Recent publications from TDC authors

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NCBI: db=pubmed; Term=(Yansouni C[Author]) OR (Iqbal A[Author] parasitology) OR (Ndao M[Author]) OR (Ward BJ[Author]) OR (Semret M[Author]) OR (Libman M[Author]) OR (Greenaway C[author]) OR (Barkati S[Author])
Updated: 19 hours 14 min ago

Clinical bacteriology in low-resource settings: today's solutions.

19 hours 14 min ago
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Clinical bacteriology in low-resource settings: today's solutions.

Lancet Infect Dis. 2018 08;18(8):e248-e258

Authors: Ombelet S, Ronat JB, Walsh T, Yansouni CP, Cox J, Vlieghe E, Martiny D, Semret M, Vandenberg O, Jacobs J, Bacteriology in Low Resource Settings working group

Abstract
Low-resource settings are disproportionately burdened by infectious diseases and antimicrobial resistance. Good quality clinical bacteriology through a well functioning reference laboratory network is necessary for effective resistance control, but low-resource settings face infrastructural, technical, and behavioural challenges in the implementation of clinical bacteriology. In this Personal View, we explore what constitutes successful implementation of clinical bacteriology in low-resource settings and describe a framework for implementation that is suitable for general referral hospitals in low-income and middle-income countries with a moderate infrastructure. Most microbiological techniques and equipment are not developed for the specific needs of such settings. Pending the arrival of a new generation diagnostics for these settings, we suggest focus on improving, adapting, and implementing conventional, culture-based techniques. Priorities in low-resource settings include harmonised, quality assured, and tropicalised equipment, consumables, and techniques, and rationalised bacterial identification and testing for antimicrobial resistance. Diagnostics should be integrated into clinical care and patient management; clinically relevant specimens must be appropriately selected and prioritised. Open-access training materials and information management tools should be developed. Also important is the need for onsite validation and field adoption of diagnostics in low-resource settings, with considerable shortening of the time between development and implementation of diagnostics. We argue that the implementation of clinical bacteriology in low-resource settings improves patient management, provides valuable surveillance for local antibiotic treatment guidelines and national policies, and supports containment of antimicrobial resistance and the prevention and control of hospital-acquired infections.

PMID: 29519767 [PubMed - indexed for MEDLINE]

Resilience from the ground up: how are local resilience perceptions and global frameworks aligned?

Sat, 04/06/2019 - 01:09
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Resilience from the ground up: how are local resilience perceptions and global frameworks aligned?

Disasters. 2019 Apr;43 Suppl 3:S295-S317

Authors: Beauchamp E, Abdella J, Fisher S, McPeak J, Patnaik H, Koulibaly P, Cissé D, Touré M, Bocoum A, Ndao M, Deme Y, Gueye B

Abstract
Numerous resilience measurement frameworks for climate programmes have emerged over the past decade to operationalise the concept and aggregate results within and between programmes. Proxies of resilience, including subjective measures using perception data, have been proposed to measure resilience, but there is limited evidence on their validity and use for policy and practice. This article draws on research on the Decentralising Climate Funds project of the Building Resilience and Adaptation to Climate Extremes and Disasters programme, which supports communities in Mali and Senegal to improve climate resilience through locally controlled adaptation funds. It explores attributes of resilience from this bottom-up perspective to assess its predictors and alignment with food security, as a proxy of well-being. We find different patterns when comparing resilience and the well-being proxy, illustrating that the interplay between the two is still unclear. Results also point to the importance of contextualising resilience, raising implications for aggregating results.

PMID: 30945764 [PubMed - in process]

Serological and molecular detection of Toxoplasma gondii in terrestrial and marine wildlife harvested for food in Nunavik, Canada.

Sat, 04/06/2019 - 01:09
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Serological and molecular detection of Toxoplasma gondii in terrestrial and marine wildlife harvested for food in Nunavik, Canada.

