Vydání první 235 stran, 32 nečíslovaných stran obrazových příloh : ilustrace (převážně barevné), portréty ; 21 cm
Publikace obsahuje rozhovor s Rastislavem Maďarem, čekým lékařem, ve kterém popisuje své zkušenosti z misií a s humanitární prací v Africe.; Procestoval téměř stovku zemí, do těch nejchudších se vrací opakovaně, aby místním lidem pomáhal k lepší budoucnosti. „Plním si tak svůj dětský sen. Je to dar, za který jsem vděčný,“ říká Rastislav Maďar, odborník na infekční nemoci a děkan Lékařské fakulty Ostravské univerzity. Navštívil místa, kde předtím nebyl bílý člověk, a získal si důvěru lidí, kteří se běžně s turisty nesetkávají. V rozhovoru s novinářkou Magdou Snížkovou vypráví nejen o nevšedních osudech z krizových oblastí různých koutů světa.
- MeSH
- Travel Medicine MeSH
- COVID-19 MeSH
- History, 20th Century MeSH
- History, 21st Century MeSH
- Epidemiology MeSH
- Infectious Disease Medicine MeSH
- Physicians history MeSH
- Religious Missions history MeSH
- Relief Work history MeSH
- Tropical Medicine MeSH
- Check Tag
- History, 20th Century MeSH
- History, 21st Century MeSH
- Publication type
- Personal Narrative MeSH
- Interview MeSH
- Geographicals
- Africa MeSH
- Czech Republic MeSH
- Conspectus
- Patologie. Klinická medicína
- Biografie
- NML Fields
- lékařství
- About
- Maďar, Rastislav Authority
BACKGROUND: The war in Ukraine has led to significant migration to neighboring countries, raising public health concerns. Notable tuberculosis (TB) incidence rates in Ukraine emphasize the immediate requirement to prioritize approaches that interrupt the spread and prevent new infections. METHODS: We conducted a prospective genomic surveillance study to assess migration's impact on TB epidemiology in the Czech Republic and Slovakia. Mycobacterium tuberculosis isolates from Ukrainian war refugees and migrants, collected from September 2021 to December 2022 were analyzed alongside 1574 isolates obtained from Ukraine, the Czech Republic, and Slovakia. RESULTS: Our study revealed alarming results, with historically the highest number of Ukrainian tuberculosis patients detected in the host countries. The increasing number of cases of multidrug-resistant TB, significantly linked with Beijing lineage 2.2.1 (p < 0.0001), also presents substantial obstacles to control endeavors. The genomic analysis identified the three highly related genomic clusters, indicating the recent TB transmission among migrant populations. The largest clusters comprised war refugees diagnosed in the Czech Republic, TB patients from various regions of Ukraine, and incarcerated individuals diagnosed with pulmonary TB specialized facility in the Kharkiv region, Ukraine, pointing to a national transmission sequence that has persisted for over 14 years. CONCLUSIONS: The data showed that most infections were likely the result of reactivation of latent disease or exposure to TB before migration rather than recent transmission occurring within the host country. However, close monitoring, appropriate treatment, careful surveillance, and social support are crucial in mitigating future risks, though there is currently no evidence of local transmission in EU countries.
- MeSH
- Adult MeSH
- Incidence MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Molecular Epidemiology * MeSH
- Tuberculosis, Multidrug-Resistant epidemiology MeSH
- Mycobacterium tuberculosis * genetics isolation & purification MeSH
- Transients and Migrants * statistics & numerical data MeSH
- Armed Conflicts MeSH
- Prospective Studies MeSH
- Tuberculosis * epidemiology transmission MeSH
- Refugees * statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
- Slovakia MeSH
- Ukraine MeSH
- MeSH
- Epidemiology * history MeSH
- Hygiene history MeSH
- Famous Persons MeSH
- Publication type
- Biography MeSH
- MeSH
- Epidemiology history MeSH
- Hygiene * history MeSH
- Famous Persons MeSH
- Publication type
- Biography MeSH
- About
- Truksová, Bohuslava Authority
BACKGROUND: The increase in syphilis rates worldwide necessitates development of a vaccine with global efficacy. We aimed to explore Treponema pallidum subspecies pallidum (TPA) molecular epidemiology essential for vaccine research by analysing clinical data and specimens from early syphilis patients using whole-genome sequencing (WGS) and publicly available WGS data. METHODS: In this multicentre, cross-sectional, molecular epidemiology study, we enrolled patients with primary, secondary, or early latent syphilis from clinics in China, Colombia, Malawi, and the USA between Nov 28, 2019, and May 27, 2022. Participants aged 18 years or older with laboratory confirmation of syphilis by direct detection methods or serological testing, or both, were included. Patients were excluded from enrolment if they were unwilling or unable to give informed consent, did not understand the study purpose or nature of their participation, or received antibiotics active against syphilis in the past 30 days. TPA detection and WGS were conducted on lesion swabs, skin biopsies, skin scrapings, whole blood, or rabbit-passaged isolates. We compared our WGS data to publicly available genomes and analysed TPA populations to identify mutations associated with lineage and geography. FINDINGS: We screened 2802 patients and enrolled 233 participants, of whom 77 (33%) had primary syphilis, 154 (66%) had secondary syphilis, and two (1%) had early latent syphilis. The median age of participants was 28 years (IQR 22-35); 154 (66%) participants were cisgender men, 77 (33%) were cisgender women, and two (1%) were transgender women. Of the cisgender men, 66 (43%) identified as gay, bisexual, or other sexuality. Among all participants, 56 (24%) had HIV co-infection. WGS data from 113 participants showed a predominance of SS14-lineage strains with geographical clustering. Phylogenomic analyses confirmed that Nichols-lineage strains were more genetically diverse than SS14-lineage strains and clustered into more distinct subclades. Differences in single nucleotide variants (SNVs) were evident by TPA lineage and geography. Mapping of highly differentiated SNVs to three-dimensional protein models showed population-specific substitutions, some in outer membrane proteins (OMPs) of interest. INTERPRETATION: Our study substantiates the global diversity of TPA strains. Additional analyses to explore TPA OMP variability within strains is vital for vaccine development and understanding syphilis pathogenesis on a population level. FUNDING: US National Institutes of Health National Institute for Allergy and Infectious Disease, the Bill & Melinda Gates Foundation, Connecticut Children's, and the Czech Republic National Institute of Virology and Bacteriology.
- MeSH
- Bacterial Vaccines immunology administration & dosage MeSH
- Adult MeSH
- Phylogeny MeSH
- Genetic Variation genetics MeSH
- Genome, Bacterial MeSH
- Genomics MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Molecular Epidemiology * MeSH
- Cross-Sectional Studies MeSH
- Whole Genome Sequencing * MeSH
- Syphilis * epidemiology microbiology MeSH
- Treponema pallidum * genetics immunology MeSH
- Treponema MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- United States MeSH
