Conference Report

THE FOURTH GLOBAL SCIENTIFIC CONFERENCE OF THE TEPHINET (TRAINING PROGRAMS IN EPIDEMIOLOGY AND PUBLIC HEALTH INTERVENTIONS NETWORK), BRAZIL, NOVEMBER 12 TO 17, 2006 Abdullah S. Al-Joudi, MD, MSc (Epidemiology) Department of Family and Community Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia – E-mail: The author was invited to attend the Fourth Global Scientific Conference of TEPHINET, which was held in Brasília the capital city of Brazil from November 12 to 17, 2006, organized by the Brazilian Ministry of Health, the TEPHINET, and the CDC (Centers for Disease Control and Prevention).  The theme of the conference was “Improving public health through global partnerships in field epidemiology”.

THE TEPHINET Epidemiology is defined as the study of the distribution and determinants of health-related events in specified populations and the application of this study to control health problems.1 Epidemiologic information is needed for taking evidence based decisions to develop, implement, and evaluate health policies.2 Centers for Disease Control and Prevention (CDC) created the Epidemic Intelligence Service (EIS) in 1951, to ensure the quality of such information.3 The EIS model was adapted by many countries to develop field epidemiology training programs (FETPs) with a principle of “training through service”.4  In 1999, the Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) was established to strengthen international public health capacity by improving competencies in applied (field) epidemiology and public health practice.5 In addition to its training and capability building role, TEPHINET is a member of WHO's Global Outbreak Alert and Response Network.6 The new International Health Regulationsrequire each country to have well- trained public health personnel for epidemic surveillance and response.7 TEPHINET and its member programs (i.e. FETPs) will work to reach this goal, through improving the quality of FETPs.8 THE CONFERENCE The fourth TEPHINET Global Scientific Conference was organized in Brasilia, Brazil, from November 12 to 17, 2006. The objectives of the conference were to:9 ·         demonstrate the usefulness of training programs in applied epidemiology (e.g. FETPs) to strengthen public health. ·         promote technical-scientific exchanges between participants or FETPs from diverse countries. ·         share the successful experiences and scientific advances of FETPs amid the public health demands in those countries. ·         disseminate the FETP experience as a strategy to provide a service and strengthen the capacity to respond to outbreaks, epidemics and events of national and international public health importance. THE WORKSHOPS The pre-conference workshops were among the major important activities. They included: 1.       Molecular Epidemiology of Infectious Diseases. 2.       Achieving Organizational Excellence in Public Health. 3.       Make the Connection: Training Techniques for Adult Learners. 4.       Public Health Emergency of International Concern (PHEIC) Assessment. 5.       Field Applications of the Case-Control Study. 6.       Avian Influenza A (H5N1). 7.       Estimating Vaccine Effectiveness from Observational Data. THE RECOMMENDATIONS Among the important recommendations were: (1) to pilot the continuous quality improvement handbook in member programs. (2) to strengthen partnerships, (3) to introduce public health management to member programs, (4) to work with member programs to build the capacity for implementing the new International Health Regulations (IHR 2005) adopted by World Health Assembly on May, 2005 with the aim of detecting events that could constitute a Public Health Emergency of International Concern (PHEIC). THE AUTHOR’S CONTRIBUTION The author presented the results of the recent national survey of the risk factors of non-communicable diseases (NCD) in Saudi Arabia, which was conducted by the Ministry of Health (MOH) in collaboration with the Research Center (RC) of King Faisal Specialist Hospital and Research Center (KFSH&RC) and the World Health Organization (WHO). The following is a summary of the abstract from the book of abstracts for the Conference. 10 Background: Thelack of representative data on NCD and their risk factors in Saudi Arabia is an obstacle to development and evaluation of a disease prevention and control program. The MOH decided to carry out a national baseline survey of selected NCD and their risk factors, and monitor their trends. Methods: The study was designed as a national community-based cross-sectional prevalence survey using the instruments and methodology of WHO’s STEPWise approach. 11 The study population was all Saudi citizens of both genders aged 15-64 years. A multistage stratified random sampling technique was used to identify the sampled subjects. A rigorous staff training and supervisory system was developed for the field work. Complex sample analysis procedures were used to analyse the data and calculate 95% confidence intervals, part of which is presented here. Results: Out of 4758 subjects, 49.2% were male and 50.8% were female. The mean age was 37.5 years for males and 35.7 years for females. Current daily smokers were 20.9% among males and 1.2% among females. Males with no physical activity were 35.3% and females were 34.5%. Of the males 28.3% and 43.8% females were obese (BMI≥30). At the time of physical measurement 24.1% males and 18.5% females had elevated Blood Pressure (BP) (systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mmHg). Taking into consideration the previous hypertension diagnosis status of the subjects, 27.5% of the males and 24.7% of the female may be considered as having hypertension. Of the males 19.6% and 17.1% of the females were found to be hyperglycemic (fasting blood sugar of ≥7 mmol/L), while 18.6% of the males and 19.7% of the females were found to be hypercholesterolemic (≥5.2 mmol/L). Conclusions: The prevalence of NCD and their known risk factors are quite high among Saudis. A national program for the control of NCD is therefore needed. ACKNOWLEDGMENT The author would like to thank Dr Nasser A. Al-Hamdan, Supervisor of Saudi FETP for recommending him to attend this conference, Dr Abdulilah Kutbi, Dr Jamil Choudhry, and Dr Mohammed Shoukri for their support, and MOH for sponsorship to the conference. REFERENCES 1.        Last JM, editor. A dictionary of epidemiology. 4th ed. New York. NY: Oxford University Press; 2001:62 2.        Detels R. Epidemiology: the foundation of public health. In: Detels R, McEwen J, Baeglehole R, Tanaka H, editors. Oxford Textbook of Public Health. 4th ed. New York, NY: Oxford University Press; 2002: 485-491 3.        Thacker SB, Dannenberg AL, Hamilton DH. Epidemic Intelligence Services of the Centers for Disease Control and Prevention: 50 years of training and services in applied epidemiology. Am J Epidemiol 2001; 154:985-992 4.        Thacker S, Buffington J. Applied Epidemiology for the 21st Century. Int J Epidemiol 2001; 30:320-325 5.        Cardenas, VC Roces MC, Wattanasri S, Navano FM, Tshimanga M, Al-Hamdan N, Jara JH. Improving global public health leadership through trainig in epidemiology and public health: the experience of TEPHINET. Am J Pub Health 2002; 92: 196-7 6.        World Health Organization. Global Outbreak Alert and Response Network. Available at outbreakwork/en.index.html. 7.        World Health Organization. Revision of the International Health Regulations. Geneva, Switzerland: World Health Organization; 2005. Available at pdf_files/WHA58/WHA58_3-en.pdf. 8.        TEPHINET. Continuous Quality Improvement Handbook.  2005. 9.        TEPHINET. The Fourth Global Scientific Conference of TEPHINET. Proceedings and, Abstract book 2006; 14 10.     Al-Joudi AS, Al-Hamdan N, Kutbi A, Choudhry AJ, Shoukry M. National survey of Non-communicable Diseases and their risk factors in Saudi Arabia, 2005. The Fourth Global Scientific Conference of TEPHINET Proceedings and, Abstract book 2006; 155 11.     Bonita R, de Courten M, Dwyer T, Jamrozik K, Winkelmann R. Surveillance of risk factors for Noncommunicable diseases: The WHO STEPwise approach. Summary. Geneva, World Health Organization, 2001.