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1.
Infect Dis Poverty ; 9(1): 86, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32646512

RESUMO

Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern. They include a large group of neglected tropical diseases (NTDs), many of which are of zoonotic nature. Coronavirus disease 2019 (COVID-19), another emerging zoonotic disease, has just increased the stakes exponentially. Most NTDs are subject to the impact of some of the very same human-related activities triggering other emerging and re-emerging diseases, including COVID-19, severe acute respiratory syndrome (SARS), bird flu and swine flu. It is conceivable that COVID-19 will exacerbate the NTDs, as it will divert much needed financial and human resources. There is considerable concern that recent progress achieved with control and elimination efforts will be reverted. Future potential strategies will need to reconsider the determinants of health in NTDs in order to galvanize efforts and come up with a comprehensive, well defined programme that will set the stage for an effective multi-sectorial approach. In this Commentary, we propose areas of potential synergies between the COVID-19 pandemic control efforts, other health and non-health sector initiatives and NTD control and elimination programmes.


Assuntos
Doenças Transmissíveis Emergentes/prevenção & controle , Infecções por Coronavirus/epidemiologia , Doenças Negligenciadas/prevenção & controle , Pneumonia Viral/epidemiologia , Medicina Tropical/métodos , Animais , Betacoronavirus , Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Coronavirus/prevenção & controle , Saúde Global , Humanos , Colaboração Intersetorial , Doenças Negligenciadas/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Alocação de Recursos , Medicina Tropical/tendências , Zoonoses/epidemiologia , Zoonoses/prevenção & controle
2.
Rev Med Suisse ; 16(693): 989-992, 2020 May 13.
Artigo em Francês | MEDLINE | ID: mdl-32401439

RESUMO

When considering women's health during travels, it is mainly pregnant women who are concerned. Indeed, because of the physiological changes, they are more vulnerable to infectious and non-infectious diseases related to the trip itself or to specific activities. This article lists the essential risks for pregnant women travelling in tropical countries and provides specific recommendations, so that the general practitioner is better able to advise this vulnerable population. If the trip is suitable and in the absence of any pre-existing complication, travelling during pregnancy is not contraindicated.


Assuntos
Complicações na Gravidez/prevenção & controle , Gestantes , Medicina de Viagem , Medicina Tropical , Saúde da Mulher , Feminino , Humanos , Gravidez , Complicações na Gravidez/epidemiologia
3.
Nursing ; 50(5): 43-45, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32332504

RESUMO

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.


Assuntos
Educação em Enfermagem/organização & administração , Medicina Tropical/educação , Currículo , Humanos
4.
Washington, D.C.; OPS; 2020-04-30.
em Espanhol | PAHO-IRIS | ID: phr-52051

RESUMO

Este documento presenta un conjunto de herramientas para ayudar a los países y los programas de lucha contra la ETD, a colaborar con la comunidad relacionada con las acciones de agua, saneamiento e higiene, y guía en la creación de alianzas, en la movilización de recursos y en el diseño, la aplicación y la evaluación de las intervenciones. Más que una guía de “buenas prácticas”, se trata de un conjunto de herramientas basadas en la experiencia adquirida en la realidad de un programa. Se espera que los interesados en usar este documento puedan elegir las herramientas y adaptarlas a sus necesidades y al contexto local. Estas herramientas ayudarán a 1) crear alianzas multisectoriales con los interesados directos clave: ministerios, agencias de WASH nacionales y locales, empresas, grupos locales activos en cuestiones de salud, expertos en cambio de comportamientos y en comunicación, etc.; 2) a formar estructuras de programa inteligentes centradas en la rendición de cuentas y en los objetivos comunes; 3) a establecer un método de programación adaptativo y flexible; 4) a garantizar la sostenibilidad mediante la creación de capacidad local a todos los niveles; y 5) a brindar apoyo y complementar las intervenciones clínicas y de salud pública en la lucha contra las EID.


Assuntos
Medicina Tropical , Doenças Negligenciadas , Saneamento , Programas Nacionais de Saúde , Prioridades em Saúde , Objetivos Organizacionais , Conservação dos Recursos Naturais
8.
PLoS Negl Trop Dis ; 14(2): e0008030, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32023242