Parasit Vectors. 2019 Apr 03;12(1):155

Authors: Bachand N, Ravel A, Leighton P, Stephen C, Ndao M, Avard E, Jenkins E

Abstract
BACKGROUND: Toxoplasma gondii, a zoonotic protozoan parasite, infects mammals and birds worldwide. Infection in humans is often asymptomatic, though illnesses can occur in immunocompromised hosts and the fetuses of susceptible women infected during pregnancy. In Nunavik, Canada, 60% of the Inuit population has measurable antibodies against T. gondii. Handling and consumption of wildlife have been identified as risk factors for exposure. Serological evidence of exposure has been reported for wildlife in Nunavik; however, T. gondii has not been detected in wildlife tissues commonly consumed by Inuit.
METHODS: We used a magnetic capture DNA extraction and real-time PCR protocol to extract and amplify T. gondii DNA from large quantities of tissues (up to 100 g) of 441 individual animals in Nunavik: 166 ptarmigan (Lagopus lagopus), 156 geese (Branta canadensis and Chen caerulescens), 61 ringed seals (Pusa hispida), 31 caribou (Rangifer tarandus) and 27 walruses (Odobenus rosmarus).
RESULTS: DNA from T. gondii was detected in 9% (95% CI: 3-15%) of geese from four communities in western and southern Nunavik, but DNA was not detected in other wildlife species including 20% (95% CI: 12-31%) of ringed seals and 26% (95% CI: 14-43%) of caribou positive on a commercial modified agglutination test (MAT) using thawed heart muscle juice. In geese, tissue parasite burden was highest in heart, followed by brain, breast muscle, liver and gizzard. Serological results did not correlate well with tissue infection status for any wildlife species.
CONCLUSIONS: To our knowledge, this is the first report on the detection, quantification, and characterization of DNA of T. gondii (clonal lineage II in one goose) from wildlife harvested for food in Nunavik, which supports the hypothesis that migratory geese can carry T. gondii into Nunavik where feline definitive hosts are rare. This study suggests that direct detection methods may be useful for detection of T. gondii in wildlife harvested for human consumption and provides data needed for a quantitative exposure assessment that will determine the risk of T. gondii exposure for Inuit who harvest and consume geese in Nunavik.

PMID: 30944016 [PubMed - in process]

Reply: regarding business travelers.

Fri, 03/29/2019 - 00:50
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Reply: regarding business travelers.

J Travel Med. 2018 01 01;25(1):

Authors: Chen LH, Leder K, Schlagenhauf P, Libman M, Keystone J, Mendelson M, Gautret P, Schwartz E, Shaw M, MacDonald S, McCarthy A, Connor BA, Hamer DH, Wilson ME, GeoSentinel Surveillance Network

PMID: 29741699 [PubMed - indexed for MEDLINE]

A protocol to count Cryptosporidium oocysts by flow cytometry without antibody staining.

Fri, 03/22/2019 - 00:49
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A protocol to count Cryptosporidium oocysts by flow cytometry without antibody staining.

PLoS Negl Trop Dis. 2019 Mar 20;13(3):e0007259

Authors: Sonzogni-Desautels K, Di Lenardo TZ, Renteria AE, Gascon MA, Geary TG, Ndao M

Abstract
Cryptosporidiosis caused by the protozoan parasites Cryptosporidium hominis and C. parvum, threatens the lives of young children in developing countries. In veterinary medicine, C. parvum causes life-threatening diarrhea and dehydration in newborn dairy calves. Protocols to detect Cryptosporidium spp. oocysts using flow cytometry have been reported; however, these protocols use antibodies against the parasite and typically focus on detection of oocysts, not quantification. These techniques are not well-suited for studies that generate large variations in oocyst burdens because the amount of antibody required is proportional to the number of oocysts expected in samples. Also, oocysts are lost in washes in the staining protocol, reducing accuracy of oocyst counts. Moreover, these protocols require costly fluorochrome-conjugated monoclonal antibodies and are not optimal for studies involving large numbers of samples. Here we present an optimized protocol for purifying oocysts from mouse stool and intestine samples combined with a reliable method to quantify oocysts in a relatively pure population without the need for antibody staining. We used morphology (SSC-A vs FSC-A) and the innate characteristics of C. parvum oocysts compared to fecal and intestinal contaminants to develop a two-step gating strategy that can differentiate oocysts from debris. This method is a fast, reliable, and high-throughput technique to promote research projects on C. parvum infections in mice and potentially other animal hosts.

PMID: 30893302 [PubMed - as supplied by publisher]

Apolipoprotein A1 and Fibronectin Fragments as Markers of Cure for the Chagas Disease.

Sat, 03/16/2019 - 01:54
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Apolipoprotein A1 and Fibronectin Fragments as Markers of Cure for the Chagas Disease.

