Contrôle et élimination du paludisme

Healthcare-associated infections prevalence in developing countries is substantially higher than in Europe and the United States, The risk of acquiring infection is 2 to 20 times higher in developing countries. Medical tourism is the term commonly used to describe people traveling outside their home country for medical treatment. Patients may pursue medical care abroad for a variety of reasons, such as decreased cost, a preference for care from providers from a similar culture, or to receive a procedure or therapy not available in their country of residence.

Medical tourism is a worldwide, multibillion-dollar phenomenon that is expected to grow substantially in the next 5–10 years.

Infection control issues must be considered, as patients may be colonized or infected with multidrug-resistant bacteria. Complicating infections may appear early or late. Prominent bacterial species causing nosocomial infections and resistance patterns vary geographically. In many countries, antibiotics are available without prescription; overuse is common and resistance widespread, so nosocomial infections may be caused by unusually resistant bacteria that reflect problem pathogens in that hospital or region.

Many countries with robust medical tourism programs lie in tropical and subtropical regions where malaria, dengue fever, enteric fever, and other endemic infections exist. Many have high background rates of tuberculosis, antibiotic resistance, and hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). Health care providers should be vigilant for the possibility of resistant infections among patients who have traveled for medical procedures and take measures to control their spread in the home country. Medical tourists are at risk for procedure-related infections e.g. wound and blood-borne infections. Travel abroad for healthcare has increased rapidly; interventions include organ transplant; cardiac surgery; reproductive care; and joint, cosmetic, and dental procedures.

Individuals who receive medical care abroad are a vulnerable, sentinel population, who sample the local environment and can carry home unusual and resistant infections. Medical tourists are at risk for hospital-associated and procedure related infections as well as for locally endemic infections. The term “medical tourism” has come to mean not only the treatment of patients in other countries, but also to indicate non-essential and elective treatments such as cosmetic surgery, treatment for substance abuse and dermatological conditions such as hair transplantation. The entry of several Arab countries into the World Trade Organization has facilitated this development. Patients from the Gulf countries were sent to Beirut, Cairo, Paris, Germany and other cities for medical treatment.

Medical tourists leave their homes and arrive at their destination having unknowingly served as a hitchhiking medium for their native microbes. Likewise, medical tourists who pick up organisms in a hospital carry these microbes back home. Just like that, two different places that were initially naïve to a world of bacteria are now colonized with new strains, including good bugs and bad bugs.

More than 1 billion people travel by air each year. There are several important ways in which air travel can influence the global spread of emerging and established infectious disease.

Travelers should be considered an integral part of the global surveillance network for emerging infections. Research and the knowledge gained can be used to alert the global community to the presence or susceptibility patterns of pathogens in different regions; inform strategies that can be used to control infections in developing countries; and prepare travelers to those areas and guide the care of those returning. Patients contemplating medical tourism should be advised of procedure-related as well as typical travel-associated risks. The public should be informed of potential infectious disease risks associated with overseas hospital care.

Efforts such as the Chennai Declaration—a consensus report resulting from a 2012 meeting in Chennai, India, of healthcare representatives, experts, and policy makers from India and WHO, which aimed to formulate a plan to address the global challenge of antimicrobial resistance from the Indian perspective—attempt to tackle the resistance problem. For medical tourists, a tracking system is needed as patients from one institution may return to many different countries and institutions, making it difficult to identify problems at a particular institution. Improved communication is essential to optimize continuity of care of medical tourists who may have follow-up on a different continent by a clinical team unaware of site(s) of medical and surgical care. Medical tourists may carry home unusually resistant microbial flora; patients hospitalized after return from medical care in high-risk destinations such as South Asia should be placed on contact isolation and cultured for resistant organisms. Decisions about empiric therapy and surgical prophylaxis should consider recent travel history and procedures abroad. Surveillance networks such as GeoSentinel (55 travel–tropical medicine clinics on 6 continents) can be refined to capture data on antimicrobial resistance.

Introduction: Lophomonas Blattarum is a round-oval formed protozoan, 20-60 distances across with apical tuft of various lashes. It dwells as an endocommensal in the hindgut of creepy crawlies, for example, cockroaches. It is progressively being perceived as one of the reason bronchopulmonary contamination. Lophomonas blattarum (L. blattarum) is a protozoan that can cause contamination in an assortment of tissues and organs. Clinically, the most well-known tissue contaminated is the respiratory tract, and the associative indications (counting hack, sputum, and dyspnea) are like those of other respiratory conditions, for example, bronchial asthma, pneumonia, bronchitis, or intense compounding of interminable obstructive aspiratory ailment (AECOPD. Clinically critical pneumonic protozoa diseases are uncommon yet have been progressively perceived in the past decades. Predisposing factors contain immunosuppression and maturing process. This endocommensal normally parasitizes the digestive system of explicit arthropods, for example, termites and roaches. Inhalation of vaporizers containing L. blattarum sores has been proposed to taint human beings but this theory has not been affirmed.

