Category: News

Oral diseases are among the most prevalent non-communicable diseases worldwide, disproportionally affecting vulnerable populations. Oral diseases manifest as pain, impairment, and loss of function, and can affect individuals throughout their lifetime. Our study published in Annals of Global Health entitled “An Assessment of Pediatric Dental Caries and Family Quality of Life in an Informal Amazonian Community” examines the associations between child dental health status (DHS) and child and family quality of life in the community of Claverito, on the outskirts of Iquitos, Peru.

Untreated dental caries in permanent teeth is the most prevalent disease, and dental caries of the primary teeth affect more than 530 million children. Oral diseases manifest as pain, impairment, and loss of function, and can affect individuals throughout their lifetime. At the most extreme end of the socioeconomic spectrum, growing populations of marginalized individuals worldwide reside in slums. Claverito, is a community in the Peruvian Amazonian rainforest, and due to lack of housing has resulted in floating structures built on the Amazon River. Unfortunately, due to such precarious housing and poor environmental conditions, residents experience chronic illnesses, vector borne and infectious diseases, exposure to severe storms and flooding, and lack of water, sanitary infrastructure, and access to food.

In 2017, a collaborative group from the University of Washington (UW) schools and departments of Dentistry, Civil and Environmental Engineering, Environmental and Occupational Health, Global Health, Landscape Architecture, Neurology, and Nursing teamed up with the Centro de Investigaciones Tecnológicas Biomédicas y Medioambientales (CITBM), the Universidad Nacional de la Amazonía Peruana (UNAP) and the Instituto Nacional de Salud (INS) in Peru and developed a transdisciplinary action research program, InterACTION Labs, to design and implement research projects aimed at advancing the health, community strength, and future development of residents of one of these informal river communities – the Community of Claverito.  As a contributor to InterACTION Labs, dental faculty collected information about the community’s oral health status and the impact of oral health on the residents’ quality of life. The purpose of this study was twofold: 1) to describe the prevalence and distribution of dental caries among the pediatric and caregiver populations of a slum community located on the Amazon River in Claverito, Peru; and 2) to evaluate the relationships between the children’s dental health status and their oral health related quality of life (OHRQoL) of the children and the impact of the child’s condition on the family.

Children and their caregivers living in the Community of Claverito exhibited high levels of dental caries. Children’s untreated dental caries were associated with both family’s quality of life and caregivers’ untreated dental caries. Further research is needed on how improving availability and access to oral health services have the potential to benefit the health of residents of informal communities like the one of Claverito.

Dr. María Elena Inocente Díaz from Universidad Peruana Cayetano Heredia (UPCH) in Lima, Peru has ranked second in the Bicentennial Generation awards. A graduate of UPCH’s Stomotology program, her excellence in oral health has led to a scholarship to the attend the Johns Hopkins University Master of Public Health program in Baltimore, Maryland, USA.

Oral health and dentistry have been a family tradition for Dr. Inocente Diaz, as both her mother and aunt have both dedicated their careers to public health dentistry. She hopes to do the same, after being introduced to the area of study in the UPCH Stomotology program’s “Social Dentistry” class which explored the dental realities in the urban-marginal areas of Lima. She went on the do her residency in the small rural town of San Miguel in Cajamarca, where she took part in the radio program “Odontologists on the Air” where she gave practical oral health advice and dispelled common dental myths.

Dr. Inocente Diaz hopes to work at improving the health system in Peru and strengthening access to quality oral healthcare upon completing her MPH program at Johns Hopkins University. She also hopes to be able to be a university professor, to collaborate in the training of public health professionals within Peru.

