28 research outputs found
Intravenous Artesunate Reduces Parasite Clearance Time, Duration of Intensive Care, and Hospital Treatment in Patients With Severe Malaria in Europe: The TropNet Severe Malaria Study
Intravenous artesunate improves survival in severe malaria, but clinical trial data from nonendemic countries are scarce. The TropNet severe malaria database was analyzed to compare outcomes of artesunate vs quinine treatment. Artesunate reduced parasite clearance time and duration of intensive care unit and hospital treatment in European patients with imported severe malari
an 8-year multi-centre observational study
Background Malaria remains one of the most serious infections for travellers
to tropical countries. Due to the lack of harmonized guidelines a large
variety of treatment regimens is used in Europe to treat severe malaria.
Methods The European Network for Tropical Medicine and Travel Health (TropNet)
conducted an 8-year, multicentre, observational study to analyse epidemiology,
treatment practices and outcomes of severe malaria in its member sites across
Europe. Physicians at participating TropNet centres were asked to report
pseudonymized retrospective data from all patients treated at their centre for
microscopically confirmed severe Plasmodium falciparum malaria according to
the 2006 WHO criteria. Results From 2006 to 2014 a total of 185 patients with
severe malaria treated in 12 European countries were included. Three patients
died, resulting in a 28-day survival rate of 98.4%. The majority of infections
were acquired in West Africa (109/185, 59%). The proportion of patients
treated with intravenous artesunate increased from 27% in 2006 to 60% in 2013.
Altogether, 56 different combinations of intravenous and oral drugs were used
across 28 study centres. The risk of acute renal failure (36 vs 17% p = 0.04)
or cerebral malaria (54 vs 20%, p = 0.001) was significantly higher in
patients ≥60 years than in younger patients. Respiratory distress with the
need for mechanical ventilation was significantly associated with the risk of
death in the study population (13 vs 0%, p = 0.001). Post-artemisinin delayed
haemolysis was reported in 19/70 (27%) patients treated with intravenous
artesunate. Conclusion The majority of patients with severe malaria in this
study were tourists or migrants acquiring the infection in West Africa.
Intravenous artesunate is increasingly used for treatment of severe malaria in
many European treatment centres and can be given safely to European patients
with severe malaria. Patients treated with intravenous artesunate should be
followed up to detect and manage late haemolytic events
Chagas Disease, France
Chagas Disease, Franc
Acute Muscular Sarcocystosis: An International Investigation Among Ill Travelers Returning From Tioman Island, Malaysia, 2011-2012
A large outbreak of acute muscular sarcocystosis (AMS) among international tourists who visited Tioman Island, Malaysia, is described. Clinicians evaluating travelers returning ill from Malaysia with myalgia, with or without fever, should consider AMS in their differential diagnosi
Severe malaria in Europe: an 8-year multi-centre observational study
Background: Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria. Methods: The European Network for Tropical Medicine and Travel Health (TropNet) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre for microscopically confirmed severe Plasmodium falciparum malaria according to the 2006 WHO criteria. Results: From 2006 to 2014 a total of 185 patients with severe malaria treated in 12 European countries were included. Three patients died, resulting in a 28-day survival rate of 98.4%. The majority of infections were acquired in West Africa (109/185, 59%). The proportion of patients treated with intravenous artesunate increased from 27% in 2006 to 60% in 2013. Altogether, 56 different combinations of intravenous and oral drugs were used across 28 study centres. The risk of acute renal failure (36 vs 17% p = 0.04) or cerebral malaria (54 vs 20%, p = 0.001) was significantly higher in patients ≥60 years than in younger patients. Respiratory distress with the need for mechanical ventilation was significantly associated with the risk of death in the study population (13 vs 0%, p = 0.001). Post-artemisinin delayed haemolysis was reported in 19/70 (27%) patients treated with intravenous artesunate. Conclusion: The majority of patients with severe malaria in this study were tourists or migrants acquiring the infection in West Africa. Intravenous artesunate is increasingly used for treatment of severe malaria in many European treatment centres and can be given safely to European patients with severe malaria. Patients treated with intravenous artesunate should be followed up to detect and manage late haemolytic events
Epidemiologic Aspects of Mycetoma in Africa
Mycetoma is a chronic, disabling infection caused by fungi or actinomycetes that affects the disadvantaged rural populations of arid tropical regions. The identification of etiological agents is long, difficult, and often imprecise or unsuccessful. Recently developed molecular methods can be used to identify causal agents at the species level. However, diagnosis can only be implemented in specialized laboratories. For these reasons, the distribution of causal agents in endemic African countries remains approximate. It is known that the pathogenic organisms of mycetoma are present in the environment, introduced as a result of injuries or trauma. There are still unknowns concerning the natural habitats of agents and the mode of infection. A potential association between mycetoma and acacia was uncovered in Sudan, allowing the elaboration of a risk map of the country. A new hypothesis for the mode of contamination involves the intervention of an intermediate host. The first surveys in Sudanese endemic villages gave a higher prevalence than the previous estimates, indicating that the prevalence of mycetoma in endemic African countries has previously been underestimated