South Europe perspective of COVID-19 impact on travel medicine.

The COVID-19 crisis has drastically impacted the travel medicine field worldwide. In this perspective we have captured the challenges faced by travel clinicians in three Southern European countries: Italy, Spain and Portugal. Current practices, solutions and areas for improvement in these specific countries are discussed.

Typhoid fever infection - Antibiotic resistance and vaccination strategies: A narrative review.

Typhoid fever is a bacterial infection caused by the Gram-negative bacterium Salmonella enterica subspecies enterica serovar Typhi (S. Typhi), prevalent in many low- and middle-income countries. In high-income territories, typhoid fever is predominantly travel-related, consequent to travel in typhoid-endemic regions; however, data show that the level of typhoid vaccination in travellers is low.

Clinical Study on the Melarsoprol-Related Encephalopathic Syndrome: Risk Factors and HLA Association.

Melarsoprol administration for the treatment of late-stage human African trypanosomiasis (HAT) is associated with the development of an unpredictable and badly characterized encephalopathic syndrome (ES), probably of immune origin, that kills approximately 50% of those affected. We investigated the characteristics and clinical risk factors for ES, as well as the association between the Human Leukocyte Antigen (HLA) complex and the risk for ES in a case-control study. Late-stage Gambiense HAT patients treated with melarsoprol and developing ES (69 cases) were compared to patients not suffering from the syndrome (207 controls).

Infection by Intestinal Parasites, Stunting and Anemia in School-Aged Children from Southern Angola.

Introduction: Intestinal parasites are responsible for morbidity in children worldwide, especially in low income countries. In the present study we determine the prevalence of intestinal parasites and explore its association with anemia and stunting in school-aged children.

Methods: A cross-sectional study was conducted from September to October 2010 enrolling 328 children attending the primary school in Lubango, the second largest city after the capital Luanda.

Direct Detection by the Xpert MTB/RIF Assay and Characterization of Multi and Poly Drug-Resistant Tuberculosis in Guinea-Bissau, West Africa.

Background: This study aimed to evaluate the usefulness of the Xpert MTB/RIF assay for the rapid direct detection of M. tuberculosis complex (MTBC) strains and rifampicin resistance associated mutations in a resource-limited setting such as Guinea-Bissau and its implications in the management of tuberculosis (TB) and drug resistant tuberculosis, complementing the scarce information on resistance and genotypic diversity of MTBC strains in this West African country.

Methods And Results: This cross-sectional prospective study included 100 consecutive TB patients with positive acid-fast smears at two months of anti-tuberculosis treatment or in a re-treatment situation, between May and December 2012.

Giardia duodenalis and soil-transmitted helminths infections in children in São Tomé and Príncipe: do we think Giardia when addressing parasite control?

Giardia duodenalis prevalence is commonly as high as soil-transmitted helminths (STH), nevertheless is not considered for large-scale chemotherapy through mass drug administration (MDA) due to its short incubation period and frequent reinfections, its control being associated to improving access to water and sanitation. A study enrolling 444 children attending preschools was conducted in May 2011 during a deworming campaign. Faecal samples were obtained and analysed through microscopy of wet mounting and after Kato-Katz and formol-ether concentration techniques.

Angola's 2013 dengue outbreak: clinical, laboratory and molecular analyses of cases from four Portuguese institutions.

Introduction: Dengue virus (DENV) is the arbovirus with the widest impact on human health. In Africa in general, and in Angola in particular, the epidemiology and public health impact of DENV is far from clear. However, rapid population growth, unplanned urbanization, increased international travel, and the presence of virus major vector (Aedes aegypti) in the country suggest that DENV transmission may occur.

Molecular and Clinical Characterization of Giardia duodenalis Infection in Preschool Children from Lisbon, Portugal.

Giardia duodenalis is the most prevalent intestinal protozoan infection especially in children. In Portugal scarce data are available relative to this infection in preschoolers. The present study was conducted from April to July 2009 in public preschools in Lisbon enrolling 316 children.

Prevalence and Level of Antibodies Anti-Plasmodium spp. in Travellers with Clinical History of Imported Malaria.

In this study, we show that 40.29% of travellers with a possible history of malaria exposure were positive for anti-Plasmodium spp. antibodies, while these individuals were negative by microscopy.

