We present a case of Nannizziopsis spp infection in an immunocompromised patient, describe clinical findings, investigation results and treatment. This rare fungal infection is reported in reptiles and humans, but not other mammals. There are only twenty case reports in medical literature to date, most in immunocompromised patients.

A 64-year-old kidney transplant recipient from urban Nigeria presented with a verrucous plaque on his dorsal left hand which has grown rapidly over the two months. He was concerned that it might represent cancer. On further examination he also had a subcutaneous fluctuant masses on his left flank and left upper arm, a fleshy mucosal plaque and a large tender fluctuant swelling over his right tibia. He was clinically well, but in the preceding months he reported haemoptysis and 7 kilograms weight loss.

Skin biopsies from multiple sites showed identical features: suppurative granulomatous inflammation and elongated elements consistent with fungal hyphae. Grocott special staining showed scattered fungal hyphae. Beta-D-glucan was raised at 441.4 pg/mL [3-6 pg/mL]. Subsequent molecular identification confirmed Nanniziopsis spp, likely to be N. guarroi. He was treated with intravenous amphotericin-B for 7 weeks and was then switched to oral posaconazole for one month with complete resolution.

Nannizziopsis is an emerging human pathogenic fungus that predominantly causes disease in immunocompromised individuals. This case highlights the importance of suspecting atypical fungal infection in immunocompromised individuals presenting with polymorphic skin lesions and the critical diagnostic role of skin biopsy and culture.

This article presents a severe cerebral malaria patient in shock with a close contact of COVID-19 that was successfully cured in a negative pressure ward during the global pandemic of COVID-19. The patient experienced a sudden onset of high fever and coma in a designated isolation hotel after returning from Africa, and was transferred to a designated hospital. Following antimalarial therapy, blood pressure elevation, increase of blood volume, bedside hemodialysis, mechanical ventilation, plasma and platelet transfusions, the case gradual recovered.
Humans ; COVID-19 ; Malaria/drug therapy* ; Antimalarials/therapeutic use* ; Africa ; Travel

Economy class syndrome (ECS) refers to a series of symptoms, such as lower limb swelling, chest pain, dyspnea, and sudden death, that occur during or after a long-distance flight. Its essence is venous thromboembolism. ECS, as a preventable syndrome, is one of the causes of sudden death in long-distance travelers. Medical assistance to the African region is a very important diplomatic matter of China. It often takes medical workers more than 10 hours of long-distance flight to reach the recipient country. Therefore, it is essential to improve the understanding of ECS and corresponding prevention strategies among the long-distance traveling people including medical workers assisting Africa, which could guarantee their health and ensure the smooth implementation of the work of assisting Africa.
Africa ; China ; Death, Sudden ; Humans ; Syndrome ; Travel

PURPOSE: Overcrowding in emergency department (ED) is a concerning global problem and has been identified as a national crisis in some countries. Several emergency sorting systems designed successfully in the world. Launched in 2004, a group of branches in South African triage scale (SATS) developed. The effectiveness of the case sorting system of SATS was evaluated to reduce the patient's length of stay (LOS) and mortality rate within the ED at Suez Canal University Hospital. METHODS: The study was designed as an intervention study that included a systematic random sample of patients who presented to the ED in Suez Canal University Hospital. This study was implemented in three phases: pre-intervention phase, 115 patients were assessed by the traditional protocols; intervention phase, a structured training program was provided to the ED staff, including a workshop and lectures; and post-intervention phase, 230 patients were assessed by SATS. All the patients were retriaged 2 h later, calculating the LOS per patient and the mortality. Data was collected and entered using Microsoft Excel software. Collected data from the triage sheet were analyzed using the SPSS software program version 22.0. RESULTS: The LOS in the ED was about 183.78 min before the intervention; while after the training program and the application of SATS, it was reduced to 51.39 min. About 15.7% of the patients died before the intervention; however, after the intervention the ratio decreased to 10.7% deaths. CONCLUSION SATS is better at assessing patients without missing important data. Additionally, it resulted in a decrease in the LOS and reduction in the mortality rate compared to the traditional protocol.
Egypt ; Emergency Service, Hospital ; Humans ; Length of Stay ; South Africa ; Triage/methods*

Pulmonary paragonimiasis and tuberculosis are endemic in Asia, South America, and Africa. However, differential diagnosis among the diseases is difficult because they present with similar clinical symptoms and diagnostic features. Here, we report a case of pulmonary paragonimiasis that was identified using Ziehl-Neelsen stain after initially being assessed for pulmonary tuberculosis. Following anti-Paragonimus chemotherapy, the patient's symptoms, laboratory test results, and lung lesions improved. Thus, the identification of Paragonimus westermani using Ziehl-Neelsen stain can be considered in the diagnosis.
Africa ; Asia ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Lung ; Paragonimiasis ; Paragonimus westermani ; South America ; Tuberculosis ; Tuberculosis, Pulmonary

