Tuesday, August 30, 2016

(LML) detection of autoantibodies in leprosy

 

Leprosy Mailing List – August 30,  2016

Ref.:    (LML) detection of autoantibodies in leprosy

From:  Ben Naafs, Munnekesburen, the Netherlands


Dear Pieter,

 

I read the question of dr Jingquan Wang (LML, August 26, 2016). The presence of auto antibodies is well known in Leprosy, even after “cure” they often stay present. In elderly people, I think these patients are elderly, ANA’s are often positive without any significance. You should exclude collagen diseases naturally. Concerning anti thyroid antibodies the same applies. AST can be positive after any infection and I think these patients may have had quite a number, including erysipelas.

I agree with not treating these old patients. These findings do not implicate active leprosy disease.

 

With regards,

 

Dr Ben Naafs


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) NERVE CONDUCTION STUDIES OF THE TIBIAL NERVE ACROSS THE TARSAL TUNNEL IN LEPROSY PATIENTS

Leprosy Mailing List – August 30,  2016

Ref.:    (LML)  NERVE CONDUCTION STUDIES OF THE TIBIAL NERVE ACROSS THE TARSAL TUNNEL IN LEPROSY PATIENTS

From: Jose Antonio Garbino, Bauru, Brazil


Dear Pieter and readers of LML,

 

This paper have just be published in English and Portuguese in the Hansen Int journal. It is also available in this link: http://www.ilsl.br/revista/atual.php

 

ABSTRACT

The authors assessed all tibial nerve conduction studies (NCS) of the patients suspicious of acute or subacute leprosy neuropathy, who have been attended the Leprosy Ambulatory Clinic of the ILSL, Bauru, Brazil, during a period of two years. Seventy-five patients have been included as follows: 52 male and 23 female, between 21 and 73 years old, with the mean age of 44.5 totaling 150 nerves. The medial plantar (MP) and lateral plantar (LP) branches were studied separately. The most involved was the LP with 57.4%, followed by the MP with 42.6%. The most frequent injury among the abnormal nerves was the axonal lesion with 66%, followed by the myelin lesion with 28.7%. The most frequent and disproportional involvement of the LP branch not only demonstrates the compressive character of the tibial nerve injury in the tarsal tunnel but also indicates a multiple entrapment mononeuropathy in the lower limbs. The high prevalence of the tibial nerve injury was considered a hallmark of the disease, as well as the ulnar neuropathy.

 

Thank you,

 

Garbino

 

Jose Antonio Garbino, MD, PhD, Clinical Neurophysiology

Research Institute “Lauro de Souza Lima’, Bauru/SP

 


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, August 26, 2016

(LML) Bunnel's splint - for leprosy patients

Leprosy Mailing List – August 26,  2016

Ref.:  (LML)  Bunnel's splint - for leprosy patients

From:  Karthikeyan, Allahabad, India


Dear LML readers,

 

I am an Occupational therapist working at one of the hospital of The Leprosy Mission Trust India.

We are in need of Bunnell splint. This splint is very effective in releasing the PIP joint contracture, which is one of the common secondary impairment seen in leprosy due to claw hand deformity.

We don't get this splint in India. 

We would be grateful if any LML readers or anyone who will be attending the 19th ILC at Beijing to bring some of these splints during the conference and we will be happy to buy from them.

I will be attending the conference and pay money in cash.

 

Thanking you,

 

With kind regards, 

 

Karthikeyan

Occupational therapist,

The Leprosy Mission Hospital Naini,

Allahabad - 211008, Uttar Pradesh,

India.

email: karthikeyan.g@leprosymission.in


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) detection of autoantibodies in leprosy

Leprosy Mailing List – August 26,  2016

Ref.:    (LML) detection of autoantibodies in leprosy

From:  Jingquan Wang, Zhejiang, China


 

Dear Pieter,

 

Greeting from Zhejiang,China.

I have examined 43 leprosy cured cases in our leprosy colony. I found over 1/3 leprosy cases with positive antinuclear antibodies, whereas there is no anyone with positive syphilis antibodies(TRUST and  TP-RT). I also found  3 cases with positive thyroid auto antibodies and 9 cases with positive anti-streptolysin o test. I am confused with the results. Are there any clinic meaning of these antibodies for cured leprosy cases? Should I take some measures  to treat the aged cured leprosy cases? I wish LML readers can give me some suggestions and explanation?