RESUMO

BACKGROUND: Skin neglected tropical diseases (NTDs) such as Buruli ulcer (BU) and leprosy produce significant stigma and disability. Shared clinical presentations and needs for care present opportunities for integrated case management in co-endemic areas. As global policies are translated into local integrated services, there remains a need to monitor what new configurations of care emerge and how individuals experience them. METHODS: To explore patient experiences of integrated case management for skin NTDs, in 2018, we conducted a field-based qualitative case series in a leprosy rehabilitation centre in Ganta, Liberia where BU services were recently introduced. Twenty patients with BU (n = 10) and leprosy (n = 10) participated in in-depth interviews that incorporated photography methods. We contextualised our findings with field observations and unstructured interviews with health workers. FINDINGS: The integration of care for BU and leprosy prompted new conceptualisations of these diseases and experiences of NTD stigma. Some patients felt anxiety about using services because they feared being infected with the other disease. Other patients viewed the two diseases as 'intertwined': related manifestations of the same condition. Configurations of inter-disease stigma due to fear of transmission were buffered by joint health education sessions which also appeared to facilitate social support between patients in the facility. For both diseases, medication and wound care were viewed as the cornerstones of care and appreciated as interventions that led to rehabilitation of the whole patient group through shared experiences of healing, avoidance of physical deformities and stigma reduction. Patient accounts of intense pain during wound care for BU and inability of staff to manage severe complications, however, exposed some shortcomings of medical care for the newly integrated service, as did patient fears of long-lasting disability due to lack of physiotherapy services. SIGNIFICANCE: Under integrated care policies, the possibility of new discourses about skin NTD identities emerging along with new configurations of stigma may have unanticipated consequences for patients' experiences of case management. The social experience of integrated medication and wound dressing has the potential to link patients within a single, supportive patient community. Control programmes with resource constraints should anticipate potential challenges of integrating care, including the need to ameliorate lasting disability and provide adequate clinical management of severe BU cases.


Assuntos
Úlcera de Buruli/complicações , Úlcera de Buruli/epidemiologia , Administração de Caso , Hanseníase/complicações , Hanseníase/epidemiologia , Doenças Negligenciadas , Humanos , Libéria/epidemiologia , Estigma Social , Apoio Social , Clima Tropical , Medicina Tropical
12.
BMC Dermatol ; 20(1): 1, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31918687

RESUMO

BACKGROUND: Mycetoma is an uncommon chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). It is the prerogative of young men between the third and fourth decade and is transmitted through any trauma causing an inoculating point. The classic clinical triad associates a painless hard and swelling subcutaneous mass, multiple fistulas, and the pathognomonic discharge of grains. Although endemic in many tropical and subtropical countries, mycetoma can also be found in non-endemic areas as in Morocco, and causes then diagnosis problems leading to long lasting complications. Therefore, we should raise awareness of this neglected disease for an earlier management. Under medical treatment however, mycetoma has a slow healing and surgery is often needed, and relapses are possible. CASE PRESENTATION: Herein we report a case of a 64 years old patient, with a history of eumycetoma occurring ten years ago treated with oral terbinafine coupled with surgery. A complete remission was seen after 2 years. He presented a relapse on the previous scar 6 months ago. There wasn't any bone involvement in the magnetic resonance imaging (MRI). The patient was put under oral terbinafine with a slow but positive outcome. CONCLUSION: Through this case report, we perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.


Assuntos
Doenças do Pé/diagnóstico , Madurella/isolamento & purificação , Micetoma/diagnóstico , Antifúngicos/uso terapêutico , Diagnóstico Diferencial , Pé/diagnóstico por imagem , Pé/microbiologia , Pé/patologia , Doenças do Pé/microbiologia , Doenças do Pé/patologia , Doenças do Pé/terapia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Marrocos , Micetoma/microbiologia , Micetoma/patologia , Micetoma/terapia , Doenças Negligenciadas , Medicina Tropical
14.
BMC Infect Dis ; 20(1): 63, 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31959110

RESUMO

BACKGROUND: Imported loiasis is a rare cause of consultation at the return of stay in central Africa, which often poses difficult diagnostic and therapeutic questions to practitioners especially those who are unaccustomed to tropical medicine. These difficulties can lead to risks for the patients especially if inappropriate treatment is given. Large series of imported loiasis are scarce. METHODS: We retrospectively studied the data including outcome in patients diagnosed with imported loiasis between 1993 and 2013 in the Paris area on the basis of a parasitological diagnosis (microfilaremia > 1/ml and/or serologic tests). We compared sub-Saharan and non sub-Saharan African patients. RESULTS: Of the 177 identified cases, 167 could be analysed. Sex ratio was 1, mean age 41 years and 83% were sub-Saharan Africans. Cameroon was the main country of exposure (62%). Incubation time may be long (up to 18 months). Of the 167 cases, 57% presented with characteristic symptoms (Calabar swellings, creeping dermatitis, eyeworm) whereas 43% were diagnosed fortuitously. Microfilaremia was evidenced in 105 patients (63%), and specific antibodies in 53%. Compared to sub-Saharan Africans, other patients were presenting less frequently with eyeworm migration and microfilaremia whereas they had higher eosinophilia and positive serology. Prevalence of Calabar swellings was not significantly different between the two groups. Cure rates were 52% with ivermectin alone, and 77% with ivermectin followed by diethylcarbamazine. No severe adverse event was reported. CONCLUSIONS: Presentation of imported loiasis varies according to ethnicity. A systematic screening should be recommended in patients with potential exposure in endemic country. Treatment with ivermectin followed by diethylcarbamazine could be a valuable option.