Hydatid disease is a zoonotic infection in humans. The disease is endemic in some parts of the world, including Africa, Australia, and Asia, where cattle grazing is common; the disease is spread by an enteric route following the consumption of food contaminated with the eggs of the parasite. Failure to identify this parasite results in delayed diagnosis and increased morbidity to the patient. Upon diagnosis, every possible step should be taken, both surgical and medical, to prevent anaphylactic reactions from the cystic fluid. Postsurgical long-term follow up along with periodical ultrasonography of the liver and computed tomography scan of the abdomen is essential to rule out possible recurrence.
Abdomen ; Africa ; Anaphylaxis ; Animals ; Asia ; Australia ; Cattle ; Delayed Diagnosis ; Diagnosis ; Echinococcosis ; Eggs ; Follow-Up Studies ; Humans ; Liver ; Ovum ; Parasites ; Recurrence ; Ultrasonography ; Zoonoses

BACKGROUND: Globally, over four million deaths are attributed to exposure to household air pollution (HAP) annually. Evidence of the association between exposure to HAP and under-five mortality in sub-Saharan Africa (SSA) is insufficient. We assessed the association between exposure to HAP and under-five mortality risk in 14 SSA countries. METHODS: We pooled Demographic and Health Survey (DHS) data from 14 SSA countries (N = 164376) collected between 2015 and 2018. We defined exposure to HAP as the use of biomass fuel for cooking in the household. Under-five mortality was defined as deaths before age five. Data were analyzed using mixed effects logistic regression models. RESULTS: Of the study population, 73% were exposed to HAP and under-five mortality was observed in 5%. HAP exposure was associated with under-five mortality, adjusted odds ratio (OR) 1.33 (95% confidence interval (CI) [1.03-1.71]). Children from households who cooked inside the home had higher risk of under-five mortality compared to households that cooked in separate buildings [0.85 (0.73-0.98)] or outside [0.75 (0.64-0.87)]. Lower risk of under-five mortality was also observed in breastfed children [0.09 (0.05-0.18)] compared to non-breastfed children. CONCLUSIONS HAP exposure may be associated with an increased risk of under-five mortality in sub-Saharan Africa. More carefully designed longitudinal studies are required to contribute to these findings. In addition, awareness campaigns on the effects of HAP exposure and interventions to reduce the use of biomass fuels are required in SSA.
Africa South of the Sahara ; Air Pollution, Indoor/adverse effects* ; Biomass ; Cooking ; Female ; Health Surveys ; Housing ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Male ; Mortality

Most of lichens are formed by Ascomycota, less than 1% are lichenized Basidiomycota. The flora investigation of lichenized Ascomycota of South Korea has been well studied in the past three decades; however, prior to this study, none of basidiolichens was discovered. During the recent excursion, an unexpected clavarioid basidiolichen, Sulzbacheromyces sinensis was collected. Morphology and ecology has been recorded in detail. DNA was extracted, and ITS, 18S, 28S nuclear rDNA were generated. In order to further confirm the systematic position of the Korean specimens, maximum likelihood and Bayesian inference analysis including all the species of the order Lepidostromatales were conducted based on the ITS. As a result, the phylogenetic tree of the order Lepidostromatales was reconstructed, which differed from the previous studies. The inferred phylogenetic tree showed that species of Sulzbacheromyces in three different continents (Asia, South Africa and South America) were separated into three clades with support. In this study, the species worldwide distribution map of Lepidostromatales was illustrated, and S. sinensis had a widest distribution range (paleotropical extend to the Sino-Japanese) than other species (paleotropical or neotropical). Prior to this study, the range of distribution, southernmost and northernmost points and the fruiting time of S. sinensis were recorded, and the genus Sulzbacheromyces was firstly reported from Korean peninsula and Philippines.
Ascomycota ; Asia ; Basidiomycota ; DNA ; DNA, Ribosomal ; Ecology ; Fruit ; Geography ; Korea ; Lichens ; Philippines ; Phylogeny ; South Africa ; Trees

OBJECTIVES: This study aimed to extend an epidemiological model (SEIHFR) to analyze epidemic trends, and evaluate intervention efficacy. METHODS: SEIHFR was modified to examine disease transmission dynamics after vaccination for the Ebola outbreak. Using existing data from Liberia, sensitivity analysis of various epidemic scenarios was used to inform the model structure, estimate the basic reproduction number ℜ₀ and investigate how the vaccination could effectively change the course of the epidemic. RESULTS: If a randomized mass vaccination strategy was adopted, vaccines would be administered prophylactically or as early as possible (depending on the availability of vaccines). An effective vaccination rate threshold for Liberia was estimated as 48.74% among susceptible individuals. If a ring vaccination strategy was adopted to control the spread of the Ebola virus, vaccines would be given to reduce the transmission rate improving the tracing rate of the contact persons of an infected individual. CONCLUSION: The extended SEIHFR model predicted the total number of infected cases, number of deaths, number of recoveries, and duration of outbreaks among others with different levels of interventions such as vaccination rate. This model may be used to better understand the spread of Ebola and develop strategies that may achieve a disease-free state.
Africa, Western ; Basic Reproduction Number ; Disease Outbreaks ; Ebolavirus ; Humans ; Liberia ; Mass Vaccination ; Vaccination ; Vaccines

Adolescent ; Adult ; Child ; Decision Trees ; Female ; HIV Infections ; economics ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; economics ; prevention & control ; Kenya ; Middle Aged ; Mothers ; South Africa ; Vietnam ; Young Adult