Cysticercosis and taeniasis cases diagnosed at two referral medical institutions, Belgium, 1990 to 2015

Background: Few case reports on human infections with the beef tapeworm Taenia saginata and the pork tapeworm, Taenia solium, diagnosed in Belgium have been published, yet the grey literature suggests a higher number of cases. Aim: To identify and describe cases of taeniasis and cysticercosis diagnosed at two Belgian referral medical institutions from 1990 to 2015. Methods: In this observational study we retrospectively gathered data on taeniasis and cysticercosis cases by screening laboratory, medical record databases as well a uniform hospital discharge dataset. Results: A total of 221 confirmed taeniasis cases were identified. All cases for whom the causative species could be determined (170/221, 76.9%) were found to be T. saginata infections. Of those with available information, 40.0% were asymptomatic (26/65), 15.4% reported diarrhoea (10/65), 9.2% reported anal discomfort (6/65) and 15.7% acquired the infection in Belgium (11/70). Five definitive and six probable cases of neurocysticercosis (NCC), and two cases of non-central nervous system cysticercosis (non-CNS CC) were identified. Common symptoms and signs in five of the definitive and probable NCC cases were epilepsy, headaches and/or other neurological disorders. Travel information was available for of the 13 NCC and non-CNS CC cases; two were Belgians travelling to and eight were immigrants or visitors travelling from endemic areas. Conclusions: The current study indicates that a non-negligible number of taeniasis cases visit Belgian medical facilities, and that cysticercosis is occasionally diagnosed in international travellers

Migrant health—a cause for concern?

The geopolitical drivers that influence human migration are complex and subject to change often influenced by conflict. Within this editorial, the term migrant is used as a generic for the heterogeneous population of asylum seekers, economic migrants and refugees. Population flows into Europe have reached unprecedented levels during the last few years

Rapid Diagnostic Tests for Non-Malarial Febrile Illness in the Tropics

The recent roll-out of rapid diagnostic tests (RDTs) for malaria has highlighted the decreasing proportion of malaria-attributable illness in endemic areas. Unfortunately, once malaria is excluded, there are few accessible diagnostic tools to guide the management of severe febrile illnesses in low resource settings. This review summarizes the current state of RDT development for several key infections, including dengue fever, enteric fever, leptospirosis, brucellosis, visceral leishmaniasis and human African trypanosomiasis, and highlights many remaining gaps. Most RDTs for non-malarial tropical infections currently rely on the detection of host antibodies against a single infectious agent. The sensitivity and specificity of host-antibody detection tests are both inherently limited. Moreover, prolonged antibody responses to many infections preclude the use of most serological RDTs for monitoring response to treatment and/or for diagnosing relapse. Considering these limitations, there is a pressing need for sensitive pathogen-detection-based RDTs, as have been successfully developed for malaria and dengue. Ultimately, integration of RDTs into a validated syndromic approach to tropical fevers is urgently needed. Related research priorities are to define the evolving epidemiology of fever in the tropics, and to determine how combinations of RDTs could be best used to improve the management of severe and treatable infections requiring specific therapy

Evaluation of the SD FK70 Malaria Ag Plasmodium vivax rapid diagnostic test in a non-endemic setting

© 2009 Gillet et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Test characteristics of the SD FK80 Plasmodium falciparum/Plasmodium vivax malaria rapid diagnostic test in a non-endemic setting

