/EH Funding Budget Period

CGIAR Research Program on Water, Land and

Ecosystems – Greater Mekong (WLE)WLE

Cambodia, China,

Laos, Myanmar,

Thailand Vietnam

Management of water development, and the

mitigation of negative impacts

(a) Water governance;

(b) Healthy rivers;

(c) River food systems;

(d) Healthy landscapes and

ecosystems.

(e) Capacity building and

professional development.

Ecohealth WLE/Australia 10 Millions 2015-18

ComAcross : Companion Approach for cross-

sectoral collaboration in health risk

management in SEA - Case study JE

CIRAD Cambodia, China

JE Human case occurrence is linked to the intensity

of transmission between pigs, thus to the

environment and pig herd management

(a) Water management

(b) agriculture

(c) public and vet health

(d) climate and environment

(e) social sciences

Ecohealth Europaid 2014-18

SEAe: Encephalitis in Southeast Asia CIRADCambodia, Laos,

Vietnam

Improved understanding of JE and Nipah

encephalitis epidemiology and risk factors.

Recommendations in terms of control measures.

Identification of the main causes of encephalitis in

Southeast asia

Improved diagnostic


(b) agriculture


(d) climate and environment

One Health

Total

Foundation-

Aviesan

2012-17

AMR in wild species of bird and mammalDublin

UniversityEurope

Using molecular techniques, screen and

characterise AMR in wildlife and to link with food

chain integrity.

(a) agriculture

(b) public health

(c) environment and biodiversity

One Health University 20 000 €2009-

ongoing

Assessing the performance of remotely

sensed flooding indicators and their

potential contribution to leptospirosis risk

mapping in Cambodia

Pasteur

InstituteCambodia

(i) to assess the performance of various remotely

sensed indicators to detect flooded areas

(ii) to evaluate their potential use in predicting the

distribution of human leptospirosis

seroconversions at local level in Kampong Cham,

Cambodia.

(a) climate

(b) public healthOne Health 2014-16

Bioprospecting on Biological Materials of

Cambodia (KRIBB-UBB)

Battambang U.

(UBB)Cambodia

to further expand the knowledge of medical plants

of Cambodia, develop nutraceuticals, and discover

new potential drugs.

(a) agriculture

(b) public health


(e) food

One Health

Korea Research

Institute of

Bioscience and

Biotechnology-

KRIBB, South

Korea

30 000 USD 2015-16


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-16th

February 2016

27


SEA-EU Partnering Initiative: Regional

Universities Network for Research and

Development of Neglected and

Underutilised Crop Species in Southeast-Asia

(RUN-NUS)

Battambang U.,

Ghent U.,

Czech U., Los

Baños U., Khon

Kaen U.

Cambodia,

Philippines,

Thailand

to bring together partner universities from SEA and

EU to discuss the future development and

implementation of the conservation, use and

research on indigenous neglected and

underutilised crop species (NUS) in Southeast Asia

(a) agriculture

(b) public health


One Health SEA-EU-NET II 19 000 € 2016

An intervention to reduce antimicrobial

usage in chicken farming systems in the

Mekong Delta of Vietnam.

OUCRU Vietnam

To reduce levels of antimicrobial usage in chicken

farm systems in the Mekong Delta of VN.

To measure the impact of these reduction on AMR

flora

To formulate a package of sustainable

interventions to the Government of VN and other

regional stakeholders.

(a) agriculture

(b) Vet public health

(c) Economics

One Health Welcome Trust 1.5M USD 2016-20

COllaborative Management Platform for

detection and Analyses of (Re-)emerging and

foodborne outbreaks in Europe (COMPARE)

29 Institutes

from 11 EU

countries

Europe

COMPARE is a large EU project with the intention

to speed up the detection of and response to

disease outbreaks among humans and animals

worldwide through the use of new genome

technology. The aim is to reduce the impact and

cost of disease outbreaks.

