BTRP training program in Central Asia: Experience in Kazakhstan and Uzbekistan

Central Asia is remarkable for its high incidence of infectious diseases caused by agents with biothreat potential. In 2000, there were 336 cases of human anthrax reported in Tajikistan, and over 3000 cases of human brucellosis reported annually in both Kyrgyzstan and Kazakhstan. However, these high numbers still underestimate the true incidence of especially dangerous pathogen (EDPs) infections occurring in the region. A large number of cases go undetected and unreported because of gaps in the disease surveillance systems of Central Asia that never used standardized case definitions or protocols for surveillance and outbreak investigation. The Biological Threat Reduction Program (BTRP) and the Centers for Disease Control and Prevention (CDC) began a program in 2004 to assist Kazakhstan and Uzbekistan establish an integrated system of disease surveillance and response known as the Threat Agent Detection and Response (TADR) project. Important components of the TADR project include trainings on pathogen-specific protocols and diagnostics, ensuring laboratory scientists are proficient in the principles of microbiology, immunology, and molecular biology, developing epidemiology training curriculum including instruction on electronic surveillance, and integration with the field epidemiology training program (FETP). The partnership between the Ministries of Health, BTRP, and CDC has resulted in many noteworthy successes. This talk will highlight CDCs efforts for implementing standardized case definitions for extremely dangerous pathogens, cohorts of epidemiologists trained to respond to and investigate EDP outbreaks, creation of nationally approved curricula for clinical health service providers, establishing continuing education credits for Post-medical Graduate Medical Institutes, and the creation and implementation of the EIDSS system that is being adopted by the host nations. This talk will present specific examples of how the TADR program has resulted in enhanced surveillance and epidemiology capacity in Central Asia, and improved detection capability for EDPs and other infectious diseases.