Research Group Coordinator – Reynaldo Dietze
The Individual Health Care Group (IHC) members are researchers and physicians with expertise on Tropical Infectious Diseases, Travelers’ health, their knowledge and attitudes related to diseases.
IHC’s mission is to implement clinical research focused on the epidemiology, prevention, treatment and diagnosis of infections in the tropics and in travelers. In addition, IHC is part of the Global Alliance against Chronic Respiratory Diseases (GARD-CPLP), acting as collaborative coordination Center.
IHC research lines engages with the following cross-cutting issues: Global Pathogen Dispersion and Population Mobility – monitoring and characterization of STDs’ in mobile populations; Drug Discovery and Drug Resistance – Efficacy of Fexinidazole on HAT due to T. b. rhodesiense and miltefosine resistance genetic markers in L. infantum; Diagnostics and Clinical Studies – development of platforms to expand diagnosis and drug susceptibility testing of TB. Four articles were published in peer review journals: The 1st, a phase II, open-label, doseescalation study on oral miltefosine in children and adolescent/adults, showed a lower than expected cure rate (43- 68%) in Brazil compared to the 95% cure rate in India. The in vitro susceptibility to miltefosine, of intracellular amastigotes of L. infantum cultured from patients with and without treatment failures, showed that pretreatment IC50 values were able to distinguish cures from failures. Miltefosine is the only anti-leishmania, oral drug available. In Europe, miltefosine is being used as a post treatment prophylaxis in HIV co-infected patients with low CD4. If similar results can be also demonstrated in L. infantum isolates from visceral leishmania endemic countries in Europe, the prophylactic use of miltefosine in HIV co-infected patients can be personalized. Other two publications were related to HAT: the 2nd paper was a review addressing WHO’s new guidelines decision process, to include fexinidazole to firstline treatment options of T.b. gambiense HAT, as an oral monotherapy, a major shift on clinical practice, especially in Africa. The 3rd paper provided results of a clinical case control study on Melarsoprol-Related Encephalopathic Syndrome, in patients with HAT due to T. B. gambiense, showing a possible association of this syndrome and with MHC haplotypes. The 4th paper on antimicrobial resistance of N. gonorrhoeae isolates, reinforce the need of the development of new therapeutic options. One last work was related to malaria and the demand for and access to health care in children in Mozambique, in an international collaborative study.
