Current Tropical Medicine Reports最新文献

Purpose of review: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), continues to affect individuals, communities, and health systems worldwide. Here, we highlight how COVID-19 threatens to jeopardize the tremendous gains made over the last few decades on improving children's health globally.

Recent findings: In contrast to adults, children with COVID-19 are less likely to develop severe disease requiring hospitalization or die as a direct result of infection. However, the pandemic will likely have other important health impacts disproportionately affecting vulnerable children globally. Possible effects include worsening of poverty and food insecurity; disruption of already strained routine child health services; damage to already imperiled healthcare workforces; a wave of mental health challenges; interruption of education; and increased risks of violence, abuse, exploitation, and neglect. These challenges notwithstanding, the response to COVID-19 may also provide opportunities, such as for health system strengthening, that could improve child health after the pandemic.

Summary: The negative impacts of COVID-19 on global child health may be substantial. However, these are not foregone conclusions and much can be done to mitigate the worst outcomes. Child health providers should advocate for an equitable response to COVID-19 that prioritizes the health of vulnerable children and furthers the gains made in global child health.

Scientific research is essential for a nation's development and is vital for generating solutions to population's health. Individual country's capacities to prevent and respond to public health issues, including health crises, is built with long-term investment in highly qualified professionals, infrastructure, and uninterrupted operating funding. Most Latin American countries, especially those at the bottom of the human development list, have limited capacity even though they are hot spots for tropical and other emerging infectious diseases. This weakness deepens these countries' dependence on nations with higher development and corresponding scientific capacity. The current COVID-19 pandemic has wreaked havoc on the health of the world's population and the global economy. Countries that lagged behind prior to the pandemic now face a myriad of additional challenges. On a more optimistic note, the pandemic could serve as a wake-up call for governments and funding agencies to strengthen scientific capacity around the world, so that we are better prepared to address the public health issues caused by current and prevalent diseases and by future diseases of pandemic potential.

Purpose of review: Infectious diseases represent up to 12% of all deaths in people with diabetes mellitus (DM). The development and progression of DM generate a chronic inflammatory state with unique characteristics that have been exploited by some pathogens; one of them is Rhizopus spp., a fungus considered the causative agent of mucormycosis. This disease has a poor prognosis with high mortality rates, and the apparition of resistant isolates each year has become a worrying concern. DM is an actual and continuing health problem, and for that reason, it is of foremost importance to study the pathogenesis of mucormycosis to generate new prevention and treatment strategies.

Recent findings: The worldwide incidence of mucormycosis has increased in recent years. The pathogenic mechanisms and factors identified in Rhizopus spp. are the cell wall, spore germination, proteins, and enzymes related to iron sequestration, CotH fungal protein, positive regulation of the GRP78 cell receptor, and immune evasion due to survival within phagocytes, among others. The physiopathology of DM offers favorable conditions for the successful replication of Rhizopus spp.

Summary: The main reason for increase of incidence of mucormycosis caused by Rhizopus spp. has been associated with the rise of worldwide prevalence of DM. Knowing the fungal pathogenic mechanisms as well as the relationships between Rhizopus with the microenvironment found in the human body will undoubtedly help generate better antifungals to enhance treatment outcomes. Nowadays, some strategies to combat the fungus are based on the knowledge of its proteins, cellular interactions, and iron metabolism.

Purpose of review: Kumbh Mela, a religious gathering of Hindus held in India, is the largest massive gathering event in the world. The COVID-19 pandemic is an unprecedented healthcare crisis in recent times with effects reverberating in all spheres of human lives. India has registered the second highest number of COVID-19 cases. This paper aims to dwell in the religious and social background of Kumbh Mela massive gathering, as well as the ritualistic practices that could potentially entail public health risks in the current situation. It also aims to identify possible preparatory and interventional measures to evade such risks.

Recent findings: In recent years, the increase in the number of people attending the Kumbh Mela has been phenomenal. Congregants are put up at the holy sites for several days. The sheer number of people assembling at the religious venues poses a great challenge to manage the crowds, to cater to the requirements of basic amenities, and to meet their healthcare needs. Some of the ritualistic practices could heighten the risk for transmission of respiratory pathogens. The COVID-19 pandemic has escalated over the past few months in India. The pandemic is expected to sustain its tempo in India throughout the foreseeable future. Organization of the forthcoming Kumbh Mela needs meticulous planning.

Summary: Kumbh Mela is a Hindu religious gathering at the banks of India's rivers, held periodically. It witnesses assembly of huge numbers of people and has the potential to amplify the COVID-19 pandemic in India; this could overwhelm the healthcare system.

Purpose of the review: To describe the intersectionality of healthcare and economy, and potential solutions to prevent the next peak of COVID-19 in Sudan.