Methods Mol Biol. 2019;1955:263-273

Authors: Ruiz-Lancheros E, Golizeh M, Ndao M

Abstract
Chagas disease (CD), endemic from Latin America, affects more than 8 million people, and the disease keeps spreading around the world due to population migrations. The treatment options for CD are currently limited to two drugs, benznidazole (BZ) and nifurtimox (Nfx), which are often unsatisfactory in chronically infected patients. To date, the only accepted marker of the cure is seroconversion (the disappearance of Trypanosoma cruzi antibodies in the patient's serum), which can take decades to occur, if ever. The lack of posttreatment test-of-cure often prevents appropriate patient counseling and limits the development of new drugs. Without a doubt, reliable biomarkers for parasitological cure are urgently needed. Several pieces of evidence suggest that apolipoprotein A1 and fibronectin fragments are produced during the infection as part of the process of T. cruzi cell invasion and can thus be used as its surrogate biomarkers. In this chapter, we present a standardized method to evaluate these fragments in serum using mass spectrometry and immunoblotting in CD patients for diagnosis, prognosis, and treatment assessment purposes.

PMID: 30868534 [PubMed - in process]

A REDOR ssNMR Investigation of the Role of an N-Terminus Lysine in R5 Silica Recognition.

Sat, 03/16/2019 - 01:54
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A REDOR ssNMR Investigation of the Role of an N-Terminus Lysine in R5 Silica Recognition.

Langmuir. 2018 07 24;34(29):8678-8684

Authors: Ndao M, Goobes G, Emani PS, Drobny GP

Abstract
Diatoms are unicellular algae that construct cell walls called frustules by the precipitation of silica, using special proteins that order the silica into a wide variety of nanostructures. The diatom species Cylindrotheca fusiformis contains proteins called silaffins within its frustules, which are believed to assemble into supramolecular matrices that serve as both accelerators and templates for silica deposition. Studying the properties of these biosilicification proteins has allowed the design of new protein and peptide systems that generate customizable silica nanostructures, with potential generalization to other mineral systems. It is essential to understand the mechanisms of aggregation of the protein and its coprecipitation with silica. We continue previous investigations into the peptide R5, derived from silaffin protein sil1p, shown to independently catalyze the precipitation of silica nanospheres in vitro. We used the solid-state NMR technique 13C{29Si} and 15N{29Si} REDOR to investigate the structure and interactions of R5 in complex with coprecipitated silica. These experiments are sensitive to the strength of magnetic dipole-dipole interactions between the 13C nuclei in R5 and the 29Si nuclei in the silica and thus yield distance between parts of R5 and 29Si in silica. Our data show strong interactions and short internuclear distances of 3.74 ± 0.20 Å between 13C═O Lys3 and silica. On the other hand, the Cα and Cβ nuclei show little or no interaction with 29Si. This selective proximity between the K3 C═O and the silica supports a previously proposed mechanism of rapid silicification of the antimicrobial peptide KSL (KKVVFKVKFK) through an imidate intermediate. This study reports for the first time a direct interaction between the N-terminus of R5 and silica, leading us to believe that the N-terminus of R5 is a key component in the molecular recognition process and a major factor in silica morphogenesis.

PMID: 27039990 [PubMed - indexed for MEDLINE]

Accessibility and Acceptability of Infectious Disease Interventions Among Migrants in the EU/EEA: A CERQual Systematic Review.

Thu, 03/14/2019 - 01:03
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Accessibility and Acceptability of Infectious Disease Interventions Among Migrants in the EU/EEA: A CERQual Systematic Review.

Int J Environ Res Public Health. 2018 10 23;15(11):

Authors: Driedger M, Mayhew A, Welch V, Agbata E, Gruner D, Greenaway C, Noori T, Sandu M, Sangou T, Mathew C, Kaur H, Pareek M, Pottie K

