Leprosy Mailing List Blog: April 2014

Saturday, April 26, 2014

(LML) ILEP survey research priorities of leprosy field workers

Leprosy Mailing List – April 27, 2014

Ref.: (LML) ILEP survey research priorities of leprosy field workers

From: June Nash, London, UK

Dear All,

Many thanks for all the help you gave me with this (LML August 31, 2013). Attached to this email is the paper that I presented at the recent ILEP Technical Commission. It fed in to our discussions about research and priorities. We are challenged to find solutions that help people in their daily work and also to communicate research findings to those working in the field.

Blessings,

June Nash

ILEP Technical Commission member

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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Tuesday, April 15, 2014

(LML) Summer School on Disability & Development in Indonesia

Leprosy Mailing List – April 16, 2014

Ref.: (LML) Summer School on Disability & Development in Indonesia

From: Wim van Brakel, Amsterdam, the Netherlands

Dear Pieter,

Could you please circulate the announcement below on list? The course is about disability in general, but uses quite a few examples from the field of leprosy. Thanks in advance for your help!

Summer School on Disability & Development in Indonesia

We are pleased to announce the fifth international Summer School on Disability & Development 2013 to be conducted at the Universitas Indonesia, Depok, Indonesia, from June 30th to July 25th, 2014. Please see the attached information for details. Participants can register via w.v.brakel@leprastichting.nl.

The Summer School is jointly organised by the Centre for Disability Studies, Faculty of Social and Political Sciences, Universitas Indonesia (UI), the Faculty of Public Health, UI, and the VU University Amsterdam. Persons interested to participate are strongly encouraged to register by May 15th at the latest.

The course is conducted in English medium. Past participants included members of Disabled People's Organisations, professionals from disability, rehabilitation or development organisations or government departments, managers or researchers, who wished to follow higher education in the field of disability.

I'm happy to announce that we are able to offer a 50% discount for all categories of students who register for the course before May 15th. The tuition fees payable would thus only be €950 per person for the 4-week course. We are unfortunately not able to sponsor airfares or board and lodging.

Best Wishes,

Wim van Brakel

Leprastichting / Netherlands Leprosy Relief (NLR)

E-mail: W.v.Brakel@Leprastichting.NL

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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(LML) Opportunities for individuals from abroad, special visiting researcher, young talents, science without borders program, Brazil

Leprosy Mailing List – April 16, 2014

Ref.: (LML) Opportunities for individuals from abroad, special visiting researcher, young talents, science without borders program, Brazil

From: Alberto Novaes Ramos Jr, Fortaleza, Brazil

Dear Pieter,

We would like to draw urgen attention to the science without borders program from Brazil. Among the LML readers there must be persons interested in this scholarship.

The scholarship program for "Special Visiting Researcher" aims to attract a senior foreign researchers recognized internationally as leadership in priority areas of Science Without Borders program, to conduct projects with Brazilian research groups and visit Brazil for up to three months each year over two to three years.

The program also provides scholarships for Brazilian students to doctoral and postdoctoral keep projects in Brazil and abroad. The benefits of this fellowship include support for living expenses when the researcher is in Brazil as well funding for the local laboratory.

Areas Covered
The proposals for the Special Visiting Researcher program should be focused in the following areas:

Engineering and other technological areas
Pure and Natural Sciences
Health and Biomedical Sciences
Information and Communication Technologies
Aerospace
Pharmaceuticals
Sustainable Agricultural Production
Oil, Gas and Coal
Renewable Energy
Biotechnology
Nanotechnology and New Materials
Technology for prevention and mitigation of natural disasters
Biodiversity and bioprospection
Marine Sciences
Minerals
New technologies for constructive engineering
Formation of technical personnel

Benefits
The fellowship will cover the period from 12 to 36 months and the benefits are:

R$ 14,000.00 (fourteen thousand reais, about seven thousand five hundred US dollars) per month for living expenses;
Research grants in maximum amount of R$ 50,000.00 (fifty thousand reais, about twenty eigth thousand US dollars) per year;
Flight tickets;

Additional scholarships can be obtained: post-doctoral scholarships in Brazil for the maintenance of the research during the absence of the visiting researcher and PhD scholarships (sandwich) abroad to Brazilian researchers to follow the visiting researcher in his country. These scholarships should be provided in the research project and requested on the application form.