 

Best regards.

Jingquan Wang

Bachelor of Medicine(MB),Chief Physician

Institute of Dermatology of Zhejiang Province,

No. 61,Wuyuan Street,Wukang, Deqing,313200,

Zhejiang,P.R.China

Under-Secretary-General of China Leprosy Association

Tel:86-572-8296002

Fax:86-572-8078115

E-mail:wjingquan@126.com  767790635@qq.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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Monday, August 15, 2016

(LML) New publications on cross-cutting issues and NTDs.

Leprosy Mailing List – August 15,  2016

Ref.:  (LML)   New publications on cross-cutting issues and NTDs.
August 2016

From:  Anneke Taal, Amsterdam, the Netherlands


Dear Pieter,

 

Greetings from InfoNTD!
 
In this newsletter you will find a selection of news items and recent publications on cross-cutting issues in NTDs. Feel free to contact me with any questions or to receive the full text versions if a link to the full text is not included.


Kind regards,
 
Anneke Taal
InfoNTD Information officer

 

infontd@leprastichting.nl

 

 

News

 

 

CallSeeking Case Studies on WASH-NTDs
The Knowledge Dissemination and Analysis task team of the NNN WASH Working Group would like to collect your experiences on integrating WASH and NTDs. The WHO has developed a template to collect case studies. Please complete
this template to share your experience with the wider NTD and WASH communities and send the completed template to: wash-ntds@fhi360.org by August 30!
Download Instructions
Download Template

News from the WHO:
The launch of Tropical Data
Tropical Data, an initiative led by the WHO, provides an end-to-end epidemiological survey support service – from planning and protocol development to training, data processing, health ministry review and approval, and through to application of the survey outputs – to assist national neglected tropical disease programmes. Initially, Tropical Data will focus on supporting trachoma prevalence surveys, but discussions to broaden its remit are already under way.
Download brochure

News:
One drug is 'new hope' hope for three killer infections by James Gallagher
It has been described as a "new hope" for tackling the parasitic infections which affect millions of people
in the poorest parts of the world. The discovery, reported in the journal Nature, was made by testing three million compounds. The new drug is now entering safety tests before human trials. The three diseases are all caused by similar parasites, leading scientists to believe one therapy might be useful against the trio (Sleeping sickness, Chagas disease and leishmaniasis).

Blog: 
The most dangerous enemies of humanity by Krisztian Magori. 
Arthropod-borne diseases, such as Lyme disease and the Zika virus, seem to be emerging and re-emerging at an alarming rate in the last few years. In this post, we discuss how the technological progress and promise of modern medicine and biotechnology, which has saved countless lives already, contrasts with the continual problems caused by the rapid changes in our world, the lack of political will to provide funding to develop new and implement existing solutions, and the simple lack of public awareness and support.  
 

 

 

New publications

 

 

Major parasitic diseases of poverty in mainland China: perspectives for better control.
Wang J-L, Li T-T, Huang S-Y, et al. Infect Dis Poverty. 2016; 5(1): 67.
Abstract Significant progress has been made in the prevention, control, and elimination of human parasitic diseases in China in the past 60 years. In this article, we review the prevalence rates, geographical distributions, epidemic characteristics, risk factors, and clinical manifestations of parasitic diseases of poverty listed in the first issue of the journal Infectious Diseases of Poverty on 25 October 2012.
Download PDF


The United States and Mexico: addressing a shared legacy of neglected tropical diseases and poverty.
Herricks JR, Matthews KRW, Hotez PJ. James A Baker III Institute for Public Policy. 2016. Report.
Abstract This report reviews the impact and prevalence of NTDs in the United States and Mexico. This report also will address key policy challenges and make recommendations for reducing NTDs in these two countries. Reducing the multifaceted impact of NTDS will require coordinated policies between these two countries that focus on preventive measures and access to therapies as well as the development of new treatments and vaccines.
Download PDF


