South-East Asia Regional Conference on Epidemiology

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<strong>South</strong>-<strong>East</strong> <strong>Asia</strong> <strong>Regional</strong> <strong>Conference</strong> on Epidemiology | 349 to endemic leprosy, many develop subclinical and some develop more serious forms of the disease. The moment BCG vaccination is given, there is a shift in immunity to a more Th-1 type of response. What happens then is a more subclinical and more indeterminate type of leprosy among the vaccinated and that does not matter. The impact is in terms of a reduced incidence of serious forms of leprosy and consequent disabilities. In an ecological study, it was realized that if the BCG vaccination rate is maintained for a long time, the leprosy incidence seems to fall. In 40 clusters of villages, the BCG scar rate was measured among the 20-year-olds (which was an indicator of BCG coverage 20 years ago) and current prevalence of leprosy. There was a significant negative correlation (Fig.2). Leprosy prevalence Fig. 2: Ecological evidence 0 10 20 30 40 50 60 70 80 % BCG scar+among 20-year-olds By 2000, leprosy was supposed to have been eliminated from India. The elimination of leprosy means prevalence of one case per 10 000 population. India has over one billion people, and if there are less than 100 000 cases on the leprosy register, the disease would then be considered to have been eliminated. The aim was to eliminate leprosy by 31st December 2000. Did it happen? No, India did not achieve the target. Myanmar, Bangladesh and many other countries were able to eliminate leprosy. Then the target date for leprosy elimination was reset for 2005. What happened between 2000 and 2005? In the top 16 leprosy-prevalent countries in the world, there has hardly been any fall in the new case detection rate since 1993. In fact, some countries like Indonesia showed an increase. It is fascinating to note that during 2000-2005, new case detection has crashed in India (Fig. 3). This is a miracle. Should not there be research to find out how India succeeded in bringing down the incidence of new cases of leprosy so rapidly which no other country could achieve? One needs to explain why leprosy incidence declined in India.
350 | <strong>South</strong>-<strong>East</strong> <strong>Asia</strong> <strong>Regional</strong> <strong>Conference</strong> on Epidemiology 60,000 50,000 40,000 30,000 20,000 10,000 0 Fig. 3: Trends in new case detection–top 17 countries 1993 2002 2003 2004 2005 Source: http://www.who.int/entity/lep/situation/NCDetection2006.pdf 500,000 450,000 400,000 350,000 300,000 250,000 200,000 150,000 100,000 50,000 0 Indonesia Myanmar Bangladesh Nepal Nigeria Ethiopia D.R. Congo China Philippines Tanzania Mozambique Egypt Sri Lanka Madagascar Angola Brazil India
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Contents Preface ..................
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Foreword The health systems in seve
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Section 1 Opening ceremony Executiv
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Conference objecti
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Opening remarks Dr Samlee Plianbang
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Inaugural address Mr Kapil Sibal Ho
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Plenary 1 The enduring relevance of
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Revitalizing primary health care: h
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Plenary 2 Epidemiology: ensuring he
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Translating data into information f
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Fig. 2: Transmission of SARS in Sin
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Research and policy interface Ulyss
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Monitoring progress towards the ach
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Social determinants of health, MDGs
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MDGs 4 and 5: the challenge of redu
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Source: World Health Statistics, 20
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Methods and application of molecula
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Scope South-<stron
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The future of epidemiology: how is
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Table: Quick poll of epidemiology g
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Towards universal childhood immuniz
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Section 3 Special lectures
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Economic crisis and health of the p
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Country Fig. 4: Growth shocks <stro
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PRC HKG PHI SIN MAL THA INO KOR IND
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6. Recommendations 6.1 Monitoring a
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The use of epidemiological data to
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Fig. 1: Modelling the IDU epidemic
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Section 4 Parallel Sessions
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Facilitating appropriate response i
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Parallel Session 2 Noncommunicable
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Reducing the burden of cardiovascul
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Research and evidence-building for
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The role of current diarrhoea manag
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Global child deaths due to rotaviru
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Health Facility 22% 25% 18% Fig. 3:
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Integrating prevention and control
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Parallel Session 4 Disease epidemio
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Trends in tuberculosis: what is the
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TB cases/100k/year South</s
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Towards universal access to HIV pre
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1995 2005 Fig. 3: Targeted interven
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Parallel Session 6 Climate change:
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Impact of climate change on diarrho
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The impact of climate change on vec
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The role of influenza surveillance
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Page 320 and 321: Evidence-informed policy network (E
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Page 328 and 329: Acknowledgements South</str
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Page 394 and 395: Nominees of Member Countries Bangla
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South-East Asia Regional Conference on Epidemiology

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