• CMV retinitis screening and treatment in a resource-poor setting: three-year experience from a primary care HIV/AIDS programme in Myanmar

      Tun, Nini; London, Nikolas; Kyaw, Moe Kyaw; Smithuis, Frank; Ford, Nathan; Margolis, Todd; Drew, W Lawrence; Lewallen, Susan; Heiden, David; Medical Action Myanmar, Yangon, Myanmar; Wills Eye Institute, Retina Service, Philadelphia, PA, USA; Médecins Sans Frontières OCA, Yangon, Myanmar; Médecins Sans Frontières, London, UK; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa; University of California San Francisco, San Francisco, CA, USA; Kilimanjaro Centre for Community Ophthalmology, Moishe, Tanzania; California Pacific Medical Center, San Francisco, CA, USA; Seva Foundation, Berkeley, CA, USA. (BioMed Central, 2011-08-15)
      Cytomegalovirus retinitis is a neglected disease in resource-poor settings, in part because of the perceived complexity of care and because ophthalmologists are rarely accessible. In this paper, we describe a pilot programme of CMV retinitis management by non-ophthalmologists. The programme consists of systematic screening of all high-risk patients (CD4 <100 cells/mm3) by AIDS clinicians using indirect ophthalmoscopy, and treatment of all patients with active retinitis by intravitreal injection of ganciclovir. Prior to this programme, CMV retinitis was not routinely examined for, or treated, in Myanmar.
    • Liposomal amphotericin B for complicated visceral leishmaniasis (kala-azar) in eastern Sudan: how effective is treatment for this neglected disease?

      Salih, Niven A; van Griensven, Johan; Chappuis, François; Antierens, Annick; Mumina, Ann; Hammam, Omar; Boulle, Philippa; Alirol, Emilie; Alnour, Mubarak; Elhag, Mousab S; et al. (John Wiley & Sons Ltd, 2014-02)
      The aim of this study was to report the patient profile and treatment outcomes, including relapses, of patients with visceral leishmaniasis (VL) treated with liposomal amphotericin B (AmBisome) in Gedaref, Sudan.
    • Sleeping sickness

      Malvy, D; Chappuis, F; Travel Clinics and Division of Tropical Medicine and Imported Diseases, Department of Internal Medicine and Tropical Diseases, University Hospital Centre, Bordeaux, France; Universite de Bordeaux, Faculty of Medicine, INSERM U897 and Centre Rene-Labusquiere (Tropical Medicine Branch), Bordeaux, France; Division of International and Humanitarian Medicine, Geneva University Hospital, Switzerland; Medecins Sans Frontieres, Operational Centre, Geneva, Switzerland (Wiley-Blackwell, 2011-04-04)
      Human African trypanosomiasis (HAT), or sleeping sickness, is a vector-borne disease that flourishes in impoverished, rural parts of sub-Saharan Africa. It is caused by infection with the protozoan parasite Trypanosoma brucei and is transmitted by tsetse flies of the genus Glossina. The majority of cases are caused by T. b. gambiense, which gives rise to the chronic, anthroponotic endemic disease in Western and Central Africa. Infection with T. b. rhodesiense leads to the acute, zoonotic form of Eastern and Southern Africa. The parasites live and multiply extracellularly in the blood and tissue fluids of their human host. They have elaborated a variety of strategies for invading hosts, to escape the immune system and to take advantage of host growth factors. HAT is a challenging and deadly disease owing to its complex epidemiology and clinical presentation and, if left untreated, can result in high death rates. As one of the most neglected tropical diseases, HAT is characterized by the limited availability of safe and cost-effective control tools. No vaccine against HAT is available, and the toxicity of existing old and cumbersome drugs precludes the adoption of control strategies based on preventive chemotherapy. As a result, the keystones of interventions against sleeping sickness are active and passive case-finding for early detection of cases followed by treatment, vector control and animal reservoir management. New methods to diagnose and treat patients and to control transmission by the tsetse fly are needed to achieve the goal of global elimination of the disease.