Number of incoming tourists and number of HAT cases among patients from non-endemic countries in Tanzania during 1995–2010.

<p>Number of incoming tourists and number of HAT cases among patients from non-endemic countries in Tanzania during 1995–2010.</p

Diagnostic means of Human African Trypanosomiasis among patients from non-endemic countries who acquired Human African Trypanosomiasis during the colonial period (1902–1966) and during the post-colonial period (1967–2012)^#.

#<p>Several cases were confirmed in more than one type of specimen or by more than one laboratory technique;</p>Ŧ<p>CSF, cerebrospinal fluid;</p>ŧ<p>In six HAT cases the subspecies type could not be determined;</p>±<p>CATT. card-agglutination test for trypanosomiasis.</p

Geographical distribution of HAT cases among patients from non-endemic countries in the colonial (1902–1966) (A) and post-colonial (1967–2012) (B) periods.

<p>Geographical distribution of HAT cases among patients from non-endemic countries in the colonial (1902–1966) (A) and post-colonial (1967–2012) (B) periods.</p

Epidemiologic data and mortality rates of patients from non-endemic countries who acquired Human African Trypanosomiasis during the colonial period (1902–1966) and during the post-colonial period (1967–2012).

<p>SD, standard deviation; E HAT, East African Trypanosomiasis; W HAT, Western African Trypanosomiasis;</p><p>*Others : Medical personnel, teachers, sailors, scientists;</p><p>**Subspecies according to microbiologic diagnosis or likely place of infection;</p>Ŧ<p>mostly West African Trypanosomiasis.</p><p>N/A – not applicable.</p

Number of reported HAT cases among patients from non-endemic countries per decade.

<p>Number of reported HAT cases among patients from non-endemic countries per decade.</p

Demographic and clinical characteristics of patients with and without Japanese Encephalitis.

Ŧ<p>SD, standard deviation;</p>ŧ<p>JE, Japanese encephalitis, NS, non significant.</p

Demographic and clinical manifestations of patients with Japanese encephalitis.

&<p>AES, acute encephalitis syndrome;</p>#<p>CSF, cerebrospinal fluid;</p

18 cases of Japanese Encephalitis diagnosed in Chitwan as per patients' district of residence.

<p>18 cases of Japanese Encephalitis diagnosed in Chitwan as per patients' district of residence.</p

Geographical zones of Nepal.

<p>Geographical zones of Nepal.</p

Open label comparative trial of mono versus dual antibiotic therapy for Typhoid Fever in adults

<div><p>Background</p><p>Emerging resistance to antibiotics renders therapy of Typhoid Fever (TF) increasingly challenging. The current single-drug regimens exhibit prolonged fever clearance time (FCT), imposing a great burden on both patients and health systems, and potentially contributing to the development of antibiotic resistance and the chronic carriage of the pathogens. The aim of our study was to assess the efficacy of combining third-generation cephalosporin therapy with azithromycin on the outcomes of TF in patients living in an endemic region.</p><p>Methods</p><p>An open-label, comparative trial was conducted at Dhulikhel Hospital, Nepal, between October 2012 and October 2014. Only culture-confirmed TF cases were eligible. Patients were alternately allocated to one of four study arms: hospitalized patients received either intravenous ceftriaxone or a combination of ceftriaxone and oral azithromycin, while outpatients received either oral azithromycin or a combination of oral azithromycin and cefexime. The primary outcome evaluated was FCT and the secondary outcomes included duration of bacteremia.</p><p>Results</p><p>105 blood culture-confirmed patients, of whom 51 were treated as outpatients, were eligible for the study. Of the 88 patients who met the inclusion criteria for FCT analysis 41 patients received a single-agent regimen, while 47 patients received a combined regimen. Results showed that FCT was significantly shorter for the latter (95 versus 88 hours, respectively, p = 0·004), and this effect was exhibited in both the hospitalized and the outpatient sub-groups. Repeat blood cultures, drawn on day 3, were positive for 8/47 (17%) patients after monotherapy, versus 2/51 (4%) after combination therapy (p = 0·045). No severe complications or fatalities occurred in any of the groups.</p><p>Conclusions</p><p>Combined therapy of third-generation cephalosporins and azithromycin for TF may surpass monotherapy in terms of FCT and time to elimination of bacteremia.</p><p>Trial registration</p><p>Trial registration number: <a href="https://clinicaltrials.gov/ct2/show/NCT02224040" target="_blank">NCT02224040</a>.</p></div