Case report: Loiasis with peripheral nerve involvement and spleen lesions.

Loiasis, which is caused by the filarial nematode Loa loa, affects millions of persons living in the rainforest areas and savannah regions of central Africa. Typical manifestations are calabar swellings and the eyeworm. We report a case of loiasis with unusual clinical complications: a peripheral neuropathy and focal hypo-echogenic lesions of the spleen, which disappeared after treatment with albendazole and ivermectin.

Estimating the vaccine-preventable burden of hospitalized pneumonia among young Mozambican children.

Polysaccharide-protein conjugate vaccines against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae have proven efficacy against radiologically confirmed pneumonia. Measurement of pneumonia incidence provides a platform to estimate of the vaccine-preventable burden. Over 24 months, we conducted surveillance for radiologically confirmed severe pneumonia episodes among children <2 years of age admitted to a rural hospital in Manhiça, southern Mozambique.

Colonic polyposis due to Schistosoma intercalatum.

Schistosomiasis polyps induced by Schistosoma mansoni and S. japonicum have been reported from pathological observations but this is not the case for colonic schistosomiasis infection by S. intercalatum which has always been associated with mild clinical presentations.

Severe pneumonia in Mozambican young children: clinical and radiological characteristics and risk factors.

Background: Pneumonia is a leading cause of hospitalization and death among children in Africa. We describe the clinical presentation of severe pneumonia among hospitalized children in a malaria endemic area with a high prevalence of HIV infection.

Methods: As part of a 2-year prospective study of radiologically confirmed pneumonia, chest radiographs, malaria parasite counts and bacterial blood cultures were systematically performed for children 0-23 months admitted with severe pneumonia.

Yellow fever-associated viscerotropic disease in Barcelona, Spain.

Yellow fever vaccine is a live, attenuated viral preparation from the 17D virus strain. Since 1996, 34 cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) have been described. We report a new case of YEL-AVD.

Congenital Trypanosoma cruzi infection in a non-endemic area.

In May 2004, after launching a screening programme to detect Trypanosoma cruzi infection in the Latin American population, a case of congenital infection in a 2-year-old boy was discovered in Barcelona. Few cases of congenital transmission have been described in non-endemic areas and little is known about the epidemiological and clinical features of congenital Chagas disease in this context. The increase in Latin American immigrants in Europe and the USA requires greater epidemiological surveillance and appropriate diagnostic techniques for managing T.

[How much primaquine is needed to eradicate Plasmodium vivax hypnozoites?].

Introduction: Primaquine is now the only drug available to eradicate Plasmodium vivax malaria. The optimal dose of primaquine to prevent relapses of P. vivax remains under discussion.

Failure of standard treatment with praziquantel in two returned travelers with Schistosoma haematobium infection.

A single 40 mg/kg dose of praziquantel (PZQ) continues to be the standard treatment for schistosomiasis caused by S. mansoni and S. haematobium in all clinical settings.

Histoplasmosis infection in Spanish travelers to Latin America.

The aim of the study presented here was to assess the incidence of histoplasma infection in a cohort of 342 individuals in Spain who had traveled to Latin America for the first time. The histoplasmin skin test was positive in 20% of the travelers, and Central America posed a higher risk for infection than South America (p=0.013).

[Molecular epidemiological surveillance of markers for antimalarial drugs in Plasmodium falciparum isolates imported to Barcelona, Spain].

Background And Objective: There have been described compelling correlations between mutations in some Plasmodium falciparum genes and resistance to antimalarial drugs. To apply molecular techniques in the mechanisms of epidemiological surveillance in the Hospital Clínic of Barcelona and to map potential levels of resistance, we investigated the presence of mutations in the relevant codons of genes associated with resistance in P. falciparum isolates imported by travellers.

Blackwater fever in children, Burundi.

Blackwater fever is characterized by acute intravascular hemolysis with hemoglobinuria in patients with Plasmodium falciparum malaria. Its pathogenesis and management are still debated. Nine cases of this syndrome occurred in 2003 at Kiremba Hospital in Burundi in children receiving multiple quinine treatments.

[Histoplasma capsulatum infection in a group of travelers to Guatemala].

Objective: To analyze the epidemiological and clinical characteristics of Histoplasma capsulatum infection in a group of volunteers who had traveled to Guatemala.

Methods: A review was performed of the clinical records of nine patients who consulted at the Tropical Medicine Outpatient Unit of Hospital Clinic in Barcelona, Spain. RESULTS.

[Imported malaria from Senegal: about 17 cases in year 2000].

Background And Objective: Senegal is increasingly becoming a touristic target for many people. In 2000, there was a greater number of cases of malaria in patients from this country. Our objective was to analyze such increase, to describe the characteristics of these patients and to identify the reasons for it.

