Junior Member News – October 2013

Alexander Diaz Rodriguez, MD
Allergist. Professor of Immunology
Medical Center: Jose M Segui
Havana, Cuba

 

 

Allergology in Cuba. General overview and future perspectives.

Allergology in Cuba is a medical specialty officially accepted and financed by the Cuban government through the Ministry of Health (MINSAP). Allergy residency is developed in eleven medicine universities throughout the country, with a three year program, developed by a training curriculum valid from 1979 and modified, for the inclusion of doctors with a previous specialty, in 1992. The residency is three years long for doctors who have a previous medical specialty, like Pediatrics, Internal Medicine or General Integral Medicine (MGI), or a four year period for general doctors and for the auto-financed professionals; this program is currently been revised and updated.

 

Source: http://www.one.cu/EstadisticaPoblacion/EstadisticaPoblacion.asp (September 2012).

 

There are some specialized web pages where you can access medical information related to our specialty: the Cuban Allergology webpage:

http://www.sld.cu/sitios/alergia/ (created in 2008), allergen webpage:

http://www.sld.cu/sitios/alergenos/index.php, asthma webpage:

http://www.sld.cu/sitios/asma/ and immunotherapy webpage:

http://www.sld.cu/sitios/inmunoterapia/, all sponsored by the Cuban Society of Allergy, Asthma and Clinical Immunology (SCAAIC). These webpages and some others, from different medical specialties, all together belong to a national network for medical information (INFOMED) addressed at http://www.sld.cu/.

 

In Cuba, like in the whole world, the prevalence of allergic diseases is high and increasing. The prevalence of asthma in general population reached 9.2% in 2010. In the next table you can find the prevalence for children and adolescents according to the Cuban ISAAC (International Study of Asthma and Allergies in Childhood) study, developed in 2002-2004 (**).

 

Disease

6-7 years

13-14 years

Asthma

31.6%

17.6%

Allergic rhinitis

39.8%

38.5%

Atopic dermatitis

22.3%

14%

** Varona Pérez P, Fabré Ortiz D, Barroso Utra I. Asma, Rinitis y Eczema en niños y adolescentes cubanos.  Estudio ISAAC. Cuba 2002-2004. Available on URL: http://www.eaaci.net/site/content.php?artid=646.

 

In our country, like in most tropical nations with warm and humid weather conditions, house dust mites are the most prevalent and relevant allergens for allergic rhinitis and asthma. The most prevalent dust mites in Cuba are Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis. Other important but less studied allergens are the airborne fungi.

One of the most recent progresses in our specialty is the insertion, in all our allergy services, of the first standardized allergen vaccines (registered as VALERGEN) for allergy immunotherapy, based on the three most prevalent dust mites: Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis. These allergen vaccines were developed in the National Center of Bioproducts (BIOCEN): http://www.biocen.cu/producto/alergia/indiceea.htm. The widespread introduction of sublingual immunotherapy in many allergy services throughout the country is now in progress using these products.

The Cuban Society of Allergy, Asthma and Clinical Immunology (SCAAIC) is the national association that joint, merely with a scientific purpose, all the allergists and other related professionals. It was created in 1949 but officially accepted in 1961; its present name (SCAAIC) was approved in 2007. Our society is member of the National Council of Scientific Societies for Public Health: http://www.sld.cu/sitios/socientificas/. The SCAAIC is a member of the World Allergy Organization (WAO) and is currently working on the inclusion in other regional allergy societies.

The most important scientific events, regularly developed every three years in our country, are the Hispanic-American Meeting and National Congress of Allergy, Asthma and Clinical Immunology, which take place together; in these magnificent events nationals and foreign delegates from Spain, Portugal and Latin America can meet together. Another important event is the Allergology territorial event, which take place every 2 years. In 2009 and 2012 the SCAAIC has endorsed and co-organized with the Cuban Immunology Society two international meetings on allergen vaccines.

Our country has more than 15 years of experience in a special program for education and treatment of children (and their parents) and adolescents with asthma. This program has begun in Juan Manuel Marquez Hospital, in Havana, and has maintained all these years with summer schools. It has also been extended to other areas and camps for asthmatic children in other regions throughout the country.   

One of the priorities for the next few years is the design and carrying out of epidemiologic studies for allergic diseases. Nowadays, starting from 2008, the first prospective research for the follow up and risk factors for wheezing in children is in execution. The study is been carried out by the National Institute for Sanitation, Epidemiology and Microbiology (INHEN), along with the collaboration of the Nottingham University, from United Kingdom.    

Our researchers are also involved in the development of new allergen vaccines, the use of new adjuvants in order to reduce the number and frequency of administrations, and to maximize the effect and duration of the immunologic response. The first of these novel products is now been tested at the Calixto García University Hospital in a Phase I clinical trial. Another important clinical trial is in progress in three Children Hospitals in Havana, testing the dose-effect dependence of sublingual immunotherapy with tropical mites. Another rising area of clinical research is food allergy, taking into account the specific features of Cuban diet and environment.  

We are now working on the creation of the Cuban Journal of Allergy, Asthma and Clinical Immunology. Another important issue is the development of a new program for the training of technicians and licentiate in allergy and immunology.

Last, I think that the possibility of fostering the academic exchange between national and foreign institutions, including Hospitals and specialized labs could benefit the development of the specialty in Cuba and also contribute to develop it in other areas of the world.