(a) public and veterinary public

health

(b) food

(c) molecular technology

One Health EU commission >20M € 2014-19

Whole genome approach to investigate the

potential zoonotic transmission of

Escherichia coli and their antimicrobial

resistance genes in chickens and humans in

Vietnam

OUCRU Vietnam

To quantify the level of zoonotic transmission of E.

coli strains and their antimicrobial resistance

determinants in chickens and humans through

occupational exposure in Vietnam.

(a) public and veterinary public

healthOne Health Welcome Trust 57 00 USD 2016-17

Predicted Climate Change Impact on Water

Resources in the Lower Mekong Basin and

Livelihood Related Issues

MRC ThailandTo quantify and compare water yields between the

baseline and future climate change scenarios

(a) Environment and Climate

(b) Water managementEcohealth MRC 2016


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-16th

February 2016

28


Burkholderia pseudomallei and associated

environmental factors in major rivers in Lao

PDR

LOMWRU Laos

(i) the presence and abundance of B. pseudomallei

in the water major rivers draining into the Mekong

and the Mekong itself and in the water and

streambed sediment along the course of the Nam

Theun river

(ii) the influence of physicochemical factors as

well as land use, soil type and geology on B.

pseudomallei presence and abundance in the

water and sediments,

(iii) the seasonal dynamic of B. pseudomallei

presence and abundance,

(iv) the relationship between the presence of

faecal indicator bacteria and the microbial

diversity in the water and sediments and the

presence of B. pseudomallei.

(a) Environment

(b) Vetrerinary and public healthOne Health Various 2016-17

Investigations on endemic parasitoses,

imported mycoses

and non-tuberculoid mycobacterioses of

Publication Health concern

Robert Koch

InstituteEurope

Obtain scientific base to assess the risk of said

Infectious agents by Laboratory investigations

(a) Public health

(b) PoliciesOne Health

Public by

federal

government and

ministry of

health

Liver fluke sustainable control: frontiers in

ecology and global health

Global Health

Asia, Mahidol

U.

Laos Thailand

Assessing the influence of

deagrarianization/urbanization on liver fluke

transmission ecology, rural communities

vulnerability

(a) Environment and biodiversity

(b) Water management

(c) Agriculture

(d) Public health

Ecohealth

WHO –

Institutional

(NUS – KKU –

Laurentian U –

Mahidol – CDC)

2015-20

Baseline survey on chemical and veterinary d

rug used in shrimp culture Thailand

Departlment of

FisheriesThailand

To gather information on situation of various chem

ical and vet drug possibly used in shrimp culture.

To provide information to policy in managing fish-f

ood Safety at farm-level.

(a) agriculture / DOF, Thailand 2015-16

ComAcross: how to improve water/waste

management at municipality level with more

benefits for people wellbeing (health,

environment, livelihood)?

CIRAD Thailand

• Improve communities' wellbeing and public

health trough Cross-sectoral approach, and taking

into account social and environmental aspects

• Improve stakeholders' cross-sectorial

collaboration (interactions between stakeholders

at the scale of the preparedness/response system;

cross-sectoral integration at local level)

• Better understand waste management impact on

human diseases and health problem

• Better understand waste and water management

at the province level and propose tools for actions


(b) agriculture and environment


(d) social science and policy

Ecohealth Europaid 2014-18


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-16th

February 2016

29

ANNEX 3 : QUESTIONNAIRE FOR GROUP WORK

F

QUESTIONNAIRE ON CURRENT RESEARCH PROJECT ON WATER AT THE INTERFACE OF HEALTH,

AGRICULTUREN ENVIRONMENT AND SOCIO6ECONOMICS IN SOUTH-EAST ASIA

Research Title

Objective/s

Area of

investigation

☐ Environment

☐ Water Management

☐ Climate

☐ Agriculture

☐ Biodiversity

☐ Public Health

☐ Veterinary health

☐ Social sciences

☐ Policy

☐ Economics

☐ Other:______________

SEA Country (ies)

involved

☐ Brunei Darussalam

☐ Cambodia

☐ China

☐ Indonesia

☐ Lao PDR

☐ Malaysia

☐ Myanmar

☐ Philippines

☐ Singapore

☐ Thailand

☐ Vietnam

Research Area

Potential relevance

or utility of

expected research

output to the

region


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30

ANNEX 4 : LIST OF PARTICIPANTS

Participants Europe Email

Speaker Eline Boelee [email protected]