Recent findings: Sudan has recently emerged from a 30-year dictatorship to face the COVID-19 pandemic in the midst of the worst economic crisis. Disease control measures that have been used in developed countries have been difficult to implement in Sudan due to economic, social, and structural challenges. There is a need for integration of data into the disease response plan and for community engagement to help with mitigation efforts. Youth-led community organizations were critical in the success of the Sudanese revolution. Their formal involvement in contact tracing and community awareness campaigns can be beneficial.

Summary: The COVID-19 pandemic has brought to the surface many of the challenges facing the healthcare system in Sudan. Culturally tailored interventions are needed to prevent the next peak of COVID-19 in the country.

Purpose of review: In the midst of the COVID-19 pandemic, several academic studies have emerged that explore the importance of vitamin D in the development of the SARS-CoV2 infection. The basis of this interest comes from the established effect vitamin D status has on other acute respiratory infections, such as influenza. This article aims to determine the role and effect of vitamin D serum concentration in the prevalence and severity of COVID-19.

Recent findings: Several observational studies have demonstrated that suboptimal levels of vitamin D serum concentrations can significantly increase the risk of developing COVID-19 and lead to a more severe symptomatology. One study suggests, however, that supplementation of vitamin D could potentially increase the incidence of mortality in COVID-19 patients.

Summary: Vitamin D status could have an influential role in the development and progression of SARS-CoV2 infection. Further studies are warranted to understand fully the veracity and the extent of this association.

Purpose of review: Malaria poses a threat to nearly half of the world's population, and recent literature in the USA is lacking regarding understanding risk for local outbreaks. This article aims to review Anopheles mosquito data, vector-borne disease outbreak preparedness, and human travel data from large international gateway cities in an effort to examine risk for localized outbreaks.

Recent findings: The majority of vector control organizations are widely unprepared for a vector-borne disease outbreak, and multiple mosquito species capable of transmitting malaria continue to persist throughout the USA.

Summary: Despite the lack of recent autochthonous cases in the USA, multiple risk factors suggest that local malaria outbreaks in the USA will continue to pose a public health threat due to large numbers of international travelers from endemic areas, multiple Anopheles spp. capable of transmitting the parasite, and unsatisfactory vector-borne disease outbreak preparedness. Climate conditions and recent changes in travel patterns will influence malaria across the globe.

Purpose of review: The goal of this review is to summarize the current knowledge of the epidemiology, clinical manifestations, diagnosis, and treatment of cutaneous, mucosal, and visceral leishmaniasis. We will describe the most recent findings and suggest areas of further research in the leishmaniasis field.

Recent findings: This article reviews newer leishmaniasis tests (including rapid diagnostic tests using rK39 antibodies), vaccine candidates, and updated treatment recommendations.

Summary: While leishmaniasis is a complex disease, learning the prominent clinical manifestations and major parasite species can guide the recommendations for diagnosis and treatment.

Purpose of review: Although the chikungunya virus was discovered more than 60 years ago, it has only really been studied since the outbreak in La Reunion in 2005-2006. Ten years later, between 2014 and 2015, the chikungunya virus spread throughout the Americas, affecting millions of people. The objective of this review is to describe the contributions of research on chikungunya virus infection gained from epidemic in the West Indies and the Guiana Shield.

Recent findings: Prevalence data were similar to those found in the Indian Ocean or Asia during epidemics. Clinically, there is now a better understanding of the typical, atypical, and severe forms. Several studies have insisted on the presence of neurological forms of chikungunya infection, such as encephalitis or Guillain-Barré syndrome. Cases of septic shock due to chikungunya virus as well as thrombotic thrombocytopenic purpura were described for the first time. Given the magnitude of the epidemic and the large number of people affected, this has led to a better description and new classifications of chikungunya virus infections in specific populations such as pregnant women, the elderly, and children. Several studies also described the behavior of populations faced with an emerging disease.

Summary: Current epidemiological data from tropical regions highlights the risk of spreading emerging diseases at higher latitudes, especially concerning arboviruses, since the vector Aedes albopictus is already established in many parts of northern countries. A better understanding of the disease and its epidemic dynamics will foster better management, the crucial importance of which was demonstrated during the COVID-19 epidemic.

Purpose of review: This review aims to describe briefly the general information of arboviruses dengue, Zika, and chikungunya infections and emphasize the clinical manifestations of each, to help identify and make a quick diagnosis of each.

Recent findings: The most relevant advances in the study of these arboviruses' infections have been in the epidemiological distribution, mainly due to international travel, migration, and climate change; in the clinical manifestations of these diseases, the development of clinical decision-making software, which can help improve the management and outcomes of these patients; and in the prevention of this disease.

Summary: Although arboviruses infections constitute a clinical challenge for the attending physician in the scope of a febrile returning traveler, a thorough clinical history and exam can help to aid diagnostic reasoning. The characteristics of the rash are a very helpful clue in the evaluation of these patients. Currently, there are clinical decision aid tools that help to get the diagnosis more quickly.