IHMT: CT - Artigos em revista internacional com arbitragem científica
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- Sexually transmitted infections, their treatment and urban change in colonial Leopoldville, 1910–1960Publication . Sousa, João Dinis; Havik, Philip J.; Vandamme, Anne Mieke; Instituto de Higiene e Medicina Tropical (IHMT); Global Health and Tropical Medicine (GHTM); Individual Health Care (IHC); TB, HIV and opportunistic diseases and pathogens (THOP); Cambridge University PressDuring the colonial period sexually transmitted infections (STIs) came to be recognised as a major public health problem in African cities. Thus, STI control and urban modernisation became deeply entangled as authorities redrew spatial and social boundaries to manage populations and their cross-cultural interaction. Public health measures, urban planning and policing were part of a coordinated effort to neutralise the potential impact of rapidly growing African urban migration on the Belgian Congo’s ‘model’ capital Leopoldville. While STI control was facilitated by new drugs (arsenicals, sulfonamides and antibiotics) to treat syphilis, chancroid, gonorrhoea and chlamydia (bacterial STIs), the effects of the 1929 economic crisis and urban social change illustrated the limits of colonial authority. Redesigning urban spaces and repressive measures to curb polygyny and prostitution operated in a parallel fashion with the expansion of health coverage, new treatments and awareness campaigns. To gain a better understanding of the evolution of STI incidence among African urban populations during the colonial period between 1910 and 1960, extensive archival records and secondary literature were consulted to assess the interplay between improved screening, diagnostic and therapeutic methods with demographic and social change. They show that STI rates, probably peaked during the pre-1929 period and apart from a short period in the early 1930s associated with mass screening, declined until becoming residual in the 1950s. Reflecting upon sanitary interventions and their broader dimensions, the article analyses the evolution of treatment regimes and their impact in the changing urban organisation and environment of the colony’s capital.
- Typhoid fever infection – Antibiotic resistance and vaccination strategiesPublication . Masuet-Aumatell, Cristina; Atouguia, Jorge; Instituto de Higiene e Medicina Tropical (IHMT); Individual Health Care (IHC); Global Health and Tropical Medicine (GHTM); ElsevierTyphoid fever is a bacterial infection caused by the Gram-negative bacterium Salmonella enterica subspecies enterica serovar Typhi (S. Typhi), prevalent in many low- and middle-income countries. In high-income territories, typhoid fever is predominantly travel-related, consequent to travel in typhoid-endemic regions; however, data show that the level of typhoid vaccination in travellers is low. Successful management of typhoid fever using antibiotics is becoming increasingly difficult due to drug resistance; emerging resistance has spread geographically due to factors such as increasing travel connectivity, affecting those in endemic regions and travellers alike. This review provides an overview of: the epidemiology and diagnosis of typhoid fever; the emergence of drug-resistant typhoid strains in the endemic setting; drug resistance observed in travellers; vaccines currently available to prevent typhoid fever; vaccine recommendations for people living in typhoid-endemic regions; strategies for the introduction of typhoid vaccines and stakeholders in vaccination programmes; and travel recommendations for a selection of destinations with a medium or high incidence of typhoid fever.
- Chronic Political Instability and the HIV/AIDS Response in Guinea-Bissau from 2000 to 2015Publication . Galjour, Joshua; Havik, Philip; Aaby, Peter; Rodrigues, Amabelia; Mpinga, Emmanuel Kabengele; Individual Health Care (IHC); Global Health and Tropical Medicine (GHTM); Instituto de Higiene e Medicina Tropical (IHMT); MDPI - Multidisciplinary Digital Publishing InstituteGuinea-Bissau suffers from political instability and an unusually high HIV/AIDS burden compared to other countries in the West Africa region. We conducted a systematic review on the HIV/AIDS epidemic in Guinea-Bissau during the Millennium Development Goals (MDGs) period (2000-2015), which dovetailed with a period of chronic political instability in the country's history. We searched published works on the HIV/AIDS epidemic in Guinea-Bissau for references to chronic political instability. Six databases and the grey literature were searched, informed by expert opinion and manual research through reference tracing. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The search yielded 122 articles about HIV/AIDS in Guinea-Bissau during the MDG years. Biomedical, clinical, or epidemiological research predominated public health research production on HIV/AIDS in Guinea-Bissau in this period. Six articles addressing themes related to chronic political instability, including how political instability has affected the HIV/AIDS disease response, were identified. The results suggest the importance of considering a broader political epidemiology that accounts for socio-political aspects such as governance, human rights, and community responses into which any national HIV/AIDS response is integrated.
