Longitudinal associations of plasma amino acid levels with recovery from malarial coma.

Background: Disordered amino acid metabolism is observed in cerebral malaria (CM). This study sought to determine whether abnormal amino acid concentrations were associated with level of consciousness in children recovering from coma. Twenty-one amino acids and coma scores were quantified longitudinally and the data were analysed for associations.

Efficacy of Helicobacter pylori eradication regimens in Rwanda: a randomized controlled trial.

Background: Successful H. pylori treatment requires the knowledge of local antimicrobial resistance. Data on the efficacy of H.

Prevalence of Strongyloides stercoralis infection and other soil-transmitted helminths by cross-sectional survey in a rural community in Gisagara District, Southern Province, Rwanda.

Background: Strongyloides stercoralis is one of the most neglected tropical diseases. Sparse, dated central African and Rwandan data on seroprevalence are available to guide public health efforts and clinical care.

Methods: In February 2016 we conducted a community-based cross-sectional study among 539 asymptomatic participants in a rural area in the Gisagara District, Southern Province, Rwanda.

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel.

Background: US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population.

Objective: To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel.

The visiting internet Fiancé/ée (VIF): an emerging group of international travelers.

Here we describe an emerging category of travelers called the Visiting Internet Fiancé/ée (VIF), characterized by their travel to pursue a romantic relationship with an individual they have only encountered online. The VIF is not well identified in travel medicine literature despite having a higher risk for several travel-related issues including sexually transmitted infections, monetary fraud, and international scams. We also propose specific counseling interventions designed to minimize the adverse outcomes faced by the VIF traveler.

Illness in travelers returned from Brazil: the GeoSentinel experience and implications for the 2014 FIFA World Cup and the 2016 Summer Olympics.

Background: Brazil will host the 2014 FIFA World Cup and the 2016 Olympic and Paralympic Games, events that are expected to attract hundreds of thousands of international travelers. Travelers to Brazil will encounter locally endemic infections as well as mass event-specific risks.

Methods: We describe 1586 ill returned travelers who had visited Brazil and were seen at a GeoSentinel Clinic from July 1997 through May 2013.

Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium.

Background: People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009-2010.

Material And Methods: We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics.

Expatriates ill after travel: results from the Geosentinel Surveillance Network.

Background: Expatriates are a distinct population at unique risk for health problems related to their travel exposure.

Methods: We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM) for travel-related illness.

Results: Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel.

Association of Campylobacter upsaliensis with persistent bloody diarrhea.

Campylobacter upsaliensis is a zoonotic, emerging pathogen that is not readily recovered in traditional stool culture. This case represents the first report of persistent bloody diarrhea with C. upsaliensis that was confirmed by filtration culture, PCR, and sequencing.

Double-blind placebo-controlled study of mesalamine in post-infective irritable bowel syndrome--a pilot study.

Objective: Post-infective irritable bowel syndrome (PI-IBS) is characterized by continuing symptoms of irritable bowel syndrome, typically diarrhea-predominant, following an episode of acute gastroenteritis. There is often an increase in sub-epithelial inflammatory and neuroendocrine cells on colonic mucosal biopsy. Mesalamine is an anti-inflammatory agent, effective in the treatment of inflammatory bowel disease.

Acute primary toxoplasmosis in travelers returning from endemic countries.

Fourteen cases of toxoplasmosis in immunocompetent travelers who visited high prevalence countries are described. This represents the first series of toxoplasmosis in returned travelers from North America, substantiating the need to consider toxoplasmosis in returned travelers who present with non-specific symptoms, especially fever, lymphadenopathy, and fatigue.

Global TravEpiNet: a national consortium of clinics providing care to international travelers--analysis of demographic characteristics, travel destinations, and pretravel healthcare of high-risk US international travelers, 2009-2011.

Background:  International travel poses a risk of destination-specific illness and may contribute to the global spread of infectious diseases. Despite this, little is known about the health characteristics and pretravel healthcare of US international travelers, particularly those at higher risk of travel-associated illness.

Methods:  We formed a national consortium (Global TravEpiNet) of 18 US clinics registered to administer yellow fever vaccination.

Patterns of illness in travelers visiting Mexico and Central America: the GeoSentinel experience.

Background: Mexico and Central America are important travel destinations for North American and European travelers. There is limited information on regional differences in travel related morbidity.

Methods: We describe the morbidity among 4779 ill travelers returned from Mexico and Central America who were evaluated at GeoSentinel network clinics during December 1996 to February 2010.

Standardized training in nurse model travel clinics.

Background: International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases.

Health risks in travelers to South Africa: the GeoSentinel experience and implications for the 2010 FIFA World Cup.

Using the GeoSentinel database, an analysis of ill patients returning from throughout sub-Saharan Africa over a 13-year period was performed. Systemic febrile illness, dermatologic, and acute diarrheal illness were the most common syndromic groupings, whereas spotted fever group rickettsiosis was the most common individual diagnosis for travelers to South Africa. In contrast to the rest of sub-Saharan Africa, only six cases of malaria were documented in South Africa travelers.

Exploring the relationship between chronic undernutrition and asymptomatic malaria in Ghanaian children.

Background: A moderate association has been found between asymptomatic parasitaemia and undernutrition. However, additional investigation using the gold standard for asymptomatic parasitaemia confirmation, polymerase chain reaction (PCR), is needed to validate this association. Anthropometric measurements and blood samples from children less than five years of age in a rural Ghanaian community were used to determine if an association exists between chronic undernutrition and PCR-confirmed cases of asymptomatic malaria.

Illness in long-term travelers visiting GeoSentinel clinics.

Length of travel appears to be associated with health risks. GeoSentinel Surveillance Network data for 4,039 long-term travelers (trip duration >6 months) seen after travel during June 1, 1996, through December 31, 2008, were compared with data for 24,807 short-term travelers (trip duration <1 month). Long-term travelers traveled more often than short-term travelers for volunteer activities (39.

Fatal granulomatous Acanthamoeba encephalitis mimicking a stroke, diagnosed by correlation of results of sequential magnetic resonance imaging, biopsy, in vitro culture, immunofluorescence analysis, and molecular analysis.

Amebic infections involving the central nervous system are rare and difficult to diagnose. Magnetic resonance imaging (MRI) at timed intervals may be helpful, where scans reveal enhancing lesions and increased signal. We report a unique case of granulomatous amebic encephalitis that was proven pathologically with progressive radiological findings on MRI.

Laboratory use in Ghana: physician perception and practice.

Clinical diagnosis of infectious diseases in Africa has been associated with increased misdiagnosis and mortality, but when laboratory testing is available, it remains underused. We retrospectively compared infectious diagnoses, test results, anti-microbial use, and patient cost with laboratory and physician surveys at a teaching hospital in Ghana to evaluate the potential barriers to laboratory use and financial impact for patients. Laboratory capacity was high, but physician survey results and objective data indicated a reliance on clinical judgment and empirical therapy.

Case report: gnathostomiasis in two travelers to Zambia.

Gnathostomiasis is a systemic infection caused by migrating nematode larvae of the genus Gnathostoma. It is a zoonosis involving a wide variety of animals as intermediate and definitive hosts, and consumption of raw fish is the main risk factor. The condition is most commonly seen in southeastern Asia, but has been described in a number of other countries, all outside Africa.