|J.D. MacLean Centre for Tropical Diseases at McGill Universitys|
Brian J. Ward MD, M.Sc.,FRSQ, DTM&H (Infectious Disease, Medical Microbiology)
a) vaccine immunology
b) nutritional interventions in infectious diseases
c) diagnostic parasitology
a) Projects in vaccine immunology include the investigation of immunopathology following high and standard titer measles vaccines [WHO (Peru), NIH (Haiti), NIH (Montreal), CIDA (Sudan)], reactogenicity to the new acellular pertussis vaccine [Pasteur Merieux Connaught Ltd (Montreal)] and the use of EMLA cream for vaccination [Astra Ltd, (Montreal).
b) Nutritional interventions in infectious diseases which are of particular interest include vitamin A in the prevention of the breast-milk transmission of HIV [CIDA (Zimbabwe)], the impact of vitamin A on measles vaccination [World Bank (Peru)] and the role of lectins in modifying intestinal parasitoses [Weston Foundation (Peru)].
c) The diagnostic parasitology projects are supported by a contract from LCDC and are outlined in Dr. Bouchera Serhir's section.
d) Other projects include the development of a vaccine against multiple myeloma [Private Donation (Montreal)], evaluation of novel $-lactamase inhibitors [Methylgene Inc (Montreal)] and investigation of immunocompetence in Inuit children [NHRDP (Baffin Island).
Theresa W. Gyorkos, Ph.D. (Epidemiology and Biostatistics)
Research focuses on the prevention and control of communicable diseases, primarily parasitic diseases in distinct population groups. Much of this work is done in Canada among high risk groups such as immigrants and refugees, travelers to tropical regions and children attending daycare centres, among others. An essential component of my research in parasite epidemiology is based overseas through collaborative partnerships with local scientists.
a) evaluation of community based health interventions for communicable
b) parasitic disease outbreak investigation
c) epidemiology of imported parasitic infection
d) daycare infectious disease epidemiology
e) biostatistical methodology for infectious disease problems
a)This work first examined the evaluation of immunization delivery strategies for vaccine-preventable communicable diseases. It led to the development of a methodology which can be used to evaluate any community based intervention. Extensions of this research have included an evaluation of the effectiveness of the prenatal screening programs for rubella and hepatitis B infections.
b) In responding to outbreaks of parasitic infections in Northern communities, epidemiologic study has been required. Outbreaks of trichinosis, toxoplasmosis and most recently metorchiasis have provided the opportunity for extensive collaboration of clinical, laboratory and epidemiological investigators.
c) Imported intestinal parasite infection has been a major focus of work in parasite epidemiology within which aspects of screening, longevity of infection in non-endemic areas and diagnostic testing have been studied. Research in malaria epidemiology includes on-going evaluations of the clinical manifestations of imported malaria and compliance issues related to antimalarial use in travelers. Overseas research in malaria is primarily community-based and examines issues such as community participation in the use of bednets, the knowledge, attitudes and practices of Ethiopian women with respect to antimalarial use, the effect of iron on the occurrence and severity of malaria in young anemic children and pregnant women and risk factors for malaria in resettled human populations in the Amazon.
d) Within the context of preventing and reducing the risk of infection within the daycare centre environment, I examined the occurrence of presence of parasite contamination in the external environment. We have currently completed an evaluation of the effectiveness of a comprehensive hygiene program, called ENVIRO-NET, in reducing the incidence of diarrhea and colds in children attending daycare centres in Quebec. The development of practice guidelines will be based on this work.
e) Using data generated from the above projects, there has been a collaboration with biostatistician colleagues to apply new biostatistical methodology to infectious disease problems. This has led to the development of better estimation methods for prevalence, when a gold standard test is unavailable (i.e. incorporating uncertainty parameters into the estimate). A current focus relates to the development of sample size estimates for studies in infectious diseases, where exposure or outcome ascertainment relies on a diagnostic test with specified or unspecified test parameters (e.g. sensitivity and specificity), Extension of these methods to other disease categories is a promising area of future collaboration.
Joyce Pickering, MD, FRCPC (Internal Medicine), MSc. (Epidemiology) Departments of Medicine, and Epidemiology and Biostatistics
a) public health in developing countries
b) research techniques for developing countries
a) In collaboration with colleagues from developing countries, I have looked at various aspects of public health in developing countries, including vaccination programs, malaria control, hypertension prevalence, surgical services, and utilization of clinic services.
b) I have developed a course to put together public health research techniques of particular relevance to developing countries, and run this in Canada and Uganda.
Michael D. Libman, MD, FRCPC (Infectious Disease, Medical Microbiology)
1. Cost-effectiveness of diagnostic testing
2. Diagnostic microbiology
1. Projects have involved the evaluation of eosinophilia and parasite serology as diagnostic tools in returning travelers, the cost-effective use of PCR in the diagnosis of tuberculosis, strategies for evaluation of Herpes Simplex and group B Streptococcus carriage in pregnancy.
2. Investigations of the utility of laboratory testing have included the use of screening for rubella and measles antibodies in pregnancy, and problems related to testing for chlamydia.
3. Ongoing work includes evaluation of methods to prevent Clostridium difficile transmission, participation in the investigation of immunopathology following measles vaccination (see Brian Ward), rapid diagnosis of MRSA carriage and evaluation of novel beta-lactamase inhibitors.