RESUMEN
Telemedicine has emerged as a valuable tool for medical training, now more than ever. It involves exchanging healthcare or healthcare information digitally across large distances. This form of teaching has become more common due to significant advances in communication technology and increased access to the internet at more affordable costs. Isolated and poorly staffed areas are now able to access specialist review, mentorship, educational materials, and general support more efficiently than before. Typically, telemedicine is used to deliver didactic sessions and lectures and not skill sharing or training exercises. While ultrasonography is a skill typically taught at the bedside, we face a global pandemic where patient safety and standard operating procedures are prohibitive of this teaching model. Our team sought to have a practical session to determine whether practical skills can be taught through virtual training workshops as a way to mitigate these constraints. Practical stations were set up, with each station hosting an independent skill. The aim of the session was to introduce the topics to learners, to have learners visualize how the scans can be done with local setup and lastly perform these scans on volunteers to the satisfaction of the supervisors. Skills such as performing ocular ultrasound, gallbladder evaluation, and aortic aneurysm assessment were carried out on volunteers under a virtual supervisor's direction at all stations. The topics were chosen based on a previous needs assessment, and participants reported great satisfaction from the session. Ultrasound provides an excellent opportunity for virtual skill-based training, mentorship and trainee support. This commentary is directed at mostly low resource African countries with nascent Emergency Medicine programs. It also applies to organizations that support remote ultrasound skills training for emergency care providers and those that run emergency care outreach programs. These principles may also apply for other lower resource settings outside of Africa.
RESUMEN
Piroplasms, especially those in the genera Babesia and Theileria, have been found to naturally infect rhinoceros. Due to natural or human-induced stress factors such as capture and translocations, animals often develop fatal clinical piroplasmosis, which causes death if not treated. This study examines the genetic diversity and occurrence of novel Theileria species infecting both black and white rhinoceros in Kenya. Samples collected opportunistically during routine translocations and clinical interventions from 15 rhinoceros were analysed by polymerase chain reaction (PCR) using a nested amplification of the small subunit ribosomal RNA (18S rRNA) gene fragments of Babesia and Theileria. Our study revealed for the first time in Kenya the presence of Theileria bicornis in white (Ceratotherium simum simum) and black (Diceros bicornis michaeli) rhinoceros and the existence of three new haplotypes: haplotypes H1 and H3 were present in white rhinoceros, while H2 was present in black rhinoceros. No specific haplotype was correlated to any specific geographical location. The Bayesian inference 50% consensus phylogram recovered the three haplotypes monophyleticly, and Theileria bicornis had very high support (BPP: 0.98). Furthermore, the genetic p-uncorrected distances and substitutions between T. bicornis and the three haplotypes were the same in all three haplotypes, indicating a very close genetic affinity. This is the first report of the occurrence of Theileria species in white and black rhinoceros from Kenya. The three new haplotypes reported here for the first time have important ecological and conservational implications, especially for population management and translocation programs and as a means of avoiding the transport of infected animals into non-affected areas.