| 1. |
- Berner-Rodoreda, Astrid, et al.
(author)
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Where is the 'global' in the European Union's Health Research and Innovation Agenda?
- 2019
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In: BMJ Global Health. - : BMJ. - 2059-7908. ; 4:5
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Journal article (peer-reviewed)abstract
- Global Health has not featured as prominently in the European Union (EU) research agenda in recent years as it did in the first decade of the new millennium, and participation of low-income and middle-income countries (LMICs) in EU health research has declined substantially. The Horizon Europe Research and Innovation Framework adopted by the European Parliament in April 2019 for the period 2021-2027 will serve as an important funding instrument for health research, yet the proposed health research budget to be finalised towards the end of 2019 was reduced from 10% in the current framework, Horizon 2020, to 8% in Horizon Europe. Our analysis takes the evolvement of Horizon Europe from the initial framework of June 2018 to the framework agreed on in April 2019 into account. It shows that despite some improvements in terms of Global Health and reference to the Sustainable Development Goals, European industrial competitiveness continues to play a paramount role, with Global Health research needs and relevant health research for LMICs being only partially addressed. We argue that the globally interconnected nature of health and the transdisciplinary nature of health research need to be fully taken into account and acted on in the new European Research and Innovation Framework. A facilitated global research collaboration through Horizon Europe could ensure that Global Health innovations and solutions benefit all parts of the world including EU countries.
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| 2. |
- Blum, Johannes, et al.
(author)
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LeishMan recommendations for treatment of cutaneous and mucosal leishmaniasis in travelers, 2014.
- 2014
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In: Journal of Travel Medicine. - : Oxford University Press (OUP). - 1195-1982 .- 1708-8305. ; 21:2, s. 116-29
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Journal article (peer-reviewed)abstract
- BACKGROUND: Treatment of cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) in travelers is still controversial. Over the last decade, national and international consortia have published recommendations for treating CL in travelers. These guidelines harmonize many issues, but there are some discrepancies.METHODS: Leishmania parasites causing CL can now be genotyped by polymerase chain reaction techniques for detecting Leishmania DNA. Therefore, treatment recommendations can now be species based rather than based on geographical exposure. To review the evidence on which the recommendations were based, "LeishMan" (Leishmaniasis Management), a group of experts from 13 institutions in eight European countries, performed a PubMed MEDLINE) literature search and considered unpublished evidence and the experts' own personal experiences. The Oxford evidence grading system was used to evaluate the information.RESULTS AND CONCLUSION: In this article, the authors provide practical treatment recommendations for imported CL and ML in Europe, drawn up from the review by the European experts.
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| 3. |
- Guery, Romain, et al.
(author)
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Clinical diversity and treatment results in tegumentary leishmaniasis : A European clinical report in 459 patients
- 2021
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In: PLoS Neglected Tropical Diseases. - : Public Library of Science (PLoS). - 1935-2727 .- 1935-2735. ; 15:10
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Journal article (peer-reviewed)abstract
- Background Cutaneous leishmaniasis (CL) is frequent in travellers and can involve oro-nasal mucosae. Clinical presentation impacts therapeutic management. Methodology Demographic and clinical data from 459 travellers infected in 47 different countries were collected by members of the European LeishMan consortium. The infecting Leishmania species was identified in 198 patients. Principal findings Compared to Old World CL, New World CL was more frequently ulcerative (75% vs 47%), larger (3 vs 2cm), less frequently facial (17% vs 38%) and less frequently associated with mucosal involvement (2.7% vs 5.3%). Patients with mucosal lesions were older (58 vs 30 years) and more frequently immunocompromised (37% vs 3.5%) compared to patients with only skin lesions. Young adults infected in Latin America with L. braziliensis or L. guyanensis complex typically had an ulcer of the lower limbs with mucosal involvement in 5.8% of cases. Typically, infections with L. major and L. tropica acquired in Africa or the Middle East were not associated with mucosal lesions, while infections with L. infantum, acquired in Southern Europe resulted in slowly evolving facial lesions with mucosal involvement in 22% of cases. Local or systemic treatments were used in patients with different clinical presentations but resulted in similarly high cure rates (89% vs 86%). Conclusion/Significance CL acquired in L. infantum-endemic European and Mediterranean areas displays unexpected high rates of mucosal involvement comparable to those of CL acquired in Latin America, especially in immunocompromised patients. When used as per recommendations, local therapy is associated with high cure rates.
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| 4. |
- Neumayr, Andreas, et al.
