Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 9th Asia Pacific Global Summit on Healthcare & Immunology July 3-5, 2017 Kuala Lumpur, Malaysia..

Day 1 :

Keynote Forum

Obeid Al Rashoud

Nursing/Children Specialist Hospital Saudi Arabia

Keynote: Challenges facing overseas nurses practicing in Saudi Arabia

Time : 09:00-09:35

OMICS International Healthcare Asia Pacific 2017 International Conference Keynote Speaker Obeid Al Rashoud photo
Biography:

He done research on Qualitative research and its uses in health care (2008),Sultan Qaboos University Medical Journal. Nursing in Saudi Arabia: Evolution or Revolution (2009), Unpublished Doctoral Thesis, Monash University, Melbourne, Australia.Obeid Al Rashoud , Nursing Director.

 

Abstract:

Introduction: Saudi Arabia being the largest country in the GCC is experiencing rapid growth and development in the healthcare sector. The increased demand for qualified nursing workforce has led to the recruitment of overseas qualified nurses (OQN) to match the healthcare sector demand and contribute to exchange of knowledge and experiences with local nurses. However, differences in culture, customs and language are expected to have an impact on the effectiveness and quality of life of OQN in Saudi Arabia.

Aim: To explore the factors associated with professional and personal challenges facing the OQNs in Saudi Arabia for ultimately formulating a set of recommendations to be employed first in ministry of health hospitals than in private hospitals in Saudi Arabia to effectively engage the OQN in their working environment to ensure successful communication, productive work and improved quality of life.

Methods: Prospective, qualitative, phenomenological study. We approached 23 OQNs. Our research tool was a qualitative interview assessing the contextual practice, accommodating to the Saudi culture, communication barriers and cultural differences. Thematic analyses were used as the data analysis technique.

Results: Two significant issues that affected the day-to-day professional practice of these nurses. The first was that the overall Saudi Islamic Culture was pervasive; and the second was that communication obstacles due to language barriers often presented insurmountable difficulties in their professional practice.

Conclusion: It appears that the language barrier is the pressing issue to be addressed by Arabic courses offered to OQNs in all hospitals. The areas of future research identified from the study include, exploring the views of hospital administrators to the challenges faced by OQNs, as well as the impact of these nurses on the quality of patient care. This links direct to the important area of strategies to increase the numbers of local Saudi nurses.

 

 

Keynote Forum

Imran Aslan

Bingol University, Turkey

Keynote: Determaining factors effecting job life quality and motivation of workers at hospitals

Time : 09:35-10:10

OMICS International Healthcare Asia Pacific 2017 International Conference Keynote Speaker Imran Aslan photo
Biography:

Imran Aslan has completed his four years healthcare education as Emergency Medical Technician at Batman Health Vocational High School between the years 1996-2000. Moreover, he completed his Graduation in Industrial Engineering from Marmara University, Turkey in 2005. Furthermore, he has done his PhD at Atatürk University, Turkey. He has published more than 25 international articles.

 

Abstract:

The numbers of Chronic Kidney Failure (CKF) cases have increased dramatically in the last years in Turkey. For that reason, the causes of CKFs and costs related to treatment of CKF are being assessed to compare the types of treatments and to plan the necessary budget for future. Through this study, the aim is to view the success factors of CKF treatment and quantify the results by Decision Tools. Hypertension and Diabetics are main causes of CKF. In a past study carried out by (Aslan & Ozen, 2013) in Turkey, it was found that first three stages of CKF are generally ignored and attention is given to the last two stages of CKF kidneys not being able to perform their functions. In the first case study, the average cost for treatment of each patient and probabilities are drawn to estimate future costs. In the second case study, average lifespan, average parameters of important body signs and cost estimations under different conditions were presented based on the data of Turkish Society Nephrology (TNS) with sensitivity analysis. It is found that the most beneficial treatment method is Transplantation (TX), but it is not possible to find a donor for each patient in Turkey. The expected lifespan is higher for Haemodialysis (HD) patients but, Dialysis (PD) provides more flexibility than HD. The expected cost of a patient for his/her living years with HD is 160,933.04 TL/Life and the expected cost of a PD patient during the life span is 142, 730.67 TL/life.

