Tropical Diseases, Travel Medicine and Vaccines最新文献

Background: Dermatologic conditions are among the most frequent health problems in international travelers, following gastrointestinal and febrile illnesses. Myiasis, defined as infestation of human tissue by dipterous fly larvae, represents a noteworthy dermatologic diagnosis, particularly in travelers returning from tropical regions. Furuncular myiasis is the most recognizable form, presenting with painful nodules containing larvae, and is commonly caused by Dermatobia hominis in Central and South America. Increasing international travel is expected to raise the incidence of such conditions in non-endemic regions.

Case report and discussions: We report the case of a 77-year-old Romanian male, with co-morbidities, who developed cutaneous furuncular myiasis following a 12-day trip to Brazil and Argentina. The patient presented with painful nodular skin lesions on the upper limb approximately one month after returning. Initial treatments with anti-inflammatory agents and antibiotics were ineffective. Subsequent surgical drainage revealed the presence of larvae, confirming the diagnosis. Complete healing occurred within 2-3 weeks. Based on clinical presentation and travel history, Dermatobia hominis was considered the most probable etiologic agent, although molecular confirmation was unavailable. Discussion highlights the epidemiology and classification of myiasis-producing flies, emphasizing the geographic distribution of Dermatobia hominis and Cochliomyia hominivorax. Furuncular myiasis is often misdiagnosed as cellulitis or abscess due to nonspecific symptoms. Key diagnostic clues include persistent nodules with central punctum, serous discharge, and recent travel to endemic areas. Ultrasound can aid in identifying larvae, while laboratory confirmation enhances epidemiological surveillance. Management typically involves mechanical or surgical larval extraction, wound care, and monitoring for secondary infection. Preventive measures include insect repellents, protective clothing, and use of insecticide-treated nets. This case underscores the need for heightened clinical awareness in non-endemic countries, where travel-related parasitic infections are increasingly encountered. Pre-travel medical consultations are crucial for providing vaccinations, preventive advice, and education on insect protection. While our patient experienced a favorable outcome, delayed diagnosis and lack of preventive measures may increase morbidity.

Conclusion: With the rising popularity of travel to tropical areas, clinicians should consider cutaneous myiasis in travelers with persistent nodular skin lesions. Prompt recognition and extraction of larvae remain the cornerstone of effective treatment.

Background: The burden of malaria remains high, particularly in sub-Saharan Africa, where it accounts for over 200 million cases annually. Vaccination is the latest tool in the armamentarium to prevent malaria. Although a couple of malaria vaccines have been deployed in some countries, gaps in knowledge about their delivery, cost, and effectiveness remain. This rapid review synthesized evidence on issues on malaria vaccines implementation to inform strategies for optimising their accessibility.

Methods: A comprehensive search of PubMed, Google Scholar, and Cochrane Library was conducted to identify studies that examined malaria vaccine delivery mechanisms, costs, and logistical challenges from 2000 to 2024. The articles underwent duplicates removal, title/abstract screening, and full-text review. Eligible studies included those on currently approved and emerging malaria vaccines. Data were extracted systematically and synthesized descriptively.

Results: Thirty studies met the inclusion criteria, with 21(%) conducted in Africa. RTS, S/AS01 was the most commonly reported vaccine (n = 23, 76.67%), with reported efficacy rates of 30% - 75%. Cost-effectiveness estimates for the vaccines varied from $20 - $50 per DALY averted, but higher costs were reported in some settings. Delivery strategies largely involved routine immunization (n = 12, 40%), although innovative methods, including drones, showed promise in one study. Key barriers were logistical constraints, community acceptance, and healthcare infrastructure limitations.

Conclusions: The findings highlighted delivery and cost-effectiveness challenges for malaria vaccination. Ways and means of reducing the costs and improving the effectiveness of different sustainable malaria vaccine delivery strategies, especially in remote and underserved communities should be developed. Limitations of this rapid review include restriction to English-language studies, exclusion of grey literature, and variability in study designs, which may have limited comprehensiveness and comparability of findings.

Background: The introduction of BPaL and BPaLM regimens has revolutionized drug-resistant tuberculosis treatment, offering superior efficacy, shorter duration, and better tolerability than conventional therapies. Despite their rapid WHO guideline incorporation, no prior bibliometric analysis has been conducted on this topic. This study addresses this gap by mapping global knowledge production, collaborations, and thematic trends to inform future research and implementation strategies.