Ethical considerations for the creation of a national neglected tropical disease policy.
James A Baker III Institute for Public Policy: Iltis AS, Matthews KRW.  2016: 23 p. Report
Abstract This report highlights some of the central ethical issues pertaining to NTD policy development and argues that ethical considerations should be included in the policy development process. We conclude that the United States should develop an NTD policy to further reduce the prevalence and impact of NTDs both within and outside our border.
Download PDF


Sustaining progress towards NTD elimination: an opportunity to leverage Lymphatic filariasis elimination programs to interrupt transmission of soil-transmitted helminths.
Means AR, Ásbjörnsdóttir K, Mwandawiro C, et al. PLoS Negl Trop Dis. 2016; 10(7): e0004737. 
Abstract A concomitant reduction in STH infection raises the possibility of moving beyond current World Health Organization (WHO) morbidity control guidelines to actual disease elimination for STHs. We identtify specific rationale, opportunities, and challenges associated with leveraging existing LF elimination platforms for the purpose of interrupting STH transmission. 
Download PDF


Cost-effectiveness of scaling up mass drug administration for the control of soil-transmitted helminths: a comparison of cost function and constant costs analyses.
Turner HC, Truscott JE, Fleming FM, et al. Lancet Infect Dis. 2016; 16(7): 838-46. 
Abstract The coverage of mass drug administration (MDA) for neglected tropical diseases, such as the soil-transmitted helminths (STHs), needs to rapidly expand to meet WHO's 2020 targets. We aimed to compare use of a costfunction to take into account economies of scale to the standard method of assuming a constant cost per treatment when investigating the cost and cost-effectiveness of scaling up a STH MDA programme targeting Ascaris lumbricoides.
Download PDF


Promoting civic engagement with neglected tropical disease education.
Bonney KM. Braz. J. Biol. Sci.2016; 3(5): 93-103.
Abstract Neglected tropical diseases (NTDs) affect over one billion people globally creating a public health burden that has far reaching implications for the fields of economics, politics, sociology, and science. Educating students and the public about relevant risks, implications, and treatments is a key component of reducing the public health burden associated with NTDs.
Read abstract


The world's great religions and their Neglected Tropical Diseases.
Hotez PJ. PLoS Negl Trop Dis. 2016; 10(7): e0004544.
Abstract New information based on data released by the World Health Organization (WHO) indicates that practically everyone infected with a major neglected tropical disease (NTD) lives in a Christian-, Muslim-, or Hindu-majority nation. The finding has implications for engaging religious leaders in NTD control and elimination activities.
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Awareness of transmission, complications and protective measures against schistosomiasis among paddy cultivators.
Msigala AR, Matuja SS. Intern Med. 2016; 6(3): 1-4.
Abstract Schistosomiasis infection is among the neglected tropical diseases seen in Sub-Saharan Africa causing acute and chronic infection by the trematode worms. Paddy farming and livestock keeping are major economic activities in Africa. Information is lacking on this target groups’ relationship to schistosomiasis infection. The aim was to assess the awareness of schistosomiasis transmission, complications, and protective measures among pad cultivators.
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The role of gender in Chagas disease prevention and control in Honduras: an analysis of communication and collaboration networks.
Triana DRR, Mertens F, Zúniga CV, et al. Ecohealth (2016). 
Abstract In Honduras, where Chagas disease is a serious health and environmental concern, prevention measures face the challenge of achieving widespread and long-term sustainable adoption by communities. The article integrates social network analysis and a gender-sensitive approach to understand the role of men and women in the implementation of a community- level intervention, based on the the adoption of housing improvements to reduce the presence of the insect vector. 
Read abstract


Dilemmas of community-directed mass drug administration for lymphatic filariasis control: a qualitative study from urban and rural Tanzania.
Kisoka W, Mushi D, Meyrowitsch DW, et al. J Biosoc Sci. (2016).
Abstract There has in recent years been a growing interest in the social significance of global health policy and associated interventions. This paper is concerned with neglected tropical disease control, which prescribes annual mass drug administration to interrupt transmission of, among others, lymphatic filariasis. 
Read abstract