 

OMICS International Healthcare Asia Pacific 2017 International Conference Keynote Speaker G Kaarthikeyan photo
Biography:

G Kaarthikeyan has completed his Post-graduation in Periodontics and Implantology from Saveetha Dental College in 2007. He has been working at Saveetha University as Faculty since 2007. He is currently working as Professor and Clinical Head at Saveetha Dental College. He has more than 30 publications in various national and international journals. He has presented papers and posters at various international conferences. He has delivered many guest lectures as well as invited speaker for many conferences. His area of research involves the role of genetics in inflammatory disease and regenerative periodontics. He is the Editor of upcoming journal- International journal of Periodontal Rehabilitation. He is reviewer of many indexed journals and Editorial Board Member of few journals.

Abstract:

Periodontitis is a chronic inflammatory disease of multifactorial etiology. Although gram negative anaerobes are essential in initiating the disease, many other factors determine the course and progression of the periodontal destruction. Among the various risk factors, the genetic component of the host plays a major role in periodontal destruction. The microbial agents are first screened by the pattern like receptors – Toll like receptors (TLR) and the signals are processed intracellularly by Nod like receptors - NLRP3. Thus, aim of the study was to analyze the association of 3’UTR polymorphisms of TLR4, NLRP3 gene and the micro RNAs regulating this region. The subjects were stratified into three groups - chronic periodontitis, aggressive periodontitis and controls. The sample size was 240. DNA extraction from blood samples was done and the polymorphisms were analyzed using real time PCR. The TLR4 (rs11536889), NLRP3 (rs10802501), miR-146a (rs2910164) were analyzed in this study.

Keynote Forum

Fatme Mawas

National Institute for Biological Standards & Control (NIBSC), UK

Keynote: Ensuring the quality and efficacy of Haemophilus influenzae b vaccines- The UK experience

Time : 11:05-11:40

OMICS International Healthcare Asia Pacific 2017 International Conference Keynote Speaker Fatme Mawas photo
Biography:

Fatme Mawas is an Immunologist/Microbiologist and completed her PhD in 1995 at King’s College (London). She is working as a Principal Scientist and Group Leader in Division of Bacteriology at NIBSC with 19-years of experience in the quality control and standardization of conjugate vaccines against Haemophilus influenzae type b, animal models and vaccine immunology. She has over 29 refereed papers covering various aspects of assay development, standardization and R&D in the field of conjugate vaccines, vaccine candidates and novel delivery systems.

 

Abstract:

Haemophilus influenzae type b (Hib) was a leading cause of meningitis in infants in the UK until October 1992, when Hib conjugate vaccine was introduced for children at age 2, 3, and 4 months. Quality control testing of the vaccine is very important to ensure the quality, safety and efficacy of the vaccine. Here, we describe our experience at the UK National Institute for Biological standards & Control in the testing and investigation of quality and efficacy of Hib vaccines in monovalent formulations and in combination with other vaccines such as meningococcal C or DTP-based combination vaccines.

 

  • Healthcare And Management | Nursing Edutaion | Healthcare Informatics
Speaker

Chair

Obeid Al Rashoud

Director of Nursing/Children Specialist Hospital, Saudi Arabia

Session Introduction

M Maldonado-Vega

Hospital Regional de Alta Especialidad del Bajío, Mexico

Title: Recycling of batteries, source of exposure and lead contamination

Time : 11:40-12:10

Speaker
Biography:

Maria Maldonado-Vega completed her PhD and Master of Science in Research and Advanced Studies Center - Polytechnic National Institute (CINVESTAV-IPN) México. Currently, she has published 18 papers in refereed journals. She is serving as an editorial member of several reputed journal like Journal of Nuclear Medicine & Radiation Therapy. She is a member of Mexican Society of Biochemistry and member of Research Ethics Committee.

 

Abstract:

The recycling of automotive batteries is an industrial process that consists of the recovery of lead grids, acidic liquids and materials that contain them. Lead recovery occurs as a smelting process at more than 1100°C. During this process there are emissions of vapors and generation of fine powders. Additionally, they obtain lead oxides in complementary processes. This paper presents the health conditions of a workers (n=32) from a company that recovers lead from automotive batteries through melt processes. This company is medium; it includes work areas from the breaking of battery boxes, and handling of worn sulfuric acids. Once the lead is melted, it is recovered in solid plates and in the form of oxides. The company has a processing capacity of 30 tons per month. The average age of the study group is 39.6 (18-70) years; it is made up of 24 men and 8 women, with a working time of 3 months and up to 18 years. The blood lead concentration has been found to range from 7.4 ug/dl to 89.6 ug/dl, averaging 40.7±21 ug/dl and d-ALAD activity 371± 231 n moles/h/ml, and 83 % of these workers have ALAD activity inhibited, which is an indicator of toxicity and lead effects. In addition, the same percentage of workers with oxidative damage determined as MDA in blood coincides. The activities of greater exposure correspond to the personnel of the maneuvers in the furnace, as well as the oxidizer area and crucibles. Independently the industrial plant has fine powder dispersion within a radius of 60 m with respect to the center of the melting furnace.