- Evaluating vertical transmission of sexually transmitted infections to newbornsPublication . Oliveira, Dinamene; Piedade, João; Castro, Rita; Lopes, Ângela; Martins, Maria do Rosário; Pereira, Filomena; Individual Health Care (IHC); Global Health and Tropical Medicine (GHTM); Instituto de Higiene e Medicina Tropical (IHMT); TB, HIV and opportunistic diseases and pathogens (THOP); Population health, policies and services (PPS); Open Learning on Enteric PathogensIntroduction: Sexually transmitted infections are among the most frequent infections affecting pregnant women. We assessed the transmission of hepatitis B virus, human immunodeficiency virus type 1 and Treponema pallidum to newborns from infected parturients. Methodology: An observational, cross-sectional, analytical facility-based survey was conducted among 57 newborns in Irene Neto Maternity, Lubango city, Huíla province, Angola. Hepatitis B virus DNA molecular identification was done through nested PCR. Human immunodeficiency virus type 1 proviral DNA detection was carried out by two successive nested PCRs. Real-time PCR was performed to examine the presence of T. pallidum DNA. Amplicons from PCR positive samples were sequenced for identity search and genotype assignment. Results: Hepatitis B virus DNA genotype E was detected in 3/41 (7.3%) newborns from HBsAg (hepatitis B surface antigen) positive mothers. To analyse the association between mothers HBeAg (hepatitis B e antigen) positivity and hepatitis B virus vertical transmission to newborns, a Fisher's exact test was performed, showing a highly significant association (p = 0.006). Human immunodeficiency virus type 1 provirus or T. pallidum DNA was not detected in any newborn. Conclusions: To prevent hepatitis B virus vertical transmission in Angola it is important to promote universal antenatal screening, expanding hepatitis B virus markers (viral load and/or HBeAg), risk-based infected mothers' antiviral therapy and newborn passive immunoprophylaxis.
- Newly discovered archival data show coincidence of a peak of sexually transmitted diseases with the early epicenter of pandemic hiv-1Publication . Sousa, João Dinis; Havik, Philip J.; Müller, Viktor; Vandamme, Anne Mieke; Instituto de Higiene e Medicina Tropical (IHMT); Global Health and Tropical Medicine (GHTM); Individual Health Care (IHC); TB, HIV and opportunistic diseases and pathogens (THOP); MDPI - Multidisciplinary Digital Publishing InstituteTo which extent STDs facilitated HIV-1 adaptation to humans, sparking the pandemic, is still unknown. We searched colonial medical records from 1906–1958 for Leopoldville, Belgian Congo, which was the initial epicenter of pandemic HIV-1, compiling counts of treated STD cases in both Africans and Europeans. Almost all Europeans were being treated, while for Africans, generalized treatment started only in 1929. Treated STD counts in Europeans thus reflect STD infection rates more accurately compared to counts in Africans. In Africans, the highest recorded STD treatment incidence was in 1929–1935, declining to low levels in the 1950s. In Europeans, the recorded treatment incidences were highest during the period 1910–1920, far exceeding those in Africans. Europeans were overwhelmingly male and had frequent sexual contact with African females. Consequently, high STD incidence among Europeans must have coincided with high prevalence and incidence in the city’s African population. The data strongly suggest the worst STD period was 1910–1920 for both Africans and Europeans, which coincides with the estimated origin of pandemic HIV-1. Given the strong effect of STD coinfections on HIV transmission, these new data support our hypothesis of a causal effect of STDs on the epidemic emergence of HIV-1.
- Insights of antiparasitic activity of sodium diethyldithiocarbamate against different strains of Trypanosoma cruziPublication . de Freitas Oliveira, Johny Wysllas; Torres, Taffarel Melo; Moreno, Cláudia Jassica Gonçalves; Amorim-Carmo, Bruno; Damasceno, Igor Zumba; Soares, Ana Katarina Menezes Cruz; da Silva Barbosa, Jefferson; Rocha, Hugo Alexandre Oliveira; Silva, Marcelo Sousa; Instituto de Higiene e Medicina Tropical (IHMT); Global Health and Tropical Medicine (GHTM); Vector borne diseases and pathogens (VBD); Nature Publishing GroupChagas disease is caused by Trypanosoma cruzi and affects thousands of people. Drugs currently used in therapy are toxic and have therapeutic limitations. In addition, the genetic diversity of T. cruzi represents an important variable and challenge in treatment. Sodium diethyldithiocarbamate (DETC) is a compound with pharmacological versatility acting as metal chelators and ROS generation. Thus, the objective was to characterize the antiparasitic action of DETC against different strains and forms of T. cruzi and their mechanism. The different strains of T. cruzi were grown in LIT medium. To evaluate the antiparasitic activity of DETC, epimastigote and trypomastigote forms of T. cruzi were used by resazurin reduction methods and by counting. Different response patterns were obtained between the strains and an IC50 of DETC ranging from 9.44 ± 3,181 to 60.49 ± 7.62 µM. Cell cytotoxicity against 3T3 and RAW cell lines and evaluated by MTT, demonstrated that DETC in high concentration (2222.00 µM) presents low toxicity. Yet, DETC causes mitochondrial damage in T. cruzi, as well as disruption in parasite membrane. DETC has antiparasitic activity against different genotypes and forms of T. cruzi, therefore, representing a promising molecule as a drug for the treatment of Chagas disease.