Abstract
In the EU/EEA, subgroups of international migrants have an increased prevalence of certain infectious diseases. The objective of this study was to examine migrants' acceptability, value placed on outcomes, and accessibility of infectious disease interventions. We conducted a systematic review of qualitative reviews adhering to the PRISMA reporting guidelines. We searched MEDLINE, EMBASE, CINAHL, DARE, and CDSR, and assessed review quality using AMSTAR. We conducted a framework analysis based on the Health Beliefs Model, which was used to organize our preliminary findings with respect to the beliefs that underlie preventive health behavior, including knowledge of risk factors, perceived susceptibility, severity and barriers, and cues to action. We assessed confidence in findings using an adapted GRADE CERQual tool. We included 11 qualitative systematic reviews from 2111 articles. In these studies, migrants report several facilitators to public health interventions. Acceptability depended on migrants' relationship with healthcare practitioners, knowledge of the disease, and degree of disease-related stigma. Facilitators to public health interventions relevant for migrant populations may provide clues for implementation. Trust, cultural sensitivity, and communication skills also have implications for linkage to care and public health practitioner education. Recommendations from practitioners continue to play a key role in the acceptance of infectious disease interventions.

PMID: 30360472 [PubMed - indexed for MEDLINE]

Peptidyl-prolyl cis-trans isomerase A - A novel biomarker of multi-episodic (recurrent) ocular toxoplasmosis.

Fri, 03/08/2019 - 00:26
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Peptidyl-prolyl cis-trans isomerase A - A novel biomarker of multi-episodic (recurrent) ocular toxoplasmosis.

Exp Eye Res. 2018 12;177:104-111

Authors: Isenberg J, Golizeh M, Belfort RN, da Silva AJ, Burnier MN, Ndao M

Abstract
Ocular toxoplasmosis (OT) is the most common etiology of posterior uveitis. The high incidence of macular scarring associated with OT is a leading cause of visual morbidity. Serum biomarkers of the disease would aid in its diagnosis. This study sought, for the first time, to elucidate serum biomarkers for OT by mass spectrometry. Blood samples were collected from four groups of nine patients each; toxoplasmosis IgG-with no history of uveitis, non-toxoplasmosis uveitis, first episode OT, and symptomatic recurrent OT. Serum was isolated and subjected to proteomics analysis using 2-dimensional gel electrophoresis (2D-GE) and surface-enhanced laser desorption ionization mass spectrometry (SELDI-MS). Selected proteins were further separated by SDS-PAGE and sequenced using tandem MS. Results were cross-validated with a T. gondii outbreak biomarker database that occurred in Brazil. Fifty markers of OT and 46 markers of recurrent disease were discovered by SELDI-MS of which 30 and 15, respectively, were cross-validated. 2D-GE analysis yielded 57 bands, selected based on the intensity of the bands, leading to the identification of 20 proteins. Eleven of those identified candidates were also found by SELDI-MS. Four candidates were chosen for immunoblotting. One serum protein, peptidyl-prolyl cis-trans isomerase A (PPIA), was confirmed as a biomarker of multi-episodic OT by immunoblotting in patients. PPIA can identify the patient with active recurrent OT from acute OT, other forms of uveitis and other parasitic infections. A validated PPIA assay may have a role in the diagnosis of the atypical OT patient before more invasive anterior chamber or vitreous tap is performed for PCR analysis or for Goldmann-Witner coefficient calculations. Base-line PPIA levels need to be studied to understand its possible use when deciding for prophylactic antibiotic use in the immunosuppressed sero-positive patient.

PMID: 30063883 [PubMed - indexed for MEDLINE]

Evolutionary genomics of anthroponosis in Cryptosporidium.

Thu, 03/07/2019 - 01:13
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Evolutionary genomics of anthroponosis in Cryptosporidium.

Nat Microbiol. 2019 Mar 04;:

Authors: Nader JL, Mathers TC, Ward BJ, Pachebat JA, Swain MT, Robinson G, Chalmers RM, Hunter PR, van Oosterhout C, Tyler KM

