LENAWEE SPOTLIGHT: Student shares information on tuberculosis with Cambodians

By Submitted photo
Sand Creek resident and Defiance College student Kelsey Huff, right, traveled to Cambodia this summer to share information with doctors there about a genetic defect that makes some Cambodians more susceptible to tuberculosis.

The Daily Telegram
By Autumn Lee
Mon Aug 25, 2008

SAND CREEK, Mich. -
As one of several scholars who traveled to Cambodia, a Sand Creek resident had the chance to share information with physicians about a genetic defect found to exist in some Cambodians.

Kelsey Huff, 21, is a molecular biology student in her senior year at Defiance College in Defiance, Ohio. Huff was able to visit Cambodia as a McMaster scholar for two-and-a-half weeks, returning in mid-January.

Through the college’s McMaster School for Advancing Humanity, undergraduate students can conduct original research in response to “community-identified needs in high-need areas” of the United States and the world, according to a news release. This was the fourth year a McMaster group traveled to Cambodia.

Huff wrote a project proposal during the spring of her sophomore year before receiving approval through a board.

Initially her project was to collect medical journals about tuberculosis, and she wanted to get journals on new vaccine development and new methods of testing, she said. Her project changed when she found an article that said 38 percent of Cambodians have a genetic defect in their immune system that makes them more susceptible to becoming infected by tuberculosis. She learned by the end of her sophomore school year that her proposal had been accepted and she would be one of several students going to Cambodia.

“I was really excited about going,” Huff said, but she was also nervous about the trip.

What is happening in Cambodia, she explained, is that when some people are given a PPD (purified protein derivative) skin test, they won’t show an immune response, even if they have active tuberculosis.

Doctors are actually turning people away because the test shows a negative response even though they may be sick with tuberculosis, she said.

While she was in Cambodia, Huff said, “We had to explain to doctors that if you have a patient that is showing signs and symptoms of tuberculosis and give them this PPD test, that even though they have tuberculosis they might not show a positive response to the test.”

They encouraged the doctors to follow up with an X-ray or a sputum test, where mucus or phlegm is cultured to see if it has tuberculosis in it. They explained that those patients may be part of that 38 percent of the population with the genetic defect.

When T-cells react with candida (a yeast) and mumps, it shows a good response, she said. When you take those same T-cells and interact them with the PPD test, there’s no response.

“That tells us that this is a genetic disorder that is specific to mycobacterium tuberculosis,” she said.

It’s specific to mycobacterium as opposed to that individual being “immuno-suppressed” from something like HIV or another disease that affects the immune system, she said. Their immune cells will react to other things but not the mycobacterium. Immune cells are either stimulated or inhibited by certain chemicals that are released in the body.

These individuals are releasing chemicals that are pushing the immune system in a direction that is not protective against mycobacterium, she said.

Huff said someone translated for her while she was there. She had to go over things to make sure they were grasping the concepts and tried to feel out how they were responding to the information, what knowledge they already had, and what information was new to them.

“From what we understood, the doctors had no knowledge of this genetic problem at all,” she said.

Huff said she had to rephrase a lot of things during her presentation.

“I didn’t want to use a lot of terms because I didn’t know how well they would be translated,” she said.

Huff said the doctors were not really receptive at first.

“It’s one thing to be an undergrad and (and another) being a female standing in front of male doctors where it’s culturally unacceptable for me to be addressing them like that,” she said.

While it took the doctors a few minutes to warm up to her, the presentation ended up going over well, Huff said.

When asked about her overall impression of Cambodia she said, “It really opens your eyes to what the rest of the world is like. ... It made me appreciate a lot of things.

“It wasn’t safe for us to travel to the hospital so the doctors had to come to us,” Huff said. Her group had bodyguards with them at all times, and they had to carry cigarettes on them in case they needed to bribe someone.

“When we left our hotel we weren’t guaranteed anything,” she said. “There’s a lot of things you don’t realize (that) people live without as far as electricity, plumbing, telephones and just a clean place to sit down. But it’s something I would do again.”