Awareness and perceptions of medical students and doctors regarding Tropical Medicine education and training in Europe: An international, online-based survey.

BACKGROUND: Multifactorial health determinants and shifts in global patterns of disease increase the need for Tropical Medicine training across Europe. A survey of university and postgraduate opportunities in Europe was conducted to identify and analyse gaps. METHOD: An online survey was circulated to medical students and doctors in Europe between April and June 2021. Significance tests and a thematic analysis of the data were conducted. RESULTS: 500 respondents (285 students and 215 doctors) from 27 countries were included. 17.2% of doctors were unsure whether postgraduate training in Tropical Medicine was available in their country. 20% of students and 10.7% of doctors said they were unsure whether they had been taught Tropical Medicine during university. 67.7% of students and 79.1% of doctors stated that the amount of Tropical Medicine training they encountered was or had been "not enough". CONCLUSIONS: Respondents demonstrated great interest in Tropical Medicine. Their self-reported knowledge, awareness, and perceived competence were partly dependent on whether there is specific teaching accessible at the university. Postgraduate training options were available in some countries but not all respondents were aware of these. There is a pressing need for harmonized curricula and expanded postgraduate training to improve Tropical Medicine competencies across Europe.

Training and capacity building in medical statistics in Sub-Saharan Africa: Impact of the London School of Hygiene & Tropical Medicine MSc in Medical Statistics, 1969 to 2021.

Since its inception in 1969, the MSc in medical statistics program has placed a high priority on training students from Africa. In this article, we review how the program has shaped, and in turn been shaped by, two substantial capacity building initiatives: (a) a fellowship program, funded by the UK Medical Research Council, and run through the International Statistical Epidemiology Group at the LSHTM, and (b) the Sub-Saharan capacity building in Biostatistics (SSACAB) initiative, administered through the Developing Excellence in Leadership, Training and Science in Africa (DELTAS) program of the African Academy of Sciences. We reflect on the impact of both initiatives, and the implications for future work in this area.

Scoping review of Neglected Tropical Disease Interventions and Health Promotion: A framework for successful NTD interventions as evidenced by the literature.

BACKGROUND: Neglected Tropical Diseases (NTDs) affect more than one billion people globally. A Public Library of Science (PLOS) journal dedicated to NTDs lists almost forty NTDs, while the WHO prioritises twenty NTDs. A person can be affected by more than one disease at the same time from a range of infectious and non-infectious agents. Many of these diseases are preventable, and could be eliminated with various public health, health promotion and medical interventions. This scoping review aims to determine the extent of the body of literature on NTD interventions and health promotion activities, and to provide an overview of their focus while providing recommendations for best practice going forward. This scoping review includes both the identification of relevant articles through the snowball method and an electronic database using key search terms. A two-phased screening process was used to assess the relevance of studies identified in the search-an initial screening review followed by data characterization using the Critical Appraisal Skills Program (CASP). Studies were eligible for inclusion if they broadly described the characteristics, methods, and approaches of (1) NTD interventions and/or (2) community health promotion. PRINCIPAL FINDINGS: 90 articles met the CASP criteria partially or fully and then underwent a qualitative synthesis to be included in the review. 75 articles specifically focus on NTD interventions and approaches to their control, treatment, and elimination, while 15 focus specifically on health promotion and provide a grounding in health promotion theories and perspectives. 29 of the articles provided a global perspective to control, treatment, or elimination of NTDs through policy briefs or literature reviews. 19 of the articles focused on providing strategies for NTDs more generally while 12 addressed multiple NTDs or their interaction with other infectious diseases. Of the 20 NTDs categorized by the WHO and the expanded NTD list identified by PLOS NTDs, several NTDs did not appear in the database search on NTD interventions and health promotion, including yaws, fascioliasis, and chromoblastomycosis. CONCLUSIONS: Based on the literature we have identified the four core components of best practices including programmatic interventions, multi sectoral and multi-level interventions, adopting a social and ecological model and clearly defining 'community.' NTD interventions tend to centre on mass drug administration (MDA), particularly because NTDs were branded as such based on their being amenable to MDA. However, there remains a need for intervention approaches that also include multiple strategies that inform a larger multi-disease and multi-sectoral programme. Many NTD strategies include a focus on WASH and should also incorporate the social and ecological determinants of NTDs, suggesting a preventative and systems approach to health, not just a treatment-based approach. Developing strong communities and incorporating social rehabilitation at the sublocation level (e.g. hospital) could benefit several NTDs and infectious diseases through a multi-disease, multi-sectoral, and multi-lateral approach. Finally, it is important the 'community' is clearly defined in each intervention, and that community members are included in intervention activities and viewed as assets to interventions.