Abstract
Human cryptosporidiosis is the leading protozoan cause of diarrhoeal mortality worldwide, and a preponderance of infections is caused by Cryptosporidium hominis and C. parvum. Both species consist of several subtypes with distinct geographical distributions and host preferences (that is, generalist zoonotic and specialist anthroponotic subtypes). The evolutionary processes that drive the adaptation to the human host and the population structures of Cryptosporidium remain unknown. In this study, we analyse 21 whole-genome sequences to elucidate the evolution of anthroponosis. We show that Cryptosporidium parvum splits into two subclades and that the specialist anthroponotic subtype IIc-a shares a subset of loci with C. hominis that is undergoing rapid convergent evolution driven by positive selection. C. parvum subtype IIc-a also has an elevated level of insertion and deletion mutations in the peri-telomeric genes, which is also a characteristic of other specialist subtypes. Genetic exchange between Cryptosporidium subtypes plays a prominent role throughout the evolution of the genus. Interestingly, recombinant regions are enriched for positively selected genes and potential virulence factors, which indicates adaptive introgression. Analysis of 467 gp60 sequences collected from locations across the world shows that the population genetic structure differs markedly between the main zoonotic subtype (isolation-by-distance) and the anthroponotic subtype (admixed population structure). We also show that introgression between the four anthroponotic Cryptosporidium subtypes and species included in this study has occurred recently, probably within the past millennium.

PMID: 30833731 [PubMed - as supplied by publisher]

Leishmania donovani PP2C: Kinetics, structural attributes and in vitro immune response.

Wed, 03/06/2019 - 00:29
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Leishmania donovani PP2C: Kinetics, structural attributes and in vitro immune response.

Mol Biochem Parasitol. 2018 07;223:37-49

Authors: Jakkula P, Qureshi R, Iqbal A, Sagurthi SR, Qureshi IA

Abstract
Most of the signaling pathways are regulated by reversible phosphorylation-dephosphorylation which involves enzymes- kinases and phosphatases. Current knowledge about the protein phosphatases in parasites like Trypanosoma and Leishmania is very minimal despite their enormousity. In present study, full length ORF of Leishmania donovani PP2C was cloned into expression vector followed by purification and molecular weight determination using Ni-NTA affinity and gel giltration chromatography respectively. Purified LdPP2C was found to be enzymatically active, while inhibition study suggested that sanguinarine acts as a non-competitive inhibitor. CD and fluorescence spectroscopy results indicated towards an adequate protein conformation from pH 3.5 to 8.5. The quenching constant (Ksv) and free energy (ΔG) of LdPP2C was found to be 11.1 ± 0.2 mM-1 and 2.0 ± 1.1 kcal mol-1 in presence of acrylamide and urea respectively. The protein was found to elicit the innate immune functions through upregulation of pro-inflammatory cytokines (TNF-α and IL-6) as well as nitric oxide generation. Simultaneously, these cytokines were found to be fairly higher in protein treated cells as compared to untreated cells at transcript level too. These observations advocate that LdPP2C generates a pro-inflammatory environment in macrophages and hence plays important role in immunomodulation. Computational modelling showed similar three-dimensional structure and metal binding sites present in other member of PP2C subfamily, while docking studies revealed its interaction with substrate as well as its specific inhibitor. Our study has provided first time reports on enzyme kinetics, structural features and immune response inside the host macrophage of metal-dependent protein phosphatases from a trypanosomatid parasite.

PMID: 29964060 [PubMed - indexed for MEDLINE]

Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review.

Thu, 02/28/2019 - 00:05
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Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review.

Int J Environ Res Public Health. 2018 09 20;15(10):

Authors: Hui C, Dunn J, Morton R, Staub LP, Tran A, Hargreaves S, Greenaway C, Biggs BA, Christensen R, Pottie K

Abstract
Newly arrived migrants to the EU/EEA (arrival within the past five years), as well as other migrant groups in the region, might be under-immunised and lack documentation of previous vaccinations, putting them at increased risk of vaccine-preventable diseases circulating in Europe. We therefore performed a systematic review conforming to PRISMA guidelines (PROSPERO CRD42016045798) to explore: (i) interventions that improve vaccine uptake among migrants; and (ii) cost-effectiveness of vaccination strategies among this population. We searched MEDLINE, Embase, CINAHL, and Cochrane Database of Systematic Reviews (CDSR) between 1 January 2006 to 18 June 2018. We included three primary intervention studies performed in the EU/EEA or high-income countries and one cost effectiveness study relevant to vaccinations in migrants. Intervention studies showed small but promising impact only on vaccine uptake with social mobilization/community outreach, planned vaccination programs and education campaigns. Targeting migrants for catch-up vaccination is cost effective for presumptive vaccination for diphtheria, tetanus, and polio, and there was no evidence of benefit of carrying out pre-vaccination serological testing. The cost-effectiveness is sensitive to the seroprevalence and adherence to vaccinations of the migrant. We conclude that scarce but direct EU/EEA data suggest social mobilization, vaccine programs, and education campaigns are promising strategies for migrants, but more research is needed. Research should also study cost effectiveness of strategies. Vaccination of migrants should continue to be a public heath priority in EU/EEA.