 

Speaker
Biography:

Chih-Yu Wang has completed his PhD from National Yang-Ming University and Post-doctoral studies from National Taiwan University. He is a Professor of Department of Biomedical Engineering, I-Shou University, Taiwan. He completed his Major in Bio-photonics, especially on laser diagnostics and treatment, such as fluorescence spectroscopy, polarized imaging, luminescence nanoparticles synthesis, and photodynamic therapy. His recent researches were mainly focused on the design and manufacture of modern instrument to implement the diagnostic and treatment methods in traditional Chinese medicine. He has published more than 40 papers in related field on reputed journals.

 

Abstract:

The autonomic nerve is composed of sympathetic and parasympathetic nerves, which usually function oppositely in the physiological body, and are mutually adjusted according to our physical conditions. In traditional Chinese medicine, the acupoint "Neiguan (PC6)" is usually considered as effective for the activation of sympathetic and parasympathetic nerves. The main purpose of this study is to explore the effect on autonomic nerve activity by simulating Neiguan using laser acupuncture with lifting and thrusting functions. We used “ANSWatch” (Taiwan Scientific Co. Ltd.) to measure the heart rate variability (HRV) of the subject before and after acupuncture stimulation, and converting to indices of sympathetic and parasympathetic activity. We adopted the home-made “emulated laser acupuncture system” which can implement the lifting and thrusting functions in traditional acupuncture. The mentioned laser acupuncture adopted NI myRIO as the main controller, which was driven with LabVIEW software; in which the depth (focus position), force (light intensity) and procedure were program-adjustable. By using the emulated laser acupuncture one can implement the acupuncture method in Chinese medicine by adjusting focus of incident light to achieve a required depth when considering the individual variation, such as the patient's body shape and the various depths of different acupoints and meridians, etc., to enhance the acupuncture efficiency. In this study, we enrolled 23 subjects from Department of Chinese Medicine, E- Da Hospital. The autonomic nerve activity was analyzed by paired t- test. The result shows that the sympathetic nerve activity was significantly increased after acupuncture with lifting and thrusting. Although parasympathetic nerve activity did not change significantly, autonomic nervous activity shows significant differences toward balance. We conclude that stimulating Neiguan point with emulated laser acupuncture casts significant impact on the autonomic nervous system, indicating that the laser acupuncture would be useful for the adjustment of human psychosomatic state.

Ya Lie Ku

Fooyin University, Taiwan

Title: Developing five simulation skills of the long-term care course

Time : 12:40-13:10

Speaker
Biography:

Ya-Lie Ku is an Associate Professor at Fooyin University, College of Nursing. She has completed her Master’s in Nursing Science at Penn State University. She has taught the long-term care nursing for more than 20 years as well as conducted the practicum teaching for more than ten years both in the elderly and psychiatric settings. Currently, she and her teaching team members have developed the simulation scenarios and skills of the long-term care course for the RN-BSN students. She has published approximately 10 articles related to long-term care and simulation teaching as well as 10 conference papers in the domestic and foreign areas.

 

Abstract:

This article introduces the five simulation skills of the long-term care course. The process of developing these skills includes a literature review, continuous education, and evaluation by different long-term care experts. The five simulation skills are difficult feeding and swallowing care, position management and skin care, promoting toileting ability care, and acute and chronic confusion care. In the long-term care course, the content of the five simulation skills comprises diverse scenarios for five long-term care cases, preparation before the practicing of skills, competency in the assessment and practicing of skills, evaluation of the cases’ problems, and professional essences while practicing the skills. There are different indicators for the preparation, assessment, practice, and evaluation of the five simulation skills in the long-term care course. After lectures and the practicing of skills, every nursing student participating in the long-term care course is evaluated through a simulation test conducted by five teachers at the OSCE center, involving five standardized patients who have been trained by the examining teachers. Additionally, every nursing student writes reflection reports for the practice and testing of the five simulation skills in terms of the learning process, obstacles, and suggestions for improvement of the long-term care course in the future. Through a sincere and careful developing process, the five simulation skills of the long-term care course could be standardized for the use of long-term care nursing teachers and students.

