Клинические инфекционные болезни: открытый доступ

Zoonotic diseases are infections that can be transmitted from animals to humans and vice versa. They include a wide range of pathogens, from bacteria and viruses to parasites and fungi. Zoonoses have been responsible for some of the most devastating pandemics in history, such as the 1918 influenza pandemic and the ongoing COVID-19 pandemic. Emerging zoonotic diseases are those that have recently appeared in human populations or have experienced a significant increase in incidence. Deforestation, urbanization and habitat destruction can bring humans into closer contact with wildlife, increasing the risk of zoonotic spill over. Increased movement of people and goods facilitates the spread of zoonotic pathogens across borders. The misuse of antibiotics in both human and animal healthcare contributes to the development of drug-resistant zoonotic pathogens.

Vector-borne diseases have long been a concern for public health. They are caused by a variety of pathogens, including viruses, bacteria and parasites and are transmitted to humans through the bite of infected vectors. Climate change, urbanization and global travel have contributed to the changing landscape of these diseases. Vector-borne diseases collectively account for a substantial burden of illness and death worldwide. According to the World Health Organization (WHO), vector-borne diseases are responsible for over 17% of all infectious diseases and contribute to more than 700,000 deaths annually. Several vector-borne diseases have gained prominence due to their global impact. Transmitted by Anopheles mosquitoes, malaria affects millions of people each year, particularly in sub-Saharan Africa. A viral disease transmitted by Aedes mosquitoes, dengue has become a growing concern in many tropical and subtropical regions. Also transmitted by Aedes mosquitoes, Zika gained attention due to its association with birth defects and neurological complications. Spread by ticks, Lyme disease is prevalent in parts of North America, Europe and Asia. Another disease transmitted by Aedes mosquitoes, Chikungunya has caused outbreaks in various regions. These include diseases like Rocky Mountain spotted fever, which are transmitted by ticks, mites, or fleas.

Vaccination, also known as immunization, is the process of introducing a vaccine into the body to stimulate the immune system's production of antibodies. These antibodies provide immunity against specific pathogens, such as viruses and bacteria, without causing the disease itself. The history of vaccination is marked by groundbreaking discoveries and has been instrumental in improving public health. Vaccines work by mimicking the presence of a pathogen in the body, typically in a weakened or inactivated form. When a person is vaccinated, their immune system recognizes the foreign substance (antigen) and generates an immune response. This response includes the production of antibodies that can specifically target and neutralize the pathogen. If the person is later exposed to the actual pathogen, their immune system can quickly respond, preventing or reducing the severity of the disease. Vaccination has played a pivotal role in eradicating or nearly eradicating infectious diseases that once posed significant threats to public health. The most notable example is smallpox, which was declared eradicated in 1980 thanks to an aggressive global vaccination campaign. Polio is another disease on the verge of eradication, with just a few remaining endemic countries.

HAIs are infections that patients acquire while receiving medical treatment in a healthcare facility. These infections can be caused by a variety of pathogens, including bacteria, viruses, fungi and parasites. HAIs are associated with increased morbidity, mortality, healthcare costs and longer hospital stays. Hand hygiene is the cornerstone of infection prevention in healthcare settings. Healthcare workers should perform hand hygiene with soap and water or alcohol-based hand sanitizers before and after patient contact. Proper hand hygiene breaks the chain of infection transmission and reduces the risk of HAIs. Robust infection prevention protocols are critical for reducing HAIs. These protocols include the proper use of Personal Protective Equipment (PPE), isolation precautions and adherence to aseptic techniques during invasive procedures. Comprehensive infection control measures should be implemented in all healthcare facilities.

Infection control is the practice of preventing and managing the spread of infections within healthcare facilities. It encompasses a range of measures, from hand hygiene and personal protective equipment use to isolation protocols and environmental cleaning. The COVID-19 pandemic has brought infection control to the forefront of healthcare, revealing both strengths and areas for improvement. Hand hygiene has long been recognized as a fundamental component of infection control. The pandemic reinforced the importance of thorough handwashing and the use of hand sanitizers. Healthcare workers and the public alike have become more vigilant about hand hygiene as a result of the pandemic. PPE, including masks, gloves, gowns and face shields, became essential in protecting healthcare workers and patients during the pandemic. Ensuring the proper use and availability of PPE is crucial for infection control, not only during pandemics but in routine healthcare as well. The pandemic highlighted the potential for airborne transmission of infectious diseases. Adequate ventilation, air filtration and the use of airborne precautions are now recognized as critical infection control measures, particularly in settings where aerosol-generating procedures are performed.

HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, weakening the body's ability to fight off infections and diseases. AIDS (Acquired Immunodeficiency Syndrome) is the advanced stage of HIV infection, characterized by severe immunosuppression. HIV/AIDS has claimed millions of lives globally, but advances in science and medicine have led to groundbreaking developments in its management. One of the most significant breakthroughs in HIV/AIDS treatment is the development of Antiretroviral Therapy (ART). ART consists of a combination of drugs that target different stages of the HIV lifecycle, preventing the virus from replicating and reducing its presence in the body. This treatment has transformed HIV/AIDS from a terminal illness into a manageable, chronic condition.

Emerging Infectious Diseases (EIDs) are infections that have recently appeared within a population or are rapidly increasing in incidence and geographic range. These diseases can originate from various sources, including zoonotic transmission, mutation of existing pathogens and changes in environmental factors. The study of EIDs is crucial for identifying and mitigating potential threats to public health. Many EIDs have zoonotic origins, meaning they jump from animals to humans. The COVID-19 pandemic is a stark example, with the SARS-CoV-2 virus likely originating in bats and possibly passing through an intermediate host before infecting humans. Other notable examples include Ebola, HIV and the H1N1 influenza virus. Deforestation, urbanization and increased human-animal interaction contribute to the risk of zoonotic spillover events. The emergence of antimicrobial resistance poses a significant threat.

Infectious diseases continue to pose a significant global health challenge. Timely and accurate diagnosis is critical for patient care, the prevention of disease transmission and the development of effective treatment and vaccination strategies. Recent years have witnessed remarkable progress in diagnostic techniques, enabling healthcare professionals to identify infectious pathogens with greater precision and speed. Polymerase Chain Reaction (PCR) and real-time PCR have revolutionized molecular diagnostics. These techniques allow for the detection of specific DNA or RNA sequences in pathogens. Real-time PCR provides rapid and quantitative results, making it invaluable for diagnosing a wide range of infectious diseases, including viral, bacterial and fungal infections. Next-generation sequencing technologies have ushered in an era of genomics-based diagnostics. NGS can sequence entire pathogen genomes quickly and at relatively low cost. This capability not only aids in pathogen identification but also helps track the evolution and spread of infectious agents. Mass spectrometry has gained popularity as a diagnostic tool for identifying pathogens.

Since the initial outbreak of COVID-19, the SARS-CoV-2 virus has undergone mutations, leading to the emergence of new variants. Some of these variants have raised concerns due to changes in their spike protein, which plays a crucial role in viral entry into human cells. Understanding the impact of these variants on vaccine efficacy is crucial for global vaccination efforts. Several SARS-CoV-2 variants have been classified as "Variants of Concern" by health authorities worldwide. First identified in the United Kingdom, this variant is associated with increased transmissibility. Originating in South Africa, it has mutations that affect vaccine efficacy and antibody neutralization. First detected in Brazil, it shares some mutations with the Beta variant and is associated with increased transmissibility. Initially found in India, it exhibits increased transmissibility and has led to outbreaks in various countries. Identified in South Africa, this variant has a large number of mutations in the spike protein, raising concerns about vaccine escape and increased transmissibility.

Malaria, one of the deadliest diseases in Africa, continues to be a public health problem in Cameroon. Malaria management involves the use of conventional drugs such as Artemether/Lumefantrine (AL), the first drug of choice in the treatment of uncomplicated malaria. Telfairia occidentalis (pumpkin leaves), a vegetable plant consumed in most parts of the world and with potential antimalarial properties, could serve as an adjunct therapy in malaria management. This study investigated the therapeutic effect of Telfairia occidentalis on the hemoglobin level, parasitaemia clearance rate and the liver enzymes activity in children below 16 years. In an open labeled randomized clinical trial, enrolled participants with P. falciparum malaria and hemoglobin level >5 g/dL were selected to receive either AL+placebo or AL and raw (or boiled) capsulated Telfairia occidentalis (2 × 1 gram) for 3 days and followed up for 7 days. Hemoglobin levels and the activity of liver enzymes were measured and data analysed using graph pad prism version 8.0.1. The overall findings showed that The hemoglobin level and hematocrit increased after AL treatment but a significant increase was seen in the AL+raw pumpkin treated group with mean Hb levels ranging from 10.30 g/dL± 0.57 g/dL on D0 to 12.43 g/dL ± 0.57 g/dL on D7, p ≤ 0.05. Parasite density decreased in both groups but significantly decreased in the group receiving AL+RP with a mean parasite density decrease from 3412.5 P/μl ± 1044 P/μl on D0 to 0.000 P/μL on D7. Liver enzymes activity was seen to significantly decreased in the AL+RP group with mean AST and ALT ranging from 40.53 IU/L ± 3.739 IU/L and 48.71 IU/L ± 5.385 IU/L at baseline to 9.075 IU/L ± 2.131 IU/L and 8.925 IU/L ± 2.105 IU/L on D7 respectively. Conclusively, Telfairia occidentalis has an impact on parasite density, the hemoglobin level and liver enzyme modulatory effects and works in synergy with AL for the treatment of uncomplicated malaria.