The first International Congress of Central Asia Infectious Diseases (ICCAID 2006) was held in Bishkek, Kyrgyzstan from October 30th until November 2nd, 2006.
It was jointly organized by the Black Sea Society of Clinic Microbiology and Infectious Diseases (BSCMID) and The Kyrgyz State Medical Academy (KSMA).
The organization of the meeting was first class and as well as the scientific agenda we were treated to a cultural evening, a trip to a 10th century Muslim minaret, an evening as the guest of the Turkish ambassador and several traditional meals.
The meeting was significant for the development of scientific research in the region and also for the world to see the extent of the infectious disease burden in central Asia. After the collapse of former Soviet Union, incidences of many infectious diseases have dramatically increased in the New Independent Central Asian States. Especially food-born diseases, vaccine-preventable diseases, blood-born diseases and tuberculosis have been sharply arising. Economic and political problems resulting in ineffective healthcare systems have contributed to such endemic diseases. Unfortunately, there is not enough collaboration among infectious diseases societies between these new independent states and the other countries.
The meeting from the outset had an agenda for collaboration and presentations were from many regional countries as well as an International cast.
During the opening ceremony, which finished ahead of schedule, we heard from the healthcare minister of Kyrgyzstan that respiratory and enteric infections were a major problem in the republic. Estimates of 300,000 cases of infectious disease were given and this was mainly in children. Although accurate figures were not available the minister listed enteric infections especially typhoid fever amongst the major problems. The Turkish Ambassador then told us about the co-operation in health care being established between Turkey and Kyrgyzstan before the president of the Black Sea Society for Infectious Diseases (Dr. Leblebicioglu) called for the globalization of infectious disease research and in particular for the development of a strong regional forum.
A session on collaboration in infectious diseases then followed during which we learned from the local CDC that the biggest increase in disease burden since 1999 was caused by trauma and road traffic accidents. Intestinal disease had reduced by 2/3rds but no specific figures for infections were available. The priority for the CDC laboratory was viral hepatitis.
The plenary lecture on the rise of antibiotic resistance was then delivered by professor P.C. Applebaum from Pennsylvania USA. He focused mainly on Gram positive bacterial pathogens and gave a comprehensive survey of the emergence of resistant Staph. aureus as well as other pathogens. Antibiotic resistance was a theme which was covered in several sessions and excellent presentations on the detection of ESBLs, resistance in, M. tuberculosis, Strep. pneumoniae and salmonella should be available from the conference web site. Tuberculosis is clearly a major problem within the region and a whole session was devoted to detection of treatment of MDR tuberculosis.
On day two the conference discussed the epidemiology of drug resistant salmonella. Prof Rubino (Italy) described the emergence of fully fluoroquinolone resistant S. Typhi in a region of India where Multi-drug resistant (MDR) S. Typhi is already present. The presence in India of some MDR S. Typhi without a plasmid suggested chromosomal integration of resistance genes and the presence of a novel 50Kb plasmid containing a class 1 integron suggested that resistant S. Typhi in this region of India was evolving. Dr. Hosoglu (conference organiser) then reviewed his extensive experience in the diagnosis of typhoid fever. His conclusions were that the Widal test is not useful in endemic countries, blood culture although still the most reliable technique is not available in many labs in central Asia and takes at least 24 hours. He concluded that PCR was becoming the gold standard. Dr. Wain (UK) then showed that the mutli-drug resistance plasmids of S. Typhi all shared a common genetic core but varied in the resistance genes they picked up. He also suggested that these resistance plasmids may also play a role in pathogenicity. Finally Dr. Karagulova gave an account of the levels of typhoid fever in Kyrgyzstan. The data was based on clinical diagnosis and showed clearly that outbreaks had occurred in the South of the country but was generally becoming less as the country developed. This session was followed by a robust discussion about the use of fluoroquinolones in children; the majority was in favour, and several questions concerning the molecular tools available for typing S. Typhi. Currently it seems that PFGE is still the gold standard but that newer PCR and sequence based techniques are being developed.
In the afternoon a description of the spread of SARS and bird flu (H5N1 influenza) in China from Dr. D. Kelvin from Toronto was followed by a state-of-the art description of the transcriptomics of the ferret model. These two lectures provided a thorough coverage of knowledge of this major infectious threat.
On day three the success in Kyrgyzstan of DOTs for tuberculosis was overshadowed by the reports of MDR TB particularly from the prisons and nosocomial infections were thoroughly explored.
This meeting was a chance to experience central Asian hospitality and also to be exposed to the latest front line clinical research as well as genomic based research. All researches have a similar goal, to understand and fight the relentless spread of infectious disease. Several unscheduled meetings took place and informal collaborations were established which, we hope, will endure and help this developing region in its fight against infectious diseases.
Congress organization committee thanks Dr. John Wain for this report.
Congress Photos