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Objective To assess the outcomes of a contact-tracing programme to increase the diagnosis of tuberculosis in Cubal, Angola and offer preventive treatment to high-risk groups. Methods A health centre-based contact-tracing programme was launched in Hospital Nossa Senhora da Paz in March 2015 and we followed the programme until 2022. In that time, staffing and testing varied which we categorized as four periods: medical staff reinforcement, 2015-2017, with a doctor seconded from Vall d'Hebron University Hospital, Spain; routine staff, 2017-2021, with no external medical support; community directly observed treatment (DOT), 2018-2019 with community worker support; and enhanced contact tracing, 2021-2022, with funding that allowed free chest radiographs, molecular and gastric aspirate testing. We assessed differences in contacts seen each month, and testing and treatment offered across the four periods. Findings Overall, the programme evaluated 1978 contacts from 969 index cases. Participation in the programme was low, although it increased significantly during the community DOT period. Only 16.6% (329/1978) of contacts had a chest radiograph. Microbiological confirmation increased to 72.2% (26/36) after including molecular testing, and 10.1% (200/1978) of contacts received treatment for tuberculosis. Of 457 contacts younger than 5 years, 36 (7.9%) received preventive tuberculosis treatment. Half of the contacts were lost to follow-up before a final decision was taken on treatment. Conclusion Contact tracing increased the diagnosis of tuberculosis although engagement with the programme was low and loss to follow-up was high. Participation increased during community DOT. Community-based screening should be explored to improve participation and diagnosis. Objectif Evaluer l'efficacite d'un programme de suivi des contacts pour ameliorer le depistage de la tuberculose a Cubal, en Angola, et proposer un traitement preventif aux groupes a haut risque. Methodes Un programme de suivi des contacts en centre de sante a ete lance en mars 2015 a l'Hospital Nossa Senhora da Paz, et nous l'avons accompagne jusqu'en 2022. Comme les effectifs et le depistage ont evolue durant cette periode, nous l'avons divisee en quatre phases: renforcement de l'equipe medicale entre 2015 et 2017, avec un medecin detache de l'hopital universitaire Vall d'Hebron, en Espagne; personnel regulier entre 2017 et 2021, sans assistance medicale externe; traitement sous surveillance directe (TSD) au niveau communautaire entre 2018 et 2019, avec l'aide des agents communautaires; et enfin, suivi renforce des contacts entre 2021 et 2022, avec un financement permettant d'effectuer gratuitement des radiographies thoraciques, ainsi que des tests moleculaires et d'aspiration gastrique. Nous avons evalue les differences dans les contacts vus chaque mois, mais aussi dans les tests et traitements proposes durant les quatre phases. Resultats Au total, le programme a examine 1978 contacts Issus de 969 cas Indicateurs. La participation au programme etait faible, bien qu'elle ait considerablement augmente au cours de la phase de TSD au niveau communautaire. A peine 16,6% (329/1978) des contacts ont fait l'objet d'une radiographie thoracique. La confirmation microbiologique a atteint 72,2% (26/36) apres avoir inclus les tests moleculaires, tandis que 10,1% (200/1978) des contacts ont recu un traitement contre la tuberculose. Sur les 457 contacts ages de moins de 5 ans, 36 (7,9%) se sont vus administrer un traitement preventif contre la tuberculose. La moitie des contacts ont ete perdus de vue avant qu'une decision finale n'ait ete prise en matiere de traitement. Conclusion Le suivi a permis de mieux diagnostiquer la tuberculose, malgre la faible participation au programme et le nombre eleve de contacts perdus de vue. La participation a augmente pendant la phase de TSD au niveau communautaire. Le depistage au niveau communautaire devrait etre renforce afin d'accroitre le taux de participation et de diagnostic. Objetivo Evaluar los resultados de un programa de rastreo de contactos para aumentar el diagnostico de la tuberculosis en Cubal (Angola) y ofrecer tratamiento preventivo a los grupos de alto riesgo. Metodos En marzo de 2015, se inicio un programa de rastreo de contactos basado en centros sanitarios en el Hospital Nossa Senhora da Paz y se siguio hasta 2022. En ese tiempo, la dotacion de personal y las pruebas variaron, lo que clasificamos en cuatro periodos: refuerzo del personal medico, de 2015 a 2017, con un medico enviado en comision de servicios desde el Hospital Universitario Vall d'Hebron (Espana); personal de rutina, de 2017 a 2021, sin apoyo medico externo; tratamiento directamente observado (TDO) en la poblacion, de 2018 a 2019, con apoyo de trabajadores comunitarios; y rastreo de contactos mejorado, de 2021 a 2022, con financiacion que permitio realizar radiografias de torax y pruebas moleculares y de aspirado gastrico gratuitas. Se evaluaron las diferencias en los contactos atendidos al mes y las pruebas y el tratamiento ofrecidos en los cuatro periodos. Resultados En total, el programa evaluo 1978 contactos de 969 casos de referencia. La participacion en el programa fue baja, aunque aumento de manera significativa durante el periodo de TDO en la poblacion. Solo el 16,6% (329/1978) de los contactos se sometieron a una radiografia de torax. La confirmacion microbiologica aumento al 72,2% (26/36) tras incluir las pruebas moleculares y el 10,1% (200/1978) de los contactos recibieron tratamiento para la tuberculosis. De 457 contactos menores de 5 anos, 36 (7,9%) recibieron tratamiento preventivo contra la tuberculosis. Se perdio el seguimiento de la mitad de los contactos antes de que se tomara una decision final sobre el tratamiento. Conclusion El rastreo de contactos aumento el diagnostico de la tuberculosis, aunque el compromiso con el programa fue bajo y la perdida del seguimiento fue alta. La participacion aumento durante el TDO en la poblacion. Se debe explorar el cribado en la poblacion para mejorar la participacion y el diagnostico., Introduction Increasing testing and diagnosis of tuberculosis (TB) is one of the main pillars of the End TB Strategy, together with rapid initiation of effective therapy and follow-up programmes. 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More than 24 pathogenic hantaviruses that are known to be pathogenic to humans have been identified worldwide (1). The diseases these viruses have caused have been traditionally divided into 2 [...]