Trypanosoma brucei: immunisation with plasmid DNA encoding invariant surface glycoprotein gene is able to induce partial protection in experimental African trypanosomiasis.

Trypanosoma brucei is the etiological agent responsible for African trypanosomiasis, an infectious pathology which represents a serious problem of public health and economic losses in Sub-Saharan Africa. As one of the foremost neglected illnesses, few resources have been available for the development of vaccines or new drugs, in spite of the current therapeutical drugs showing little efficiency and high toxicity. Hence, it is obviously important to widen effective therapeutics and preventive strategies against African trypanosomiasis.

Partial biochemical characterization of a metalloproteinase from the bloodstream forms of Trypanosoma brucei brucei parasites.

Metalloproteinases (MMP) belong to the family of cation dependent endopeptidases that degrade matrices at physiological pH and to cleave extracellular matrix proteins. They play an important role in diverse physiological and pathological processes; not only there diverse types of MMP differ in structure and functionally, but also their enzymatic activity is regulated at multiple levels. Trying to shed some light over the processes that govern the pathology of African Trypanosomiasis, the aim of the present study was to examine the proteolytic activity of the crude trypanosome protein extract obtained from the bloodstream forms of Trypanosoma brucei brucei parasites.

DNA vaccines: a rational design against parasitic diseases.

Parasitic diseases are one of the most devastating causes of morbidity and mortality worldwide. Although immunization against these infections would be an ideal solution, the development of effective vaccines has been hampered by specific challenges posed by parasitic pathogens. Plasmid-based DNA vaccines may prove to be promising immunization tools in this area because vectors can be designed to integrate several antigens from different stages of the parasite life cycle or different subspecies; vaccines, formulations and immunization protocols can be tuned to match the immune response that offers protective immunity; and DNA vaccination is an affordable platform for developing countries.

Molecular identification of T. brucei s.l. in tsetse flies after long-term permanence in field traps.

Background: Tsetse flies (Glossina spp.) are responsible for the transmission of trypanosomes, agents of animal and Human African Trypanosomiasis (HAT). These diseases are associated with considerable animal and human economical loss, morbidity and mortality.

Trans-sialidase from Trypanosoma brucei as a potential target for DNA vaccine development against African trypanosomiasis.

African trypanosomiasis (AT), also known as sleeping sickness in humans and Nagana in animals, is a disease caused by the protozoan parasite Trypanosoma brucei. AT is an extremely debilitating disease in human, cattle, and wild animals, and the treatment is difficult with frequent relapses. This work shows that BALB-c mice immunized intramuscularly with a single dose (100 microg) of a plasmid DNA encoding the 5'-terminal region of the trans-sialidase (nTSA) gene of T.

An alternative approach to detect Trypanosoma in Glossina (Diptera, Glossinidae) without dissection.

Background: Determining if a tsetse fly is infected by trypanosomes and thus potentially able to transmit trypanosome-related human and animal diseases is an extremely laborious and time-consuming task to perform, especially under field conditions. In this study we tested a possible alternative approach that uses the entire insect vector for DNA extraction and PCR analysis to detect and identify Trypanosoma spp. in field collected tsetse flies.

Sexually transmitted infections in an African migrant population in Portugal: a base-line study.

Background: For geographical and recent historic reasons, Portugal is a gateway and home for immigration from sub-Saharan countries. Misconceptions related to these populations often lead to consider them as high-frequency clusters for dissemination of sexually transmitted infections (STIs). Epidemiological evidence-based data is needed to elucidate these issues and baseline prevalence studies are the starting point for this.

Quality assessment in a travel clinic: a study of travelers' knowledge about malaria.

Background: Quality in health care delivery is considered essential and should be expected for all who deliver health care. We were not able to identify in Portugal any previous studies that assessed the quality of travel medicine consultations. The aims of this study was to assess the impact of travel health advice on travelers' knowledge and the quality of the outcome of the travel consultations at the Institute of Hygiene and Tropical Medicine, Portugal.

Pharmacists and travel advice for tropics in Lisbon (Portugal).

Background: In Portugal, little is known about the quality of advice given to international travelers by pharmacists. The aim of this study was to determine pharmacists' training, experience, and interest in travel medicine and to assess the technical quality of the information given.

Methods: We sent a postal questionnaire to all pharmacies in the Lisbon area.