Assuntos
Grupo com Ancestrais do Continente Africano , Doenças Transmissíveis Importadas/etnologia , Doenças Transmissíveis Importadas/epidemiologia , Loa/imunologia , Loíase/etnologia , Loíase/epidemiologia , Adolescente , Adulto , África do Norte/etnologia , Animais , Criança , Pré-Escolar , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/tratamento farmacológico , Dietilcarbamazina/uso terapêutico , Feminino , Humanos , Lactente , Recém-Nascido , Ivermectina/uso terapêutico , Loíase/diagnóstico , Loíase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Paris/epidemiologia , Prevalência , Estudos Retrospectivos , Resultado do Tratamento , Medicina Tropical , Adulto Jovem
15.
PLoS Negl Trop Dis ; 14(1): e0007860, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31999695

RESUMO

In the past two decades there has been a significant expansion in the number of new therapeutic monoclonal antibodies (mAbs) that are approved by regulators. The discovery of these new medicines has been driven primarily by new approaches in inflammatory diseases and oncology, especially in immuno-oncology. Other recent successes have included new antibodies for use in viral diseases, including HIV. The perception of very high costs associated with mAbs has led to the assumption that they play no role in prophylaxis for diseases of poverty. However, improvements in antibody-expression yields and manufacturing processes indicate this is a cost-effective option for providing protection from many types of infection that should be revisited. Recent technology developments also indicate that several months of protection could be achieved with a single dose. Moreover, new methods in B cell sorting now enable the systematic identification of high-quality antibodies from humanized mice, or patients. This Review discusses the potential for passive immunization against schistosomiasis, fungal infections, dengue, and other neglected diseases.


Assuntos
Anticorpos Monoclonais/farmacologia , Doenças Negligenciadas/tratamento farmacológico , Animais , Dengue/tratamento farmacológico , Desenvolvimento de Medicamentos , Humanos , Imunização Passiva , Camundongos , Micoses/tratamento farmacológico , Esquistossomose/tratamento farmacológico , Medicina Tropical
16.
Am J Trop Med Hyg ; 102(1): 9-10, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31971145
17.
Am J Trop Med Hyg ; 102(3): 494-496, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31912776

RESUMO

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.


Assuntos
Pesquisa Biomédica/economia , Pesquisa Biomédica/educação , Países em Desenvolvimento , Recursos em Saúde , Pesquisadores/educação , Medicina Tropical/educação , África ao Sul do Saara , Escolha da Profissão , Assistência à Saúde , Humanos , América Latina , Medicina Tropical/economia
18.
Infect Dis Poverty ; 9(1): 10, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31987053

RESUMO

BACKGROUND: Neglected tropical diseases (NTDs) have long been overlooked in the global health agenda. They are intimately related to poverty, cause important local burdens of disease, but individually do not represent global priorities. Yet, NTDs were estimated to affect close to 2 billion people at the turn of the millennium, with a collective burden equivalent to HIV/AIDS, tuberculosis, or malaria. A global response was therefore warranted. MAIN TEXT: The World Health Organization (WHO) conceived an innovative strategy in the early 2000s to combat NTDs as a group of diseases, based on a combination of five public health interventions. Access to essential NTD medicines has hugely improved thanks to strong public-private partnership involving the pharmaceutical sector. The combination of a WHO NTD roadmap with clear targets to be achieved by 2020 and game-changing partner commitments endorsed in the London Declaration on Neglected Tropical Diseases, have led to unprecedented progress in the implementation of large-scale preventive treatment, case management and care of NTDs. The coming decade will see as challenges the mainstreaming of these NTD interventions into Universal Health Coverage and the coordination with other sectors to get to the roots of poverty and scale up transmission-breaking interventions. Chinese expertise with the elimination of multiple NTDs, together with poverty reduction and intersectoral action piloted by municipalities and local governments, can serve as a model for the latter. The international community will also need to keep a specific focus on NTDs in order to further steer this global response, manage the scaling up and sustainment of NTD interventions globally, and develop novel products and implementation strategies for NTDs that are still lagging behind. CONCLUSIONS: The year 2020 will be crucial for the future of the global response to NTDs. Progress against the 2020 roadmap targets will be assessed, a new 2021-2030 NTD roadmap will be launched, and the London Declaration commitments will need to be renewed. It is hoped that during the coming decade the global response will be able to further build on today's successes, align with the new global health and development frameworks, but also keep focused attention on NTDs and mobilize enough resources to see the effort effectively through to 2030.


Assuntos
Controle de Doenças Transmissíveis/estatística & dados numéricos , Saúde Global , Doenças Negligenciadas/prevenção & controle , Pobreza/estatística & dados numéricos , Medicina Tropical/estatística & dados numéricos , Humanos
19.
Trop Doct ; 50(1): 43-49, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31594530

RESUMO

Results from medical research from high-income countries may not apply to low- and middle-income countries. Some expatriate physicians combine clinical duties with research. We present global health research conducted by Dutch medical doctors in Global Health and Tropical Medicine in low- and middle-income countries and explore the value of their research. We included all research conducted in the last 30 years by medical doctors in Global Health and Tropical Medicine in a low- and middle-income country, resulting in a PhD thesis. Articles and co-authors were found through Medline. More than half of the 18 identified PhD theses concerned maternal health and obstetrics, and the majority of the research was conducted in low-income countries, mostly in rural hospitals. Over 70 local co-authors were involved. Different aspects of these studies are discussed.


Assuntos
Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Países em Desenvolvimento , Papel do Médico , Autoria , Saúde Global , Humanos , Países Baixos , Medicina Tropical
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