- Artemether-lumefantrine treatment failure of uncomplicated Plasmodium falciparum malaria in travellers coming from Angola and MozambiquePublication . Silva-Pinto, André; Domingos, João; Cardoso, Margarida; Reis, Ana; Benavente, Ernest Diez; Caldas, João Paulo; Conceição, Cláudia; Toscano, Cristina; Baptista-Fernandes, Teresa; Clark, Taane G; Mansinho, Kamal; Campino, Susana; Nogueira, Fatima; Global Health and Tropical Medicine (GHTM); Instituto de Higiene e Medicina Tropical (IHMT); Individual Health Care (IHC); Vector borne diseases and pathogens (VBD); ElsevierThe failure of artemisinin combination therapy (ACT) in malaria patients returning from endemic regions may be driven by parasite resistance to this treatment. ACT is used globally as the first-line treatment for Plasmodium falciparum malaria. However, artemisinin-resistant strains of P. falciparum have emerged and spread across Southeast Asia, with the risk of reaching high malaria burden regions in Africa and elsewhere. Here, we report on two malaria imported cases from Africa with possible parasite resistance to the ACT artemether-lumefantrine (AL). Case presentation: Two middle-aged males returning from Angola and Mozambique developed malaria symptoms in Portugal, where they were diagnosed and received treatment with AL as hospital inpatients. After apparent cure and discharge from hospital, these individuals returned to hospital showing signs of late clinical failure. Molecular analysis was performed across a number of drug resistance associated genes. No evidence of pfk13-mediated artemisinin resistance was found. Both subjects had complete parasite clearance after treatment with a non-ACT antimalarials. Conclusion: Our case-studies highlight the need for close monitoring of signs of unsatisfactory antimalarial efficacy among AL treated patients and the possible implication of other genes or mutations in the parasite response to ACTs.
- Chronic political instability and HIV/AIDS response in Guinea-BissauPublication . Galjour, Joshua; Havik, Philip J; Aaby, Peter; Rodrigues, Amabelia; Hoemeke, Laura; Deml, Michael J; Zhao, Jinkou; Mpinga, Emmanuel Kabengele; Individual Health Care (IHC); Global Health and Tropical Medicine (GHTM); Instituto de Higiene e Medicina Tropical (IHMT); BioMed Central (BMC)BACKGROUND: The Republic of Guinea-Bissau in West Africa has a high HIV/AIDS disease burden and has experienced political instability in the recent past. Our study used qualitative methods to better understand key stakeholders' perceptions of the effects of chronic political instability on the HIV/AIDS response in Guinea-Bissau from 2000 to 2015 and lessons learned for overcoming them. METHODS: Seventeen semi-structured in-depth key informant interviews were conducted in Bissau, Guinea-Bissau in 2018. Interviews were recorded and transcribed verbatim, coded thematically, and analyzed inductively. RESULTS: Four themes emerged: (1) constantly start over; (2) the effects of instability rippling from central level throughout the health pyramid; (3) vulnerable populations becoming more vulnerable; and (4) coping mechanisms. CONCLUSIONS: Stakeholders from government, civil society, and donor organizations have recognized instability's effects as a barrier to mounting an effective local response to HIV/AIDS in Guinea-Bissau. To mitigate the effects of the country's political instability on the health sector, concerted efforts should be made to strengthen the capacities of health officials within the Ministry of Health to shield them from the effects of the country's political instability.
- Emerging and under-recognized Chagas cardiomyopathy in non-endemic countries.Publication . Cortez,, Joana; Providência,, Rui; Ramos,, Evelise; Valente,, Cristina; Seixas, Jorge Beirão de Almeida; Meruje,, Manuela; Leitão-Marques,, António; Vieira, António; Centro de Malária e outras Doenças Tropicais (CMDT); Baishideng Publishing GroupDue to recent population emigration movements, an epidemic of Chagas disease is currently menacing most developed countries. The authors report the case of a 53-year-old Brazilian woman living in Europe for the last 10 years who developed heart failure symptoms, having a previous symptomatic sinus node disease with a pacemaker implant at age of 40 years. The diagnosis was based on serology and myocardial biopsy and the patient was treated with nifurtimox. The authors emphasize the need of a high level of suspicion in patients with suggestive epidemiology and the need of populational screening of specific high risk groups. New treatment options are also discussed.
- Prevalence and level of antibodies anti-Plasmodium spp. in travellers with clinical history of imported malaria.Publication . Atouguia, Jorge Luís Marques da Silva; Silva, Marcelo; Centro de Malária e outras Doenças Tropicais (CMDT); Hindawi Publishing CorporationIn this study, we show that 40.29% of travellers with a possible history of malaria exposure were positive for anti-Plasmodium spp. antibodies, while these individuals were negative by microscopy. The antibody test described here is useful to elucidate malaria exposure in microscopy-negative travellers from endemic countries.
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