Human rabies survivors in India: an emerging paradox?
Subramaniam Mani R. PLoS Negl Trop Dis. 2016; 10(7): e0004774. Viewpoints
Abstract On a particularly hot afternoon early last year, a couple—barefoot and in tattered clothes—walked into the emergency services at the National Institute of Mental Health and Neurosciences (NIMHANS), a public neurocare hospital in Bangalore, India. The woman held a sick child in her arms and her male companion followed with two more children in tow.
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Onchocerciasis along Anambra River System of Kogi State, North Central Nigeria.
Odo GE, Ekeh FN, Agwu EJ,et all. Transylv Rev. 2016; 24(7).  
Abstract The high transmission in Nigeria has been attributed to misconceptions of the disease by several cultural groups which led to neglect of personal protection against the disease vector and non compliance of infected individuals to treatment regime.  People in Kogi State attributed the disease to witchcrafts (hence, a superstitious disease) while others attribute it to a repercussion of sins committed by one’s ancestors in the distant past (a repercussive disease). 
Read abstract


Low prevalence of ocular chlamydia trachomatis infection and active trachoma in the western division of Fiji.
Macleod CK, Butcher R, Mudaliar U, et al. PLoS Negl Trop Dis. 2016; 10(7): e0004798. 
Abstract Trachoma is the leading infectious cause of blindness and is caused by ocular infection with the bacterium Chlamydia trachomatis (Ct). While the majority of the global disease burden is found in sub-Saharan Africa, the Western Pacific Region has been identified as trachoma endemic. Population surveys carried out throughout Fiji have shown an abundance of both clinically active trachoma and trachomatous trichiasis in all divisions.
Download PDF


Schistosomiasis and soil-transmitted helminth infections in schoolchildren in north-eastern Democratic Republic of Congo.
Knoblauch AM, Archer C, Owuor M et al. Trans. R. Soc. Trop. Med. Hyg. 2016; 110(7): 424-6.
Abstract There is a paucity of epidemiological data pertaining to schistosomiasis and soil-transmitted helminth (STH) infections in the Democratic Republic of the Congo (DRC).  A cross-sectional survey was carried out in the north-eastern part of DRC enrolling 400 schoolchildren aged 9-14 years. 
Read abstract


A centenary of Robert T. Leiper's lasting legacy on schistosomiasis and a COUNTDOWN on control of neglected tropical diseases.
Stothard RJ, Kabatereine NB, Archer J,et al. Parasitology. 2016: 1-11. 
Abstract Part of Robert T. Leiper's (1881-1969) lasting legacy in medical helminthology is grounded on his pioneering work on schistosomiasis (Bilharzia). Having undertaken many expeditions to the tropics, his fascination with parasite life cycles typically allowed him to devise simple preventive measures that curtailed transmission. Building on his formative work with others in Africa and Asia, and again in Egypt in 1915, he elucidated the life cycles of African schistosomes. 
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Drug repositioning approaches to parasitic diseases: a medicinal chemistry perspective.
Ferreira LG, Andricopulo AD. Drug Discov. Today. (2016)
Abstract Identifying new indications for clinically useful drugs is a worthwhile approach for neglected tropical diseases. The number of successful repurposing cases in the field is growing as not-for-profit organizations, in association with academia and pharmaceutical companies, enable screening campaigns for the identification of new repositioning candidates. Current programs have delivered encouraging results as the use of state-of-the-art technologies, such as genomic and structural biology tools, and high-throughput screening platforms have become increasingly common in infectious disease research.
Read abstract


Prevention of disability 


People with disabilities working in the disability sector in Timor Leste: a study of ‘lived experience’ using PhotoVoice
Shamrock J, Smith N, Gray M, Cameron M, Oprescu F. Third World Quarterly. 2016: 1-17. 
Abstract Perspectives on disability originating from non-Western cultures are beginning to appear in disability literature, however discussions may become lost in rhetoric unless grounded in experiences of people with disabilities themselves. The purpose of this study was to investigate the lived experience of physical disability in Timor Leste with the assistance of a group of Timorese participants with disabilities who were employed in the disability sector.
Abstract 