Methods: We analyzed Scopus-indexed publications using controlled vocabulary for BPaL/BPaLM regimens. From 551 initial records, 120 met inclusion criteria after screening. Bibliometrix and VOS Viewer software evaluated publication trends, authorship, institutional/geographical contributions, citations, and keyword networks. Visualization tools mapped collaborations and thematic clusters, while statistical methods assessed growth rates and citation impacts.

Results: The study identified 1,081 authors, with publications growing at 11.61% annually and peaking in 2024 (n = 56). International collaborations featured in 53.33% of studies, led by the US (n = 56), UK (n = 25), and South Africa (n = 20). Johns Hopkins University was the top institution (n = 56), and Antimicrobial Agents and Chemotherapy the leading journal (n = 15). Landmark 2019 publications had the highest citation rate (13.05/year). Thematic analysis revealed categorization into three domains: pathogen and drug resistance, treatment regimens and efficacy, and demographics and clinical studies. Strong collaborations linked high-income and high-burden countries, notably the US and South Africa.

Conclusion: This first bibliometric assessment of BPaL/BPaLM research highlights progress in evidence generation but reveals gaps in implementation science and equitable knowledge production. Future work should address operational challenges, special populations, and resistance monitoring. These insights can guide researchers, policymakers, and funders to optimize TB control programs and advance global elimination goals.

The respiratory system of humans is impacted by infectious and deadly illnesses like COVID-19. Early identification and diagnosis of this type of illness is essential to stop the infection from spreading further. In the present research, we presented a technique for determining the condition using COVID-19's current genome sequences employing the DenseNet-16 framework. We operated a network of already trained neurons before using a transfer learning method to prepare it according to our dataset. Additionally, we preprocessed the collected information using the NearKbest interpolation approach; then, we utilized Adam Optimizer to optimize our findings. Compared with special deep learning models like ResNet-50, VGG-19, AlexNet, and VGG-16, our approach produced an accuracy of 99.18%. The model was deployed on a platform with GPU support, which greatly decreased training time. Dataset size and the requirement for further validation are two of the study's limitations, despite the encouraging results. The current research showed how a deep learning approach may be useful to categorize the genome sequence of infectious disease like COVID-19 using the suggested GenoDense-Net architecture. The next step in this research project is conducting investigations in the clinic.

Background: Malaria remains a significant global health issue, with an estimated 263 million cases and 597,000 deaths reported in 2023. Plasmodium ovale, although less common than P. falciparum and P. vivax, presents diagnostic challenges due to its morphological resemblance to P. vivax and its ability to form latent liver-stage hypnozoites, leading to delayed relapses.

Case presentation: This case report describes a 29-year-old male who presented with fever, chills, and myalgia upon returning to Bogotá, Colombia, after a three-month stay in Côte d'Ivoire, Africa. Initial microscopy misidentified the parasite as P. falciparum, leading to diagnostic uncertainty. Polymerase chain reaction (PCR) confirmed P. ovale infection, emphasizing the critical role of molecular diagnostics in differentiating malaria species. The patient was treated with chloroquine and primaquine for radical cure. Initially, the patient received artemether-lumefantrine empirically. Once the diagnosis of P. ovale was confirmed, he was switched to chloroquine followed by primaquine (15 mg base daily for 28 days) as radical cure. G6PD testing was not available in our setting, but the patient was monitored clinically and tolerated the medication without adverse effects.

Conclusions: Given that P. ovale is not endemic to Colombia, increased awareness among clinicians is necessary for accurate diagnosis and management of imported malaria cases. Enhanced surveillance and advanced diagnostic techniques are essential to prevent misdiagnosis and ensure appropriate treatment.

Background: Malaria is a major health problem around the world. Plasmodium falciparum (P. falciparum) is the species that is most commonly associated with the severe and complicated forms of malaria, especially in tropical and subtropical areas, including Ethiopia. One of the complications of malaria is its impact on kidney and electrolyte levels. The objectives of the study were to assess the kidney function and serum electrolyte levels among untreated malaria patients infected with P. falciparum.

