May 24, 2018

Learning From The Best: Four Fellows Receive Clinical Diagnosis Training At Top Research Laboratory

HSP recently launched a Clinical Diagnostic Fellowship program to mentor select laboratory professionals from Indonesia on best practices for timely laboratory diagnosis and biorisk management of melioidosis. An infectious disease caused by the bacterium Burkholderia pseudomallei found in soil and water, melioidosis is endemic to South East Asia. It is currently the rainy season in Thailand and suspected cases are coming in to the hospital, providing unique learning opportunities for each of our four Fellows.

The following are real-time reports from our four fellows on site:

“I was selected as a Health Security Partners (HSP) Clinical Diagnostic Fellow for Melioidosis, and my mentoring period is from May 10-June 2, 2018 in Thailand.

It is such a great opportunity to learn about melioidosis from the experts at Mahidol Oxford Tropical Medicine Research Unit (MORU) laboratory in Sappasithiprasong Hospital, Ubon Ratchathani in Thailand. Currently, MORU Ubon Ratchathani is the leading unit in the world for clinical melioidosis research, and holds the largest collection of bacterial isolates in the world.

During the first week of my fellowship program, I was trained to properly isolate and identify B. pseudomallei by the head of the laboratory, Gumphol Wongsuvan. I practiced identifying the melioidosis pathogen, and learned how to properly store, transport, and discard the specimen.

The most important lesson I have learned during this training experience so far is that a laboratory does not need to be fancy or sophisticated to properly diagnose pathogens. Standard laboratories are very capable of producing top quality results, which can then be leveraged by policymakers. It is important, however, that each laboratory professional follows standardized quality control procedures and proper biosafety and biosecurity practices.”

“I’m Pepy from DR. Soetomo Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. I’m  one of the participants who was selected to join the melioidosis training at Sappasithiprasong Hospital in Ubon Ratchatani, Thailand, June 24 – July 14, 2018. I feel happy and very lucky to be selected as a participant of this training.

Sappasithiprasong Hospital is the largest hospital in the Province of North East Thailand, and it has a Melioidosis Laboratory that performs the diagnosis and research of B. pseudomallei.

I have benefited greatly from this training, as we have never found a case of melioidosis in my home  laboratory, which it is likely due to under-diagnosis. During this training, I have learned a lot about how to detect, isolate and identify B. pseudomallei from clinical samples and also from soil samples.

In addition, I also learned proper laboratory risk management to handle melioidosis samples, to make selective media for melioidosis isolation, as well as its quality control.

I was trained by the Head of the Melioidosis Laboratory at Sappasithiprasong Hospital, Mr. Gumphol Wongsuvan, a kind, highly experienced teacher and an expert in melioidosis.

Fortunately during the training, we found many cases of melioidosis from clinical specimens sent to this melioidosis laboratory, so we could practice how to detect B. pseudomallei from clinical specimens. From this training I realized that detection and identification of B. pseudomallei does not require a sophisticated tool, but it is very important for people working in the laboratory to have the knowledge and experience to do it.

Hopefully after this training I can increase my laboratory capacity in detecting melioidosis from the patients and do surveillance to detect B. pseudomallei from the environment.”

“I was selected as one of two Fellows for the Health Security Partners (HSP) Clinical Diagnostic Fellowship for Melioidosis within the period of June 24th until July 14th, 2018. This fellowship program is conducted in Sappasithiprasong Hospital, Ubon Ratchathani in Thailand, specifically in Melioidosis Lab, handled by Mahidol Oxford Tropical Medicine Research Unit (MORU).

There is a limit to studying by ourselves. At a certain point, guidance is essential to tell us the right from the wrong, or to improve the right to be better. This is what I have experienced during my fellowship period. I have been trying to learn about melioidosis and isolate B. pseudomallei by myself in recent years, and I am very aware of my own limitations. That is why I am very thankful to finally have a mentor who can show me what to do.

These weeks have been very fulfilling. I have learned many things – more than I expected. I spent my first two weeks directly honing my knowledge and ability to isolate B. pseudomallei. This week, I learned to find B. pseudomallei from environmental samples, which is essential even after a diagnosis is made. Here, I realized that utilizing simple methods is more beneficial and approachable for many labs. It makes me think that, yes, we don’t need to complicate things using complicated methods to diagnose melioidosis, we just need to fully understand what we are doing and what to expect from the bacterial isolation process.

Now that I am in my last week of this fellowship, I have so many ideas and hopes inside my mind, waiting to be made real once I go back to my own hospital. Hopefully, in the near future, I will be able to promptly and accurately make the diagnosis of melioidosis, as well as give the right treatment for patients.”

“Hello, I am Maryati Surya. I am currently working at the Microbiology and Immunology Laboratory, Primate Research Center, Bogor Agricultural University, as a microbiologist. I am very grateful to be selected as one of the participants for the HSP Clinical Diagnostic Fellowship for Melioidosis in Indonesia. This is a big opportunity to have Melioidosis mentoring at the Microbiology Laboratory, Mahidol-Oxford Tropical Medicine Research Unit (MORU), Sappasithiprasong Hospital, Ubon Ratchatthani, Thailand.

The mentoring has been conducted by Gumphol Wongsuvan as a Microbiology Laboratory Manager of MORU.  He has many experiences with isolating and identifying Burkholderia pseudomallei causes of Melioidosis.  Training materials include preparation and quality control of media, isolation and identification from clinical and environmental (soil) samples, and proper biosafety and biosecurity B. pseudomallei management. After 2 weeks of mentoring, I realized that it is possible to develop a laboratory to handle B. pseudomallei at my institution. This can be conducted conventionally and does not require sophisticated equipment.

I believe through this fellowship that our center can provide better diagnostic tools for B. pseudomallei and also for other bacterials. I will be setting up the standard microbiology laboratory to help diagnose bacterial diseases in nonhuman primates and others animals.

I hope that together with the other fellows we can cooperate and build a stronger network for socializing and handling the case of melioidosis in Indonesia as a One Health program.”

HSP is grateful to our partners at Mahidol Oxford Tropical Medicine Research Unit (MORU) for hosting the Fellows.