Attendee's awareness about preventive chemotherapy neglected tropical diseases (PC-NTD) control during the first world neglected tropical diseases day in Ekiti State, Nigeria.

BACKGROUND: The need to control Neglected Tropical Diseases (NTDs) and sustain progress towards elimination through mass administration of medicines requires substantial communal participation. This study, therefore, assessed the knowledge and perception of attendees' regarding NTDs and its control activities during the inaugural World NTD day event in Ekiti State, Nigeria. METHODOLOGY: A cross-sectional study involving the administration of pretested semi-structured questionnaires to consenting attendees at the Inaugural World NTD day event was conducted on the 30th January, 2020. The questionnaire collected data on attendee's demography, knowledge and awareness about NTDs and its control in Nigeria. Quantitative data were analysed using descriptive statistics in SPSS. 20.0 software and expressed as frequencies and percentages. However, qualitative data to support quantitative analysis were obtained using open-ended questionnaires and analysed thematically. PRINCIPAL FINDINGS/CONCLUSION: A total of 309 attendees comprising 167 (54.0%) females, and 142 (46.0%) males participated in this study. By age groupings, majority 206 (66.7%) were within 15-25 years. 167 (54.8%) of the attendees have not heard about NTDs before, whereas 77(35.0%) have heard about NTDs through the advertisement of the event. 181(63.3%) were aware of ongoing NTD control programs in schools and communities. Also, 246 (83.4%) of them have not taken or do not know anyone that has taken drugs donated in schools or communities. The number of attendees 41(13.3%) who incorrectly classified malaria as NTDs is higher than those who recognized onchocerciasis 36 (11.7%) and worm infections 34(11.0%) as NTDs (p>0.05). This study has shown that awareness and knowledge about NTDs control activities in Ekiti State is low, thus justifying the event as an awareness day for addressing NTDs. Public enlightment and regular promotional activities such as media engagement will raise the public appreciation and participation in NTDs control activities.

Integration of Management Strategies for Skin-Related Neglected Tropical Diseases.

The concept of skin neglected tropical diseases has been widely adopted into the policy and strategy of various organizations, governments, nongovernmental organizations, and health agencies. By pooling information and resources across different diseases, whose primary manifestations affect the skin, it is possible to deliver integrated surveillance and control programs and promote advocacy and reduction of disability and stigma. A further key part of the skin neglected tropical diseases program is the development and validation of training methods for front-line health workers. Networks that allow those involved in this work to share and compare expertise are being developed through various organizations.

Scientific Representations at the UPR School of Tropical Medicine. IV: Special Technical Studies.

The essay examines the scientific representations that unfolded and evolved at the University of Puerto Rico School of Tropical Medicine (STM) under the auspices of Columbia University (1926-1949). This article on the STM's scientific endeavors is the fourth in a historical serial collection about the images and evolution of sciences at the institution and it portrays the diagrammatic representations of special technical research aspects and studies (i.e., personnel, epidemiology, methodology, animal studies, biology, field studies, treatment and immunology, and chemotherapy agents). The essay focuses on the emerged scientific representations and on the nature and evolution of sciences at the School, and has been divided into four sections: a) images of science, b) evolution during the first two eras, c) the third and last era unfolding, and d) special technical studies. In this paper the scientific representations have been brought about mainly through the analyses of research publications in external and local venues. The analysis of the STM's scientific evolution has been organized in three distinct historical stages: 1926-31, 1932-40, and 1941-49. These representations open an exploration pathway for a better understanding of the intricate interrelationships between the techné and the episteme horizons of tropical medical science in Puerto Rico.

