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WHAT’S INSIDE >> RITM strengthens study groups Dr. Lupisan steers RITM forward to 2017 M oving forward towards excellence is never an easy feat, but that is exactly what the Biologicals Manufacturing Division (BMD) is doing. For 30 years, BMD has been working with the Department of Health (DOH) towards responding to the country’s need for vaccines. On the 30th of January 2017, BMD commemorated its 30th anniversary. The celebration was a humble one but boasting with pride on the numerous accomplishments BMD has had over the years. The highlight of the celebration was the commendations to outstanding employees over the years and the unveiling of the audio-visual presentation entitled ‘BMD Before, Now and Beyond’ which showcased the growth of BMD from its early days to its transfer in the Research Institute for Tropical Medicine (RITM). BEFORE: The Biologicals Production Service In 1805, King Charles IV of Spain sent a scientific expedition – La Real Expedición Filantrópica de la Vacuna (The Royal Philantropic Vaccine Expedition), to Manila. The world’s first immunization campaign was headed by Dr. Francisco Javier de Balmis, court physician of the Spanish crown, the mission carried the Vaccinia virus to the archipelago and maintained it by serial passages in children, who were purposely brought along in passage. Research Institute for Tropical Medicine (RITM) Director Dr. Socorro P. Lupisan delivered the first “State of RITM Address (SORA)” last January 30 at the Training Center Auditorium. During the SORA, feedback about the Institute’s accomplishments, and future initiatives were presented to RITM staff. Moreover, Dr. Lupisan underscored that the Institute’s thrust and priority revolves around improving service delivery to better cater the needs of the Filipinos. One important metric towards achieving this goal is the ISO 9001:2015 accreditation. RITM has already conducted an internal audit in preparation for the actual ISO audit this coming March. >> p8 STAFF UPDATES & PUBLICATIONS A year after the expedition, a Central Board of Vaccination was created to propagate and produce smallpox vaccine. This was followed by the establishment of the First Municipal Laboratory in Manila. In 1893, the Central Board of Vaccination was reorganized, paving the way for the formation of the Bureau of Governmental Laboratories in 1901. The latter was renamed Bureau of Science in 1905 where the production of smallpox vaccine begun. In 1920, the Serum and Vaccine Unit of the Bureau of Science was transferred to Alabang, Muntinlupa. It was renamed as Alabang Serum and Vaccine Laboratories (ASVL) and was transferred to the University of the Philippines in 1936. Through Executive Order 94, the Division of Laboratories that includes the ASVL was created and incorporated with DOH. Three years after, the Division of Laboratories was transformed to Public Health Research Laboratories (PHRL). In 1958, PHRL was replaced with the Bureau of Research and Laboratories (BRL), making ASVL a division of BRL. On the 30th of January 1987, ASVL was separated from BRL and became a support service of DOH known as the Biologicals Production Service (BPS). The year 1999 marked the transfer of BPS to RITM as well as the start of the Vaccine Self- Sufficiency Project (VSSP). BPS then became >> continued on page 7 >> continued on page 3 >> continued on next page The Research Institute for Tropical Medicine (RITM), through its newly established Research and Innovation Office (RIO), held the first Institutional Research Agenda Setting to identify research priorities and to develop a comprehensive research agenda last January 26-27 at the Orchid Garden Suites, Manila. Almost 60 attendees comprised of RITM investigators, and representatives from different study groups participated in the two-day workshop. The output of the workshop will encompass the future research work of the Institute for the next five years. According to RIO Senior Science Research Specialist Kristel Perdigon, RITM marks this as its initial research agenda output. >> p6 INFOGRAPHIC/ ZIKA Virus >> p4 FEATURE/ Leprosy: A Biblical Disease (Or so we Thought) >> p3 NEWS/ National Polio Laboratory toughens efforts for the PH Polio Endgame Plan Biologicals Manufacturing Division: Pushing towards growth and innovation

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Page 1: WHAT’S INSIDE >> - Research Institute for Tropical …ritm.gov.ph/wp-content/uploads/2017/07/RITM-Newsletter...WHAT’S INSIDE >> RITM strengthens On the 30th of January 2017, BMD

WHAT’S INSIDE >>

RITM strengthens study groups

Dr. Lupisan steers RITM forward to 2017

Moving forward towards excellence is never an easy feat, but that is exactly what the

Biologicals Manufacturing Division (BMD) is doing. For 30 years, BMD has been working with the Department of Health (DOH) towards responding to the country’s need for vaccines.

