Western Pacific Region

Activities From the Field - Western Pacific Region

By Dr. Zeng Guang

The region is diverse. The first program established in TEPHINET’s western Pacific region was that of the Philippines in 1987. At the beginning of the 1990’s Australia began its Masters of Applied Epidemiology program; towards the end of that decade both the Republic of Korea and Japan established FETPs. The most recent addition to the fold have been China (2001) and Malaysia (2002). Approximately 40 trainees are expected to graduate from these programs in 2005.

Program trainees have served on teams that have responded to outbreaks, where the interventions have thwarted epidemics. Improvements in policies and practices are adopted as a direct result of recommendations following these interventions, to prevent recurrence. Recent examples include recommendations which were made as a result of the following investigations:

  • Trainees of the Philippine Field Epidemiology Training Program
    • responded to a SARS outbreak in a village in Alcala, Pangasinan, Philippines (2003)
    • carried out an investigation of a waterborne diarrhea outbreak in Tondo, Manila, Philippines (2003)
    • investigated a measles outbreak in ethnic tribe in village in Bukidnon, Philippines (2002)
    • undertook an an investigation of a malaria outbreak in a highland barangay of Nueva Vizcaya, Philippines (2003)
    • investigated a cholera outbreak in central Pangasinan Philippines (2004)
    • investigated a cholera outbreak linked to gelatin in two multinational companies – Batangas, Philippines (2004)
    • investigated an outbreak of clupeotoxin poisoning associated with eating blue-striped herring in a fishing village in Malay, Aklan, Philippines (2003) 
  • Trainees of the Chinese Field Epidemiology Training Program
    • Conducted an evaluation of effectiveness of personal protective measures in prevention of nosocomial transmission of SARS Guangdong China (2003)
    • Revised the Chinese ministry of health quarantine criteria, to focus on the contacts during a SARS patient’s symptomatic period based on a surevy conducted by trainees of the China FETP
    • Conducted an investigation of an outbreak of gastroenteritis from water dispensers at a secondary school in China (2004)
    • investigated a iquid chlorine leak accident in China (2003)
    • investigated a Hepatitis A outbreak linked to poor water quality, hygiene & sanitation in rural Guizhou China
    • investigated an epidemic of paratyphoid fever from shellfish and well water in a city on the east coast of China
    • conducted a study of the timeliness of Hepatitis B vaccination among newborns in Hebei province, China (2002 – 2003)
    • conducted a survey of gastric disease among taxi drivers in Beijing (undated)
       
  • Trainees of the Japanese Field Epidemiology Training Program

 

    • conducted an investigation of a large hepatitis B outbreak in a nursery school in Japan (2002)
    • investigated a nosocomial outbreak of VRE infections in Japan (2004)

       

  • Students of Australian National University’s Master of Applied Epidemiology Program

 

    • investigated outbreaks of Norovirus in Australia in 2003-04 associated with imported oysters
    • conducted a multi-jurisdictional investigation of an outbreak of Hepatitis A in people attending a youth camp in Australia (2003)
    • investigated occupationally-acquired pneumonia in a commercial duck farm in Australia (2004)
    • carried out a study of the application of geographical information system to investigating a cluster of melioidosis in Malaysia (2003)

Research and investigations conducted by FETP trainees contribute to the general understanding of the epidemiology of certain diseases and conditions, methods of combating epidemics and so forth. Recent examples include knowledge gained from the following studies and investigations:
 

  • In 2003, trainees of the Philippine Field Epidemiology Training Program conducted a study of the efficacy of chloroquine plus sulfadoxine/pyrimetyhamine compared to artemether-lumefatrine for the treatment of uncomplicated plasmodium falciparum malaria in Isabela, Philippines
     
  • Trainees of the Chinese Field Epidemiology Training Program
    • Conducted a study of earlier SARS cases searched by retrospective investigation of inpatients of febrile pneumonia with unknown cause in Guangdong province (2004)
    • Did a matched case-control study on personal protective factors of SARS infection among health care workers – Guangzhou, China (2003)
    • Undertook a study of early case of SARS outbreak retrospectively in Hechi of Guangxi, China 2003
    • Performed a retrospective case note review of a typical pneumonia in Guangdong province (2003)
    • Carried out an investigation of a cluster of brucellosis cases in a certain village of Shandong province (2004)
    • Investigated food poisoning in Songyuan county of Jilin province, China (2003)
    • Investigated an outbreak of influenza-like illness in school X Fujian province, China (2004)
    • Investigated a salmonellosis outbreak among factory workers from a sauce prepared with raw egg, China (2004)
    • Investigated a Varicella outbreak among highly susceptible primary school students, China (2004)
    • Investigated skin injuries during hairdressing, haircutting and tattooing – Beijing (2003)
    • Did an evaluation of the capacity to detect and respond to measles outbreaks, by analyzing the data of outbreak reporting in China (2003)
       
  • In 2003, trainees of the Japanese Field Epidemiology Training Program undertook a study using outbreaks in Japan to calculate the measles vaccine coverage needed to prevent transmission in school
     
  • Students of Australian National University’s Master of Applied Epidemiology Program undertook an investigation of an unusual norovirus outbreak involving a cook, his son, a sewage leak and a strudel (Australia)
     
  • Trainees of the Malaysian Field Epidemiology training program
    • undertook an investigation of a measles outbreak in Selangor State, Malaysia: Year 2000
    • conducted a study of the risk factors of typhoid fever in Kelantan, Malaysia (2004)
       
  • In 2004, trainees of the Taiwan Field Epidemiology Training Program conducted an investigation of a viral gastroenteritis outbreak associated with person-to-person spread among patients in respiratory care wards, Taiwan (2004)
     
  • In 2004, trainees of the Korean Field Epidemiology Training Program conducted an investigation of an outbreak of unexplained acute respiratory illness among school students and family, Korea

Program trainees have contributed a great deal to the improvement of surveillance systems within their countries. Recent examples include improvements resulting from the following studies and investigations:

  • Trainees of the Chinese Field Epidemiology Training Program
    • Undertook an evaluation of early detection & reporting of SARS outbreak in Beijing & Anhui province (2004)
    • Studied the medical seeking behaviour and attitude among urban residents of Beijing (2002/03)
    • Undertook an evaluation of a new, web-based, Hepatitis B surveillance system in Fujian Province China (2003)
    • Performed an evaluation of the utilization of laboratory testing for Hepatitis B markers in the surveillance of acute Hepatitis B – Shanghai (2004)
       
  • Trainees of the Philippine Field Epidemiology Training program
    • established the Philippine SARS surveillance & outbreak response system, (2003)
    • studied rumour surveillance during the SARS outbreak: using regional networks to strengthen disease surveillance – Manilla, 2003
       
  • Students of the Australian National University’s Master of Applied Epidemiology Program
    • Studied efforts to enhance measles surveillance in Victoria, Australia (2003)
    • Conducted a study on the usefulness of the WHO regional rumour surveillance for avian influenza H5N1 (2004 WPRO region)
       
  • In 2002, trainees of the Malaysian Field Epidemiology Training program conducted an evaluation of TB notification system for Muar district, Johor, Malaysia

Dr. Zeng Guang

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