Submission
The proposal to receive a Special Visiting Researcher must only be submitted by the host researcher in Brazil, exclusively by internet, through the Online Application Form available in the website. It is necessary to attach a file with the research project and the candidate's Curriculum resume into Lattes Platform or the summary of the candidate's resume. New Public Call has been released in February, 5^th 2014. Finding a partner in Brazil, clicking here.

For the institutional proposals related to postgraduate programs in Brazil, recommended by CAPES, and corresponding to Line 1 on the previous calls, please click here for futherinformation. A specific call for projects linked to Postgraduate Programs will be available on the Programa Ciência sem Fronteiras website.

Submission Form, click here.

Proposals related to: a) Research Centers of the MCTI; b) National Institutes of Science and Technology (INCT); c) Research groups coordinated by researchers fellows of Productivity in Research (PQ) or technological development and innovative extension (DT), category 1 or 2 of CNPq researcher with equivalent profile; or d) Laboratories, research and development institutes or centers either public or private, please click here for the public call text. Submission Form, click here.

Young Talents

Young researchers working abroad with very good scientific accomplishments and who have excelled both qualitatively and quantitatively in their scientific or technological career are eligible to receive funding and resources to perform a two to three year-long research project in Brazil. The host research group would also receive funds, as a bench fee. An international call for proposals will be periodically and internationally disclosed. The program anticipates the availability of funds for at least 100 young researchers per year.

Expected candidate's profile
The scholarship program for "Young Talent Attraction" aims to attract young researchers living abroad, especially Brazilians, who have a highlighted scientific and technology production within the areas of interest to the Science Without Borders.

Covered Areas
Proposals for the Young Talent program must be focused on priority areas of the Science Without Borders Program, listed below:

Engineering and other technological areas
Pure and Natural Sciences
Health and Biomedical Sciences
Information and Communication Technologies
Aerospace
Pharmaceuticals
Sustainable Agricultural Production
Oil, Gas and Coal
Renewable Energy
Biotechnology
Nanotechnology and New Materials
Technology for prevention and mitigation of natural disasters
Biodiversity and bioprospection
Marine Sciences
Minerals
New technologies for constructive engineering
Formation of technical personnel

Benefits
The scholarship will cover the period of 12 to 36 months and the included benefits are:
Young Talent Researcher Level A

R$ 7.000,00 (seven thousand reais, about US$ 3.500,00) per month for living expenses;
Grant amounting to R$ 20.000,00 (twenty thousand reais, about US$ 10.000,00) per year;
Airline tickets; and
Accommodation aid amounting R$ 7.000,00 (seven thousand reais, about US$ 3.500,00).

Young Talent Researcher Level B

R$ 4.100,00 (about US$ 2.000,00) per month for living expenses;
Grant amounting to R$ 10.000,00 (about US$ 5.000,00) per year;
Airline tickets; and
Accommodation aid amounting R$ 4.100,00 (about US$ 2.000,00).

Submission
Only host researcher in Brazil can submit the proposal, exclusively by the Internet, through the Online Application Form, available in the website http://www.cienciasemfronteiras.gov.br/web/csf/jovem-talento3 .

When the research contributor submits the proposal, its necessary to attach to the form, a file with the research project and the candidate's Curriculum resume into platform lattes application or the summary of the candidate's resume. New Public Call has been released in February, 5^th, 2014. Finding a partner in Brazil, clicking here.

For any further questions you can contact Dr. Alberto Novaes Ramos Jr.

Regards,

Alberto Novaes Ramos Jr.