On the 30th of January 2017, BMD commemorated its 30th anniversary. The celebration was a humble one but boasting with pride on the numerous accomplishments BMD has had over the years.

The highlight of the celebration was the commendations to outstanding employees over the years and the unveiling of the audio-visual presentation entitled ‘BMD Before, Now and Beyond’ which showcased the growth of BMD from its early days to its transfer in the Research Institute for Tropical Medicine (RITM).

BEFORE: The Biologicals Production Service

In 1805, King Charles IV of Spain sent a scientific expedition – La Real Expedición Filantrópica de la Vacuna (The Royal Philantropic Vaccine Expedition), to Manila. The world’s first immunization campaign was headed by Dr. Francisco Javier de Balmis, court physician of the Spanish crown, the mission carried the Vaccinia virus to the archipelago and maintained it by serial passages in children, who were purposely brought along in passage.

Research Institute for Tropical Medicine (RITM) Director Dr. Socorro P. Lupisan delivered the first “State of RITM Address (SORA)” last January 30 at the Training Center Auditorium.

During the SORA, feedback about the Institute’s accomplishments, and future initiatives were presented to RITM staff.

Moreover, Dr. Lupisan underscored that the Institute’s thrust and priority revolves around improving service delivery to better cater the needs of the Filipinos.

One important metric towards achieving this goal is the ISO 9001:2015 accreditation. RITM has already conducted an internal audit in preparation for the actual ISO audit this coming March.

>> p8 STAFF UPDATES & PUBLICATIONS

A year after the expedition, a Central Board of Vaccination was created to propagate and produce smallpox vaccine. This was followed by the establishment of the First Municipal Laboratory in Manila. In 1893, the Central Board of Vaccination was reorganized, paving the way for the formation of the Bureau of Governmental Laboratories in 1901. The latter was renamed Bureau of Science in 1905 where the production of smallpox vaccine begun.

In 1920, the Serum and Vaccine Unit of the Bureau of Science was transferred to Alabang, Muntinlupa. It was renamed as Alabang Serum and Vaccine Laboratories (ASVL) and was transferred to the University of the Philippines in 1936. Through Executive Order 94, the Division of Laboratories that includes the ASVL was created and incorporated with DOH.

Three years after, the Division of Laboratories was transformed to Public Health Research Laboratories (PHRL). In 1958, PHRL was replaced with the Bureau of Research and Laboratories (BRL), making ASVL a division of BRL. On the 30th of January 1987, ASVL was separated from BRL and became a support service of DOH known as the Biologicals Production Service (BPS).

The year 1999 marked the transfer of BPS to RITM as well as the start of the Vaccine Self-Sufficiency Project (VSSP). BPS then became

>> continued on page 7

>> continued on page 3

>> continued on next page

The Research Institute for Tropical Medicine (RITM), through its newly established Research and Innovation Office (RIO), held the first Institutional Research Agenda Setting to identify research priorities and to develop a comprehensive research agenda last January 26-27 at the Orchid Garden Suites, Manila.

Almost 60 attendees comprised of RITM investigators, and representatives from different study groups participated in the two-day workshop. The output of the workshop will encompass the future research work of the Institute for the next five years.

According to RIO Senior Science Research Specialist Kristel Perdigon, RITM marks this as its initial research agenda output.

>> p6 INFOGRAPHIC/ ZIKA Virus

>> p4 FEATURE/ Leprosy: A Biblical Disease (Or so we Thought)

>> p3 NEWS/ National Polio Laboratory

toughens efforts for the PH Polio Endgame Plan

Biologicals Manufacturing Division: Pushing towards growth and innovation

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RITM UPDATE >> January to March 2017

2Biologicals Manufacturing Division... (from page 1)

the Biologicals Manufacturing Division (BMD) that people know today. In 2001, a new Current Good Manufacturing Practice (cGMP)-certified vaccine production plant was established in RITM.

NOW: The Biologicals Manufacturing Division

With the aim of improving vaccine production and boosting productivity, BMD established the Vaccine and Antisera Study Group (VANTUG) in 2016, a team under the new Vaccine Research and Development Committee (VRDC). At present, RITM-BMD is lead by Dr. Noel G. Macalalad.

The division is currently producing two vaccines: the freeze-dried Bacillus Calmette–Guérin (BCG) vaccine in its experimental stage and the Purified Cobra Anti-Venom (PCAV). BMD Production Department Chair Ms. Cristina Ruga emphasized, “RITM is the sole manufacturer of PCAV in the Philippines. We have future plans to innovate our PCAV product here at BMD. We plan to shorten the length of time of production process by adopting a new technique that will also increase the number of ampules produce per lot. Hopefully, by second semester of this year, we can start the pre-qualification for the innovation of our anti-venom.”

