Piattaforma telematica multimediale per il supporto agli operatori sanitari dell Swaziland nella lotta alle patologie da malnutrizione

Brief description of project







A multimedia telematics platform for the exchange of clinical information and education dedicated to health workers in Africa have already been developed by the proponent . The platform will be tailored to the clinical needs of the Hospital of Siteki .



After testing on site, the system will provide support to a number of studies.







The general objective







The use of telematics platform will have an immediate effect on the ability to drive the activities of local health workers in the everyday clinics , to get excellence specialistic consulting in emergency situations and to lead a permanent teaching activity, aimed at improving the management of local health structures and release them gradually from the need for ongoing support by Italian operators .



It will also be used immediately as a support to a number of specific clinical studies.







Specific objectives







Start up of the electronic platform for the use of the platform in clinical practice and for educational purposes .



Implementation of specific clinical studies :







1 . Pharmacogenetic polymorphisms in genes CYP2A6 , CYP2B6 , CYP2C19 , CYP2D6 , CYP3A4 , CYP3A5 and MDR1 and their influence on the plasma concentrations of Efavirenz and Nevirapine in Swaziland



2 . Genetic polymorphisms and lipodystrophy associated with antiretroviral therapy in Swaziland. Correlation between polymorphisms of the POLG 1 gene encoding the catalytic subunit of the mitochondrial polymerase gamma and lipodystrophy in HIV-1 infected patients treated with nucleoside reverse transcriptase inhibitors ( NRTIs).



3 . Correlation between polymorphisms in genes involved in lipid metabolism and apoptosis and the onset of lipodystrophy associated with antiretroviral therapy.



4 . Study of the prevalence and molecular epidemiology of HTLV and HBV in HIV-positive patients in Swaziland.















Planned Activities







-development and engineering of the platforms developed



-implementation of customizations regarding the reality of the local Siteki Hospital ,



-transfer of software and hardware resources required for the functionality of the system



-testing of the system with on-site presence of operators of the Sacco Hospital



-start up of the clinical applications and teaching with training of health personnel who will work on site



-transfer of the activity on the platform in clinical practice and in a teaching permanent program



Quantization of the markers of hepatotoxicity by measuring plasma concentrations of Efavirenz and Nevirapine in different times



-Analysis of gene polymorphisms POLG1 in patients treated with NRTIs with lipodystrophy and in a control group without lipodystrophy



-Analysis of polymorphisms of APOC3 genes , Fas , ARβ2 , ARβ3 and PPAR in patients on HAART with lipodystrophy and a group of control patients without lipodystrophy.



-Molecular characterization of the S and P genes of HBV viral DNA in HIV / HBsAg -positive in Swaziland



-Molecular characterization of isolates of HTLV- 1 from HIV / HTLV -Ab positive in Swaziland











Expected Results







The online platform will enable the permanent connection between Sacco Hospital and the Hospital of Siteki , from one side to rationalize the health in the African district , with the development of an incremental clinical database , on the other hand to support the growth of knowledge of hygiene and care of the local operators , in a perspective of real and effective co-development.



In addition, these studies will allow:



- Monitoring the hepatotoxicity of some antiretroviral drugs in HIV-infected patients in antiretroviral treatment , with special focus on HIV-positive pregnant women



- Assisting in the identification of correlated genetics related to HIV-related lipodystrophy in patients on antiretroviral treatment , with special focus on HIV-positive pregnant women



- Monitoring the epidemiological trend of HBV infection and HTLV in HIV-positive population in Swaziland , with special focus on HIV-positive pregnant women



- Spillover effect on the people of Milan in terms of information and awareness on international cooperation and on the issues of food security







The experience gained over the years working in Africa has brought the project to the awareness of the importance of human awareness in relation to both international cooperation, both in respect of the extra-EU people living in our area. The extra- HIV seropositive extra-EU subject is the representation of the extreme marginalization in solitude and abandonment by friends and institutions.



In addition to the work done in Swaziland , the project is therefore active in the region in the context of information and awareness through fruitful collaborations with organizations such as, for example, ANLAIDS Lombardia Section, which organizes meetings to raise awareness on the subject of HIV / AIDS in many areas, from prisons to secondary schools .