Departamento de Saúde Comunitária

Faculdade de Medicina - Universidade Federal do Ceará

Rua Professor Costa Mendes 1608 - Bloco Didático 5º andar - Rodolfo Teófilo

Fortaleza - Ceará, CEP: 60430-140

Tel/Fax: +55 85 3366-8045

E-mail: novaes@ufc.br / anramosjr@gmail.com

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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Wednesday, April 9, 2014

(LML) Comparing the Clinical and Histological Diagnosis of Leprosy Reactions in the INFIR Cohort of Indian Patients with Multibacillary Leprosy

Leprosy Mailing List – April 10, 2014

Ref.: (LML) Comparing the Clinical and Histological Diagnosis of Leprosy Reactions in the INFIR Cohort of Indian Patients with Multibacillary Leprosy

From: Piet Both, Apeldoorn, the Netherlands

Dear Dr Schreuder,

While preparing a presentation I came across a post at LML of 29 June 2012. Old stuff, 2012, but probably as relevant as ever. It is about: “Comparing the Clinical and Histological Diagnosis of Leprosy Reactions in the INFIR Cohort of Indian Patients with Multibacillary Leprosy” by Lockwood DNJ, Nicholls P, Smith WCS, D a s L, Barkataki P, van Brakel W and, Suneetha S (see attached file).

This very informative mail was posted, but if I understand well it did not receive any questions or comment at LML. The conclusion of this article is that ‘Leprosy reactions may be under-diagnosed by clinicians and increasing biopsy rates would help in the diagnosis of reactions. Future studies should look at T1R and ENL and whether they have impact on clinical outcomes.’ The author says that ‘The public health implication of this work is that leprosy centres need to be supported by pathologists to help with the clinical management of difficult cases.’

In the study in two respected centres in India there were 303 persons enrolled, newly diagnosed with MB leprosy. The study reveals a very significant difference between the clinical and histological diagnosis of leprosy, of Type 1 Reaction and Type 2 Reaction. There is a ‘substantial disparity between clinical and histological diagnosis of reactions’ with ‘reactions are more frequent than is clinically evident.’ (From the table’s in the article it seems that reaction is ‘much more’ frequent than is clinical evident.)

If this is true in the two centres in India the question arises what the reality will be elsewhere, in programmes in which health-workers see far less leprosy and will be less trained in the diagnosis of reaction than in centres where colleagues still see many persons affected by leprosy (and reaction). Increasing biopsy rates would help, but in which countries does that facility exist and what should programmes do when that facility does not exist? Are there examples of countries in which in recent years programmes have lobbied with in-country pathologists or out of country facilities and have acquired this kind of support? Such countries may need to share their success story.

Conclusions and recommendations of this paper:

- The study recommends studies, in order to establish diagnostic criteria that link the diagnosis of clinicians and pathologists more closely. Apparently there are different clinical definitions of T1R as well as for ENL and the ones used for this study are mentioned in the article. It might be important to find out whether in programs the best possible definition is used (and compare the ones used with the definitions in this study).

- It may be that patients with subclinical reactions would benefit from steroid treatment, says the study. But when and how and where will health-workers be able to diagnose subclinical reactions?

- The study also highlights ‘the importance of training doctors and health workers to specifically ask patients with LL and BL type disease about symptoms of ENL, such as new nodular lesions, bone pain, orchitis and fever’. This is probably the easiest recommendation to implement from this study.

- And then there is the conclusion that ‘health workers need to be trained to suspect reaction’. This is and should be possible when leprosy is still ‘high’ endemic, but in other programmes, in the absence of many cases, the health workers may be taught about reaction, but there is little chance to train.

- Finally, in this excellent study there is a call for robust referral systems and for adequate supplies of steroids in field stations and referral centres.

Is this where we are: a position in which still many reactions are not diagnosed, or will be diagnosed late, and in which clinical consequences like nerve impairment may be unavoidable and lives will be damaged because we are unable to diagnose this most important consequence in leprosy? To diagnose reactions early is the very reason, one most important reason, for the maintenance of leprosy control programs.

At the International Leprosy Congress there were a few publications only to support earlier diagnosis of reactions in leprosy. Dr Annamma John presented a paper re early detection by using first 0.2 gms Semmes Weinstein filaments for the palm and 2 gms for the soles before the usual 2 gms for palms and 10 gms for the sole were used. Of the 374 (PB and MB) persons tested 117 had sensory nerve function impairment and 22 of them were picked up by the 0.2 gms (palm) and 2 gms (sole). Does that help to close the gap a little between clinical and histological diagnosis differences in diagnosing reaction T1R? Or is testing with such sensitive filaments possible in referral settings only?

Will the testing of less usually tested nerves, the radial cutaneous and sural nerves help to diagnose more reactions (work presented by Wagenaar, Brandsma, Post and Nicholls at the International Leprosy Congress)?