Recently, BMD is starting to revive the VSSP initiative between RITM and DOH. VSSP aims to produce vaccines for DOH’s Expanded Program on Immunization (EPI), including the revival of BCG vaccine production.

Subsequently, BMD also pursues funding from the Philippine Amusement and Gaming Corporation (PAGCOR) and Health Facilities Enhancement Program (HFEP) to cover the facilities, production costs and equipment.

The last quarter of 2016 stirred public concern as the first local transmission of the Zika Virus was reported. We were swift in taking action as the Department of Health through the Research Institute for Tropical Medicine organized the first National Summit on Zika Virus gathering experts to talk about the virus in the international and local context.

We responded with vigor to the Zika outbreak through our intensified surveillance and outbreak response activities, with our stringent tests confirming 61 positive cases of Zika Virus to date. RITM will remain steadfast in its outbreak investigations for early detection and impact reduction of infectious diseases.

Moving forward to 2017, RITM promises to improve service delivery by achieving our ultimate goal for the year which is to acquire the ISO 9001:2015 accreditation. Apart from better services, we hope to implement our master development plan to enhance the facilities and services our Institute has to offer.

In this issue, we highlight 30 years of biologicals and vaccine production. We also feature our strategies on strengthening and supporting our research groups; fostering dialogue in addressing polio, pneumonia, and tuberculosis; and, encouraging collaborations in the public health scene through trainings.

I welcome and enjoin everyone as RITM undertakes another year of responding to public health needs through excellence in research, training, control, and management of infectious and tropical diseases.

Director’s Desk

SOCORRO P. LUPISAN, MDDirector IV, RITM-DOH

NEWS

BMD is also continuing its drive to enhance the knowledge, skills and capabilities of its Quality Control Department staff.

To fulfill the growth and expansion of the biological products being manufactured, the revival and development of Bacterial Typing Antisera, BCG Vaccine, and Equine Rabies Immunoglobin (ERIG) are currently in progress.

Ms. Ruga also talked about the legacy that comes with being part of BMD. She said “Our senior staff here at BMD underwent trainings abroad in their respective fields and specializations. They have years of experience and capability to produce under their belt. Meanwhile, BMD management is currently conducting continuous cGMP and Cold-chain Breakdown Trainings to equip the staff the basic and most relevant manufacturing work routines.”

BEYOND: BMD in the years to come

Hundreds of years have passed since the Balmis expedition arrived in the Philippines. On April 15, 2004, a marker was mounted at RITM in honor of the expedition. At present, the Balmis Building also houses the BMD office.

In the coming years to come, BMD plans to create new departments as well as hire additional manpower to aid in the production of vaccines and biologicals. New vaccines are aimed to be produced every year and researches are continuously being conducted to keep up with the latest innovations in vaccine production and to tame the current supply-chain complexity.

BMD has a lot more to offer, whether as a division of RITM or as the leading vaccine producer in the country. Big changes are in store for the year 2017 and beyond.

Dr. Lupisan steers RITM...from page 1)

According to Dr. Lupisan, most of the findings in the internal audit are now being resolved. She reminded staff that they “just need to implement what is written in the Standard Operating Procedures (SOPs) and follow the process flows as a way of life” and the Institute can earn the thumbs up from the ISO auditors.

RITM also plans to strengthen its research groups in producing globally competitive studies for public health through its newly established Research and Innovation Office (RIO). “We hope to create more impact in the public health sector through developing and communicating health policies based on our research outputs and data,” said Dr. Lupisan.

True to its oath of serving the Filipino people, RITM’s Technology, Transfer, and Review Committee (TTRC) is set to become a Training Office this April to further build staff capacity and better their skills in delivering the Institution’s vision.

RITM aims to continuously improve its services in surveillance, referral laboratory functions, biologicals production, and most importantly, patient care.

“With all these plans set in motion. I enjoin everyone to help us achieve the Institution’s vision. Let us all be united in our endeavors as we embark on yet another dynamic year. In our continuous pursuit of excellence, we will journey on and collectively fulfill what we have set out to do because we are OneRITM!,” said Dr. Lupisan as she ended her encouraging address.

RITM in numbers

Last year, RITM made fruitful progress in the local and international scene of public health as it distributed more than 46 million vaccines all over the country and produced more than eight thousand ampoules of purified cobra antivenin (PCAV), 62% of which have been provided to stakeholders upon request.