Hanan Elkafafi Hassan

King Saud bin Abdul-Aziz University for Health Sciences, KSA

Title: The efficacy of silver-coated urinary catheters in reducing urinary tract infection

Time : 14:10-14:40

Speaker
Biography:

Hanan Elkafafi Hassan is working as an Assistant Professor of Medical Surgical Nursing at Nursing College, Cairo University. She moved to Saudi Arabia and worked as an Assistant Professor in Nursing College at Dammam University till 2015 then she moved to King Saud bin Abdul-Aziz University for Health Sciences. She teaches many courses for undergraduates and postgraduates, participated in supervising of Master’s projects and students researches as an Academic Supervisor. She has published many national and international research articles. She has experience in quality assurance and accreditation in higher education. Her interested area of research is Education and Clinical Research.

Abstract:

Background: Catheter Associated Urinary Tract Infections (CAUTI) is the most common nosocomial infection at ICUs. Urinary infections can increase patient’s length of stay and mortality. One of the strategies to reduce CAUTI is the use of silver coated urinary catheters.

Aim: Aim of this study is to explore the efficacy of silver-coated urinary catheter on reducing CAUTI.

Methods: An experimental design was used and the study was conducted in ICU at King Fahd University Hospital, Al-khobar, Eastern Province. The study subjects include 60 adult patients (18 years or more) who were on urinary catheter attending during the period of data collection and were randomly divided to two groups. Two instruments were used for data collection: 1) Demographic and Medical Data Sheet, 2) CAUTI Sheet.

Results: There was a statistical significance difference between the two groups among symptoms of UTI, temperature, and WBC (P<0.05). The patients having silver –coated catheter has less organisms in the blood. Fewer leukocytes, bacteriura and yeast cell in urine culture when compared to uncoated catheter patients after 3 days. CAUTI rate was a statistically significant difference between the two groups (p=0.003).

Conclusion & Recommendation: It can be concluded that the use of silver alloy coated urinary catheter reduces the incidence of CAUTI rate to 2.2% per three days compared to uncoated catheter rate of 13.3% per three days. It can be recommended that changing practice to use the silver coated Foley catheter to decrease risk of CAUTI.

Sylvain HABA

Medico-Spiritual Center , west Africa

Title: Challenges of nursing in West African family

Time : 14:40-15:10

Speaker
Biography:

Sylvain haba Admission to Bachelor in 1984, orientation to school nurses 1985-88. 1989- 1997 Internship in a medical post in Sèbètèrè Gaoual Prefecture. 1992-1993 Remote Training on medical semology. In 1998 admitted to the public service test. 2004-2005 Training in traditional medicine in DR Congo. Back Guinea in 2006 establishment of the Medico-Spiritual Center Tradi koumi Talitha (Marc5: 41-42) to (Labe) Guinea. 2008 Transfer of the center in Conakry.

Abstract:

Conflicts and difficulties between doctors, pastors, marabouts quacks, magicians and witch doctors in villages West Africans. The practice of nursing in the villages confronts mediocre traditional and religious practices which cannot advance nursing. Despite the evolution of science, 60 to 80% of the population believes pastors, imams, quacks, magicians, marabouts in their vain consultation, so the diagnosis is usually about: wizards, poisoning, the devil and evil spirits denying scientists the real causes. Nurses who reject their diagnoses are threatened, sometimes even their family tested using the mesmerizing plant against them, which my research has uncovered some plants:

 