Background Prolonged or recurrent gastrointestinal symptoms may persist after acute traveller's diarrhoea (TD), even after adequate treatment of the primary cause. This study aims to describe the epidemiological, clinical and microbiological characteristics of patients with post-infectious irritable bowel syndrome (PI-IBS) after returning from tropical or subtropical areas. Methods We conducted a retrospective study of patients presenting between 2009 and 2018 at the International Health referral centre in Barcelona with persistent gastrointestinal symptoms following a diagnosis of TD. PI-IBS was defined as the presence of persistent or recurrent gastrointestinal manifestations for at least 6 months after the diagnosis of TD, a negative stool culture for bacterial pathogens and a negative ova and parasite exam after targeted treatment. Epidemiological, clinical and microbiological variables were collected. Results We identified 669 travellers with a diagnosis of TD. Sixty-eight (10.2%) of these travellers, mean age 33 years and 36 (52.9%) women, developed PI-IBS. The most frequently visited geographical areas were Latin America (29.4%) and the Middle East (17.6%), with a median trip duration of 30 days (IQR 14–96). A microbiological diagnosis of TD was made in 32 of these 68 (47%) patients, 24 (75%) of whom had a parasitic infection, Giardia duodenalis being the most commonly detected parasite (n  = 20, 83.3%). The symptoms persisted for a mean of 15 months after diagnosis and treatment of TD. The multivariate analysis revealed that parasitic infections were independent risk factors for PI-IBS (OR 3.0, 95%CI 1.2–7.8). Pre-travel counselling reduced the risk of PI-IBS (OR 0.4, 95%CI 0.2–0.9). Conclusions In our cohort, almost 10% of patients with travellers' diarrhoea developed persistent symptoms compatible with PI-IBS. Parasitic infections, mainly giardiasis, seem to be associated with PI-IBS. [ABSTRACT FROM AUTHOR]

Angola is among the 30 countries with the highest incidence of tuberculosis (TB) and multidrug-resistant (MDR) TB worldwide (1). However, drug-resistance prevalence is unknown in the absence of a national [...]

The aim of this study was to describe and compare the clinical characteristics of hospitalized patients with COVID-19 pneumonia according to their geographical origin. This is a retrospective case-control study of hospitalized patients with confirmed COVID-19 pneumonia treated at Vall d'Hebron University Hospital (Barcelona) during the first wave of the pandemic. Cases were defined as patients born in Latin America and controls were randomly selected among Spanish patients matched by age and gender. Demographic and clinical variables were collected, including comorbidities, symptoms, vital signs and analytical parameters, intensive care unit admission and outcome at 28 days after admission. Overall, 1080 hospitalized patients were registered: 774 (71.6%) from Spain, 142 (13.1%) from Latin America and the rest from other countries. Patients from Latin America were considered as cases and 558 Spanish patients were randomly selected as controls. Latin American patients had a higher proportion of anosmia, rhinorrhea and odynophagia, as well as higher mean levels of platelets and lower mean levels of ferritin than Spanish patients. No differences were found in oxygen requirement and mortality at 28 days after admission, but there was a higher proportion of ICU admissions (28.2% vs. 20.2%, p = 0.0310). An increased proportion of ICU admissions were found in patients from Latin America compared with native Spanish patients when adjusted by age and gender, with no significant differences in in-hospital mortality. [ABSTRACT FROM AUTHOR]