Scientific Representations at the UPR School of Tropical Medicine. III: The Evolution of Science, the Last Era (1941-1949).

The essay examines the scientific representations that unfolded and evolved at the University of Puerto Rico School of Tropical Medicine (STM) under the auspices of Columbia University (1926-1949). It focuses on the emerged scientific representations and on the nature and evolution of sciences at the School, and has been divided into four sections: images of science, evolution during the first two eras (1926-31 and 1932-40), the unfolding last era (1941-49), and special technical studies. This article on the STM's scientific endeavors is the third in this historical serial collection about the images and evolution of sciences at the institution, and portrays the events and processes of the last scientific era. It analyzes the faculty's principal investigations, development of research programs, and concomitant scientific productivity and research outcomes. The scientific representations have been brought forth through the analyses of different sources: academic and research reports, and publications in external and local venues. The analysis of the STM's scientific evolution has been organized in three distinct chronological stages, while also considering other time evolving models (e.g., historical moments). The main themes of the collection are the scientific images and knowledge exemplars: the emergence of a tradition. An analytical framework of research schemas, exemplars of knowledge, and epistemes proved useful and constructive. These studies on the history of science allow for the postulation of an 'enriched thesis' on the different kinds of paradigmatic diseases of tropical medicine in Puerto Rico during the 20th Century, and enable further substantiation of the tropical obliviousness thesis.

Preparing nurses for fieldwork in tropical nursing.

Due to factors related to increasing globalization, geopolitical conflicts, and climate change, tropical nursing is increasingly important. This article offers an overview of the Diploma in Tropical Nursing program and explores the challenges facing nurses who serve patients in tropical settings with limited resources.

Challenges and Strategies for Biomedical Researchers Returning to Low- and Middle-Income Countries after Training.

The brain drain of professionals from low- and middle-income countries (LMICs) to developed countries is well documented and partially due to the challenges faced by biomedical researchers to establish themselves back at home, after training abroad. These challenges may result in the loss of highly trained individuals from LMICs and reduce the availability of local expertise to develop/inform best practices in health care and to direct locally relevant research. The path of training of LMIC researchers in high-income countries is well documented. However, strategies for a successful reintegration of biomedical researchers back to their home research institutions in LMICs are less clear. We report observations of workshops addressing repatriation needs of researchers returning to their home countries after training abroad during the American Society of Tropical Medicine and Hygiene (ASTMH) 2017 and 2018 annual meetings. Strategies proposed include maintaining connections with the home research institution, ideally through collaborations, planning 18 months ahead before returning with grants applications submitted, and engaging in networking throughout the training period. In addition to presenting our observations, we hope to build a network to facilitate this process, compile resources, and identify expertise within the ASTMH to develop robust strategies to allow young biomedical researchers to flourish in LMICs.

Emergency Medicine Providers' Knowledge and Management of Pediatric Tropical Diseases: A Needs Assessment.

OBJECTIVE: The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases. METHODS: An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations. RESULTS: A total of 333 physicians (285 PEM, 32 EM, 8 combined PEM/EM, and 8 general pediatricians in emergency department) participated. Fifty-five percent of vignettes were answered correctly. Those who trained outside the United States or Canada (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-3.0) and PEM-trained providers (OR, 2.6; 95% CI, 1.2-5.9) were more likely to answer questions correctly. Providers answered more questions correctly about dengue (76%) and tuberculosis (77%) than typhoid (53%) and malaria (39%) (OR, 3.8; 95% CI, 3.0-4.9). Diagnostic evaluation for tropical diseases was variable with greater than 75% agreement for only 2 tests: blood smears in febrile patients from Africa (86%) and bacterial stool cultures in patients with bloody stools from Africa, Asia, or Latin America (94%). Providers had low (62%) or medium (35%) comfort level with pediatric tropical diseases, and 93% were interested in accessing emergency department-specific resources. CONCLUSIONS: Pediatric EM and EM providers' knowledge and evaluation for pediatric tropical diseases are variable. Providers recognized their knowledge gaps and expressed interest in gaining access to resources and guidelines to standardize and improve evaluation and treatment of these diseases.

