Wednesday 13 August 2008

This strange disease of modern life

Not sure want triggered it, but the front page headlines in Kompas for the last couple of days have been about tropical diseases. As in most of the world, these are neglected, not only in terms of treatment, but also as the reports are making clear, also in local research.

It is worrying that leprosy is on the rise again. Only a month or so ago, we had our first report of this nasty disease affecting a PLHIV in North Sulawesi. Let's hope that's not the shape of things to come. And while malaria incidence is said to be decreasing, it still remains high, particularly in Eastern Indonesia, where the burden of HIV (and of course many other diseases) remain high. As you probably know, malaria can exacerbate the transmission of HIV from a mother to her unborn baby.

Seems like one problem with research is that we want to leapfrog, with exciting new results. But as the Vice-President noted on a recent visit to the Indonesian Research Institute (LIPI), the results are often only suitable for a museum. The fact is that, if there is any operational research, the results remain secret. As one respondent to our question/answer forum recently noted, we have no idea about the profile of antiretroviral side effects , and whether this differs from other parts of the world, let alone around the multiple ethnic groups in Indonesia.

We also have no clear picture about frequency of opportunistic infections. Partly this is because most hospitals lack ability to diagnose many of these, but surely the major teaching hospitals in Java, where most of the AIDS cases are treated, should have this ability? As it is, we still report diarrhoea as the second most common 'infection', with no data about the causes. And MAC, usually quite a common opportunistic infection, does even make it to the list.

If we can't diagnose it, how can we research it?

Babé

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