Raphyostylisbénénien Family: Icacinaceae (partly used sheets), Phaullopsus Falicicepala (Part used leaf and fruit), Daturastramonium Family: Solanaceae (Part used seed), this combination is used to hypnotize. It is used for other events. A pastor fired the candle on the fingers of a child to be claimed sorcerer in the name of the holy spirit he said. A Catholic priest based in kizaom’vété (DRC Matadi) retrieves abandoned children through this ordeal by their parents. Pastors had gone to the center of the treatment of Ebola fever late to pray for those who were suffering, but were chased away by the police. Fetish and marabouts had accused of dangerous devils and bad spirits the first victims of the Ebola before the World Health Organization (WHO) designated Ebola You can not put god to the test regardless of our faith. Only god can bring us to the test. Science is a tool created by god himself and it is unavoida. the fight between wizards, Man could not be separated from his wife after sex, the penis was not erect, but stuck in the vagina of the woman for two (2) days, because of my research they made me leaving and witnesses said the couple were sent naked in a public place, people screamed and yelled at them to separate them, A group of magicians did the sexes disappear by shaking hands with people. Some difficulties nurses face by residing in the areas with lack of medical equipment and medicines. Educational films for health, awareness Exclude those who did not receive training for health care and everything that is not scientific. Train, inform to transform, Adapting our lifestyles as time and circumstances.

  • Vaccination | Innate adaptive Immunity
Speaker

Chair

Fatme Mawas

National Institute for Biological Standards & Control (NIBSC), UK

Speaker
Biography:

Jacques Choucair completed his MD degree in 1994 from Saint-Joseph University, Faculty of Medicine in Beyrouth. Since May 2001, he is a Practitioner and ID Consultant in the Infectious Diseases department at Hôtel Dieu de France de Beyrouth Teaching Hospital. He has published more than 20 articles and is a Reviewer of many national and international journals. His main topics of research interest are bacterial resistance and the proper use of antibiotics. He is a member in the Arab Association for the Proper Use of Antibiotics and member of ESCMID.

Abstract:

Objectives: The objectives of the study is to evaluate the knowledge of Lebanese women about cervical cancer (CC) and human papillomavirus (HPV) infection. To measure the uptake of the cervical cancer screening test (Pap smear) and the uptake of HPV vaccination, and determine the influencing factors.

Methods: 444 women with no medical background filled out a 32 item questionnaire. Collected data was analyzed in SPSS® v. 21.0.

Results: Results revealed that 45.7% aged 18 to 25 with high education qualifications (73.9%) and employed in a field not related to health (84.9%). They did not visit a general physician (64%) or a gynecologist (64.6%) regularly. 85.6% were aware of CC with a median CC symptom knowledge score of 3.00±2.13. HPV infection involvement in the pathogenesis of CC was identified in 53.9% of cases. 35.6% of women were aware of HPV infection. The median HPV general knowledge score was 5.39±2.38 and the median HPV vaccination score was 6.00±2.41. 37.6% of participants had been screened by Pap smear for CC at least once in their lives whereas 9% did not know what a Pap smear was. Screening was significantly associated with CC awareness and regular visits to physicians. Only 11.7% of participants aged 18 to 35 were vaccinated against HPV. Vaccination uptake was significantly associated with CC awareness, religion, field of work and studies, and regular visits to gynecologists.

Conclusion: Lebanese women residing in the urban communities are not well informed about CC and HPV. Screening by Pap smear and HPV vaccination uptakes are non-satisfactory.

 

Speaker
Biography:

Narasaraju Teluguakula has received his PhD from Osmania University, India and Post-doctoral training from Center for Veterinary Health Sciences, Oklahoma State University and at School of Medicine, National University of Singapore. He has published more than 30 papers in reputed journals mainly related to respiratory biology and pathology. Currently, he is working as a Project Leader at Oklahoma Center for Respiratory and Infectious Diseases and Assistant Professor at Oklahoma State University, USA.

 

Abstract:

Complications of acute respiratory distress syndrome (ARDS), a severe form of acute lung injury, remain major cause of death in influenza pneumonia. Several recent studies have demonstrated that considerable lung damage is contributed by the host immune response in addition to the cytopathic effects of the influenza virus. Previously, we have demonstrated that excessive neutrophils recruitment and their generated neutrophil extracellular traps (NETs) contribute to pathologic complications of ARDS in severe influenza pneumonia in mice. Neutrophils express predominantly CXC chemokine receptors including CXCR1 and CXCR2, which play key role in the recruitment and activation of neutrophils. This study was aimed to test the therapeutic potential of CXCR1/2 antagonism in severe influenza pneumonia. Our results have shown high increase in CXCR2 expression in both circulating and lung-recruited neutrophils. We used a selective CXCR1/2 antagonist, SCH527123 alone or in combination of an anti-vial agent, oseltamivir. BALB/c female mice were challenged with lethal influenza A/PR/8/34 (H1N1), 2500 pfu. Oseltamivir or SCH527123 were administered orally. Treatment with oseltamivir alone showed 15% survival, while all animals were died in SCH527123 alone treatment group. However the combined administration of these drugs resulted in 60% to 100% survival in mice after lethal influenza infection. The addition of SCH527123 to the combination therapy regime was also found to significantly alleviate lung pathology, compared to oseltamivir treatment alone. Lungs of infected animals following combination therapy showed decreased neutrophil influx, decreased release of extracellular histones, reduced vascular leakage, and reduced alveolar capillary damage. These results demonstrate that the use of CXCR1/2 antagonists in combination with a classical antiviral therapy can be a novel and effective treatment approach for severe influenza pneumonia.

