Case Report: Typhoid Fever Complicated by Ileal Perforation in an Urban Slum of Dhaka, Bangladesh.

Intestinal perforation is one of the most dangerous complications of typhoid fever and demands urgent hospitalization, diagnosis, and surgical management to reduce morbidity and prevent mortality. Here, we report a case of typhoidal intestinal perforation in a 19 year-old young man detected by passive surveillance during a cluster-randomized trial with Vi-tetanus toxoid conjugate vaccine (Typhoid Vaccine Acceleration Consortium: TyVAC) in an urban slum area in Mirpur, Dhaka, Bangladesh. The patient presented with a high-grade fever, lower abdominal pain, and vomiting and was admitted to a healthcare facility.

A new global strategy for the elimination of schistosomiasis.

Mass drug administration utilising a single oral dose of 40mg/kg of praziquantel (PZQ) has been endorsed and advocated by the World Health Organisation (WHO) for the global control and elimination of schistosomiasis. However, this strategy is failing primarily because the drugs are not getting to the people who need them the most. The current global coverage is 20%, the drug compliance rate is less than 50%, and the drug efficacy is approximately 50%.

Biennial versus annual treatment for schistosomiasis and its impact on liver morbidity.

Objective: This study assessed the impact of annual versus biennial praziquantel treatment regimens on the prevalence, intensity of infection, and liver fibrosis dynamics of Asiatic schistosomiasis (caused by Schistosoma japonicum) among individuals residing in 18 endemic barangays in Northern Samar, Philippines.

Methods: Five hundred and sixty-five subjects who reported symptoms of gastrointestinal illness and/or were believed to have clinical morbidity based on physical examination were selected for cohort follow-up.

Results: The mean prevalence of schistosomiasis was 34% and the mean intensity of infection was 123.

Risk factors for human helminthiases in rural Philippines.

Background: A cross-sectional survey was performed in 2012 among 18 rural barangays in Northern Samar, the Philippines in order to determine the prevalence of single and multiple species helminth infections and the underlying risk factors of acquiring one or more parasites.

Methods: A total of 6976 participants who completed a medical questionnaire and provided a stool sample for examination were included in the final analysis.

Results: The overall prevalence rates of Schistosoma japonicum, Ascaris lumbricoides, Trichuris trichiura, and hookworm were found to be moderate to high at 28.

Mass drug administration and the global control of schistosomiasis: successes, limitations and clinical outcomes.

Purpose Of Review: Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. Despite the well known short-term benefits of treating patients for schistosomiasis, the impact of mass drug administration (MDA) campaigns to control the disease in the long term remains unresolved.

Recent Findings: Many studies have advocated the success of MDA programs in order to attract donor funds for elimination efforts but such successes are often short-lived given the drug does not alter the life cycle of the organism or prevent reinfection.

Planning for the Next Global Pandemic.

In order to mitigate human and financial losses as a result of future global pandemics, we must plan now. As the Ebola virus pandemic declines, we must reflect on how we have mismanaged this recent international crisis and how we can better prepare for the next global pandemic. Of great concern is the increasing frequency of pandemics occurring over the last few decades.

The dire sexual health crisis among MSM in the Philippines: an exploding HIV epidemic in the absence of essential health services.

The rate of HIV is exploding in the men who have sex with men (MSM) population in the Philippines. There is a paucity of information with respect to sexual behaviour, condom use, psychological health, and the prevalence of other STIs in the MSM subpopulation. At present there are no existing private or public clinical services in the country that focus on health services of MSM.

Prudent care of head trauma in the elderly: a case report.

Introduction: Severe traumatic brain injury is a major public health problem that accounts for one-third of all deaths due to trauma in the United States. This case report illustrates some of the challenges faced by the elderly in accessing essential emergency services for traumatic brain injury.

Case Presentation: A 74-year-old Caucasian man presented with head trauma at his local acute care hospital (level III/IV) in Canada at 2:30 PM.

Immunity, immunopathology, and human vaccine development against sexually transmitted Chlamydia trachomatis.

This review examines the immunity, immunopathology, and contemporary problems of vaccine development against sexually transmitted Chlamydia trachomatis. Despite improved surveillance and treatment initiatives, the incidence of C. trachomatis infection has increased dramatically over the past 30 years in both the developed and developing world.

Are we ready for a global pandemic of Ebola virus?

We are not ready for a global pandemic of Ebola virus. The current West African epidemic should serve as a dire warning of things to come.

The chronic enteropathogenic disease schistosomiasis.

Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. The disease afflicts approximately 240 million individuals globally, causing approximately 70 million disability-adjusted life years lost. Chronic infections with morbidity and mortality occur as a result of granuloma formation in the intestine, liver, or in the case of Schistosoma haematobium, the bladder.

Utility of Diagnostic Imaging in the Diagnosis and Management of Schistosomiasis.

Diagnosis of schistosomiasis is made by demonstration of the parasite ova in stools, urine,and biopsy specimens from affected organs, or presence of antibodies to the different stages of the parasite or antigens circulating in body fluids by serologic techniques. DNA of schistosomes can now also be detected in serum and stool specimens by molecular technique.However, these tests are unable to determine the severity of target organ pathology and resultant complications.

Can mass drug administration lead to the sustainable control of schistosomiasis?

Background: In the Philippines, the current national control strategy for schistosomiasis is annual mass drug administration (MDA) with 40 mg/kg of praziquantel in all schistosomiasis-endemic villages with a prevalence ≥10%.

Methods: A cross-sectional survey of schistosomiasis was conducted in 2012 on 18 221 individuals residing in 22 schistosomiasis-endemic villages in the province of Northern Samar. The prevalence of schistosomiasis, intensity of Schistosoma infection, and morbidity of disease were assessed.

Clinical management of advanced schistosomiasis: a case of portal vein thrombosis-induced splenomegaly requiring surgery.

We report for the first time in the Philippines a case of portal vein thrombosis in a 12 year old Filipino boy with advanced schistosomiasis. The boy was referred to the Research Institute for Tropical Medicine (RITM), Manila, due to a rapidly enlarging spleen post-praziquantel treatment. At RITM, liver function tests were within normal limits but complete blood examinations showed pancytopenia and abnormal coagulation times.

Childhood malnutrition and parasitic helminth interactions.

Background: There is evidence to support that nutritional deficiency can reduce the body's immune function, thereby decreasing resistance to disease and increasing susceptibility to intestinal parasites.

Methods: A cross-sectional survey was carried out on 693 school-aged children from 5 schistosomiasis-endemic villages in Northern Samar, the Philippines. Data on dietary intake, nutritional status, and intestinal parasitic infection were collected.

Bilharzia in the Philippines: past, present, and future.

Schistosomiasis japonica has a long history in the Philippines. In 1975, 24 endemic provinces were identified in the northern, central, and southern islands of the Philippines. More than five million people were at risk, with approximately one million infected.

Road to the elimination of schistosomiasis from Asia: the journey is far from over.

Schistosomiasis is a neglected tropical disease with a very long endemic history in Asia. Great strides have been made to control the disease in China and the Philippines but the road to elimination is far from over, given the zoonotic nature of the schistosome parasites in both countries.

Bilharzia: Pathology, Diagnosis, Management and Control.

More than one billion people travel internationally each year and approximately 100 million to the tropics. Schistosomiasis is a neglected tropical disease caused by trematode blood flukes of the genus . It currently infects over 250 million people worldwide and results in approximately 25 million disability adjusted life years lost.