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Iraq

ICDDR,B uses videoconferencing to share expertise with Iraqi physicians

ICDDR,B recently shared its expertise in diarrhoeal disease management with a group of Iraqi doctors, helping them establish better preventive and control measures in response to an anticipated cholera outbreak in Kirkuk, Iraq. In response to an appeal forwarded by the U.S. Department of State, ICDDR,B doctors met with Iraqi doctors via video conference and lent their advice on handling the epidemic in Kirkuk, which is located 250 kilometers north of Baghdad.

The most recent conference included six ICDDR,B experts and lasted over an hour. Four Iraqi doctors took part from the video conferencing facility of WiRED, which provides medical and healthcare information, education and communications resources to communities in post-conflict regions.

During the conference, held on 3 June, participants discussed the health systems situation in Kirkuk and Iraq. Eighty percent of people in Kirkuk province live in the city, and the rest live in distant, isolated, smaller communities, often not linked with improved roads. Personal hygiene is a problem there, as are sanitary and piped water supply systems, which often cross contaminate.

Cholera is a greater problem in Kirkuk than in other areas of Iraq with outbreaks often seen from June to September. In 2006 over 3500 confirmed cholera cases were reported with 24 deaths, at facility level -- the magnitude of the problem among the general population is not precisely known.

ICDDR,B scientists provided information to the Iraqi doctors on the endemicity of cholera in Iraq while the Iraqi doctors provided information on the magnitude of the problem and also indicated the places in Iraq where the disease is endemic. Participants discussed the implications of a possible drought in the Kirkuk province this year and concluded it could make the situation worse making safe point-of-use water important in their agenda. The participants also discussed several traditional approaches to ensuring safe water including chlorination of the piped water (and super chlorination before the outbreak period), and the use of water purifying tablets.

Because outbreaks in Kirkuk are relatively predictable, Centre researchers discussed the possibility of vaccination for the at-risk population, suggesting the WHO might be helpful in procuring the vaccines in bulk at lower cost. Using the oral vaccine would also be likely to reduce the burden of ETEC infections, another important cause of diarrhoea globally.

ICDDR,B doctors also suggested the establishment of a surveillance system sampling only a small fraction of all diarrhoeal patients, with a suggestion to increase the sampling frame only during the early days of an outbreak. This would help identify the pathogen causing diarrhea outbreaks and provide information on antimicrobial susceptibility, guiding appropriate therapy.

In the past, the Centre has shared its expertise in diarrhoeal disease control with others around the globe. In 1991, for example, Centre researchers, at the request of USAID, advised health authorities in Ecuador and Peru who were dealing with cholera outbreaks there. An eight-member ICDDR,B team was also sent to Goma, Africa in response to a 1994 cholera epidemic there, receiving international acclaim for their efforts.

With its commitment to promote realistic solutions to the major health problems facing the poor people of Bangladesh and other countries and its expertise in diarrhoeal diseases, the Centre remains ready to respond to those in need, both in Bangladesh and throughout the developing world.

For more information on the videoconference please contact Dr. Md. Abdus Salam.