Bernstein, Charles N. MD, FRCPC*; Steffen, Robert MD, FFTM/ACTM† ‡
*Department of Internal Medicine, Section of Gastroenterology, University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Canada
†Division of Epidemiology and Prevention of Communicable Diseases, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland
‡WHO Collaborating Centre for Travellers' Health and Adjunct, Epidemiology and Disease Prevention Division, University of Texas School of Public Health, Houston, TX
Reprints: Charles N. Bernstein, MD, FRCPC, Section of Gastroenterology, University of Manitoba IBD Clinical and Research Centre, University of Manitoba, 804F-715 McDermot Avenue, Winnipeg, Canada (e-mail: email@example.com)
Conflict of Interest: None.
Each year on May 29, the World Gastroenterology Organisation (WGO) holds a World Digestive Health Day (WDHD) to raise awareness about a particular disease. The disease for 2010 has been inflammatory bowel disease (IBD), a disease that affects millions. The public health campaign which involves WGO's 110 national societies and 50,000-plus physicians is promoted throughout the world. WGO together with its Foundation compiles a list of resources, tools, and most importantly a corresponding Global Guideline. This year's IBD guideline, offered in English, Portuguese, Mandarin, French, Russian, and Spanish, provided clinical cascades for treatment at different resource levels. Other tools included tips for living with IBD, frequently asked questions on IBD by patients, important issues for physicians managing patients with IBD, and other material in e-WGN, WGO's e-newsletter. As Chair of the 2010 WDHD campaign, I worked to create these tools with the help of other IBD experts.
Digestive Disease Week, an annual event in the USA, included events focusing on both WDHD and IBD. An IBD Task Force was created and experts from all over the world presented on the disease from the view of their specific country. The epidemiology, phenotype presentations, diagnostics, therapeutics, and important differential diagnosis considerations were discussed. Planning was initiated for a Symposium held on 24th October at United European Gastroenterology Week in Barcelona where internationally renowned IBD investigators presented on nutritional issues in IBD, diagnostic testing in IBD and choosing between surgery and biological therapy in IBD.
Over 25 member societies took part in WDHD by hosting events throughout the year with over 50 events taking place. Various events focusing on IBD included public campaigns, courses and lectures on treatments of IBD, marathons, national meetings, press conferences, creating a country's own IBD Day or celebrating WDHD, publications, and much more. Here are some highlights from events that took place all over the world.
The Argentine Society of Gastroenterology held a press conference to increase media awareness, bringing in experts from Spain, the United States of America, and Argentina to assess IBD diagnosis, management, and treatment; held multiple courses offering new information on IBD; and created a public awareness campaign which was promoted on its website.
In India, experts successfully promoted IBD awareness in rural areas by offering both information and discounts on procedures such as colonoscopies throughout the month of May. The second national IBD meeting under the auspices of the Colitis and Crohn's Foundation (India) took place on May 23, 2010. This year, the Secretaries of all 3 major Gastroenterology societies of India held a program which included a ceremonial meeting, an IBD Symposium, and release of IBD patient awareness literature in Indian languages.
Under the patronage of the Ministry of Health in Syria, the Syrian Group for the Study of IBD, in collaboration with the Syrian Society of Gastroenterology, organized a WDHD event that highlighted IBD with the aim to raise awareness about the disease.
In Guatemala, a gala event to open the IBD awareness meeting was held, along with multiple newspaper publications to raise IBD awareness among the general public. The involvement of WGO's member societies is what has made WDHD 2010 a success.
LOOKING AHEAD TO 2011
Overcoming Enteric Infections: Clean Water, Clean Food, Clean Environment—Dr Robert Steffen, 2011 WDHD Chair
“Nearly 1 in 5 child deaths—about 1.5 million each year—is due to diarrhea. Today, only 39% of children with diarrhea in developing countries receive the recommended treatment, and limited trend data suggest that there has been little progress since 2000.”1 Enteric infections, however, occur not only in developing countries. In the United States, it is estimated that children below 5 years of age will have 2.2 episodes of diarrhea per year; in those above the age of 16 years this rate is still 1.7. German sources describe that one-third of the total population will have diarrhea at least once annually. There were some 16,000 deaths from diarrhea recorded in Europe in 2002.2 Lastly, travelers originating in industrialized countries must expect an incidence rate of travelers' diarrhea exceeding 20%, sometimes even exceeding 50%, during a 2-week stay in a developing country.3
The objective of the WDHD 2011 is to focus attention on the prevention and management of diarrheal diseases, to improve child survival in developing countries, and also to reduce morbidity and mortality in the industrialized world. Special attention will be given to at-risk travelers. Obviously, the strategies will vary in different parts of the world.
For instance clean water, clean food, and clean environment initiatives will play a greater role in less-developed, low-resource countries. Improvement of the infrastructure will reduce the risk of children developing the disease in the first place. The WGO's selection of the topic for the WDHD is timely: On July 28, 2010 the United Nations General Assembly declared access to clean water and sanitation a human right. In addition, vaccines will increasingly play a role in prevention. Still, reducing deaths “depends largely on delivering life-saving treatment of low-osmolarity oral rehydration salts and zinc tablets.”1
Although sanitation is not perfect everywhere in industrialized countries, even greater emphasis will be given here to the option of diarrheal prevention by vaccines, sometimes also by medication. Therapeutic guidelines will be propagated, and appropriate travel kits will be recommended to those planning to visit high-risk countries.
Thus, gastroenterologists worldwide as “Global Guardians of Digestive Health” are expected to greatly contribute to the global fight against enteric infections on May 29, 2011 and throughout next year.
1. UNICEF/WHO. Diarrhoea: Why Children are Still Dying and What can be Done. New York/Geneva: The United Nations Children's Fund (UNICEF)/World Health Organization (WHO); 2009:68.
2. WHO. The World Health Report: Changing History. Geneva: World Health Organization (WHO); 2004:96.
3. Ericsson CD, Melgarejo NA, Jelinek T, et al. Travelers' preferences for the treatment and prevention of acute diarrhea. J Travel Med. 2009;16:172–178.
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