It is evident that breastfeeding and human breast milk provide numerous health advantages for both children and mothers. Many health organizations recommend continuing breastfeeding for as long as mother and child desire. However, there is concern that breastfeeding more than 12 months may increase caries risk in children, but existing evidence on this relationship are still inconsistent and limited, especially from longitudinal studies. Researchers at Khon Kaen University in Thailand and University of Washington, led by Sirima Sritangsirikul, PhD Program in Oral Sciences, Faculty of Dentistry, Khon Kaen University, (NIH D43 trainee, #1D43TW009071) conducted a prospective cohort study that followed 1-year-old children for 2 years to investigate the association between breastfeeding duration and dental caries titled “Impact of Prolonged and On Demand Breastfeeding on Early Childhood Caries in Khon Kaen”.

The researcher team recruited 568 one-year-old children from 18 public health facilities in Khon Kaen, Thailand and interviewed their main caregivers using a structured questionnaire every 6 months to update breastfeeding information prospectively and collect information on possible confounding factors. Disregarding other foods and liquids, “full breastfeeding” refers to feeding breastmilk without formula milk, whereas “any breastfeeding” refers to feeding breastmilk with or without formula milk. Based on breastfeeding duration, children were categorized into four groups: less than 6 months, 6-11 months, 12-17 months, and equal to or greater than 18 months, for full breastfeeding and any breastfeeding separately. When the children were 36 months old, a dental caries examination was performed by a trained and calibrated dentist using World Health Organization criteria. At the end of the study, we had 486 children who completed the two-year study follow-up.

The results were interesting. They found that full breastfeeding and any breastfeeding had different patterns of caries risk. The longer the “full breastfeeding” duration, the lower the risk of caries. In contrast, once formula milk is added in “any breastfeeding”, the longer any breastfeeding duration, the higher the risk of caries. Importantly, this study is different from most previous studies as they investigated full breastfeeding and any breastfeeding separately and categorized the duration into intervals rather than just using one cutoff point. This allowed the research team to see the differing breastfeeding and caries pattern which will be recommended for future studies.

This study just won “The 1^st Prize Winner of the Asian Academy of Preventive Dentistry (AAPD) LION AWARD” in the 14^th International Conference of Asian Academy of Preventive Dentistry (AAPD) from October 1-2, 2021, in Daegu, South Korea.

ComMed, or Integrated Health Science Field Work at Khon Kaen University (KKU) Thailand, is an Inter-Professional Education program for undergraduate students from 6 schools: Dentistry, Medicine, Nursing, Physiotherapy, Pharmaceutical Science, and Veterinary Medicine at KKU and the College of Asian Scholars.  In 2020, this was the 38^th annual event in which 694 third- and fourth-year students, and over 70 academic staffs from various schools, joined forces as a health team to conduct community surveys and health promotion activities in a rural area.

Normally, students would have to spend 7-10 days in rural villages, overnight staying at the villagers’ homes to understand the community’s folkways and complicated context of people’s illnesses. But due to COVID-19 last year, the ‘new normal’ practice has been implemented, while we must fulfil the original course’s objectives and learning outcomes.

In 2020, a group of mixed 56-58 students from different schools was arranged in 12 clusters within 12 villages under the supervision of 5-6 academic staff members. The program orientation and meetings were provided online via the website, ZOOM meetings, and Google Classroom Platform which was offered manually for students, video clips, documents, and various information manuals.  All academic activities in university and villages were designed to guard against the spread of COVID-19: social distancing, facial mask wearing, hand washing, early detection of signs and symptoms, telemedicine communication, and staying away from the villages. This new normal practice could encourage students to achieve learning community health amid the spread of the coronavirus pandemic all over the world.

 

Despite efforts to improve oral health, low- and middle-income countries such as Kenya often lack the resources necessary to build research and health system capacity. University of Washington and University of Nairobi were awarded an NIH D71 planning grant entitled “TABASAMU: A multidisciplinary collaboration on building up research capacity in oral health and HIV/AIDS”, in June 2021. This innovative D71 award will provide the basis for developing a training program with the goal of creating sustainable institutional capacity in research and training for oral health and HIV/AIDS.

