measuring the burden of lung disease · maxwell akanbi, md. the burden of respiratory disease . in...

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PATS MECOR (Methods in Epidemiologic, Clinical & Operations Research) ~ Measuring the Burden of Lung Disease ~ Pan African Thoracic Society/American Thoracic Society University of Malawi College of Medicine Liverpool School of Tropical Medicine Supported by a grant from the Nuffield Foundation Blantyre, Malawi 2125 September 2009

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Page 1: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

PATS MECOR(Methods in Epidemiologic, Clinical & Operations Research)

~ Measuring the Burden of Lung Disease ~

Pan African Thoracic Society/American Thoracic SocietyUniversity of Malawi College of Medicine

Liverpool School of Tropical Medicine

Supported by a grant from the Nuffield Foundation

Blantyre, Malawi

21‐25 September 2009

Page 2: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

PATS MECOR— Measuring

the Burden of Lung Disease in Africa

BLANTYRE

Page 3: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Arriving in Blantyre

Page 4: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

University of Malawi, College of Medicine Malaria Alert Center

The “MAC”

Mosquito control in the “MAC”

Arriving atthe “MAC”

Page 5: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 1

Page 6: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 1 cont.

Page 7: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 1 cont.

Page 8: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 1 cont.

Page 9: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 2

Page 10: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 2 cont.

Page 11: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 2 cont.

Page 12: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 2 cont.

Page 13: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 3

Page 14: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Students—Level 3 cont.

Page 15: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Faculty‐‐PATS

“Our FearlessLeader”

Stephen “Flash”

Gordon, MD

Director, PATS MECOR

Page 16: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Faculty‐‐PATS

Page 17: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Faculty‐‐ATS

“ Our Lady of

Wisdom ”

A. Sonia Buist, MD

Director, MECOR Program

Page 18: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Faculty‐‐ATS

Page 19: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The PATS MECOR Staff

“ Our Lady of 

Fix It!”

Sandra Mooney  OBE  FFOM

Course Facilitator

Page 20: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The PATS MECOR Staff

“ Our Lady of 

Fix It!—in Training”

Jane Ardrey,

PATS Administrator

Page 21: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The PATS MECOR Staff

“The Lady from ATS”

Fran Du MelleSr. Director

International Activities

Page 22: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Staff & Assistants at the “MAC”

Page 23: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Hard at Work:  The Discussions In Classrooms & Hallways

Page 24: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Hard at Work:  Small Groups

Page 25: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Hard at Work:  Small Groups

Page 26: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

What is the Question?   Level 1 Studies

• Are urban vs. rural environments associated with  higher prevalence of asthma in children?  Asthma  prevalence in urban vs. rural settings in four African 

countries:  Botswana, Kenya, Namibia, and Nigeria.

• Do HIV infected patients with high CD4 counts differ  in their sputum conversion rate from those with a 

low CD4 count?

• What is the yield and cost effectiveness of passive vs.  active TB case finding?

Page 27: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

What is the Question?   Level 2 Studies

• What is the influence of chest x‐ray findings on the decision 

to treat with antibiotics in children with wheezing, meeting 

the WHO definition of non‐severe pneumonia?• What is the prevalence of cooking with biomass in patients 

with lung disease in Cotonou, Benin?• What is the association of exacerbation on lean body mass in 

patients with Chronic Obstructive Pulmonary Disease?• What is the level of control and quality of life in school aged 

children with asthma in Enugu, North East Nigeria?• What is the knowledge, attitude, and practice of sleep 

medicine among community based academic pediatricians in 

Lagos, Nigeria?

Page 28: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

What is the Question?   Level 2 Studies

• What is the prevalence of asthma, allergic rhinitis, and 

eczema among university students in Maiduquri, Borno

State, 

Nigeria?• What is the knowledge, attitude, and practice of asthma 

among care givers of asthmatic children in Lusaka, Zambia?• Is there a correlation between environmental tobacco smoke 

and low respiratory tract infection in children with human 

adenovirus related bronchiectasis?• What is the pulmonary function among petrol pump workers 

in Ile‐Ife, Nigeria?• What are the pneumonia‐related perceptions and core 

practices of women with children under five years in a rural 

community, Oyo State, Nigeria?• What are the determinants of poor outcomes among under 

five children with severe pneumonia?

Page 29: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

What is the Question?   Level 3 Studies

• What is the delay in TB diagnosis in Patakou,  Benin?

• What is the prevalence and clinical  presentation of TB and HIV co‐infection 

among Nigerian children?• What is the knowledge, attitude, and practice 

among private practitioners of TB care?• What is the HIV seropositivity

and TB 

mortality in Jos, North Central Nigeria?

Page 30: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

What is the Question?   Level 3 Studies

• What is the knowledge, attitude and practice of  infectious disease surveillance and notification 

among doctors in a tertiary institution in Sagamu,  Nigeria?

• What is the epidemiological and clinical profile of  children attending the asthma clinic at the University 

Teaching Hospital in Lusaka, Zambia?• What is the cost associated with treatment of 

childhood persistent asthma without inhaled  corticosteriods

in Nairobi, Kenya? 

• What are the patient characteristics and treatment  outcomes for TB patients in a private health care 

setting?

Page 31: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Research in the Field:  A site visit to  Chikawa

for a reality check

Page 32: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Research in the Field:  A site visit to  Chikawa

for a reality check

Page 33: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

The Course “Welcome”

Page 34: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

PATS MECOR 2009 Writing Prize

Maxwell Akanbi, MD

The burden of respiratory disease in Nigeria: A Review

(African Journal of Respiratory Medicine, March 2009)

Page 35: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Course Presentations

Page 36: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Course Presentations

Page 37: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Course Presentations

Page 38: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Level 1

Page 39: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Page 40: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Page 41: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Page 42: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Level 2

Page 43: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Page 44: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Page 45: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Page 46: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Level 3

Page 47: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Certificates & Graduation

Page 48: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

PATS MECOR Celebration (s)

Celebrating the contributions of Sandy Mooney to PATS MECOR

“If Sandy couldn’t fix it, it couldn’t be fixed!

Page 49: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

PATS MECOR Celebration (s)

Page 50: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

PATS MECOR 

Faculty Level 1

Level 2 Level 3

Page 51: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

PATS MECOR 2009

Zikomo

Kwambiri!

Improving lung health in Africa through development oflocal and regional lung disease research capacity

Page 52: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

See you next year for Levels 1, 2 & 3!

Pan African Thoracic SocietyAmerican Thoracic Society

Page 53: Measuring the Burden of Lung Disease · Maxwell Akanbi, MD. The burden of respiratory disease . in Nigeria: A Review (African Journal of Respiratory Medicine, March 2009) Course Presentations

Acknowledgements

• The Nuffield Foundation provided the primary  support for

the 2009 PATS MECOR Course 

• Additional support was provided by:– Wellcome

Trust Research Laboratories, Blantyre, Malawi

– Malawi‐Liverpool‐Wellcome

Programme

of Clinical 

Tropical Research– American Thoracic Society– Francophone Respiratory Societies

Our sincere thanks to all who believe  in the  MECOR  mission and support this program