(author)
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Sentinel surveillance of imported dengue via travellers to Europe 2012 to 2014 : TropNet data from the DengueTools Research Initiative
- 2017
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In: Eurosurveillance. - : European Centre for Disease Prevention and Control (ECDC). - 1025-496X .- 1560-7917. ; 22:1, s. 39-47
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Journal article (peer-reviewed)abstract
- We describe the epidemiological pattern and genetic characteristics of 242 acute dengue infections imported to Europe by returning travellers from 2012 to 2014. The overall geographical pattern of imported dengue (South-east Asia > Americas > western Pacific region > Africa) remained stable compared with 1999 to 2010. We isolated the majority of dengue virus genotypes and epidemic lineages causing outbreaks and epidemics in Asia, America and Africa during the study period. Travellers acted as sentinels for four unusual dengue outbreaks (Madeira, 2012-13; Luanda, 2013; Dar es Salaam, 2014; Tokyo, 2014). We were able to characterise dengue viruses imported from regions where currently no virological surveillance data are available. Up to 36% of travellers infected with dengue while travelling returned during the acute phase of the infection (up to 7 days after symptom onset) or became symptomatic after returning to Europe, and 58% of the patients with acute dengue infection were viraemic when seeking medical care. Epidemiological and virological data from dengue-infected international travellers can add an important layer to global surveillance efforts. A considerable number of dengue-infected travellers are viraemic after arrival back home, which poses a risk for dengue introduction and autochthonous transmission in European regions where suitable mosquito vectors are prevalent.
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| 5. |
- Rosdahl, Anja, 1972-
(author)
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The impact of viral vaccines in immunosuppressed and at-risk individuals
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Vaccines have saved millions of lives, but for some individuals with a defective immune system the protection may be uncertain. This thesis aims to assess the immune response following viral vaccines in immunocompromised patients and in other groups at-risk.In paper I the immune response to a modified vaccine schedule against hepatitis A, adding an extra vaccine dose, was tested in patients with rheumatoid arthritis (RA) on immunomodulating drugs. Following two doses,88% of RA patients developed seroprotective antibodies against hepatitis A compared to 94% of healthy controls. In paper II 53 cases of Tick borne encephalitis (TBE) vaccine failure were characterized. The majority of cases were seen in men, 81% were 50 years or older and 51% had co-morbidities. Vaccine failure was most common after three or four doses only, but was seen in up to nine doses. Four out of five had a moderate to severe disease. In paper III the immune response to mRNA vaccines was compared in SARS-CoV-2 experienced and naïve health care workers. Experienced individuals had an increased innate immune cell activation, cytokine and chemokine production and changes in innate gene expression following the first vaccine dose as well as a stronger adaptive response with higher antibody titres and B-cell and CD4+ T-cell activity. The differences were less after the second dose, but three doses were required before an equal immune response was observed in naïve and experienced individuals. In paper IV the immune response to SARS-CoV-2 mRNA vaccine was assessed in patients with chronic kidney disease (CKD) stage 4 and 5 prior to renal replacement therapy. CKD patients were found to have an immune response comparable with healthy controls, with the exception of lower secreted anti-spike antibodies in the saliva and a decreased cytotoxic CD8+ T-cell activity.In conclusion, a deeper understanding of the immune response to vaccines is needed to be able to adapt recommendations and improve outcome in vulnerable groups
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| 6. |
- van Rheenen, Wouter, et al.
(author)
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Genome-wide association analyses identify new risk variants and the genetic architecture of amyotrophic lateral sclerosis
- 2016
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In: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 48:9, s. 1043-1048
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Journal article (peer-reviewed)abstract
- To elucidate the genetic architecture of amyotrophic lateral sclerosis (ALS) and find associated loci, we assembled a custom imputation reference panel from whole-genome-sequenced patients with ALS and matched controls (n = 1,861). Through imputation and mixed-model association analysis in 12,577 cases and 23,475 controls, combined with 2,579 cases and 2,767 controls in an independent replication cohort, we fine-mapped a new risk locus on chromosome 21 and identified C21orf2 as a gene associated with ALS risk. In addition, we identified MOBP and SCFD1 as new associated risk loci. We established evidence of ALS being a complex genetic trait with a polygenic architecture. Furthermore, we estimated the SNP-based heritability at 8.5%, with a distinct and important role for low-frequency variants (frequency 1-10%). This study motivates the interrogation of larger samples with full genome coverage to identify rare causal variants that underpin ALS risk.
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