AUTHOR=Leung Daniel , Chua Gilbert T. , Mondragon Alric V. , Zhong Youjia , Nguyen-Ngoc-Quynh Le , Imai Kohsuke , Vignesh Pandiarajan , Suratannon Narissara , Mao Huawei , Lee Wen-I , Kim Yae-Jean , Chan Godfrey C. F. , Liew Woei Kang , Huong Le Thi Minh , Kanegane Hirokazu , Muktiarti Dina , Zhao Xiaodong , Santos-Ocampo Fatima Johanna , Latiff Amir Hamzah Abdul , Seger Reinhard , Ochs Hans D. , Singh Surjit , Lee Pamela P. , Lau Yu Lung 

TITLE=Current Perspectives and Unmet Needs of Primary Immunodeficiency Care in Asia Pacific

JOURNAL=Frontiers in Immunology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.01605

DOI=10.3389/fimmu.2020.01605

ISSN=1664-3224

ABSTRACT=<p><bold>Background:</bold> The Asia Pacific Society for Immunodeficiencies (APSID) conducted nine primary immunodeficiency (PID) Schools in 5 years since inauguration to provide PID care training for early career physicians in Asia Pacific, a region with divergent needs in PID resources and training.</p><p><bold>Objective:</bold> To identify differences in PID patient care resource and training needs across Asia Pacific and propose a corresponding action plan.</p><p><bold>Methods:</bold> The Human Development Index (HDI) indicates the degree of socio-economic development in each country/region. Information related to investigations and learning issues were extracted from the abstracts and personal statements from all Schools and mapped onto resource and training needs. Correlations between HDI and country/region-specific parameters were tested by two-tailed Pearson correlation.</p><p><bold>Results:</bold> A total of 427 abstracts were received in nine Schools between 2015 and 2020, predominantly on immunodeficiencies affecting cellular and humoral immunity. Genetic confirmation was described in 61.8% of abstracts, and its absence negatively correlated with HDI (<italic>r</italic> = −0.696, <italic>p</italic> = 0.004). Essential immunologic and genetic tests were not available in 25.4 and 29.5% of abstracts, respectively, and their absence negatively correlated with HDI (<italic>r</italic> = −0.788, <italic>p</italic> &lt; 0.001; <italic>r</italic> = −0.739, <italic>p</italic> = 0.002). HDI positively correlated with average testing level (<italic>r</italic> = 0.742, <italic>p</italic> = 0.002). Cases from medium-HDI countries/regions focused on learning how to investigate a patient for PIDs in cases of severe or atypical infections, whereas those from very-high-HDI countries/regions, from which most faculty members originated, listed hematopoietic stem cell transplantation and gene therapy, newborn screening, and research as learning issues more frequently.</p><p><bold>Conclusion:</bold> There are unique HDI-related PID resource and training needs in each country/region. APSID proposes HDI group-specific strategies to improve PID care and education in her member countries/regions. Further quantitative analysis of needs in PID care in Asia Pacific is needed for lobbying governments to increase their support for PID care and research.</p>