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Barragan P.,Hospital Universitari Of Bellvitge | Lopez-Velez R.,Tropical Medicine and Clinical Parasitology | Olmo M.,Hospital Universitari Of Bellvitge | Podzamczer D.,Hospital Universitari Of Bellvitge
American Journal of Tropical Medicine and Hygiene

Visceral leishmaniasis is an opportunistic infection that affects human immunodeficiency virus-infected persons in leishmaniasis-endemic areas. The standard treatment may not be effective and relapses are common. We report the case of a human immunodeficiency virus-1-infected patient who had several relapses of visceral leishmaniasis after treatment with standard therapies and responded to a combined therapy. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene. Source

Schlagenhauf P.,University of Zurich | Weld L.,EuroTravNet | Goorhuis A.,University of Amsterdam | Gautret P.,Aix - Marseille University | And 17 more authors.
The Lancet Infectious Diseases

Background: Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice. Methods: We analysed travel-associated morbidity in ill travellers presenting at EuroTravNet sites during the 5-year period of 2008-12. We calculated proportionate morbidity per 1000 ill travellers and made comparisons over time and between subgroups. We did 5-year trend analyses (2008-12) by testing differences in proportions between subgroups using Pearson's χ2 test. We assessed the effect of the pre-travel consultation on infection acquisition and outcome by use of proportionate morbidity ratios. Findings: The top diagnoses in 32 136 patients, ranked by proportionate morbidity, were malaria and acute diarrhoea, both with high proportionate morbidity (>60). Dengue, giardiasis, and insect bites had high proportionate morbidity (>30) as well. 5-year analyses showed increases in vector borne infections with significant peaks in 2010; examples were increased Plasmodium falciparum malaria (χ2=37·57, p<0·001); increased dengue fever (χ2=135·9, p<0·001); and a widening geographic range of acquisition of chikungunya fever. The proportionate morbidity of dengue increased from 22 in 2008 to 36 in 2012. Five dengue cases acquired in Europe contributed to this increase. Dermatological diagnoses increased from 851 in 2008 to 1102 in 2012, especially insect bites and animal-related injuries. Respiratory infection trends were dominated by the influenza H1N1 pandemic in 2009. Illness acquired in Europe accounted for 1794 (6%) of all 32 136 cases-mainly, gastrointestinal (634) and respiratory (357) infections. Migration within Europe was associated with more serious infection such as hepatitis C, tuberculosis, hepatitis B, and HIV/AIDS. Pre-travel consultation was associated with significantly lower proportionate morbidity ratios for P falciparum malaria and also for acute hepatitis and HIV/AIDS. Interpretation: The pattern of travel-related infections presenting in Europe is complex. Trend analyses can inform on emerging infection threats. Pre-travel consultation is associated with reduced malaria proportionate morbidity ratios and less severe illness. These findings support the importance and effectiveness of pre-travel advice on malaria prevention, but cast doubt on the effectiveness of current strategies to prevent travel-related diarrhoea. Funding: European Centre for Disease Prevention and Control, University Hospital Institute Méditerranée Infection, US Centers for Disease Control and Prevention, and the International Society of Travel Medicine. © 2015 Elsevier Ltd. Source

Arnalich-Montiel F.,Cornea Unit | Lumbreras-Fernandez B.,Cornea Unit | Martin-Navarro C.M.,University of La Laguna | Martin-Navarro C.M.,University of Edinburgh | And 4 more authors.
Journal of Clinical Microbiology

Genotype T4 is by far the most frequent genotype of Acanthamoeba keratitis (AK) and therefore has been considered the most virulent. This study included 14 cases of AK of genotype T4 and three cases of non-T4 genotype. We found that cases of non-T4 genotype had a worse response to medical therapy, greater need for surgical intervention, greater risk of extracorneal involvement, and remarkably poorer final visual outcome than those of T4 genotype, suggesting an association between Acanthamoeba virulence and genotype that requires additional case investigation. Copyright © 2014, American Society for Microbiology. All Rights Reserved. Source

Navarro M.,Tropical Medicine and Clinical Parasitology | Norman F.F.,Tropical Medicine and Clinical Parasitology | Perez-Molina J.A.,Tropical Medicine and Clinical Parasitology | Lopez-Velez R.,Tropical Medicine and Clinical Parasitology
American Journal of Tropical Medicine and Hygiene

Chagas disease is a neglected tropical disease endemic in Latin America. The first-line treatment option is benznidazole, but stocks are expected to run out in the coming months. Spain would need around 5 million benznidazole tablets. This drug shortage could make Chagas disease a neglected tropical disease also in developed countries. Copyright © 2012 by The American Society of Tropical Medicine and Hygiene. Source

Navarro M.,Tropical Medicine and Clinical Parasitology | Navaza B.,Tropical Medicine and Clinical Parasitology | Guionnet A.,Tropical Medicine and Clinical Parasitology | Lopez-Velez R.,Tropical Medicine and Clinical Parasitology
Travel Medicine and Infectious Disease

VFRs are at a greater risk of contracting travel-related illnesses such as malaria, and their knowledge about travel health tends to be poor. Since 2009, community-based activities targeting potential and impending VFRs were performed by a multidisciplinary team in Madrid, Spain. The design and distribution of multilingual and culturally-sensitive material following a qualitative research, and intercultural mediators were key tools of the health education programme. © 2012 Elsevier Ltd. All rights reserved. Source

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