The Institute processed 100, 000 outbreak samples in its outbreak investigations and performed almost 66,000 confirmatory tests. In response to the Zika outbreak in the last quarter of 2016, RITM conducted tests and was able to confirm 61 cases to date.

The Institution catered to almost 89,000 patients and provided them with quality hospital services as there are two nurses for every bed, and one doctor for every ten beds.

RITM has been actively communicating research and surveillance data for Health Sector Policies with 21 research projects, 97% of which are published in international journals.

The Institution has also been proactive in its conduct of trainings to almost 2,000 individuals from different local government units and partners nationwide.

Lastly, RITM celebrated a milestone as it marked its 35th year of being responsive in providing relevant and quality health services to all Filipinos against infectious and tropical diseases.

National Polio Laboratory toughens efforts for the PH Polio Endgame PlanThe National Polio Laboratory (NPL), housed at the RITM Department of Virology, wins the support of local academic institutions, environmental agencies, as well as research and military laboratories in strengthening efforts toward polio eradication in the Philippines.

Key representatives from various institutions pledged their commitment to the Philippine Polio Endgame Plan during the Second Polio Endgame Multi-stakeholder Consultative Meeting and Workshop on March 14-16, 2017 at the B Hotel, Alabang. The program was part of the comprehensive strategic approach to address the laboratory aspect of the Polio Endgame, which includes the (1) establishment of environmental surveillance laboratory, (2) reactivation of the National Task Force for the Laboratory Containment of Poliovirus, (3) distribution of advocacy materials to key stakeholders, and (4) initiation of polio legacy planning.

The Task Force also eyes for the passage of an Executive Order addressing all pillar objectives of

the Polio Eradication and Endgame Strategic Plan including detection and interruption of poliovirus (PV) transmission; strengthening of immunization systems and cessation of the use of oral polio vaccine (OPV); laboratory containment and certification; and global polio legacy planning.

In 2016, NPL has established the Environmental Surveillance for Poliovirus and other Viral Pathogens following provision of equipment and laboratory supplies from the World Health Organization (WHO). NPL also conducts regular laboratory confirmation of cases in support to DOH’s AFP Surveillance Program. Currently, the Philippines is updating its national inventory of clinical and diagnostic facilities.

The Global Polio Eradication Initiative (GPEI) – the largest international public health effort to be undertaken – has decreased the annual incidence of polio by 99% since its launching in 1988. The last wild poliovirus and circulating vaccine-derived poliovirus cases in the Philippines was detected in 1993 and in 2001 respectively.

BMD in retrospect

Checking cultures for purity

Filling ampoules with BCG Vaccine

Using goat’s brain in Rabies Vaccine production

Milking cobra venom

BMD steam boilers

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RITM UPDATE >> January to March 2017

4 FEATURE

Malaki ang pagasa ko na gagaling ako, kaya lang

tiyagaan lang talaga.Kasi syempre pag ganito...hindi maiwasan na pandirihan ka. Kahit nga sa sasakyan ka eh, kung ikaw sumakay ng jeep,

iiwasan ka.

“Kasi syempre pag ganito...hindi maiwasan na pandirihan ka. Kahit nga sa sasakyan ka eh, kung ikaw sumakay ng jeep, iiwasan ka. (Because of this, it can’t be avoided that you’d be detested. Even in public transportation, if you ride the jeepney, people would avoid you.)”

*Jane can’t help but tear up as she recounts the way people would avoid her. She is part of the small population of people with leprosy in the Philippines. The numbers remain low up to now, but the prejudice associated with the leprosy population is great and grave.

The country has reached the WHO elimination target for leprosy of less than 1 in 10,000 persons in 1997.

In the Bible, people would distance themselves from lepers--and lepers themselves try to stay away from everyone else.

“Unclean, unclean” the leper would warn as he walks through the streets, wearing his lesions and disfigurements as marks of ‘uncleanliness,’ to set him apart from the ‘pure.’

More than 2,000 years have passed, but the social stigma experienced by leprosy patients remains the same.

Is leprosy even relevant?

“Hindi ko rin kasi noon alam [leprosy], ngayon ko lang din nalaman na may sakit na ganito. (I also didn’t know what [leprosy] is before, it is only [when I’ve got it] that I learned that a disease like this exists.)”

Jane was unfamiliar with the disease she contracted. It was only when she was clinically diagnosed as a leprosy patient, that her father mentioned her late mother contracting the disease during her teenage years.

