Current Perspectives and Unmet Needs of Primary Immunodeficiency Care in Asia Pacific.

Abstract

Background: The Asia Pacific Society for Immunodeficiencies (APSID) conducted nine primary immunodeficiency (PID) Schools in 5 years since inauguration to provide PID care training for early career physicians in Asia Pacific, a region with divergent needs in PID resources and training. Objective: To identify differences in PID patient care resource and training needs across Asia Pacific and propose a corresponding action plan. Methods: The Human Development Index (HDI) indicates the degree of socio-economic development in each country/region. Information related to investigations and learning issues were extracted from the abstracts and personal statements from all Schools and mapped onto resource and training needs. Correlations between HDI and country/region-specific parameters were tested by two-tailed Pearson correlation. Results: A total of 427 abstracts were received in nine Schools between 2015 and 2020, predominantly on immunodeficiencies affecting cellular and humoral immunity. Genetic confirmation was described in 61.8% of abstracts, and its absence negatively correlated with HDI (r = -0.696, p = 0.004). Essential immunologic and genetic tests were not available in 25.4 and 29.5% of abstracts, respectively, and their absence negatively correlated with HDI (r = -0.788, p < 0.001; r = -0.739, p = 0.002). HDI positively correlated with average testing level (r = 0.742, p = 0.002). Cases from medium-HDI countries/regions focused on learning how to investigate a patient for PIDs in cases of severe or atypical infections, whereas those from very-high-HDI countries/regions, from which most faculty members originated, listed hematopoietic stem cell transplantation and gene therapy, newborn screening, and research as learning issues more frequently. Conclusion: There are unique HDI-related PID resource and training needs in each country/region. APSID proposes HDI group-specific strategies to improve PID care and education in her member countries/regions. Further quantitative analysis of needs in PID care in Asia Pacific is needed for lobbying governments to increase their support for PID care and research.

• Authors: Daniel Leung, Gilbert T Chua, Alric V Mondragon, Youjia Zhong, Le Nguyen-Ngoc-Quynh, Kohsuke Imai, Pandiarajan Vignesh, Narissara Suratannon, Huawei Mao, Wen-I Lee, Yae-Jean Kim, Godfrey C F Chan, Woei Kang Liew, Le Thi Minh Huong, Hirokazu Kanegane, Dina Muktiarti, Xiaodong Zhao, Fatima Johanna Santos-Ocampo, Amir Hamzah Abdul Latiff, Reinhard Seger, Hans D Ochs, Surjit Singh, Pamela P Lee, Yu Lung Lau
• Journal: Frontiers in immunology (Front Immunol) Vol. 11 Pg. 1605 ( 2020) ISSN: 1664-3224 [Electronic] Switzerland
• PMID: 32903579 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Leung, Chua, Mondragon, Zhong, Nguyen-Ngoc-Quynh, Imai, Vignesh, Suratannon, Mao, Lee, Kim, Chan, Liew, Huong, Kanegane, Muktiarti, Zhao, Santos-Ocampo, Latiff, Seger, Ochs, Singh, Lee and Lau.

Topics

• Asia (epidemiology)
• Delivery of Health Care
• Disease Management
• Disease Susceptibility
• Genetic Testing
• Geography, Medical
• Health Resources
• Health Services Needs and Demand
• Humans
• Immunologic Deficiency Syndromes (diagnosis, epidemiology, etiology, therapy)
• Primary Health Care
• Public Health Surveillance