Non-Communicable Diseases

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General issues of Vaccine
Cold chain Correlates of Protection Vaccines for Asplenia Vaccines for Pregnant women Vaccines for Immunocompromised hosts Vaccine hesitancy Additional materials of vaccine

General issues of Tropical med.

Definition of Tropical Medicine Matrices of tropical infection General issues of Helminths Neglected Tropical Diseases Sexually-transmitted infections Non-Communicable Diseases Maternal health and contraception Child health Malnutrition and Micronutrient Eosinophilia Fever in the tropics Diarrhea in the tropics Anemia in the tropics Dermatology in the tropics Ophthalmology in the tropics Neurology in the tropics Mental health in the tropics Surgery in the tropics Humanitarian emergency Epidemiology in outbreak Antimicrobial resistance Pathology of infectious diseases

General issues of Travel med.
Epidemiology of Travel health Last minute traveler Time zone issue High altitude medicine Diving medicine Pregnancy and travel Children and travel Elderly and travel

Immunology
Principle of human immune system Innate immunity Cellular immunity Humoral immunity Neutralizing antibody and its assay Antigenic Cartography Additional materials of immunology

Epi & Stats
Basics & Definition Epidemiology Odds in statistics and Odds in a horse race Collider bias Data distribution Statistical test Regression model Multivariate analysis Marginal effects Prediction and decision Table-related commands in STATA Missing data and imputation

Virus
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COVID-19
Bivalent BA.1/BA.4-5 mRNA vaccines Monovalent XBB-1.5 mRNA vaccine Private archives of the initial phase of the pandemic Private archives of lecture materials of COVID vaccine as of March 2021 厚生労働省が発出する保健行政関連の文書の読み解き方

Bacteria
Bacteriological tests Tuberculosis Tuberculosis in Children HIV-TB co-infection Leprosy Dermatological mycobacterium infecions Syphilis and Yaws Plague Pneumococcus Meningococcus Typhoid Salmonellosis Melioidosis Leptospirosis Brucellosis Bartonellosis Lyme disease and Relapsing fever Tularaemia Tetanus Diphtheria Anthrax Coxiellosis

Rickettsia
Rickettsiosis Scrub typhus Spotted fevers Epidemic typhus Murine typhus

Protozoa
Overview of protozoa Overview of medicine for protozoa Malaria Chagas disease African trypanosomiasis Leishmaniasis Trichomoniasis Toxoplasmosis Amoebiasis Giardiasis Cryptosporidiosis Cyclosporiasis Isosporiasis Pentatrichomoniasis Microsporidiasis Babesiosis

Fungi
General issues of fungi Coccidioidomycosis Paracoccidioidomycosis Histoplasmosis Talaromycosis Blastomycosis Sporotrichosis

Nematode (roundworm)
Nematode principles Lympatic filariasis Onchocerciasis Loiasis Microscopic differentiation of microfilariae Strongyloidiasis Ascariasis Ancylostomiasis (hookworm) Trichuriasis (whipworm) Enterobiasis (pinworm) Angiostrongyliasis (rat lungworm) Dracunculiasis (Guinea worm) Anisakiasis Trichinellosis (Trichinosis) Gnathostomiasis Spirurinasis Soil-transmitted helminths

Trematode (fluke, distoma)
General issues of Helminths Trematode principles Schistosomiasis Clonorchiasis Fascioliasis Paragonimiasis Metagonimiasis

Cestode (tapeworm)
General issues of Helminths Cestode principles Diphyllobothriasis Sparganosis Taeniasis Echinococcosis

Medical Zoology
Zoonosis Insectology Mosquitology Acarology Batology Snake toxicology Scorpion and spider toxicology Marine toxicology

definition

• IDs vertical program ⇔ NCDs horizontal program
• some IDs in tropics have NCD-like characterics
  • HIV
  • lymphatic filariasis
  • Chagas disease

epidemiology

• 41 mil. deaths per year worldwide
  • 71% of all deaths
• 15 mil. deaths by NCDs occur between 30 and 69 y/o ... "premature" death

NCDs in LMICs

• tobacco
• food pricing and availability
• food preferences
• physical activity
• technologies
• social movement
• limited research of NCDs in LMICs

measuring burdens of NCDs

• death
• DALY
• QALY
  • 

WHO Package of Essential NCDs intervention (PEN)

• PEN

diabetes and insulin treatment in LMIC

• Insulin Zeer
• cool wallet (ex. Frio)
• DOT (directly observed treatment) like in a refugee camp

• Malnutrition-modulated diabetes mellitus (MMDM)
  • Protein-deficient DM in West Africa
  • Fibrocalculus pancreatic DM
  • onset 10-30 y/o
  • rural origin, poor economic status
  • history of inadequate nutrition since in mother's uterus
  • more severe DM

• tropical diabetic hand syndrome
  • usually after minor trauma
  • seems not due to peripheral angiopathy/neuropathy
  • localised cellulitis confined to hands, often progressive to amputation

stroke

• 2/3 of worldwide stroke occur in developing countries
• 40% occur in <70y/o
• ethnic differences
  • caucasian
  • 80% ischemic stroke
• South Asian
  • 20-30% hemorrhagic stroke
• Africa
  • 26-33% cerebral hemorrhage
• Head CT
  • ≈100% in HICs
  • 90% in LMICs, but confined to a certain size of hospitals to which many residents have difficulty in access
• antiplatelet
  • 92% in HICs
  • 78% in LMICs
• rtPA
  • 30% in HICs
  • 3% in LMICs

NCDs among children and adolescent

• WHO definition for NCD deaths exclude that in < 30 y/o
• insufficient data
• rheumatic heart disease
  • 15.6 mil. per year
• Sickle cell anemia
  • 70% of world cases in Sub-Sahara
• pediatric and adolescent malignancy
  • cure rate 80% in HICs, 20% in LMICs
• bronchial asthma
  • high risk factor is solid fuel burned inside house
• suicide
  • third leading deaths in 15-19 y/o
  • risk
    • sexual violence
    • bullying
    • discrimination
    • in conflict or disaster zone
• injuries and violence
  • intentional
    • self
    • by others
  • unintentional 90%
    • 1st deaths in 10-19 y/o
    • road traffic accidents 93% in LMIs
    • drowning
    • burns, death rate in LMIC 11 times higher than in HIC
    • fall
    • poisoning

cancer and palliative care

• cancer 2nd deaths worldwide
• 9.6 mil. deaths in 2018
  • 1 in 6 deaths
• incidence in both sexes
  • 1 lung, 2 breast, 3 colon, 4 prostate
• mortality in both sexes
  • 1 lung, 2 colon, 3 stomach, 4 liver

• only 26% of LMICs have pathology service available
• only 20% of LMICs have cancer data

• 1/3 of death by cancer are potentially preventable
  • obesity reduction
  • smoking cessation
  • alcohol reduction
  • infection control for HPV, HepB, HepC, H. pyroli
  • occupational exposures to environmental carcinogenic agents

HPV

• 90% of HPV infection spontaneously regress within 24 months
• risk factors of infection
  • early sexual activity
  • young age at first birth
  • multiple pregnancies
  • multiple
• risk factors of cervical cancers
  • HPV type
  • immune status
  • coinfections with other STIs including HIV
  • multiparity and young age at first birth
  • tobacco
  • OC > 5 years, but it is confounding with sexual activity