Many people, nowadays, are unaware that leprosy exists, rather, still exists. Some have heard of it, maybe from their parents, grandparents, history books, and even the Bible. But rarely does it pop to people’s minds when talking about skin ailments.

While leprosy was once considered “incurable”, in 1978 - the WHO recommended the multi-drug therapy (MDT) as the world’s combat to leprosy. MDT is comprised of two or three drugs, depending on the kind of leprosy the patient has.

Soon after, the Philippines was declared leprosy free in 1997.

The “Great Mimickers”

“Akala ko, pigsa lang (I thought it was just a boil).”

It took Jane two years to have her skin lesions checked. She didn’t mind them much but people at her previous work urged her to have them checked at a local clinic in Calamba.

When Jane went to the clinic to have her bumps examined, they said that she had leprosy. She

couldn’t believe it. She was then sent to RITM, as the local clinic claimed to have insufficient facilities to treat her accordingly.

After examining Jane, RITM confirmed that she had leprosy. Only then did Jane believe, and accept, that she contracted the disease.

Leprosy is caused by the bacteria Mycobacterium leprae, which affects the skin and the nerves. Its effects depend on the person’s immunity status. It can range from whitish discoloration of the skin with insensation; to multiple bumps all over the body, face and ears; to disability and disfigurement.

Correct and early diagnosis

It is important to consult a specialist when you deal with skin lesions that do not respond to various treatments. Correct and early diagnosis of leprosy prevent drastic disabilities and disfigurements like losing nose bridge, blurring eyesight, non-healing wounds, and shortening fingers and toes.

“Leprosy is called by others as the ‘Great Mimicker’ because it mimics a lot of diseases,” explained Dr. Ma. Teresita Gabriel, RITM’s Dermatology Department Head and Leprosy Unit Head.

In far-flung areas, there is a scarcity of physicians. The health workers are the ‘frontliners’ when approached by people inquiring on their skin lesions

and ailments. These may lead to misdiagnosis, Dr. Gabriel explained.

To address this, the DOH’s National Leprosy Control Program, in cooperation with RITM’s Dermatology Department, conducts leprosy workshops for healthcare workers nationwide. In these workshops, healthcare workers are taught how to correctly diagnose leprosy.

Out of the leprosarium, into the frying pan

“Kasi dati nung wala akong (leprosy) nakakalabas ako kung san ko gusto. Ngayon hanggang bahay nalang eh. Syempre nahihiya na rin lumabas kasi pag nakita ka ng tao, tititigan ka pa ng husto (Before, when I still didn’t have (leprosy,) I was able to go wherever I want. Now, I only stay at home. Of course, I feel ashamed, because when people see you, they look at you intently).”

Since her diagnosis and treatment in 2013, Jane rarely goes outside her house. Her rare trips outside are to RITM for her check-ups. In the biblical days, leprosy was diagnosed by priests. People with leprosy have to live then in predetermined conditions, clothe in such a way that people would see their scars and boils, warn passers-by of their coming presence, and live away from homes and towns, as other people might contract the ‘incurable.’

Compared to the lepers in the Bible, leprosy patients in the succeeding centuries had leprosariums to stay in. Since there was no known cure then, the best way to avoid the spreading of the disease was to segregate the leprosy patients from the ‘healthy.’

Leprosariums in the Philippines were mostly set up and run by friars, nuns, and doctors. Due to leprosy’s severity in the Philippines during the 1900s, the government decided to move leprosy

Like Jane, many patients seeking treatment are safe to roam around without the risk of infecting anyone. She knows that, but still opts to stay inside closed doors, away from prying eyes, and looks of disgust.

Out of Relationships

“Dati nung wala akong ganito, marami (akong kaibigan). Ngayon nagkaroon akong ganito, wala na... Dati mga napunta pa sila sa bahay, ngayon wala na (When I didn’t have leprosy, I have a lot of friends. But now that I have the disease, I don’t anymore... Before, they even visit my house, now no one does).”

Not everybody knows that a leprosy patient can become uninfectious. Once others see the scars, lesions, and disfigurements, they treat patients as ‘untouchables’.

The MDT renders you uninfectious, but one of its drugs have side effects that still alter the patients’ appearance.

Patients with more than five skin lesions, multibacillary leprosy, is given dapsone, rifampicin, and clofazimine. Clofazimine’s side effects include skin discoloration, turning the skin in a brownish black color, and extreme skin dryness.

Hope found in treatment

“Malaki ang pagasa ko na gagaling ako, kaya lang tiyagaan lang talaga. (I have great hope that I’d be healed, but I really need to persevere.)”

