**3.2 Summer school**

Creating of Summer school is considered a viable solution to promote scientific interaction, and standardization of PID knowledge in different member countries because educational systems and medical residents differ in each country member (Condino-Neto *et al.,* 2011; Leiva *et al.,* 2011). In Brazil, São Paulo in 2006 was held the first Summer School, based on model proposed by ESID and CIS. This meeting was attended by 12 teachers of LAGID, ESID and CIS experts PID and 12 students, where they were focused biochemical and molecular diagnosis PID, major PID in Latin America; IVIG therapy guidelines, hematopoietic bone marrow transplantation; communication network LAGID. New meeting was held in 2008 in Temuco, Chile, and recently in 2010, Bahia, Brazil, with inclusion of 90 students from different Latin America countries.

#### **3.3 Scholarship program offer**

366 Epidemiology Insights

Those studies contributed with new insights on clinical presentation and impacted positively on the molecular diagnosis of PID. All together the Latin American experience shows that BCG complications is prevalent among SCID, T-cell deficiencies, and CGD patients; that fungal infections is highly prevalent among X-linked HIGM patients, and that ataxia-teleangiectasia is especially frequent in Mexico and Costa Rica. Currently Chile is building a new diagnostic center at University La Frontera that will interact with research centers in Argentina, Brazil, and Colombia. This strategy will strength even more the

Studies by LAGID showed numerous factors responsible for delay in diagnosis and treatment of patients with PID. Most pediatricians and family physicians in Latin America are not sufficiently trained to carry out the diagnosis of PID, there is a low amount of specialized installations for specific immunological tests, there is limited coverage for screening tests given by the government or private institutions, regional variability access to health and failure to comply with guidelines in certain countries and regions. To improve some of these aspects, diagnosis and treatment of patients with PID, experts from Latin America and the USA meet to discuss three specific programs, educational program (The L-Project), scholarships program and establishing of laboratory network to expand access to data (The Latin América Advisory

Board on Primary Immunodeficiencies) (Leiva *et al.,* 2011; Condino-Neto *et al.,* 2011).

The educational program (L-Project) was established to create increased awareness of general public, continuing education network on PID, promote basic and clinical research of PID and inform government officials in impact of PID on health published in Latin America. This program covers students, residents, pediatricians, nurses and officials involved in health system. It also emphasizes encouragement medical students seeking academic placement of teaching, research and clinical PID. These programs include summer school, containing cases and report on short-term programs associated with PID infection, dissemination of information by radio, television, websites, newspapers, magazines and educational material for community (Marodi & Casanova, 2009; Leiva *et al.,* 2011). This proposal directly contributes to knowledge generation and increase technological capacity of Latin America in this field. It is virtuous chain where all the researchers and the community involved propagate their knowledge acquired in other centers of reference,

Creating of Summer school is considered a viable solution to promote scientific interaction, and standardization of PID knowledge in different member countries because educational systems and medical residents differ in each country member (Condino-Neto *et al.,* 2011; Leiva *et al.,* 2011). In Brazil, São Paulo in 2006 was held the first Summer School, based on model proposed by ESID and CIS. This meeting was attended by 12 teachers of LAGID, ESID and CIS experts PID and 12 students, where they were focused biochemical and molecular diagnosis PID, major PID in Latin America; IVIG therapy guidelines, hematopoietic bone marrow transplantation; communication network LAGID. New meeting was held in 2008 in Temuco, Chile, and recently in 2010, Bahia, Brazil, with inclusion of 90

interaction among the several Latin American research centers.

allowed expansion of existing lines of research in Brazil.

students from different Latin America countries.

**3.1 Educational program** 

**3.2 Summer school** 

One of great difficulties encountered in developing countries for training professionals in PID is to awaken academic and professional interests, without compromising quality of life and survival of students and health professionals. Thus, different Latin American countries offer scholarships funded by educational institutions and other entities, governmental or private, with development of people involved and trained in specific areas of health. One of major problems seen in developing countries is the absence of jobs, which means that many students, just looking for graduate services that offer post-graduate scholarships, forgetting commitment they have with the community. Another problem in Latin America is formation of highly trained and qualified for certain areas of education and research, which are not absorbed by countries, end migrating to other parts of world. To resolve these problems, the Advisory Council LAGID determined availability of scholarships for doctors interested in area of clinical PID, as well doctors and teachers interested in immunology. The participating institutions were willing to participate in record LAGID, and grant applicants to submit personal statement, career development plan, and mentor involved with project statement of no conflict of financial interest and letters of recommendation. In this agreement, it was established that no country could be assigned more than two grants during period of two years, and beneficiaries of scholarship must publish report on its activities or clinical results or research (Leiva *et al.,* 2011).

#### **3.4 Creation of centers of education, diagnosis and treatment**

One of the major problems encountered in developing countries is lack of proper training of physicians and pediatric regional variability in access to educational program and establishment of diagnostic and treatment center. Thus, education and training are needed for specialists, pediatricians, general practitioners from different countries and regions of Latin America, ensuring that they are able to recognize warning PID signs. This includes creation of Summer School, symposia and conferences of PID. These educational efforts should also be understood to medical students, nurses and general public. For that, programs are needed government and private funding, and network (Leiva *et al.,* 2011). In Brazil, the Jeffrey Modell Foundation, and Baxter pharmaceutical industry, created on April 29, 2009 at Federal University of São Paulo-UNIFESP, the first Jeffrey Modell Diagnostic Center for PID in Latin America, based in field of Immunology pediatric UNIFESP, with working points in different parts of the country. The Jeffrey Modell Diagnostic Center operates in front of medical education, diagnosis and records of PID and patient education (Modell, 2007a; Modell, 2007b). Other diagnostic centers sponsored by the Jeffrey Modell will be opened in Mexico, Argentina, Colombia and Chile. Advancing educational model for educational outreach in Latin America is observed in the Brazilian Group of Human Immunodeficiency (BRAGID) (http://www.bragid.org.br), whose number of registered doctors increased from 190 in 2002 to 2.500 in 2009, after creation of local seminars on dating PID. The BRAGID provides information on warning PID, different clinical presentation PID of and diagnostic laboratories. Offer clinical cases that can be discussed in Internet. This model is followed in Colombia, which has specialized site that shows warning PID signs, types of PID and use of IVIG. In other Latin American countries, government agencies related to areas of health are more concerned with control of infectious diseases, and most professionals in the field of immunology work independently.

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