PMID: 30241320 [PubMed - indexed for MEDLINE]

Fecal sludge as a fuel: characterization, cofire limits, and evaluation of quality improvement measures.

Sun, 02/17/2019 - 00:49
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Fecal sludge as a fuel: characterization, cofire limits, and evaluation of quality improvement measures.

Water Sci Technol. 2018 Dec;78(12):2437-2448

Authors: Hafford LM, Ward BJ, Weimer AW, Linden K

Abstract
In many low-income cities, a high proportion of fecal sludge, the excreta and blackwater collected from onsite sanitation systems such as pit latrines, is not safely managed. This constitutes a major danger to environmental and human health. The water, sanitation, and hygiene sector has recognized that valorization of treated fecal sludge could offset the upfront cost of treatment by using it as a fuel source. The few quantitative studies on fecal sludge fuel published to date have focused on heating value, moisture, ash fraction, and heavy metals. However, other factors impacting fuel utility, specifically ash speciation, have not been adequately quantified for fecal sludge. This study contributes to closing that gap and shows the value of more detailed quantification. It first characterizes fecal sludge samples from Colorado and Uganda, confirms that the fuel is better if cofired with other biomass, and outlines a framework for determining safe cofire ratios. Second, the study evaluates two methods for improving fecal sludge as a fuel: carbonization and ash leaching. Carbonization of fecal sludge did not improve fuel quality, but leaching showed promise in ash reduction.

PMID: 30767909 [PubMed - in process]

Embracing the challenges of migration medicine.

Fri, 02/08/2019 - 00:12
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Embracing the challenges of migration medicine.

J Travel Med. 2019 Feb 06;:

Authors: Greenaway C, Castelli F

PMID: 30726955 [PubMed - as supplied by publisher]

Infectious diseases at different stages of migration: an expert review.

Fri, 02/08/2019 - 00:12
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Infectious diseases at different stages of migration: an expert review.

J Travel Med. 2019 Feb 06;:

Authors: Greenaway C, Castelli F

Abstract
Background: Human migration is increasing in magnitude and scope. The majority of migrants arriving in high income countries originate from countries with a high prevalence of infectious diseases. The risk and burden of infectious diseases are not equally distributed among migrant groups and varies with migration stage.
Methods: A broad literature review on the drivers for infectious diseases and associated health outcomes among migrants across different stages of migration was conducted. The aim was to provide practitioners with an overview of the key infectious disease risks at each stage to guide health promotion strategies.
Results: A complex interaction of factors lead to infectious diseases and associated poor health outcomes among migrants. The most important drivers are the epidemiology of infectious diseases in their countries of origin, the circumstances and conditions of the migration journey, and barriers accessing health care post arrival. During the recent large waves of forced migration into Europe the primary health concerns on arrival were, psychological, traumatic and chronic non-communicable diseases. In the early settlement period, crowded and unhygienic living conditions in reception camps facilitated outbreaks of respiratory, gastrointestinal, skin infections and vaccine preventable diseases. After re-settlement, undetected and untreated latent infections due to tuberculosis, viral hepatitis, HIV, chronic helminthiasis and Chagas disease lead to poor health outcomes. Migrants are disproportionally affected by preventable travel related diseases such as malaria, typhoid and hepatitis due to poor uptake of pre-travel prophylaxis and vaccination. Infectious diseases among migrants can be decreased at all migration stages with health promotion strategies adapted to their specific needs and delivered in a linguistically and culturally sensitive manner.
Conclusions: Tailored health promotion and screening approaches and accessible and responsive health systems, regardless of legal status, will be needed at all migration stages to limit the burden and transmission of infectious diseases in the migrant population.

PMID: 30726941 [PubMed - as supplied by publisher]

What's in a Name and Why "Tropical Medicine" Matters in 2019.

Wed, 02/06/2019 - 00:04
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What's in a Name and Why "Tropical Medicine" Matters in 2019.

Infect Dis Clin North Am. 2019 Mar;33(1):xiii-xiv

Authors: Libman M, Yansouni CP

PMID: 30712770 [PubMed - in process]

Migration Medicine.