Speaker Barry McMahon [email protected]

Speaker Anton Aebischer [email protected]

Speaker Simone Maro Caccio [email protected]

Speaker Alexis Ribas [email protected]

Speaker Pierre Echaubard [email protected]

Speaker Damien Jourdain [email protected]

Speaker Julia Ledieu [email protected]

Speaker Alain Perret [email protected]

Speaker David Dance [email protected]

Speaker Yupin Suputtamongkol [email protected]

Speaker Yongyut Trisurat [email protected]

Speaker Ngor Peng Bun [email protected]

Speaker Kanchana Nakhapakorn [email protected]

Speaker Ubolratana Suntornratana [email protected]

Speaker Somphou Sayasone

[email protected] ;

[email protected]

Observer Kim Geheb [email protected]

Observer Marisa Peyre [email protected]

Observer Véronique Chevalier [email protected]

Observer Michel de Garine [email protected]

Observer Marc Souris [email protected]

Observer Samnag Nguon [email protected]

Observer Nguyen Binh Minh [email protected]

Observer Ngo Chung Thuy [email protected]

Observer Vinh Trung [email protected]

Coordination Flavie Goutard [email protected]

Coordination Serge Morand [email protected]

Coordination Claire Khoury [email protected]

Coordination Jintana [email protected]

Coordination Phimpa Paboriboune [email protected]

Coordination Kong Chen [email protected]


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31

Participants Institution Country Email

Eline Boelee Water health Netherlan

d

[email protected]

Barry McMahon University College Dublin Ireland [email protected]

Anton Aebischer Robert Koch Institute Germany [email protected]

Simone Maro Caccio Istituto Superiore di Sanità Italy [email protected]

Alexis Ribas Barcelona University Spain [email protected]

Pierre Echaubard Khon Kaen university Thailand [email protected]

Damien Jourdain CIRAD Thailand [email protected]

Julia Ledieu IPC Cambodia [email protected]

Alain Perret IRD Laos [email protected]

David Dance LOMH Welcome trust Laos [email protected]

Yupin

Suputtamongkol

Mahidol University Thailand [email protected]

Yongyut Trisurat Kasetsart University Thailand [email protected]

Ngor Peng Bun Mekong River Commission Cambodia [email protected]

Kanchana

Nakhapakorn

Mahidol University Thailand [email protected]

Ubolratana

Suntornratana

Department of Fisheries Thailand [email protected]

Somphou Sayasone National Institute of Public

Health

Laos [email protected]

Kim Geheb WLE-Laos Laos [email protected]

Marisa Peyre CIRAD Vietnam [email protected]

Participants Institution Country Email

Véronique Chevalier CIRAD France [email protected]

Michel de Garine CIRAD Zimbabw

e

[email protected]

Patrick d'Aquino CIRAD Laos patrick.d'[email protected]

Paul Brey Pasteur Laos Laos [email protected]


Vientiane, 15th

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32

Daniel Reinharz FMED, Laval University Laos [email protected]

Marc Souris IRD Laos [email protected]

Emma Zalcman VSF Canada Laos [email protected]

Samnag Nguon University of Battambang Cambodia [email protected]

Nguyen Binh Minh NIHE Vietnam [email protected]

Ngo Chung Thuy NIVR Vietnam [email protected]

Kongsap Akkhavong National Institute of Public

Health

Laos [email protected]

Vinh Trung OUCRU Vietnam [email protected]

Flavie Goutard CIRAD Thailand [email protected]

Serge Morand CNRS / CIRAD Laos [email protected]

Claire Khoury CIRAD France [email protected]

Jintana CIRAD / KU Thailand [email protected]

Phimpa Paboriboune CCM Laos [email protected]

Kong Cheng FCO Singapour [email protected]

water- related-diseases workshop · 2016-06-22 · european – southeast-asian experts water...

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