In excess of 100 instances of L. blattarum disease have been accounted for since the principal case rose in 1993. Most by far of studies detailed L. blattarum contamination dependent on morphology under a light magnifying lens. Since 2011, a few reports have demonstrated that a couple of studies misidentified respiratory ciliated cells as L. blattarum or multi-whipped protozoans. The specialists accepted that in spite of some comparative highlights between L. blattarum and respiratory ciliated cells, which are hard to separate, a lot of morphological highlights are one of a kind to L. blattarum or respiratory ciliated cells under a light magnifying lens. The morphological highlights saw by light microscopy are lacking. Here, we present an instance of ceaseless eosinophilia pneumonia that was at first misdiagnosed as a multi-lashed protozoan disease.

Case Report: A 22-year-old female gave objections of hack with blood clumps in expectorant, windedness on effort, wheeze and poor quality fever, for recent year. Before showing up to our Outpatient Department (OPD), tolerant had counseled other clinical focuses. There she was determined to have tuberculosis. In our OPD she was surveyed with past reports, exhorted new examinations, proceeded on Antitubercular Therapy (ATT) and was gotten ready for bronchoscopy. The Bronchoaleveolar Lavage (BAL) was sent for research center testing. Wet mount of the example uncovered a motile multiflagellate protozoan taking after ciliated respiratory epithelium. After further appraisal, it was accounted for as Lophomonas blattarum. The patient was kept on ATT, while anticipating Mycobacterium Tuberculosis (MTB) test results. Progressing ATT had no beneficial outcome patient is condition. Understanding was conceded and begun on Anti-protozoan treatment.

Discussion: It is hard to separate Lophomonas blattarum indications from other respiratory contaminations showing comparative side effects. Research center finding depends on recognizable proof of morphological highlights under light microscopy. Missed ID could be because of deferred test handling and its nearby likeness to bronchial epithelium. With advancement of serological and sub-atomic strategies for recognizable proof, finding and treatment can improve. Most detailed cases in late decades indicated a positive reaction after metronidazole treatment, as for this situation. The improvement was not just ascribed to the expansive range property of this anti-toxin, particularly against anaerobic microscopic organisms, yet in addition to the organization of bronchodilator operators and physicotherapeutics, for example, noninvasive ventilation. In spite of the fact that eosinophilia and expanded complete IGE showed parasite or protozoan contamination, direct proof, for example, detachment and culture, was insufficient, and pictures of light microscopy were not adequate for an indisputable ID.

Around 30 cases had eosinophilia, representing 33% of the all-out cases. Protozoan disease in these cases, which would clarify the eosinophil tallies, could be reevaluated. Another conceivable issue is that the wellspring of tests, sputum and throat swabs, could be polluted with oral vegetation and food materials. At long last, with the exception of 10 cases from abroad, most of cases were accounted for in China; nonetheless, there is no proof that lashed protozoan contamination is an endemic illness. For this situation, we utilized methodologies including light microscopy, examining electron microscopy, BALF and bronchoscopy brush spreads recoloring for analysis. In spite of the fact that multi-flogged protozoan morphological highlights were recognized from bronchial ciliated epithelia cells by checking electron microscopy, transmission electron microscopy is basic for investigating inward structures.

Despite efforts of prevention done in the world, malaria remains a great public health problem with 216 million cases reported in 2017. It is one of first causes of morbidity and mortality in the world; 445,000 deaths in 2017 were due to malaria. The majority of malaria cases occur in Africa.

Households selected for the survey (DHS) were grouped into clusters of which longitude and latitude were recorded. Results from RDTs were used. Variance contribution of factors was estimate with the Generalized Linear Mixed-effects model. Mean Gini decrease was used for measuring importance of each predictor and mean decrease accuracy was used for estimating how much each factor reduces error. GWR were performed in order to assess the heterogeneity of relationships between geographical factors and malaria. A CRT was performed for observing partition of data by the most important independent variable.

