PS036 - Selected Case Studies on Neglected Diseases

Case Study # 1:  Hurdles faced in implementing quality clinical research in Human African Trypanosomiasis

Mr Bilenge presented the challenges faced in implementing quality clinical research for Human African Trypanosomiasis (HAT), also known as sleeping sickness, in the Democratic Republic of Congo (DRC). Currently, the disease affects thirty six sub-Saharan African countries. There exist two forms of HAT: The chronic form that affects West & Central African countries and lasts for years, and the acute form, which affects countries in East Africa and lasts for a maximum of six months. Mr Bilenge went on to explain how in the case of the DRC, the main concern is the scarcity of treatment for more than twelve million people exposed to the disease.  In order to reach the exposed population nationwide, there's an urgent need for trained health professionals. Before independence in 1960 there were 200 mobile & trained teams for a population of forty million; currently there are thirty eight for a population of sixty million!  Another concern that was brought up by Mr. Bilenge was how to get patient documentation for the trials, not only due to the lack of workforce and resources to reach far-fetched regions, but also the fact that its difficult to obtain information from the population as this is not very well accepted culturally. With the collaboration of partners such as the Swiss Tropical Institute (STI), Antwerp Tropical Medicine Institute (ATMI) and the World Health Organization (WHO), as well as a number of NGOs, there are some improvements in terms of the number of trained staff, health care centres and people documented and treated with HAT in the DRC, as well as neighbouring countries.

Case Study # 2:  Clinical research on Diabetes Mellitus and other disease related to lifestyle changes

Professor Khan presented the case of how change in life-style is also changing the disease pattern/increasing the number of cases of Non-Communicable diseases (NCDs) such as heart diseases, cancer, chronic respiratory diseases and also diabetes. NCDs represent approximately 60% of all deaths in the world (2005 statistics). Prof. Khan gave examples of how lifestyle changes, such as driving instead of walking, dietary changes towards fast foods, sitting in front of TV/computer screens instead of playing or working outside, have resulted in a general deterioration in health and an increase in the number of cases of the diseases mentioned above. Diabetes is considered a world epidemic. Prof. Khan shared the latest statistics: a predicted global increase of 72% by 2025 and an increase of 347% in Bangladesh alone. Not long ago, diabetes was considered to be a disease which mainly affected people in industrialized countries; however that trend is shifting due to the lifestyle changes cited above. Having said this, diabetes can be prevented in a number of ways.  The Diabetic Association of Bangladesh (DAB) runs a mass awareness programme on the 28th Feb. of every year. Events include things such as rallies, seminars, awards ceremony for diabetes patient able to control the disease, screenings at public venues etc.  Awareness centres are being erected at public places such as airports, bus terminals etc. Employers are being encouraged to incorporate diabetes prevention and control programmes in the workplace.   Bangladeshi folk singers and film stars are also being used to pass on the message that a long and healthy life comes from healthy eating and exercise.