[Ciguatera poisoning in Spanish travellers].

Background And Objective: Ciguatera poisoning appears after ingestion of contaminated fish from tropical coral reefs. Due to the diversity of clinical symptoms and the absence of a specific test in humans, the diagnosis is often difficult.

Patients And Method: A retrospective study of 10 patients consulting for a clinical and epidemiological picture compatible with ciguatera poisoning after a trip to tropical countries between 1993 and 2000.

Imported schistosomiasis in Europe: sentinel surveillance data from TropNetEurop.

Background: Schistosomiasis is a major parasitic disease, increasingly imported into temperate climates by immigrants from and travelers to endemic areas.

Method: To generate valid data on imported infectious diseases to Europe and to recognize trends over time, the European Network on Imported Infectious Diseases Surveillance (TropNetEurop) was founded in 1999. Three hundred and thirty-three reports of schistosomiasis were analyzed for epidemiologic and clinical features.

[Imported diseases in African immigrants in Spain: study of 1,321 patients].

Background: Immigrants can carry diseases characteristic from their countries of origin. These are known as imported diseases (ID) and can be classified into tropical diseases (TD) or cosmopolitan diseases (CD). The aim of this study was to analyse the ID in African immigrants and evaluate their repercussion in the Spanish Public Health.

Epidemiology and clinical features of imported dengue fever in Europe: sentinel surveillance data from TropNetEurop.

Travelers have the potential both to acquire and to spread dengue virus infection. The incidence of dengue fever (DF) among European travelers certainly is underestimated, because few centers use standardized diagnostic procedures for febrile patients. In addition, DF is currently not reported in most European public health systems.

Schistosomiasis and international travel.

Infection with Schistosoma species is acquired by exposure to fresh water that harbors cercariae released by infected snails. Although the route of infection is clear, clinical presentation of the established infection in the nonimmune tourist typically differs from that in the local population of areas of endemicity. For the health care practitioner, the traveler's syndrome presents distinctive management problems: water-transmitted bacterial and viral infections may coexist, and identification of the stage of disease at presentation, along with identification of the causative species, will maximize treatment options.

Comparative, clinico-epidemiologic study of Schistosoma mansoni infections in travellers and immigrants in Spain.

The study presented here aimed to contrast the marked clinical differences in the presentation of Schistosoma mansoni-induced infection between immigrants and travellers entering Spain from endemic regions, and to elucidate the therapeutic implications of these infections. A total of 200 African immigrants and 80 travellers with schistosomiasis were included in the study. Among the immigrants, 25 patients were diagnosed with Schistosoma mansoni infection; 15 presented with nonspecific symptoms, and 10 were asymptomatic.

Imported Falciparum malaria in Europe: sentinel surveillance data from the European network on surveillance of imported infectious diseases.

Malaria continues to have a high morbidity rate associated among European travelers. Thorough recording of epidemiological and clinical aspects of imported malaria has been helpful in the detection of new outbreaks and areas of developing drug resistance. Sentinel surveillance of data collected prospectively since 1999 has begun within TropNetEurop, a European network focusing on imported infectious diseases.

Susceptibility patterns of enteroaggregative Escherichia coli associated with traveller's diarrhoea: emergence of quinolone resistance.

Enteroaggregative Escherichia coli (EAggEC) isolates were identified as a cause of traveller's diarrhoea in 50 (9%) of 517 patients and their antimicrobial susceptibility was determined. Molecular epidemiological characterisation and investigation of the mechanisms of acquisition of quinolone resistance among nalidixic acid-resistant EAggEC strains was performed. Seventeen (34%) of 50 patients needed antimicrobial therapy, because of persistence of symptoms in nine cases and the severity of symptoms in eight cases.

Cholera outbreak in southern Tanzania: risk factors and patterns of transmission.

To identify risk factors and describe the pattern of spread of the 1997 cholera epidemic in a rural area (Ifakara) in southern Tanzania, we conducted a prospective hospital-based, matched case- control study, with analysis based on the first 180 cases and 360 matched controls. Bathing in the river, long distance to water source, and eating dried fish were significantly associated with risk for cholera. Toxigenic Vibrio cholerae O1, biotype El Tor, serotype Ogawa, was isolated in samples from Ifakara's main water source and patients' stools.

[Sexual behavior risk in Spanish international travelers].

Background: To know the sexual behavior of Spanish international travelers and its association with geographical destinations and sexually transmitted disease acquisition.

Patients And Method: 1,008 consecutive patients who attended a tropical out-patient clinic during 26 months were surveyed by means of a previously designed clinical questionnaire that included specific questions regarding sexual practices during the trip.

Results: 19% of travelers had sexual intercourse; 53.