We found that wealth status is the first socio-economic factor that contributes in differences of malaria risk. Quantity of rainfall, temperature and density of population were most important environmental factors. While in certain regions; high quantity of rainfall, high temperature or high density of population were associated with an increase in malaria risk; in certain regions the relationship was the inverse. We identified countries with high association with malaria risk and countries having low association with malaria risk. There was however a significant difference between these two groups of countries in the education level of mothers, the use of bed net, the anaemia status, the size of household, density of population. We observed that the country where the child lived was the most important factor for malaria risk and it contributed to half of the variability of malaria risk. Wealth status is the first socio-economic factor that contributes in the differences of malaria risk.

Our study has the potential for driving control effort in the fight against malaria in the continent which represent the majority of global malaria cases. The study indicates that, when implementing health policies, community characteristics must be taken into account. To assess the importance of malaria risk factors for children in sub-Saharan African countries. 61,292 children of 16 countries from DHS and MIS surveys were included in analysis. A regression model with analyse of variance and plots of mean decrease accuracy and mean decrease Gini indices were performed. The most important risk factor was the country and it contributed 52.33 % to the variance of the model. Wealth status of the child's family was the first socio-economic factor which contributed more to the difference of malaria risk among African children. There was no geographic factor among the five most important variables. Quantity of precipitation was the sixth most important factor. Our study has the potential for driving control effort in the fight against malaria in the continent which represent the majority of global malaria cases. The study indicates that, when implementing health policies, community characteristics must be taken into account. The aim of this study was to assess the prevalence of and factors associated with malaria in children under the age of five years in Malawi using GAMM. The current findings show that the government should consider other factors associated with malaria especially in children less than five years of age; such as anaemia, region, residence type, toilet facilities, wealth index, and the use of electricity, mothers' education, children's age and the altitude of the region of residence.

The findings from this study revealed that malaria is still a major problem and is linked to socio-economic factors as well as geographical location. The government should focus on poorer communities from rural and low altitude areas, especially in the Central Region, as their target group of individuals to educate, support and help change mindsets. In addition, children with anaemia should take priority in receiving the necessary health care and support. The key findings also show that there is a need to educate the population through workshops, mobile clinics and various social media platforms on how to prevent malaria in children under five years of age.

The study will help the government and donors to control and possibly eliminate malaria in children less than five years of age. The main focus should be on children with anaemia, mother's education level, wealth index, children's age, the altitude of the place of residence, region, and place of residence, toilet facility and electricity facilities. Furthermore, the model used in this study will help other researchers to compare findings.

Wild koala populations continue to experience serious declines as a result of several threatening factors including: loss of habitat, motor vehicle trauma, dog attacks and, chlamydial disease. Chlamydial infections are associated with diseases ranging from ocular disease leading to blindness, as well as urinary and genital tract disease, leading to female infertility. Modeling shows that targeting chlamydial disease would have a major impact on stabilizing population decline. Our previous studies have demonstrated that koalas can be safely immunized with a vaccine containing a mixture of chlamydial major outer membrane protein (MOMP) antigens combined with a single or three-dose subcutaneous regime.

Recently, large scale, field trial of the vaccine, we vaccinated 30 koalas that were outwardly clinically healthy but either chlamydia PCR negative or chlamydia PCR positive, and followed them for 1-2 years to assess the protective effect of the vaccine (compared to a control group of unvaccinated koalas). We observed strong, specific and long-lasting immune responses in the vaccinated koalas; high titer antibody responses (as measured by ELISA and also in vitro neutralization) as well as chlamydia-specific cytokine responses (interferon-gamma and IL-17 in particular). We also observed protection from progression to clinical disease in the vaccinated animals. We have also conducted a small trial to vaccinate animals which already have clinical signs of ocular disease. Instead of the normal practice of administering antibiotics (chloramphenicol, daily for 28 days, which severely disrupts the animal’s gut microbiome) we vaccinated four animals with a single dose, 3-MOMP vaccine. For all vaccinated animals, their chlamydia PCR load decreased, often to zero, and in two animals at least, we observed a decrease in their clinical disease score. These results are promising for the future development of an effective chlamydial vaccine for use in captive as well as wild koalas.