Faisal Mohammed Hanif Girach

Cyberjaya University College of Medical Sciences, Malaysia

Title: Homeopathy in managing immunological diseases

Time : 16:30-17:00

Speaker
Biography:

Faisal Mohammed Hanif Girach has completed his Master Degree from India. He is practicing homeopathy over a period of 10 years and has shown good results in various diseases with homeopathic medicines. At present, he is lecturing at Cyberjaya University College of Medical Science, Malaysia. It is one of the only government recognized university college to offer Homeopathy course in entire South East Asia.

 

Abstract:

Homeopathic research has developed over the past 20 years with the increasingly greater use of modern medical methods (clinical trials, observational studies, statistical evaluations, computerized storage programs and instrumental or laboratory testing). Over 200 clinical trials designed to verify the efficacy of homeopathic treatments have been published, many (but not all) of which have led to positive results. The main principle of homeopathy is- “a remedy can cure a disease if it produces in healthy person symptoms similar to those of the disease”. It is said that “like cures like”. Homeopathic remedies are diluted to such an extent that there can be no possible side effects from even the most toxic substances. The dilution process is known as 'Potentization'. Taken in this ultra-diluted form, these remedies have no side effects and are perfectly safe, non-toxic and non-addictive. This concept has been proved through nanotechnology which says that particles which are tinier than the viruses are capable to act on human body. Homeopathy has good role in managing immunological diseases. From homoeopathic point of view immunological diseases are chronic constitutional disorders, therefore we require individualistic approach as patient responds to medicine according to its constitution and susceptibility. The constitutional medicines are drawn out after thorough understanding of concerned individual. These medicines can help decreasing the intensity of symptoms and can thus improve standard of living. During the session, we would discuss how a case of ankylosing spondylosis and psoriasis was managed with homeopathic medications. Homeopathic medicines can help in treating immunological diseases, but proper research must be done to understand the efficacy of homeopathic medicines in immunological cases.

 

Speaker
Biography:

Jacques Choucair completed his MD degree in 1994 from Saint-Joseph University, Faculty of Medicine in Beyrouth. Since May 2001, he is a Practitioner and ID Consultant in the Infectious Diseases department at Hôtel Dieu de France de Beyrouth Teaching Hospital. He has published more than 20 articles and is a Reviewer of many national and international journals. His main topics of research interest are bacterial resistance and the proper use of antibiotics. He is a member in the Arab Association for the Proper Use of Antibiotics and member of ESCMID.

Abstract:

Aim: Aim of this study is to assess in non vaccinated healthy adults, the response to the standard protocol SP of vaccination for hepatitis B (0, 1, 6 months), and the response to two booster protocols in non-responders (NR).

Methods: 192 adults with mean age of 44.3 have received Engerix® B 20 µg/1 ml by the SP. The non-responders (anti-Hbs antibodies <10UI/l) were divided into two groups. The first group (P1) received a single booster (R1) four months after the SP, and those who remained non-responders received a double booster (R1b) two years after the SP. The second group (P2) received a unique double booster (R2), two years after the SP.

Results: The rate of response after the SP is 75.5% (145/192). 28 NR in P1 have a response rate of 32.14% (9/28). The 19 NR in R1b have a response of 36.84% (7/19). 19 NR in P2 have a response of 63.16% (12/19). 9.9% (19/192) of individuals don't respond to any booster. The rate of response decreases with the age (5% every year and 41% every 10 years). For the same age, men are two fold more responders than women.

Conclusion: A unique double booster done two years after the SP gives a better response than a single booster done after four months, and a similar response to a single booster done after four months followed by a double booster done after two years. The female gender and the age are two factors that decrease the response to the vaccination.