Scientific Representations at the UPR School of Tropical Medicine. I: Images of Science.

The essay examines the scientific representations that prevailed at the University of Puerto Rico School of Tropical Medicine (STM) under the auspices of Columbia University (1926-1949). This article on the STM's scientific endeavors is the first in a historical serial collection about the images and evolution of sciences at the institution. It reviews faculty's principal investigations (by disciplines and research problems), development of research programs, and concomitant scientific productivity and research outcomes. The essay focuses on the emerged scientific representations and the nature of sciences, and has been divided into four sections: 1) images of science, 2) the evolution of science in the first two eras (1926-40), 3) the third and last era unfolding (1941-49), and 4) special studies. This first paper focuses on the scientific images that emerged from an examination of communities' interactions, networks, and academic and foundational documents. The scientific representations have been brought about through the analyses of different sources: academic and research reports, and publications in external and local venues. The most significant findings of this representational inquiry are: the idea of an academic tropical center in the tropics had a shared colonial-metropolis image; the community of common, but unequal, scientific citizens became an integrated epistemological community; interdisciplinary cooperation was the School's research dictum; and an image of a mature science and school of tropical medicine emerged. The richness and varieties of the practices and outcomes of science at the STM are analytically viewed as research schemas, exemplars of knowledge (paradigms), and epistemological fields (epistemes).

Needs and coordination mechanism for capacity building by the RNAS.

For the Regional Network on Asian Schistosomiasis and Other Helminth Zoonosis (RNAS+), capacity building with emphasis on modern technology with correspondence to traditional techniques was found to be a priority. This article summarized the actual needs of capacity building among RNAS+ member countries and the working mechanism of capacity building during the last 20 years. The needs with respect to the RNAS+ target diseases are highly correlated with the research priorities, since most problems with regard to the performance of the national disease control programme in the member countries are connected with inadequate capacity in relation to implementation of innovative research, epidemiological investigations, laboratory performance; and sociological investigations. The capacity building arranged through RNAS+ platform includes short training courses, individual training in member institutions, e.g., supervision of Ph.D./Masters students; postdoctoral training; and internship training in institutions of southeast Asia as well as in famous institutions of Europe and the United States. In the future, capacity building will focus on platform design and technical standardization aiming at fostering research capacity in the future. Moreover, new training projects, such as massive online courses (MOOC) will be explored under RNAS+ platform.

Scientific Representations at the UPR School of Tropical Medicine. II: The Evolution of Science, the First Two Eras (1926-31, 1932-1940).

The essay examines the scientific representations that unfolded and manifested at the University of Puerto Rico School of Tropical Medicine (STM) under the auspices of Columbia University (1926-1949). It focuses on the emerged scientific representations and on the kind of science practiced at the School, and has been divided into four sections: images of science, evolution during the first two eras (1926-31 and 1932-40), the unfolding third and last era (1941-49), and special technical studies. This article on the STM's scientific endeavors is the second in this historical serial collection about the images and evolution of sciences at the institution, and portrays the events and processes of the first two scientific eras. It reviews the faculty's principal investigations, development of research programs, and concomitant scientific productivity and research outcomes. The following historical sources were considered: academic and research reports, and publications in external and local venues. On findings, bacteriological investigations and studies on mycology and dermatological fungal infections characterized research during the first era. Parasitology became the hegemonic science of tropical medicine during the second scientific era, in conjunction with important studies on nutrition and streptococcal bacteriological infections. Variations of an earlier tropical medicine discourse of 'abundance of material for study' were: the socioeconomic toll of tropical diseases and a biopower exertion of induced recruitment of medical bodies. And public health field-community studies became a critical research approach at-end of periods. The evolution of science in the last and third era will be the main subject of the next article.