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Rwanda is a country in East Africa, a region characterized by highly mobile populations and outbreaks of high-consequence infectious diseases occurring on a regular basis. To increase the level of outbreak preparedness in the region, the Rwandan government and the German Ministry of Health signed a joint agreement to construct a new high-level isolation unit in Rwanda, the first in East Africa, and implement a training program for Rwandan healthcare workers to equip them with the necessary skills and knowledge for medical management of patients under high-level isolation conditions, including intensive care treatment. To better understand the scope and format of the planned training program, a needs assessment was performed based on findings from a standardized survey of 4 intensive care units in Rwanda as well as observations from 2 members of a German high-level isolation unit who completed clinical internships at Rwandan hospitals. In this case study, we describe the necessary steps to promote the sustainability and capabilities of the new high-level isolation unit in Kigali and ensure the successful implementation of the training program.

Travellers to foreign countries can acquire infections with pathogens that are not endemic in Germany. In light of the steadily increasing foreign travel these infections in returning travellers are of growing importance. Older travellers and those with underlying diseases constitute a special risk group. The knowledge of pathogens endemic to foreign countries and of the respective clinical picture is essential for determining a suspected diagnosis, especially in patients not responding to a first empirical antibacterial treatment. The documentation of a thorough travel history is crucial for taking a possible exposure to specific pathogens into account and thus for guiding the diagnostic pathway. In addition to pathogens which primarily lead to an infection of the lungs, non-pulmonary infections, which can cause pulmonary symptoms, e.g. schistosomiasis and malaria also have to be considered. Two examples of infectious diseases of the lungs, which can only be acquired abroad, are melioidosis and coccidioidomycosis. While a pulmonary manifestation of melioidosis can take an acute and fulminant course associated with a high mortality rate, coccidioidomycosis primarily presents mostly as oligosymptomatic, but with a substantial latent period can lead to pulmonary manifestations that in their diversity resemble tuberculosis or malignancies., (© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020.)