Wed, 02/06/2019 - 00:04
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Migration Medicine.

Infect Dis Clin North Am. 2019 Mar;33(1):265-287

Authors: Greenaway C, Castelli F

Abstract
Migration is increasing and practitioners need to be aware of the unique health needs of this population. The prevalence of infectious diseases among migrants varies and generally mirrors that of their countries of origin, but is modified by the circumstance of migration, the presence of pre-arrival screening programs and post arrival access to health care. To optimize the health of migrants practitioners; (1) should take all opportunities to screen migrants at risk for latent infections such as tuberculosis, chronic hepatitis B and C, HIV, strongyloidiasis, schistosomiasis and Chagas disease, (2) update routine vaccines in all age groups and, (3) be aware of "rare and tropical infections" related to migration and return travel.

PMID: 30712766 [PubMed - in process]

Antimicrobial Resistance in the Tropics.

Wed, 02/06/2019 - 00:04
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Antimicrobial Resistance in the Tropics.

Infect Dis Clin North Am. 2019 Mar;33(1):231-245

Authors: Semret M, Haraoui LP

Abstract
Antimicrobial resistance (AMR) is on the rise and spreading rapidly worldwide. Low- and middle-income countries, because of weak health systems, are particularly vulnerable to this increase. Population mobility further fuels the globalization of AMR, with travelers and migrants at significant risk of harboring drug-resistant organisms. This article provides an overview of the factors that contribute to the emergence, spread, and persistence of AMR, particularly antibiotic-resistance, in the tropics. Also addressed are clinical implications of this emergent global crisis for migrants and travelers, using specific scenarios commonly encountered in those populations.

PMID: 30712764 [PubMed - in process]

New Tools to Test Stool: Managing Travelers' Diarrhea in the Era of Molecular Diagnostics.

Wed, 02/06/2019 - 00:04
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New Tools to Test Stool: Managing Travelers' Diarrhea in the Era of Molecular Diagnostics.

Infect Dis Clin North Am. 2019 Mar;33(1):197-212

Authors: Eckbo EJ, Yansouni CP, Pernica JM, Goldfarb DM

Abstract
Travelers' diarrhea affects up to 60% of visitors to tropical and subtropical regions. Although symptoms are generally self-limited, some infections are associated with significant morbidity and occasional mortality. Newer molecular diagnostic techniques allow for highly sensitive, specific, and expeditious testing of a wide range of potential pathogens. Identification of the causative pathogen of travelers' diarrhea allows for targeted therapy and management and a reduction in empiric broad-spectrum coverage.

PMID: 30712762 [PubMed - in process]

Toxoplasma gondii infection in stranded St. Lawrence Estuary beluga Delphinapterus leucas in Quebec, Canada.

Wed, 02/06/2019 - 00:04
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Toxoplasma gondii infection in stranded St. Lawrence Estuary beluga Delphinapterus leucas in Quebec, Canada.

Dis Aquat Organ. 2018 09 27;130(3):165-175

Authors: Iqbal A, Measures L, Lair S, Dixon B

Abstract
The St. Lawrence Estuary (SLE) beluga Delphinapterus leucas in Quebec, Canada, is endangered due to intensive hunting in the 19th and 20th centuries and subsequent anthropogenic contamination and human activities in the region. Infectious disease is a primary cause of death in this population. The protozoan parasite Toxoplasma gondii is reported in numerous marine mammal species, including beluga. In the present study, 55 tissue samples (heart and brain) collected from 34 stranded SLE beluga were analysed by PCR followed by DNA sequencing and restriction fragment length polymorphism analysis (RFLP) to determine the PCR prevalence and genotypes of T. gondii in these beluga. Of 34 beluga tested, 44% were positive for T. gondii by PCR, with males having a higher prevalence of infection than females and with more infected neonates and juveniles than adults. Molecular analyses indicated that all T. gondii infecting stranded SLE beluga grouped into genotype II, which predominates in humans. While our results indicate that a high prevalence of stranded beluga are PCR-positive for T. gondii infection, very few deaths are attributed to toxoplasmosis based on published necropsy results. Toxoplasma gondii can cause a range of diseases, including neurological deficits, and more data are needed to investigate this parasite's effect on population recovery.

PMID: 30259869 [PubMed - indexed for MEDLINE]

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