As part of this two-year planning, we will interview stakeholders and key investigators in Kenya, identifying oral health champions and potential researchers who will play a pivotal role in defining an organizational structure to support a future HIV research training program in oral health. We have partnered with experts in qualitative analysis, Dr. Matthew Saxton and Dr. David Hendry, at the University of Washington’s Information School, and are finalizing the instruments and will conduct our interviews September 2021 to February 2022. Drs. Saxton and Seminario both serve on the University of Washington’s Advisory Committee for the Office of Global Affairs and look forward to continued collaboration in global health research in Kenya and other DeRouen Center sites around the world.

From these interviews, we will identify key stakeholders and discuss current oral health research capacity and needs, identify potential mentors and trainees and gather data on access and barriers to research, and finalize our NIH D43 grant application which will pave the way to implementing a comprehensive oral health research training program across Kenya. This project will conduct the stakeholder analysis in several areas, including Nairobi, and in Western (Kisumu) and Eastern (Mombasa) cities where the prevalence of HIV is highest.

The University of Washington’s DeRouen Center for Global Oral Health has submitted another NIH grant entitled, “Tabamasu-EHR: Integrating dental records within an existing HIV electronic health system.” This proposal aims to strengthen the scientific capacity for interdisciplinary research in Kenya involving the University of Washington (Seattle, USA), the Maseno University Jaramogi Oginga Odinga Teaching and Referral Hospital (Kisumu, Kenya), and the University of Nairobi (Nairobi, Kenya). The Tabasamu-EHR application complements our existing D71 Tabasamu grant. Our overarching goal is to develop a robust infrastructure that provides support and training for conducting oral HIV research in Kenya utilizing existing resources based on the JOOTRH HIV electronic health records (EHR) system.

Our aims for this project are to: 1) Ensure adequate computer hardware infrastructure for integration of the dental and HIV clinic EHR systems, 2) Integrate dental electronic records within existing HIV EHR software, and 3) Generate a cadre of oral HIV researchers with expertise in the retrieval of electronic health records, health statistics, management of large databases, and epidemiologic research, while making JOOTRH a model for oral health integration into the national HIV HER for other large institutions in Kenya.

On this project we are excited to partner on UW’s International Training and Education Center for Health (iTECH) who has vast experience in EHR. This project will provide training opportunities in research areas that will be needed to conduct research utilizing EHRs. If funded, Tabamasu-EHR will provide the foundational basis for a future medium- or long-term program aimed at mastering clinical and health service research, strengthen inter-professional collaborations, decrease Kenyan geographical research inequalities, and increase capacities in oral HIV research.

The number of people fleeing wars, violence, and persecution rose to 82.4 million people in 2020, an increase of four percent since 2019. The COVID-19 pandemic did not slow the rate of refugee displacement, despite pleas from the international community for a global ceasefire. The result was one percent of the world’s population (1 in 95 people) is now forcibly displaced. A decade ago, the worldwide number of displaced people was 1 in 159.

According to UNHCR Global Trends 2020 report, these numbers include people displaced for the first time as well as people displaced repeatedly, both within and beyond countries’ borders. Crises in Ethiopia, Sudan, Mozambique, Yemen, Afghanistan, Columbia, Syria, Venezuela, and more have displaced 20.7 million refugees’ under UNHCR’s mandate by the end of 2020, which another 48 million people were internally displaced within their own countries.  The COVID-19 pandemic affected the refugee population hard, who has faced increased food and economic insecurity and reduced health care access. At the height of the pandemic in 2020, over 160 countries had closed their borders, with 99 making no exception for people seeking protection. Per UNHCR data, poverty, food insecurity, climate change, conflict, and displacement are becoming more interconnected which is driving additional people to search for new homes.

The UN High Commissioner for Refugees, Filippo Grandi, is calling for world leaders to increase efforts to cooperate to halt and reverse the decade-long trend of increased displacement led by violence and persecution, saying “Behind each number is a person forced from their home and a story of displacement, dispossession and suffering. They merit our attention and support not just with humanitarian aid, but in finding solutions to their plight.”