Wild koala populations continue to have significant levels of infection with C. pecorum and as a result are suffering debilitating disease, which is threatening their long-term survival. In many populations, these levels of infection and disease are actually higher than previously reported and current treatment options are showing little to no impact on the decline in the level of infection and disease, with hospital admission records remaining stable over time. The widespread implementation of a vaccine in wild koalas could offer the protection needed to reverse this progression. To date, previous rMOMP protein vaccine trials conducted on both infected and diseased wild koala populations have been very successful. These trials have shown that an rMOMP protein vaccine stimulates the immune system and is responsible for an increase in neutralizing antibodies. Vaccinated koalas have shown a decrease in their chlamydial infections load as well as ocular disease status, post-vaccination, and importantly, rMOMP vaccinated wild koalas have also shown a decrease in the progression to disease over a 12 month period. However, in spite of this success, there are many challenges in producing and implementing a recombinant protein format vaccine on a wider scale. A synthetic peptide based vaccine could overcome some of these challenges, assuming that it induces a strong and relevant immune response. The development of a peptide based anti-chlamydial vaccine that can elicit the same, or even stronger immune responses as the current C. pecorum MOMP vaccine, with the potential to be mass produced, would be an ideal candidate for future anti-chlamydial vaccine development.

In this study, we have shown that a vaccine consisting of two relatively short peptides, derived from the full length MOMP, is capable of inducing an immune response in koalas up to 26 weeks post-vaccination. We have shown a mucosal IgA antibody response to full length rMOMP (G), in both the MOMP-peptide and MOMP-protein vaccinated koalas. Chlamydia infection and disease are endemic in free-ranging koalas. Antibiotics remain the front line treatment for Chlamydia in koalas, despite their rates of treatment failure and adverse gut symbiosis outcomes. This study investigated whether a productive immune response could be induced by vaccinating koalas during antibiotic treatment for Chlamydia-induced cystitis. Plasma IgG antibody levels against the C. pecorum major outer membrane protein (MOMP) dropped during antibiotic treatment in both vaccinated and unvaccinated koalas.

Post-treatment, IgG levels recovered. The IgG antibodies from naturally-infected, vaccinated koalas recognized a greater proportion of the MOMP protein compared to their naturally-infected, unvaccinated counterparts. Furthermore, peripheral blood mononuclear cell gene expression revealed an up-regulation in genes related to neutrophil degranulation in vaccinated koalas during the first month post-vaccination. These findings show that vaccination of koalas while they are being treated with antibiotics for cystitis can result in the generation of a productive immune response, in the form of increased and expanded IgG production and host response through neutrophil degranulation.

I am pleased to introduce International Journal of Malaria Control & Elimination (MCCE) which is an open access electronic journal aiming to provide an online compendium for anatomical variations in gross, radiological, neuroanatomical, surgical anatomy, and case reports in clinical anatomy. We have been started in year 2008 International Journal of Malaria Control & Elimination (ISSN: 2470-6965) is growing continuously. It is our pleasure to announce that during year 2019, all issues of volume 9 were published online on time and the print issues were also brought out and dispatched within 30 days of publishing the issue online.

All published articles of this journal are included in the indexing and abstracting coverage of CAS Source Index (CASSI), Index Copernicus, Google Scholar, Sherpa Romeo, Academic Journals Database, Genomics JournalSeek, Journal TOCs, CiteFactor, Electronic Journals Library, RefSeek, Hamdard University, EBSCO A-Z, Directory of Abstract Indexing for Journals, World Catalogue of Scientific Journals, OCLC- World Cat, Scholarsteer, SWB online catalog, Virtual Library of Biology (vifabio), Publons, Dtufindit, Geneva Foundation for Medical Education and Research.

During the calendar year 2019, International Journal of Malaria Control & Elimination received a total of 30 papers, out of which 2 articles were rejected in the preliminary screening due to plagiarism or being out of the format and peer review process. During 2019 around 16 articles were subjected for publication after they are accepted in the peer review process. In the 3 issues of Volume 9 published during the year 2019, a total of 16 articles were published (at an average of 3 articles per issue of which, articles were published from authors all around the world. A total of 30 research scientists from all over the world reviewed the 16 articles published in volume 9. Average publication period of an article was further reduced to 14-21 days.

During the calendar year 2019, a total of three Editors, ten Reviewers joined the board of MCCE and contributed their valuable services towards contribution as well as publication of articles, and their valuable reviewer comments will beneficial to publish quality of article in the Journal.

I take this opportunity to acknowledge the contribution of Editor-in-chief and Associate Editor during the final editing of articles published and bringing out issues of MCCE in time. I would also like to express my gratitude to all the authors, reviewers, the publisher, language editor, honorary editors, the scientific advisory and the editorial board of MCCE, the office bearers for their support in bringing out the new volume (Volume 9) of MCCE for the calendar year 2020 and look forward to their unrelenting support further to release more issues for International Journal of Malaria Control & Elimination MCCE in scheduled time.