There has been an extensive exchange of mails at LML about SW Mono-filaments last summer. Dr P. Narasimha Rao reported that a series of workshops were planned to train methods to identify Nerve Function Impairment early. It will be interesting to hear whether those who are trained have become more successful in closing that gap that exists between clinical and histological diagnosis.

And it will be interesting to hear from others, who received the monofilaments at the time of the ILC, whether the skill to diagnose NFI early has been improved.

A few other studies were presented at the ILC, about risk factors. If these factors would be generally known and understood, will this also increase the number of right diagnosis of reaction? The presentations about the risk factor were referring to laboratory investigations, which again are less accessible in many areas in which leprosy control takes place.

Can there be a word of encouragement by some of those who understand these matters better than I do? The reading of the study ‘comparing the clinical and histological diagnosis...’ left me a little in despair because of how much will be missed in diagnosis of this most serious complication of leprosy.

Yours sincerely,

Dr Piet Both

The Leprosy Mission International

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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Friday, April 4, 2014

(LML) Effectiveness of sensory re-education in leprosy

Leprosy Mailing List – April 5, 2014

Ref.: (LML) Effectiveness of sensory re-education in leprosy

From: Grace Warren, Sidney, Australia

Dear Pieter,

I am so glad that Piet Both sent that article about sensory re-education (LML April 1, 2014). I must confess that I have not tried hard to re-educate sensory perceptors but feel I must share the experiences I have now had for many years with re-education of motor nerves.

Back in the 1960s, when I was learning leprosy we concentrated on the patients doing hand exercises to maintain their ability to function after the damage to motor nerves in the hands. The therapists who came to us at the Hong Kong Leprosarium early in the 1960s had little idea of what would help so we developed a series of 7 exercises aimed at maintaining the usefulness of hands. We found that if applied early with adequate anti-inflammatory therapy these exercises often meant the patient regained the function of the hand and it was no longer obviously clawed or was not as badly clawed as initially, and did not deteriorate further while exercising was continued.

Many years later dealing with hand deformities due to other causes - i.e not leprosy - e.g. CMT (Charcot–Marie–Tooth disease, a group of disorders of the peripheral nervous system characterised by progressive loss of muscle tissue and touch sensation across various parts of the body) has a similar picture of a clawed hand - I found that many CMT patients were able to re-educate the hand muscles to a functional degree. In CMT they may never get full strength ( weak flexors) but were often able to improve at least lumbrical action so that without any surgery they could return to a normal looking functional hand. Several of my patients were able to resume office jobs working with pins and papers after a few months of exercise ( one patient achieved it in a few weeks!) and maintained that ability for many years.

These hand exercises are published in my Book" Care of neuropathic foot" which will soon be available in the web if you do not already have it, or copies of the exercises that have been published in several places. We have also made it into a DVD so we can give to any patient to whom it may be helpful so they can see the exercises and teach themselves.

With the CMT patients with foot involvement, whom I saw in the 1990s I discovered some very interesting facts. If, in the patient with a definite foot drop, we transferred Tib. Posterior to the dorsum as a dorsiflexor he often got return of effective dorsiflexion in other muscles on that foot. Certainly he appeared to get no further muscle loss in the anti tibial muscles. And if he exercised both legs he often prevented the complete drop developing in the other foot.

I found that if a patient was seen when the ant Tib. Muscles had weakened but still could produce a flicker, and was taught strengthening exercises and rested at night in a splint to prevent marked plantar flexion which stresses the anterior tibial muscles he could often restore a practical dorsiflexion. This was in contrast to the routine therapy to put on night splints which may prevent gross plantar flexion but do not encourage strengthening on the anterior tibial muscles. It was most satisfying to see a number of younger siblings prevent the development of a full drop even though their muscles were already weak when they presented as the time an elder sibling came for reconstructive surgery. One teenager, we operated on the bad foot - one foot only at mothers request- and the Physio took him in hand and within 6 months of surgery the other foot had recovered enough so he could resume football without any surgery.

