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donderdag 2 februari 2017

The Lancet: [Personal View] Guidelines, law, and governance: disconnects in the global control of airline-associated ...

[Personal View] Guidelines, law, and governance: disconnects in the global control of airline-associated infectious diseases
International air travel is increasingly affecting the epidemiology of infectious diseases. A particular public health, economic, and political concern is the role of air travel in bringing infectious passengers or vectors to previously non-endemic areas. Yet, little research has been done to investigate either the infection risks associated with air travel or the empirical evidence for the effectiveness of infection control measures on aircraft and at borders. We briefly review the interface between international and national legislation, policy, and guidelines in the context of existing infection risks and possible scenarios.
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[Articles] The spread of artemisinin-resistant in the Greater Mekong Subregion: a molecular epidemiology observational study
Our results suggest that the dominant artemisinin-resistant P falciparum C580Y lineage probably arose in western Cambodia and then spread to Thailand and Laos, outcompeting other parasites and acquiring piperaquine resistance. The emergence and spread of fit artemisinin-resistant P falciparum parasite lineages, which then acquire partner drug resistance across the Greater Mekong subregion, threatens regional malaria control and elimination goals. Elimination of falciparum malaria from this region should be accelerated while available antimalarial drugs still remain effective.
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[Comment] Cholera vaccination: pregnant women excluded no more
Cholera is a serious dehydrating diarrhoeal disease caused by toxigenic serogroups (O1 and O139) of Vibrio cholerae, which is spread by faecal contamination of water and food. It is a disease of poverty and is closely linked to poor sanitation and lack of clean water.1 Cholera affects up to 2·8 million people and kills approximately 91 000 each year.2 Children aged younger than 5 years have the greatest incidence of disease in endemic areas. Among pregnant women, cholera can cause serious complications—namely, fetal loss, with rates varying from 2% to 36%.
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[Articles] Safety of a killed oral cholera vaccine (Shanchol) in pregnant women in Malawi: an observational cohort study
Our study provides evidence that fetal exposure to oral cholera vaccine confers no significantly increased risk of pregnancy loss, neonatal mortality, or malformation. These data, along with findings from two retrospective studies, support use of oral cholera vaccine in pregnant women in cholera-affected regions.
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[Comment] Evidence of a hard selective sweep for artemisinin resistant
Artemisinin combination therapies (ACTs) remain the gold standard for the treatment of uncomplicated Plasmodium falciparum malaria, 1 although artemisinin resistant P falciparum has been detected in five countries in the Greater Mekong subregion (GMS).2 Artemisinin resistance is problematic, in that the associated slow parasite clearance leads to selection for partner drug resistance.3 Malaria treatment failure to ACTs containing the partner drugs mefloquine and piperaquine has already reached alarming levels in areas of the GMS.
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