Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response System A Program Review (2001) / Chapter Skim
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4 GEIS at Armed Forces Research Institute of Medical Sciences (AFRIMS), Thailand
4 GEIS at Armed Forces Research Institute of Medical Sciences (AFRIMS), Thailand
Pages 65-82
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From page 65... ...
It is physically separated from but collaborates with various other national institutions, including the Thai Ministry of Health (Department of Medical Sciences, National Institute of Health, Department of Communicable Disease Control, and the Office of the Permanent Secretary and its Field Epidemiology Training Program) and the Ministry of Agriculture (Department of Livestock Development)
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From page 66... ...
For example, the GEIS malaria pillar complements ongoing surveillance for antimalarial drug resistance, whereas surveillance for acute febrile illness is a somewhat new area of involvement. AFRIMS's overall strategy integrates GEIS activities into traditional research streams to leverage AFRIMS resources and expertise already in place, to reduce program overhead costs, and to complement the activities of the Thai government.
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From page 67... ...
AFRIMS currently uses its laboratory capacity to support Thailand's infectious disease diagnostic efforts by providing reference testing services, diagnostic support, and support for special epidemic investigations when requested. Thai public health priority areas, along with AFRIMS's training activities, are incorporated into GEIS project areas.
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From page 68... ...
All department heads have significant involvement in programs other than GEIS, including MIDRP projects. In addition, AFRIMS staff are actively engaged in a multitude of training activities, both formal and informal, for a variety of personnel (laboratory technicians; field survey personnel; and students from the United States and Southeast Asian national and regional institutions, including master's and doctoral candidates, physicians and medical students, and others)
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From page 69... ...
SURVEILLANCE At AFRIMS GEIS includes four standard pillars defined by the GEIS Central Hub (AFRIMS, 2000~. These pillars are · drug-resistant malaria surveillance, · surveillance for enteric pathogens and antibiotic resistance, · acute febrile illness surveillance, and · influenza surveillance.
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From page 70... ...
because the Thai Ministry of Public Health has extensive surveillance coverage and health care service delivery capacities in the more central geographical areas of the country and because large numbers of displaced individuals, including refugees, are located in these areas. AFRIMS's infectious disease surveillance activities are generated by specific study protocols and are generally limited to patients seeking care at public and nongovernmental (missionary)
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From page 71... ...
Acute Febrile Illness Surveillance Surveillance for acute febrile illness is based in sentinel surveillance sites that were established previously for other projects, such as longstanding antimalarial drug resistance surveillance sites. New sites (e.g., Chiang Rai Hospital)
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From page 72... ...
Influenza surveillance is conducted as part of the DoD LaboratoryBased Influenza Surveillance Program, Brooks Air Force Base, San Antonio, Texas. GEIS-supported sentinel sites for specimen collection exist in Nepal and Thailand.
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From page 73... ...
Timely sharing of surveillance results is important for the development of informed national policies for human, animal, and agricultural antibiotic use. AFRIMS staff, supported by GEIS, provide considerable training in the course of establishing enteric pathogen sentinel sites in the Southeast Asian region.
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From page 74... ...
AFRIMS has collaborated in identifying the causative pathogens in several epidemics of acute febrile illness. As GEIS project data accumulate, ongoing epidemiological analyses of these data may be used to identify unusual events and possible epidemics.
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From page 75... ...
, 2001~. Linkages between AFRIMS GEIS acute febrile illness surveillance activities and national epidemic investigation capacity were not clear.
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From page 76... ...
John) and Somsak Wattanasri, current director of the Ministry of Health's International Health Office and former director of the Thai FETP in the Office of the Permanent Secretary, it was noted that ties with AFRIMS were much stronger in the past.
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From page 77... ...
If GEIS is to be successful, AFRIMS must continue to work through the complex set of relationships that exist within Thailand and continue to work with other in-country international organizations and agencies on a continual and productive basis. Satellite laboratories and sentinel surveillance sites in Southeast Asia are most likely to operate efficiently and effectively if GEIS efforts are coordinated among GEIS consortium members in the region (including AFRIMS, NAMRU-2, and the 18th Medical Command in Korea)
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From page 78... ...
· The subcommittee recognizes that the GEIS pillar disease areas are important ones and that defining these targets helps to provide some standardization of GEIS activities across sites, but the pillar structure should be flexible enough to permit, on a case-by-case basis, local infectious diseases that are of global concern (e.g., tuberculosis) to be addressed as high priorities through GEIS.
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From page 79... ...
Furthermore, it is important that the GEIS Central Hub review and approval process for GEIS projects provides AFRIMS with follow-up guidance regarding project progress in a consistent and timely manner (see also Chapter 7~. Recommendation: Consideration should be given to revising the current GEIS project application and review process.
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From page 80... ...
Pathom Sawanpanyalert, director, Department of Medical Sciences, National Institute of Health, Ministry of Public Health Dr. Sornchai Looareesuwan, dean, Faculty of Tropical Medicine, Mahidol University Dr.
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From page 81... ...
Scott Miller Veterinary medicine brief, LTC David Ruble 0930 Tour hospital, villages Meet with local collaborators 1200 Lunch
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From page 82... ...
82 Depart Sangkhlaburi 1900 Arrive Bangkok Friday, October 13 0800 Depart hotel 0830 Arrive AFRIMS Final questions for AFRIMS staff 0900 Private IOM discussions; IOM out-brief, official good-byes PERSPECTIVES ON GEIS
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