One can only assume that in CMT and in Leprosy, the all the fibres of any one nerve are not affected, and often there are enough functioning fibres to use, if the patient can learn to think function . This is so opposite to the traditional idea in CMT “Oh give him a foot drop splint at night and toe raising devise by day- and no effort to make him use what he has got”. Work here in Australia has also shown the Vit C in large doses helps to reduce the amount of dysfunction in motor neural deficit in CMT. We found in Thailand that adequate doses of B1 per day helped maintain nerve function in areas were polished rice is the staple and little attention is paid to supplementing for the fact that the same fields have been cultivated for years and not adequately fertilised.

Yes, these are simple ideas and I must confess I do not have documented records of trials but it certainly works. I have many CMT patients here in Australia who are convinced that the vitamin and mineral cocktail ( we regularly order) makes all the difference, in some indefinable way, to their general well being. The same as we found in Thailand that a good Multivitamins and mineral, with Vit B1 at 10 mgs reduced symptoms and problems for many patients. Quite as few of them have benefited from the same tendon transfers we use for leprosy and are very grateful for the increased function and acceptability that they now have. Many of our leprosy patients come for areas were their diet in compromised and I have long recommended the use of a good multivitamin and mineral to help improve the whole of the patients well being.

I would be fascinated to hear of others who have tried this and have any statistics to support or contradict what I am saying.

Grace Warren

Previously Travelling Adviser Leprosy and Reconstructive Surgery for the Leprosy Mission Asia

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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(LML) Effectiveness of sensory re-education in leprosy

Leprosy Mailing List – April 5, 2014

Ref.: (LML) Effectiveness of sensory re-education in leprosy

From: Robert Jerskey, California, USA

Dear Pieter,

I enjoyed reading the two correspondences posted last Monday [LML March 24, 2014: Dr. Dinkar Palande and Mr. G. Karthikeyan, respectively]. I greatly appreciate all the well crafted details, including the table, Mr. Karthikeyan submitted. Very, very informative.

I was able to locate and peruse the full article on sensory re-education cited (Nakada M & Uchida H., "Case Study of a Five-stage Sensory Re-education Program". J Hand Ther, 1997; 10:232-239). Indeed, the patient described in their case study--who is blind--was with considerable sensory loss in her left hand, e.g., not able to perceive the thickest of the monofilaments: 300 gm level [filament index number, or FIN, 6.65]. That said, they report how the 5 stage sensory re education program, well elucidated in the article, achieves some degree of success with that leprosy patient. They mention in the conclusion that "the most effective techniques of sensory re-education involved discrimination of an object's characteristics or materials by utilizing step-by-step proprioception and input sensory information" [pg. 238].

I italicized the word "proprioception" earlier because, due to the significant degree of sensory impairment, that sensory modality may be key, whether the patient is visually impaired or not---as apparently is the case with Mr. Karthikeyan's patient. The latter part of that sentence, "input sensory information" appears to be what is being well implemented for the 23 year old student, including his home exercise program with the kit. And, as he is being followed in Naini, Allahabad with occupational therapy; purposeful therapeutic activities, a cornerstone of O.T., engages, among other functions, the proprioceptive.

To reference the other March 24th posting: Dr. Palande cogently closes his post, "purposive movements with a feedback are the key to recovery". I would see that as an essential for any sensory re-education program.

In the Americas, at the L.A. and San Diego clinics we have used a range of textures and common items/objects with patients with less degree of sensory impairment, ie., mild-moderate. I can appreciate how integral proprioception would be as a key modality for those who are not able to even perceive the 300 gm filament. We follow a 52 year old patient at the San Diego clinic who is not able to perceive that filament at any site in either hand, and he clearly has cultivated that modality to help compensate for deep pressure sensory impairment amidst his activities of daily living.

I don't have, unfortunately, any novel strategies to contribute to such a methodical program in Naini, Allahabad underway for patients as the 23 year old student, but I would like to encourage the inclusion of the use of the 200 mg [0.2 gm] monofilament [FIN 3.61]* for all patients who receive a sensory assessment for the hand. If that 200 mg filament----1/10th the peak designated force on the target area of the skin vs. the 2 gm monofilament [FIN 4.31]---is systematically utilized with the others, patients with nerve function impairment, whether via silent neuritis or acute neuritis, may be identified much earlier on, and treated accordingly with corticosteroids. Less likely to have residual long term sensory impairment, or worse.

