Academic Center for Migratory Health and Neglected Tropical Diseases

Last updated: 365 days ago.

To establish an (inter)nationally renowned platform of Migratory Health and Tropical Neglected Diseases in which the research lines fever, diarrhea, skin infections, HIV and global public health will be embedded and connected.

The aim in all research lines is to achieve synergy by combining the existing centers of excellence for patient care, research and education, to strengthen insight into (immune)pathogenesis, improve diagnostic methods and therapy, and to optimize prevention and control strategies.

Academic Center of Excellence

Research Activities

Research lines:

  1. Fever will focus on interaction between inflammation and hemostasis using tropical diseases of global concern; malaria, viral hemorrhagic fever, HIV and schistosomiasis. Translation of our fundamental research is imperative as illustrated by the controlled human malaria studies in volunteers.
  2. Diarrhea will focus on host-pathogen interaction. Translation of fundamental research into clinical practice is shown in determination of antimicrobial resistance in salmonella by mass spectrometry.
  3. Skin infections will focus on clinical aspects and host-pathogen interactions in NTDs like leprosy, mycetoma and leishmaniasis.
  4. HIV focusses on early identification of HIV+ patients and increased adherence in migrants.
  5. Public Health represents the global public health component and focuses on mathematical (micro)simulation models of HIV and tuberculosis, and of NTDs in support of international elimination programs and where possible strengthen epidemiological and public health components of research lines 1, 2,3 and 4.

National collaboration: SOA AIDS Nederland, all academic hospitals and HIV treatment centres International partners: University of Khartoum (Sudan); Karolinska Institue (Sweden); DBT/ IAVI (India); Mycetoma research Centre (WHO collaborative center ), Sudan; Drugs for Neglected Diseases initiative, Switzerland; University of Sydney, Australia; Indonesia University of Airlanga; Barbados University of the West Indies; Suriname Academisch ziekenhuis Paramaribo

Type of

Collaborations

University of Khartoum (Sudan); Karolinska Institue (Sweden); DBT/ IAVI (India); Mycetoma research Centre (WHO collaborative center ), Sudan; Drugs for Neglected Diseases initiative, Switzerland; University of Sydney, Australia; Indonesia University of Airlanga; Barbados University of the West Indies; Suriname Academisch ziekenhuis Paramaribo

Educational

Contributions

Staff members of this ACE coordinate and contribute to all relevant Bachelor and Master courses (Medicine, Clinical Technology, Nanobiology, Health Policy & Management), they supervise large numbers of MSc and PhD students (8 from abroad) during research education, and over 45 residents (2 from abroad, 2 outbound) in different medical specialization training. Building upon unique and very global educational networks (27 research institutes and university medical centers in 22 countries on all continents; https://goo.gl/Gmcbqd), this ACE is able to integrate existing educational programs across the broad field of (Bio)Medical Sciences and Public Health) into a real and unique Global Health educational platform.

Example courses are: - Bachelor of Medicine, Clinical Technology, O Ba3 Minor Global Health (120 students/year, outbound) and Biomedical Research (20 students/year, outbound) - Research Master o Infection & Immunity (MolMed; 20 international students/year, inbound; 'Best Biomedical Master program in the Netherlands [Keuzegids 2016])) o Health Sciences (NIHES; 20 international students/year) o Clinical Research (NIHES; 20 international students/year) - Graduate Program Infection & Immunity (graded as Excellent by NWO 2013 and recipient of the 800.000 euro NWO Graduate Program Award 2013/14) Finally, this ACE organizes national and international symposia in the Netherlands as well as abroad.

Patient

Care Activities

Migratory Health involves travel advice and post travel cure of diseases in 0ver 25.000 patients per year. Care is obliged to be multidisciplinary due to the complexity of diseases, and the following groups of ROBIJN-labelled patient populations are included: intensive care patients; patients where research is closely associated with patient care; multi-specialism care patients; patients presenting with rare diagnoses; patients who are referred to Erasmus MC by medical specialists and patients younger than 50 years of age presenting with 3 or more diseases.

Value based health care will be reached within 5 years because of the following track record: The Harbor Hospital is national referral center for tropical diseases and a core-site of the EuroTravNet and GeoSentinel network with direct communication lines towards CDC in Atlanta, USA. Leprosy, HIV, malaria, leishmaniasis, and travelers diseases in this ACE have been designated as centers of excellence by the NFU.

The department of Public Health has a world-leading position in mathematical modeling of (tropical) infectious diseases in conjunction with international organizations such as WHO and is part of the Neglected Tropical Diseases (NTDs) Modelling Consortium supported by the Bill & Melinda Gates Foundation. Taken together, this ACE will improve care by bringing together different expertises into a knowledge platform.