Prevalence of leprosy-related disability in Bangladesh
Butlin RC, Kundu K, Hossain D, et al. Lepr Rev. 2016; 87(2): 264-66.  
Abstract Disability due to leprosy often lasts lifelong, so estimates of the burden of leprosy in a community based on ‘registered prevalence of leprosy cases’ or on ‘proportion with Grade 2 disability amongst new cases in past year’ will seriously underestimate the number of disabled people in the community needing support or services. In a previously highly endemic are of Bangladesh, the accumulated prevalence of disability due to leprosy amongst adults was 45·35/100,000 population.
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Rapid assessment of disability in the Philippines: understanding prevalence, well-being, and access to the community for people with disabilities to inform the W-DARE project.
Marella M, Devine A, Armecin GF, et al. Population Health Metrics. 2016; 14(26) 1-11. 
Abstract International recognition that people with disabilities were excluded from the Millennium Development Goals has led to better inclusion of people with disabilities in the recently agreed Global Goals for Sustainable Development (SDGs) 2015–2030. Given the current global agenda for disability inclusion, it is crucial to increase the understanding of the situation of people with disabilities in the Philippines. The aim of this study was to estimate the prevalence of disability and compare the well-being and access to the community between people with and without disabilities.
Download PDF


Cultural understanding of wounds, Buruli ulcers and their management at the Obom sub-district of the Ga south municipality of the Greater Accra Region of Ghana.
Koka E, Yeboah-Manu D, Okyere D, et al. PLoS Negl Trop Dis. 2016; 10(7): e0004825. 
Abstract This study was conducted with the aim to understand some of the cultural belief systems in the management of wounds and patients practices that could contaminate wounds at the Obom sub-district of the Ga South Municipality of Ghana.
Download PDF


Lipid-based nanocarriers for cutaneous leishmaniasis and Buruli ulcer management.
Simões S, Carvalheiro M, Gaspar MM. Curr. Pharm. Des.(2016).
Abstract Currently, progresses and challenges in constructing nanocarrier platforms for delivering various antimicrobial drugs for infected skin lesions have been attempted. This article reviews the potential of these nanocarriers in the treatment of cutaneous infections, especially regarding mycobacteria and Leishmania induced skin lesions.
Read abstract


WASH


The potential of positive deviance approach for the sustainable control of neglected tropical diseases.
Ong KIC, Araki H, Kano S, Jimba M. Trop Med Health. 2016; 44(20): 1-3. 
Abstract Neglected tropical diseases (NTDs) have gained much attention in recent years due to the support from various agencies. However, the main approach to combat NTDs has been to cure rather than to prevent. As many NTD infections are closely linked with human behaviors such as hygienic practices and tradition, behavior change is also very crucial to prevent relapse or reinfection. Therefore, we would like to suggest a potential new approach-the positive deviance approach-to tackle NTDs by focusing on the preventive phase. 
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The impact of a rural sanitation programme on safe disposal of child faeces: a cluster randomised trial in Odisha, India.
Freeman MC, Majorin F, Boisson S, et al. Trans. R. Soc. Trop. Med. Hyg. 2016; 110(7): 386-92. 
Abstract Unsafe disposal of child faeces is persistent and may lead to considerable impact on the health of young children. Research is limited on the impact of sanitation or hygiene interventions to improve child faeces disposal practices. In the context of a randomised controlled trial to assess the health impact of a programme in Odisha, India, to promote rural sanitation under the Government of India's Total Sanitation Campaign, we explored whether the intervention affected the safe disposal of faeces of children under-5 years of age.
Read abstract


Soil contamination with soil-transmitted helminthes in schools and play areas of Kermanshah City, west of Iran.
Mohaghegh MA, Vafaei MR, Azami M, et al. Int J Infect. (2016).  

