ID4U - Infectious Disease Podcasts for Users of the CMES program
Techies Without Borders (TWB) is a non-profit organization that aims to deliver high-quality CME to low- and middle-income countries (LMIC) where there are significant cost and internet access barriers for clinicians to stay up-to-date. Our program is currently established in 19 countries, serving 13,000 doctors who care for more than 20+ million patients. Our primary content delivery method is via the Continuing Medical Education Solutions (CMES) and CMES-Pi, a small computer at each site that automatically downloads content from our cloud-based server each month. The content includes podcasts and written summaries from Emergency Medicine Reviews and Perspectives (EM:RAP-GO), emDocs.net, Don’t Forget the Bubbles, and the World Health Organization (WHO), Life in the Fast Lane, and EM Cases. There is also point-of-care ultrasound content donated by Alfred Health and emergency medical services (EMS) content donated by the MCHD Paramedic Podcast. The CME material is geared toward EM, but all specialties will find useful content. New content for other specialists is being added. We are also able to upload local CME materials. The content from the Pi can be transferred to an app so that users can access material remotely without the need for the internet. You can learn more about our initiatives here: https://cmesworld.org/ https://techieswithoutborders.us/ One resounding theme of user feedback that there is not enough ID content on our server relevant to LMIC. IDs are the most common causes of death in these parts of the world. There is also a disparity in publication and scholarship among authors in the “global North” compared with the “global South.” In response to these perceived needs, we have developed an ID podcast mini series consisting of interviews with CMES participants in areas of their expertise. These podcasts are uploaded to the CMES audience before being made available to the pubvlic. The dual purpose of this podcast is to tailor the content on the CMES server to the needs of our users and to provide digital scholarship opportunities for our partners in the global South.
Episodes
Dr. Jessica Pelletier and Dr. Kamoga Dickson discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of cholera.
Take-Home Points:
- Cholera is a disease with high morbidity that disproportionately affects sub-Saharan Africa
- The O1 and O139 serogroups of V. cholera make cholera toxin and cause the disease
- Colonization happens in the small intestine, so higher volumes of bacteria...
Dr. Jessica Pelletier and Noah Kronk speak with Dr. Steve Liang and Dr. Gaston Omba about the diagnostic workup, management, and prevention of ebola virus disease (EVD).
Take-Home Points:
- Patients may present in either the dry or wet phases of disease and may progress to death or recovery
- Early recognition of possible EVD cases helps protect more people from becoming infected
- IPC measures are critical to break the cycle of infectio...
Dr. Jessica Pelletier and Noah Kronk speak with Dr. Gaston Omba, an emergency medicine resident physician with expertise in international cooperation, humanitarian aid, health management, and ebola epidemic response.
Take-Home Points:
- Ebola virus outbreaks typically occur in Sub-Saharan Africa
- The natural reservoir is thought to be bats, but this isn’t definitive
- Early detection of suspected Ebola cases is crucial to prevent viral ...
Dr. Jessica Pelletier and Noah Kronk speak with Dr. Stephen Liang, an emergency medicine physician and infectious disease expert, about the diagnosis and management of mpox in the ED setting.
Take-Home Points:
- Two clades:
- Clade 1 (Central Africa): classic, more severe disease
- Clade 2 (West Africa): subtle, non-classic presentations including genital/anal lesions and proctitis in the 2022 global outbreak
- Transmitted via expo...
Dr. Jessica Pelletier speaks with Ambrose Ndabahwerize, a nurse working in Uganda, regarding his first-hand experience working with mpox patients in a resource-limited setting.
Take-Home Points:
- Most cases of mpox are non-severe
- Treatment of mpox is primarily supportive
- Community education, isolation of suspected cases, and proper PPE access are key for preventing the spread of disease
Episode art attribution: image generated u...
In this special episode of ID4U, we move away from our focus on tropical medicine and instead discuss the non-profit Techies Without Borders (TWB). We learn the following:
- What does the TWB non-profit do?
- Why are the TWB volunteers passionate about their work?
- What is the Continuing Medical Education Solutions (CMES) initiative, and how does it work?
- How are donations used?
You can learn more about TWB here: https://techieswith...
Dr. Jessica Pelletier speaks with Dr. Emmanuel Effa, a nephrology expert, about tropical infections in chronic kidney disease (CKD) patients.
Take-Home Points:
- CKD and particularly end-stage kidney disease (ESKD) impose significant morbidity and mortality.
- Early recognition and management of CKD is critical to prevent progression to ESKD.
- Numerous tropical infections can increase the risk for AKI, CKD, and ESKD.
- Management typically...
Dr. Jessica Pelletier speaks with Dr. Emmanuel Effa, a nephrology expert, about tropical infections in chronic kidney disease (CKD) patients.
Take-Home Points:
- CKD and particularly end-stage kidney disease (ESKD) impose significant morbidity and mortality.
- Early recognition and management of CKD is critical to prevent progression to ESKD.
- Numerous tropical infections can increase the risk for AKI, CKD, and ESKD.
- Management typically...
Dr. Jessica Pelletier speaks with Dr. Ly Cloessner, a public health expert, about current malaria vaccines and the rollout process
Take-Home Points:
- Malaria can cause severe symptoms requiring emergency care and lead to significant morbidity and mortality worldwide.
- Malaria prevention includes the use of bednets, insecticide spraying, and antimalarial medications, especially for pregnant women and children in high-transmission are...
Dr. Jessica Pelletier speaks with Dr. Emmanuel Effa, a malaria expert, about diagnosing and managing severe malaria in the emergency setting.
Take-Home Points:
- Severe malaria is characterized by parasitemia plus 1 or more of the severe features we discussed - basically, signs of organ damage
- Kids are at higher risk of getting and dying from this
- These folks will often need resuscitation from an ABCDE standpoint
- Early recognition and...
Dr. Jessica Pelletier speaks with Dr. Brit Long, who recently published a review article on malaria for emergency clinicians, about uncomplicated malaria infection.
Take-Home Points:
- Malaria is a highly prevalent disease worldwide that causes millions of cases and hundreds of thousands of deaths, though improving prevention strategies are helping mitigate this
- Malaria can be asymptomatic, uncomplicated, or complicated; we covere...
In Part 2, Dr. Jess Pelletier speaks with Dr. Moses Kitakule about tuberculosis (TB) complications, including pulmonary and extrapulmonary emergencies and serious side effects of anti-TB medications.
Take-Home Points:
- There are a number of life-threatening pulmonary emergencies that can occur in active or latent TB patients due to structural lung changes, and we need to be ready to manage them
- Extrapulmonary TB can impact any orga...
In this episode, Dr. Jess Pelletier speaks with Dr. Emmanuel Effa about typhoid fever.
Take-Home Points:
- Typhoid fever is endemic in settings with water and sanitation issues
- In other places, it is more commonly imported from overseas when people visit endemic areas
- Typically, infected people present with varying degrees of fever, fatigue, headaches, abdominal pains and constipation/diarrhea. It can run a severe course that leads t...
In Part 1, Dr. Jess Pelletier speaks with Dr. Moses Kitakule about tuberculosis: epidemiology, pathophysiology, and diagnosis.
Take-Home Points:
- TB is a pathogen impacting only humans which infects about ⅓ of the globe
- Most cases of TB are latent and asymptomatic, but TB can reactivate at any time, particularly if a host becomes immunocompromised or highly exposed to TB
- Patients with active pulmonary TB may have fevers, night sw...
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