Jane is no stranger to RITM as she’s been going to the Institute’s Dermatology Clinic for three years now. She’s very active in RITM’s leprosy program and often visits the hospital even when she has no check-up scheduled for that day.

She has joined livelihood trainings conducted by the Technical Education and Skills Development Authority in the Institute.

She’s also part of the Hansen’s Disease Club, where she meets other leprosy patients and hear their stories.

Jane also joins lay fora wherein leprosy patients are encouraged to meet with non-leprosy patients. In these meetings, RITM gives lectures, patients share their stories, and get support for their journeys to complete healing. Family members and other hospital patients are among the non-leprosy patients during lay fora.

Dr. Gabriel stresses that these activities are done to “remove the stigma” associated with leprosy inflicted persons.

“Mahirap din”

When Jane was telling her stories, she kept repeating the word ‘mahirap’-- referring to the pain she encounters, to the judgement she receives, and to the fact that she was left alone by the people she cares about.

Amidst all the persecution and judgement, and even knowing that one of the drugs that’s curing her is causing more deplorable skin marks, Jane is pushing through with her treatment.

Leprosy is a historically acclaimed disease that shook the world and changed lives. We achieved a great milestone in eliminating it, but we cannot stop there. We cannot just forget the leprosy patients now. They still matter, and they’re fighting to make themselves heard. We just have to listen to their battle cries.

“Kung pagsubok man binigay mo sa akin, kakayanin ko (Although You give me challenges, I will endure).

by Hannah Benedicto

LEPROSY: A BIBLICAL DISEASE (Or So We Thought)

“Leprosy is called by others as the ‘Great Mimicker’ because it

mimics a lot of diseases,”

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RITM UPDATE >> January to March 2017

6 NEWS

RITM strengthens study groups.. (from page 1)

“This is a milestone event for the Institution, because it has generated research objectives that will serve as the research targets of RITM in the coming years. The workshop has set future research directions and priorities in the field of tropical and infectious diseases in the Philippines,” she emphasized.

Once collated and finalized, the coherent research agenda will be presented to the Department of Health to lobby for support and funding.

RITM Director Dr. Socorro Lupisan mentioned that through collaboration with external and foreign partners, formal ties with other hospitals and institutions, publications and dissemination of research outputs, investigator-initiated researches, and funding support, RITM will further encourage and strengthen its study groups in producing globally competitive research.

Hinged on the Institution’s vision of being responsive to public health needs through excellence in research, RITM expects 80% of its researches to address current public health concerns, and 50% of its research outputs to be published in international journals by the year 2018.

NTRL pilots nanotechnology application in detecting TB

The National Tuberculosis Reference Laboratory of the Research Institute for Tropical Medicine (RITM-NTRL) in partnership with the National Institute of Molecular Biology and Biotechnology of the University of the Philippines Los Baños (UPLB BIOTECH), the Alocilja Nano-Biosensors Lab of the Michigan State University (MSU), and the Provincial Government of Bohol conducted the Applications of Nanotechnology in Tuberculosis Detection Workshop last February 20 at Tagbilaran City, Bohol.

According to RITM-NTRL Policy and Research Unit Head Mr. Dodge Lim, the workshop aligns with the effort of the Provincial Government of Bohol to establish the very first development center for nanotechnology in the Philippines encompassing health, tourism, and education particularly in

agriculture and biosystems engineering. Lim added that the workshop addresses the need of the province to manage and control Tuberculosis (TB), as Bohol is currently close to the national positivity rate of 12% with smear-positive cases.

Increasing awareness on the potential use and application of nanotechnology in nanomedicine and diagnostics, Lim along with RITM-NTRL Laboratory Services Unit, Routine Section Head Ms. Rocelle Marie Agero demonstrated the use of nanoparticles in TB detection, while UPLB BIOTECH Dr. Lilia Fernando showcased their different nanotech applications in agriculture. The team also presented the wide applications of nanotechnology in agriculture and health to the students of Bohol Island State University (BISU) Bilar Campus.

RITM ARI embarks on IMCI Evaluation after SATREPS project completionFollowing the completion of the SATREPS project, RITM-TOHOKU Collaborating Research Center for Emerging and Re-emerging Infectious Diseases continues the implementation of the Childhood Pneumonia Project focusing on the transmission of respiratory syncytial virus (RSV) in Biliran province.