July 28, 2021 was the 70-year anniversary of the signing of Refugee Convention, a key international treaty establishing the right of people forced to flee their home countries. Since that date in 1951, millions of lives have been saved through this United Nations compact.

The United Nations Refugee Agency (UNHRC), was established in 1950 by the United Nations in the aftermath of the horrors of the Second World War. The UNHRC statute was published in 1951, setting out the terms of its operations and instructing plenipotentiaries of 26 states to meet in Geneva to finalize the text of the Convention. UNHCR is the guardian of the 1951 Convention, with the mandate to supervise its application and to work with states to protect refugees and find durable solutions. The 1951 Convention and the 1967 Protocol, which broadened the scope of those in need of international protection, define who is a refugee and the kind of protection, assistance, and social rights they are entitled to receive. The principles of the Convention were reaffirmed in December 2018 by the Global Compact on Refugees, an outline for more equitable responsibility-sharing. Both the Convention and the Compact affirm that sustainable solutions to refugee issues cannot be achieved without international cooperation.

The Refugee Convention continues to protect the rights of refugees around the world and is a crucial component of international human rights law, remaining as relevant now as it was when it was drafted and agreed to 70 years ago. Filippo Grandi, the UN High Commissioner for Refugees, says “The language of the Convention is clear as to the rights of refugees and remains applicable in the context of contemporary and unprecedented challenges and emergencies – such as the COVID-19 pandemic.” Mr. Grandi expressed alarm at recent attempts by some countries to disregard the Convention’s principles, including expulsions and pushbacks of refugees and asylum seekers at land and sea borders, and recent proposals to transfer refugees to third-party countries for processing without adequate protection or safeguards. Both the 1951 Refugee Convention and the more recent Global Compact on Refugees call for international cooperation to find a range of solutions for refugees.

The Universidad Peruana Cayetano Heredia (UPCH) has risen in the global ranking of best universities in the world by the QS World University Ranking, going from the score of 701-750 to 651-700. This year, QS analyzed 1,673 universities worldwide, of which 1,300 passed the minimum qualifications to be considered in the current ranking. In Peru, only eight universities were considered, among them the four universities that make up the Consortium: PUCP, UPCH, UP and ULIMA.

The QS World University Rankings is the world’s most popular source of comparative data on university performance where 8 evaluation indicators are considered, such as: academic and employer reputation, personnel with a doctorate, citations per article, impact on the web, among others. As a university, they have improved their standards in the indicators of 1) the ratio of students to faculty, 2) academic reputation, 3) employer reputation. This has allowed UPCH to improve their position in the world ranking and place 33rd in Latin America.

The President of the Universidad Peruana Cayetano Heredia (UPCH), Dr. Enrique Castañeda Saldaña, greeted the Minister of Health, Dr. Oscar Ugarte Ubillúz, at the university facilities for Ministry of Health’s supervision of the vaccination process against COVID-19, where volunteers are participating in the Sinopharm/China National Pharmaceutical Group vaccine clinical trial.

During the visit, Dr. Ugarte, accompanied by University authorities, toured each of the volunteers’ vaccination stations, verifying that the immunization process complies with the provisions of the Ministry of Health. The vaccination of the volunteers began May 24^th, with volunteers receiving either the placebo or the Sinopharm/China National Pharmaceutical Group vaccine. The trial is expected to inoculate 300 to 400 volunteers per day. Dr. Enrique Castañeda stressed the commitment of the University to vaccinate all volunteers in the clinical trial.

The visit was accompanied by Dr. Carlos Cáceres Palacios, Associate Provost for Research, Dr. Sergio Recuenco Cabrera, Principal Investigator of the Center for Clinical Studies-UPCH and Dr. Javier Bustos Palomino, Co-Investigator of the Center for Clinical Studies-UPCH.