[afro-nets] Infectious Diseases Pathology meeting

["Leela McCullough" <leela@healthnet.org>]

Infectious Diseases Pathology meeting
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May 2007
Kampala, Uganda

**NOTE: Please respond directly to Dr. Ann Nelson <Ann.Nelson@afip.osd.mil> or 
Professor Sebastian Lucas <sebastian.lucas@kcl.ac.uk>

CONSENSUS MEETING TO DEVELOP PROTOCOLS FOR AUTOPSY DIAGNOSIS AND EPIDEMIOLOGICAL SURVEILLANCE OF SIGNIFICANT AND EMERGING INFECTIOUS DISEASES, Uganda May 2007

Dear colleagues,

This is a preliminary announcement of a meeting, in Africa, to build on the International Academy of Pathology (IAP) initiative at Montreal 2006. Please can you pass it on to other pathologists in the regions (all!) so that it gets a wide circulation.

And please can you send back comments. When we know it will go ahead with enthusiasm, we can approach the funders in US and UK.

Ann Nelson will copy it on to many names that I do not have on my email listing.

Prof Sewankambo, Dean of Medicine in Kampala, has offered to provide the host institution there for the meeting.

Yours sincerely,
Sebastian Lucas

Professor Sebastian Lucas
Dept of Histopathology
King's College London School of Medicine
St Thomas' Hospital
London SE1 7EH
TEL: +44-20-7188-2945 (direct) & 2954 (secretary)
FAX: +44-20-7401-3661
Mobile: +44-7718-240593

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Proposed meeting in Kampala, under the auspices of Association of Pathologists of East, Central and Southern Africa (APECSA), in May 2007
 
CONSENSUS MEETING TO DEVELOP PROTOCOLS FOR AUTOPSY DIAGNOSIS AND EPIDEMIOLOGICAL SURVEILLANCE OF SIGNIFICANT AND EMERGING INFECTIOUS DISEASES
 
BACKGROUND
The autopsy is an underused facility for establishing true prevalences of significant diseases in a community. Death certificates alone are well documented, in most societies, to be inaccurate for health planning purposes; they under- and overestimate significant conditions. 
 
The diseases of most concern in resource-poor countries are infectious diseases (ID), whose clinical presentations are confusing and overlap. In particular, HIV disease (in its many guises), TB and malaria head the list, with other old and emerging infectious diseases included. 
 
Identification of ID-simulators that are not infectious (eg cancer) is an important secondary aim. 
 
There is insufficient significant ID prevalence data for targeted health interventions and research projects.
 
The term 'autopsy' is here used in its broadest sense as the examination of tissues of a deceased person by investigative tools backed up by laboratory resources. This includes microbiology, parasitology, serology, cytopathology and histopathology.
 
'Autopsy' is not restricted to the standard full dissection of all internal organs. According to medical, epidemiological, demographic and social circumstances, limited, targetted, sampling may be equally valuable to obtain critical data. 
 
WHAT IS NEEDED
There are no protocols on how to optimise the utility of the autopsy (as defined above) to answer questions on the epidemiology of critical infectious diseases. The depiction of an agreed generic investigative protocol and dataset, which can be modified locally according to circumstances, would be critical in providing information to health workers, researchers, and government departments of health. 
 
There is a body of knowledge in journals, books and the heads of active pathologists, but it is not organised and not accessible for all. We propose a consensus meeting of pathologists and other specialists to address the issue and develop autopsy protocols for infectious disease identification surveillance in populations. 
 
These protocols will be published online and changed as information and knowledge is accrued when they are used. The resulting data on local and regional ID epidemiology will be published online as it emerges, available to all.
 
PROPOSAL OF MEETING
To have a consensus meeting (max 4 days) in a central African country (eg Uganda) at which a good number of active representative pathologists attend from many countries in the region.
 
Preliminary proposals will be submitted to all participants in advance as the basis (no more) for discussion. These will be based on published data and personal experience. The outcome will be an agreed set of feasible, reproducible techniques for obtaining and the analysis of autopsy material. It is important that microbiology is represented, in addition to classical morbid anatomy, since morphology alone cannot capture all the important infection diagnoses.
 
The moderators of the meeting will be Ann Nelson (AFIP) and Sebastian Lucas (London), and it would ideally be hosted under the auspices of APECSA (Association of Pathologists of East, Central and Southern Africa) but will include pathologists from West Africa. Funding will be sought for travel and accommodation, and local expenses of the meeting facilities.
  
Dr. Ann Nelson, Armed Forces Institute of Pathology
"Nelson, Ann M. Dr.  [VA]" <mailto:Ann.Nelson@afip.osd.mil>

Professor Sebastian Lucas,  King's College London School of Medicine
mailto:sebastian.lucas@kcl.ac.uk


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Leela McCullough, Ed.D.
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