“The SATREPS project funded by JICA was completed but the Childhood Pneumonia Project is still ongoing. Now we are moving towards looking at RSV under the RITM-TOHOKU Collaboration. It is the most common pathogen observed in children with pneumonia. It was not a major cause of mortality but it was causing illnesses and admissions to hospital. We are looking at the RSV transmission so that we can come up with recommendation for control, an RSV vaccine maybe, so we can decrease hospital admissions of children,” says Dr. Socorro Lupisan, RITM Director and Childhood Pneumonia Project investigator.

The Research Institute for Tropical Medicine (RITM), through its Acute Respiratory Illnesses (ARI) Study Group received a 20 million-peso sub-allotment from the Disease Prevention and Control Bureau (DPCB) for the evaluation of the Integrated Management of Childhood Illnesses (IMCI) program as continuation of the Childhood Pneumonia Project.

The RITM ARI Study Group is also looking at evaluating the implementation of the existing IMCI programs of the Department of Health in relation

to the success of the pilot implementation of the eIMCI Plus, a new Integrated Management of Childhood Illnesses (IMCI) program composed of pneumonia-diagnosing applications loaded in a computer tablet plus a pulse oximeter device as an additional respiratory assessment tool.

This Childhood Pneumonia Project was originally part of the intervention study under the SATREPS project “Comprehensive Etiological and Epidemiological Study on Acute Respiratory Infections in Children: Providing Evidence for the Prevention and Control of Childhood Pneumonia in the Philippines” that started on April 2011 and ended on March 31, 2017. It was a joint research project funded by the Japan Science and Technology Agency (JST) and the Japan International Cooperation Agency (JICA) through its Science and Technology Research Partnership for Sustainable Development (SATREPS) program.

The SATREPS project looked at the etiology, burden of the disease, and the risk factors of childhood pneumonia. Laboratory testing sites were set up in selected project hospitals: (1) RITM Hospital and Laboratory, (2) Eastern Visayas Regional Medical Center (EVRMC) in Tacloban City, Leyte, (3) Ospital Ng Palawan (ONP) in Puerto Princesa, and (4) Biliran Provincial Hospital (BPH) in BIliran Province. A cohort study was also conducted in two municipalities and twenty-five barangays (villages) of Biliran wherein 2,000 children where enrolled and followed up in the pilot implementation of the eIMCI Plus program.

Bohol Health Cluster Head Dr. Cesar Tomas Lopez, Provincial Health Officer Dr. Greg Sodusta, Dr. Evelyn Flordelis led and facilitated the workshop with 25 physicians, medical technologists, and nurses all throughout the day.

As an outcome of the workshop, RITM-NTRL is set to collaborate with the province of Bohol in its nanotechnology studies as a potential study site.

“This project is timely in response to the call of the End TB Strategy to reduce the incidence of TB by 95% in 2035 compared to the 2015 data through discovery, development and rapid uptake of new tools, interventions and strategies. The future of bio sensing diagnostics through the use of nanoparticles for rapid, sensitive, affordable and simple pathogen detection is within our grasp,” said Lim.

RITM-NTRL aims to evaluate the nanoparticles technology pioneered and brought by MSU Alocilja Nano-Biosensors Lab Director Dr. Evangelyn Alocilja into the Institute in the diagnostics of TB and other infectious diseases such HIV among others in the country.

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RITM UPDATE >> January to March 2017

Olveda, D.U., Inobaya, M.T., McManus, D.P., Olveda, R.M., Vinluan, S.Ng., Harn, D.A.,… Ross, A. GP. (2017). Biennial versus annual treatment for schistosomiasis and its impact on liver morbidity. International Journal of Infectious Diseases, 54, 145-149.

Medina, P., Padua, A., Casagan, M., Olpindo, R., Tandoc III, A., & Lupisan, S. (2017). Development and Pilot Implementation of a Ladderized Biosafety Training Program in a Specialty Infectious Disease Hospital and Research Institute. Philippine Journal of Pathology, 2(1).

Gabriel, Ma.T.G., Teodosio, G.B., & Tasmin, N.K.D. (2017). Differential Diagnosis of Vitiligo in Brown Skin. Melasma and Vitiligo in Brown Skin, 227-241.

Bijker, R., Jiamsakul, A., Kityo, C., Kiertiburanakul, S., Siwale, M., Ditangco, R.,… Hamers, R.L. (2017). Adherence to antiretroviral therapy for HIV in sub-Saharan Africa and Asia: a comparative analysis of two regional cohorts. Journal of the International AIDS Society, 20(1).

Scheman, A., Hipolito, R., Severson, D., & Youkhanis, N. (2017). Contact Allergy Cross-reactions: Retrospective Clinical Data and Review of the Literature. Dermatitis, 28(2), 128-140.