I, again, extend my appreciation to Mr. Karthikeyan and his colleagues with the work, investigations they are carrying out with sensory re-education in leprosy patients---a challenging area with a paucity of published literature as a touchstone, unlike re: trauma or nerve repair.

Friendly greetings to all.

Thank you,

Robert

Robert S. Jerskey, LOTR, prevention of disability consultant

robjerskey@yahoo.com

*There have been a number of normative studies with the monofilaments on the hand [and the foot] in the Indian subcontinent over the years that have concluded that the 200 mg filament is the choice filament to begin the sequential order of graded monofilament testing for the hand**. With the exception of children, that was my conclusion for a normative study of 579 subjects in north and south India which I presented at the 1993 Congress in Orlando. I found the 70 mg filament [FIN 2.83] appropriate for children's hands.

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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(LML) Clinical Expert in Leprosy - Region of the Americas

Leprosy Mailing List – April 5, 2014

Ref.: (LML) Clinical Expert in Leprosy - Region of the Americas

From: Jim Oehrig, ALM, Greenville, USA

Dear Dr. Schreuder,

Greetings from your colleagues at American Leprosy Missions.

Please see the attached Clinical Expert in Leprosy - Region of the Americas Search Announcement.

Modeled after our current agreement with WPRO and Dr Gemma Cabanos, American Leprosy Missions will contract the to-be-identified clinical expert and second her/him to PAHO. The position is Brasilia based.

I request the attached announcement be circulated to the LML

Wishing you the best this day.

Sincerely,

Jim Oehrig

Chief Programme Officer

American Leprosy Missions
One ALM Way Greenville, SC 29601

Skype: jsoehrig
Direct: +1 864.241.1712 | Toll-free: 800.543.3135

Mobile +1 864.420.6033

j oehrig@leprosy.org | www.leprosy.org

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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Tuesday, April 1, 2014

(LML) Uniting to Combat Neglected Tropical Diseases: A Conversation on Progress webcast

Leprosy Mailing List – April 1, 2014

Ref.: (LML) Uniting to Combat Neglected Tropical Diseases: A Conversation on Progress webcast

From: Ilse Egers, Amsterdam, the Netherlands

Dear Dr. Schreuder,

Infolep received information about the Webcast on “Uniting to Combat Neglected Tropical Diseases”. This might be of interest for you. Please find more information about the Webcast below.

Dear Partners,

Thank you again for helping to share the Uniting to Combat Neglected Tropical Diseases: A Conversation on Progress webcast with your communities. We have an amazing group of partners who will ensure interested audiences around the world are able to join this important conversation.

I am writing to share an updated toolkit and share graphics. You can access the updated graphics here and the toolkit is attached. Given these changes, please only use this version of the toolkit and share graphics moving forward when promoting the webcast.

In particular, we wanted to flag that a new speaker has joined the panel, Dr. Onésime Ndayishimiye, National Director of the Neglected Tropical Disease and Blindness Control Program in Burundi.

Finally, with the event just days away, we encourage you to start promoting the webcast through your social media channels, website and email list (and continue to do so if you’ve already begun). We have included some sample tweets for you below and will be in touch later this week with additional updates.

Please let me know if you have any questions, and again, thank you for your support!

Stephanie Platis, MPH

Senior Associate

Global Health Strategies | New York

Office: +1 212.929.7888 ext. 29

http://www.globalhealthstrategies.com

Twitter @GHS

Here are a few sample tweets to help spread the word over the next couple days:

· Check out the #NTDprogress webcast on April 2 to hear how public & private sector leaders are combatting NTDs: bit.ly/CombatNTDs

· Join @gatesfoundation, @WHO, @WorldBank & others to talk about #NTDprogress during our global webcast on April 2: bit.ly/CombatNTDs

· Ask @gatesfoundation, @WHO, @WorldBank & others about #NTDprogress during our live webcast and Q&A on April 2: bit.ly/CombatNTDs

Kind regards,

Ilse Egers

Medewerker InfoLep / Information Office

Infolep Leprosy Information Services

Postbus / P.O. Box 95005

1090 HA Amsterdam

The Netherlands

Tel: +31 20 5950500

Mob:

E-mail: I.Egers@Leprastichting.NL

Web: www.leprosy-information.org

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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