Abstract Geohelminth infections are common infections worldwide. These helminthes are parasitic nematodes, which could infect humans and animals by contact with eggs or infective larvae and in some cases cause serious disorders, especially in children.The present study was designed to evaluate the prevalence of geohelminth eggs in the soil of schools and play areas of Kermanshah city, western Iran.
Download PDF


Data collection, mapping and indicators


Estimating dengue transmission intensity from case-notification data from multiple countries.
Imai N, Dorigatti I, Cauchemez S, Ferguson NM. PLoS Negl Trop Dis. 2016; 10(7): e0004833. 
Abstract
 Despite being the most widely distributed mosquito-borne viral infection, estimates of dengue transmission intensity and associated burden remain ambiguous. With advances in the development of novel control measures, obtaining robust estimates of average dengue transmission intensity is key for assessing the burden of disease and the likely impact of interventions.
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Evaluation of the control of West Nile virus in Ontario: did risk patterns change from 2005 to 2012?
Thompson M, Berke O. Zoonoses Public Health. (2016).
Abstract The goal of this study was to evaluate and compare the risk distribution of human cases of West Nile virus (WNV) disease in Ontarioin 2005 to 2012. The objectives were to: map the risk distribution of WNV in 2005 and 2012, identify clusters of human WNV disease and determine whether the clusters are significantly different between the years 2005 and 2012.
Read abstract


A Comparison of four methods of diseases mapping.
Yang, C. Lund: Lund University, Dept of Phys Geogr and Ecosys Science. 2016: 46p. Thesis
Abstract Disease susceptibility mapping can produce risk maps showing predictive distribution of disease incidences. Hence, it is a useful tool for disease prevention. In this study, four data-driven models: logistic regression (LR), backpropagation neural network (BPNN), radical basis functional link nets (RBFLN) and general regression neural network (GRNN) for disease susceptibility mapping were implemented using Python.
Download PDF


The schistosomiasis clinical trials landscape: a systematic review of antischistosomal treatment efficacy studies and a case for sharing Individual Participant-Level Data (IPD).
Julé AM, Vaillant M, Lang TA, et al. PLoS Negl Trop Dis. 2016; 10(6): e0004784. 
Abstract Schistosomiasis control mainly relies on preventive chemotherapy with praziquantel (PZQ) distributed through mass drug administration. With a target of 260 million treatments yearly, reliably assessing and monitoring efficacy is all-important. Recommendations for treatment and control of schistosomiasis are supported by systematic reviews and meta-analyses of aggregated data, which however also point to limitations due to heterogeneity in trial design, analyses and reporting. Some such limitations could be corrected through access to individual participant-level data (IPD), which facilitates standardised analyses.
Download PDF


Health systems factors


Inequality and inequity in healthcare utilization in urban Nepal: a cross-sectional observational study.  
Saito E, Gilmour S, Yoneoka D, et al. Health Policy Plan. 2016; 31(7): 817-24.
Abstract Inequality in access to quality healthcare is a major health policy challenge in many low- and middle-income countries. This study aimed to identify the major sources of inequity in healthcare utilization using a population-based household survey from urban Nepal. A cross-sectional survey was conducted covering 9177 individuals residing in 1997 households in five municipalities of Kathmandu valley between 2011 and 2012.
Download PDF


A systematic review of the literature


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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Sunday, August 14, 2016

(LML) WHO Goodwill Ambassador's Newsletter No.80 Issue

Leprosy Mailing List – August 14,  2016

Ref.:    (LML) WHO Goodwill Ambassador's Newsletter No.80 Issue

From:  Hiroe Soyagimi, Tokyo, Japan 


 

Dear Dr Schreuder and Friends,

 

Warm greetings from Sasakawa Memorial Health Foundation in Tokyo. 

We have uploaded our latest edition of "WHO Goodwill Ambassador's Newsletter No.80 Issue" to our website. 

Please visit http://www.smhf.or.jp/e/ambassador/index.html 

to obtain electronic version of this issue. 

 

In this issue we feature articles about ...

Message:     The Wheels of a Motorcycle

Global Leprosy Strategy 2016-2020:   Going Forward Faster

Report:    Getting Down to Business  

Interview:   Grounds for Optimism                  

Feature:   From Spain to the World                             

Ambassador's journal: Checking on Progress

News: Beijing Readies for ILC 2016

From the Editors:   Our Shared Vision  

 

We hope you enjoy our latest Newsletter!

 

Hiroe Soyagimi 

Sasakawa Memorial Health Foundation

*********************************************************

Sasakawa Memorial Health Foundation

Tel03-6229-5377 

Fax03-6229-5388

email: smhf@tnfb.jp

visit our website at http://www.smhf.or.jp/

facebook  https://www.facebook.com/smhftokyo


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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