Thompson, M.G., Hunt, D.R., Arbaji, A.K., Simaku, A., Tallo, V.L., Lucero, M.G.,… Gresh, L. (2017). Influenza and respiratory syncytial virus in infants study (IRIS) of hospitalized and non-ill infants aged< 1 year in four countries: study design and methods. BMC Infectious Diseases, 17, 222.

Alday, P.P., Mercado, E.S., Tan, A.G., Javier, J.B., Lupisan, S.P. Tallo, V.,… Oshitani, H. (2017). Estimates of influenza and respiratory syncytial virus incidences with fraction modeling approach in Baguio City, the Philippines, 2012–2014. Influenza and Other Respiratory Diseases, 1-8.

RITM PUBLICATIONS/JANUARY to MARCH 2017

Dr. Kristy EvangelistaAwarded the 2017 Strauss and Katz World Congress Fund Scholarship by the American Academy of Dermatology

Dr. Ma. Rosario CapedingConferred with the rank Scientist II in the Scientific Career System by the National Academy of Science and Technology

Dr. Blanca JarillaCompleted a Post Doctoral Fellowship at Brown University, Providence, Rhode Island, United States of America

Ms. Polle Krystle MacaranasCompleted a Diploma in Medical Microbiology with Distinction at the Institute of Medical Research, Kuala Lumpur, Malaysia

Dr. Fedelino Malbas, Jr. Awarded the “Most Outstanding Veterinary Pracititioner in the Laboratory Animal Practice” by the Veterinary Practitioners Association of the Philippines

RITM Program on Awards and Incentives for Service Excellence (PRAISE) Committee Awardees

Dr. Beatriz QuiambaoReceived the “Ulirang Manggagawa Award” for demonstrating exemplary performance in her 25 years of service in the Institution as

a clinician, trainor, and researcher

Ms. Gemma MontañoReceived the “Gantimpala Agad Award” for having been commended through the RITM Customer Satisfaction Survey (CSS) result

Head Jun Ryan C. Orbina

Communication and Engagement Officers Allenor R. Enciso

Reina D. ManongsongJoyce Anne C. Quinto

Communication AssistantMa. Patricia M. Lansang

ContributorsHannah Andione R. Benedicto

Kristine Nicole R. San Juan

RITM Update is a quarterly newsletter published by the Research Institute for Tropical Medicine - Department of Health (RITM-DOH), through its Communication and Engagement Office.

Web: www.ritm.gov.ph Mail: 9002 Research Drive, Filinvest Corporate City Alabang, Muntinlupa City 1781 PhilippinesTel: (632) 807-2631/32/37 Fax: (632) 842-2245

For your feedback and article suggestions, please e-mail us at [email protected].

RITM joins Southeast Asian countries in enhancing laboratory containment capacitiesThe Research Institute for Tropical Medicine (RITM) in collaboration with Cooperación Española, FORMIT, Ospedale Luigi Socco, and ASST Fatebenefratelli Sacco, hosted the Design Experts Team (DET) Training Course on Design, Construction, and Management of General Containment Laboratories from February 6-10 at the Training Center Lecture Rooms of RITM.

The five-day training course was funded by the European Union (EU) and the Chemical, Biological, Radiological, and Nuclear (CBRN) Centers of Excellence. RITM Veterinary Research Department Head, Dr. Fedelino F. Malbas, Jr. led the training and served as the CBRN National Coordinator.

According to Dr. Malbas, RITM only hosted the first part of the training which aimed at general containment laboratories (i.e. laboratories found in national, regional, provincial hospitals and clinics).

The training course tackled introduction to biosafety and biosecurity, principles of laboratory

design and containment, facility conception, processes, and elements, laboratory biosafety equipment, addressing encountered problems, and introduction to high containment laboratories.

EU Engineer Mark Wheatley, National University of Singapore Dr. Sabai Pityu, and Health Education Research Associates (HERA) Laboratory Planners Architect Mitsy Canto-Jacobs facilitated the course discussions. Thirty four participants from eight ASEAN member countries which include Brunei, Cambodia, Laos, Malaysia, Myanmar, Philippines, Thailand, and Vietnam attended the training.

The second part of the DET Training was held at the National Institute of Hygiene and Epidemiology (NIHE) at Hanoi, Vietnam. Insights from the DET Trainings Part I and Part II will be discussed and consolidated to refine a training material and booklet which will be released and distributed during the workshop at Brunei Darussalam by the end of 2017.