<p>Abstract</p> <p>Background</p> <p>The SD FK80 P.f/P.v Malaria Antigen Rapid Test (Standard Diagnostics, Korea) (FK80) is a three-band malaria rapid diagnostic test detecting <it>Plasmodium falciparum </it>histidine-rich protein-2 (HRP-2) and <it>Plasmodium vivax</it>-specific lactate dehydrogenase (Pv-pLDH). The present study assessed its performance in a non-endemic setting.</p> <p>Methods</p> <p>Stored blood samples (n = 416) from international travellers suspected of malaria were used, with microscopy corrected by PCR as the reference method. Samples infected by <it>Plasmodium falciparum </it>(n = 178), <it>Plasmodium vivax </it>(n = 99), <it>Plasmodium ovale </it>(n = 75) and <it>Plasmodium malariae </it>(n = 24) were included, as well as 40 malaria negative samples.</p> <p>Results</p> <p>Overall sensitivities for the diagnosis of <it>P. falciparum </it>and <it>P. vivax </it>were 91.6% (95% confidence interval (CI): 86.2% - 95.0%) and 75.8% (65.9% - 83.6%). For <it>P. falciparum</it>, sensitivity at parasite densities ≥ 100/μl was 94.6% (88.8% - 97.6%); for <it>P. vivax</it>, sensitivity at parasite densities ≥ 500/μl was 86.8% (75.4% - 93.4%). Four <it>P. falciparum </it>samples showed a Pv-pLDH line, three of them had parasite densities exceeding 50.000/μl. Two <it>P. vivax </it>samples, one <it>P. ovale </it>and one <it>P. malariae </it>sample showed a HRP-2 line. For the HRP-2 and Pv-pLDH lines, respectively 81.4% (136/167) and 55.8% (43/77) of the true positive results were read as medium or strong line intensities. The FK80 showed good reproducibility and reliability for test results and line intensities (kappa values for both exceeding 0.80).</p> <p>Conclusion</p> <p>The FK80 test performed satisfactorily in diagnosing <it>P. falciparum </it>and <it>P. vivax </it>infections in a non-endemic setting.</p

Gambiense human African trypanosomiasis: the bumpy road to elimination.

Gambiense human African trypanosomiasis (gHAT), a disease that has killed hundreds of thousands as recently as the 1990s, could be on the verge of elimination or even eradication. This review describes recent developments that give us reasons for optimism as well as some caveats. New developments in diagnostic and vector control tools, and especially in treatment, make it possible to strive for elimination of transmission of gHAT by 2030, perhaps even eradication. Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid diagnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence

Test characteristics of two rapid antigen detection tests (SD FK50 and SD FK60) for the diagnosis of malaria in returned travellers

<p>Abstract</p> <p>Background</p> <p>Two malaria rapid diagnostic tests were evaluated in a travel clinic setting: the SD FK50 Malaria Ag <it>Plasmodium falciparum </it>test (a two-band test) and the SD FK60 Malaria Ag <it>P. falciparum</it>/Pan test (a three-band test).</p> <p>Methods</p> <p>A panel of stored whole blood samples (n = 452 and n = 614 for FK50 and FK60, respectively) from returned travellers was used. The reference method was microscopy with PCR in case of discordant results.</p> <p>Results</p> <p>For both tests, overall sensitivity for the detection of <it>P. falciparum </it>was 93.5%, reaching 97.6% and 100% at parasite densities above 100 and 1,000/μl respectively. Overall sensitivities for <it>Plasmodium vivax, Plasmodium ovale </it>and <it>Plasmodium malariae </it>for the FK60 test were 87.5%, 76.3% and 45.2%, but they reached 92.6% and 90.5% for <it>P. vivax </it>and <it>P. ovale </it>at parasite densities above 500/μl. Specificities were above 95% for all species and both tests when corrected by PCR, with visible histidine-rich protein-2 lines for <it>P. malariae </it>(n = 3) and <it>P. vivax </it>and <it>P. ovale </it>(1 sample each). Line intensities were reproducible and correlated to parasite densities. The FK60 tests provided clues to estimate parasite densities for <it>P. falciparum </it>below or above 1,000/μl.</p> <p>Conclusion</p> <p>Both the FK50 and FK60 performed well for the diagnosis of <it>P. falciparum </it>in the present setting, and the FK60 for the diagnosis of <it>P. vivax </it>and <it>P. ovale </it>at parasite densities > 500/μl. The potential use of the FK60 as a semi-quantitative estimation of parasite density needs to be further explored.</p