Methodology: A case-control study that enrolled a total of 108 participants (54 with confirmed untreated P. falciparum malaria as a case and 54 were non-malaria as a control). Participants in the study were included based on systematic random sampling technique. Data were collected using questionnaires administered by interviewers. 5 ml of blood samples were collected to investigate kidney function such as creatinine and urea, as well as serum electrolytes such as sodium ion (Na⁺) and potassium ion (K⁺), using a chemistry automated analyzer. Data were analyzed using the statistical package for social science (SPSS) version 27. P < 0.05 was considered statistically significant at a 95% confidence interval (CI).

Result: The study subjects were comprised of 52 (48.1%) men and 56 (51.9%) women. The mean age for the case group and the control group was 26.85 ± 8 and 27.17 ± 7.17 years old, respectively. The result showed a statistically significant (P < 0.05) increase in serum creatinine and urea level in the case group (1.32 ± 0.29 mg/dL and 39.8 ± 8.34 mg/dL) compared with the control group (0.92 ± 0.32 mg/dL and 25.78 ± 7.97 mg/dL), respectively. The serum levels of Na⁺ and K⁺ were significantly (P < 0.05) decreased in the case group (132.15 ± 3.96 mmol/L and 3.44 ± 0.40 mmol/L) as compared to the control group (137.11 ± 3.11 mmol/L and 3.94 ± 0.39 mmol/L), respectively.

Conclusion: Malaria has a significant impact on kidney function (creatinine and urea) and serum electrolytes (Na⁺ and K⁺). This may indicate that malaria is the determinant factor for developing kidney dysfunction and serum electrolyte imbalance. Hence, we recommend routine evaluation of these parameters in malaria-infected individuals.

Background: Malaria still remains one of the leading causes of death, especially in Africa, with one of the major struggles associated with eradication being resistance to antimalarial medications. Imatinib, a selective tyrosine kinase inhibitor used to treat chronic myeloid leukemia, has emerged as a potential pharmacological approach for malaria management.

Methods: This review synthesizes studies from the inception of the databases of PubMed, Scopus, Google Scholar, Cochrane, Web of Science, and Embase to February 2025, identifying key clinical trials and invitro studies conducted to assess the efficacy and safety of Imatinib in malaria.

Results: With varying sample sizes, dosage and follow-up data, the studies reported a decline in parasite density, pyrexia, parasite growth inhibition, and synergism with other anti-malarial medications like Artesunate. Across the nine (9) studies reviewed, Imatinib showed a favorable safety profile with no adverse drug-related events reported.

Conclusions: We discuss the potential advantages and challenges of repurposing Imatinib for treating malaria, its pharmacokinetic profile, and its use in other patient populations, such as children and pregnant women. Future studies should focus on randomized controlled trials with larger sample sizes and possible combination therapies with other antimalarial medications.

Background: Hypersensitivity reactions (HSR) to the COVID-19 vaccine have been reported. Despite these reactions, revaccination remains essential.

Objective: This study aims to explore the potential outcomes of COVID-19 revaccination in individuals with prior vaccine-related adverse reactions.

Methods: A retrospective study was employed with a sample of 225 patients, with HSR regarding COVID-19 vaccines, who were referred to a university hospital. Demographic data, vaccine types and HSR were collected.

Results: Seventy-seven percent (175/225) of patients were revaccinated post HSR. Out of the 175 patients, 57.1%, 34.2% and 8.5% had a history of HSR in connection to inactivated vaccines, viral vector vaccines, and mRNA vaccines, respectively. Sixty percent were revaccinated with the same type of vaccine and 63.4% received antihistamines and/or anti-leukotriene premedication. After revaccination, 89.1% did not have adverse reactions, while 10.9% had mild reactions. When comparing patients who experienced HSR following COVID-19 revaccination with those who did not exhibit reactions, a significant association among patients with revaccination adverse effects were a revaccination with inactivated vaccines; Sinovac-CoronaVac (P < 0.001), a history of any allergic diseases (P < 0.001) and underlying allergic rhinitis (P = 0.003). Premedication or change of vaccine type did not have an effect to the rate of adverse reactions reported post revaccinations.

Conclusions: In this study, COVID-19 revaccination in patients with a history of COVID-19 vaccine-related HSRs was generally safe, with most patients tolerating it well. However, individuals with underlying allergic conditions, particularly allergic rhinitis, exhibited a higher incidence of mild reactions, especially following revaccination with an inactivated vaccine.