Societal Relevance to Research, Education and Patient Care

Members of this Ace participate in multiple national regulatory boards for infectious diseases, such as LCI, LCR, NVHB and SWAB, in (inter)national guideline committees for tuberculosis, STD, Tropical Diseases, HIV, Leprosy, schistosomiasis, and Leptospirosis and in the international working group on eumycetoma (ISHAM) and the mycetoma consortium, which got mycetoma recognized as NTD by the WHO in May 2016.

The Erasmus MC harbors (inter)national reference/expertise centers for, among others, Arthropod Borne viruses, Hemorrhagic Fever Viruses, measles, Rubella (ACE VICER), mycobacterial (ACE ARTE) and parasitic infections. Close collaboration with VICER and ARTE provides crucial expertise Formation of this ACE will expand the portfolio of research options in global and various migratory populations, such as short and long-term travelers, expats, immigrants, as well as the potential impact on global public health.

This will not only further enhance the expertise and knowledge center function , but also provide more possibilities for students to participate in innovative educational projects and research on tropical infectious diseases in tropical countries and in travelers with imported diseases. Due to the nature of this ACE and the growing preventive possibilities for diverse diseases, substantial contributions will be established in public health, guidelines and standard of care.

Viability of Research, Education and Patient Care

Advanced knowledge sharing within the ACE is taking place for the separate topics such as leprosy, HIV, malaria. In the ACE this will be expanded to multidisciplinary meetings on all areas of interest which will attract both renowned clinicians and researchers as well as starting professionals .

In the past 5 years participation in over 100 international conferences, and over 250 international publications with authors from over 20 countries show our sustainable international networks. International working experience from fellowship to lab rotations to local travel advice took place all over the world.

Talent identification will be done individually by ACE members and discussed in the board meetings. Due to the international consortia and networks of this ACE, talent scouting will take place nationally and internationally and partly via the research master Infection and Immunity. Monitoring and review will be done with direct supervisors and board members with a standard form. Members of the ACE belong to the top in education, research and clinical care. A bibliometric network analysis is not yet available.

Key and relevant publications of the last five years

  • International travel and acquisition of multidrug-resistant Enterobacteriaceae: a systematic review. Hassing RJ, Alsma J, Arcilla MS, van Genderen PJ, Stricker BH, Verbon A. Euro Surveill. 2015;20(47).
  • Increased virological failure in naive HIV-1-infected patients taking lamivudine compared with emtricitabine in combination with tenofovir and efavirenz or nevirapine in the Dutch nationwide ATHENA cohort. Rokx C, Fibriani A, van de Vijver DA, Verbon A, Schutten M, Gras L, Rijnders BJ;.Clin Infect Dis. 2015 Jan 1;60(1):143-53.
  • Salmonella subtypes with increased MICs for azithromycin in travelers returned to The Netherlands. Hassing RJ, Goessens WH, van Pelt W, Mevius DJ, Stricker BH, Molhoek N, Verbon A, van Genderen PJ. Emerg Infect Dis. 2014 Apr;20(4):705-8.
  • Interference with the host haemostatic system by schistosomes. Mebius, M.M., van Genderen, P.J.J., Urbanus, R.T., Tielens, A.G.M., de Groot, Ph.G. and van Hellemond, J.J. PLOS Pathogens2013; 9: e1003781
  • Fatal Balamuthia mandrillaris Meningoencephalitis in the Netherlands after Travel to The Gambia. Van der Beek NA, van Tienen C, de Haan JE, Roelfsema J, Wismans PJ, van Genderen PJ, Tanghe HL, Verdijk RM, Titulaer MJ, van Hellemond JJ. Emerging Infectious Diseases 2015;21:896-898.
  • Concerted Efforts to Control or Eliminate Neglected Tropical Diseases: How Much Health Will Be Gained "de Vlas, S. J., W. A. Stolk, E. A. le Rutte, J. A. Hontelez, R. Bakker, D. J. Blok, R. Cai, T. A. Houweling, M. C. Kulik, E. J. Lenk, M. Luyendijk, S. M. Matthijsse, W. K. Redekop, I. Wagenaar, J. Jacobson, N. J. Nagelkerke and J. H. Richardus. PLoS Negl Trop Dis. 2016; 10(2): e0004386.
  • Effect of Puumala hantavirus infection on human umbilical vein endothelial cell hemostatic function: platelet interactions, increased tissue factor expression and fibrinolysis regulator release.Goeijenbier M, Meijers JC, Anfasa F, Roose JM, van de Weg CA, Bakhtiari K, Henttonen H, Vaheri A, Osterhaus AD, van Gorp EC, Martina BE. Front Microbiol. 2015 Mar 24;6:220
  • Madurella mycetomatis is highly susceptible to ravuconazole. S. Abdalla Ahmed, W. Kloezen, F. Duncanson, E. Zijlstra, G.S. de Hoog, A.H. Fahal, W.W.J. van de Sande. PLoS Negl Trop Dis (2014) 8(6):e2942
  • African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost. Coffeng, L. E., W. A. Stolk, H. G. Zoure, J. L. Veerman, K. B. Agblewonu, M. E. Murdoch, M. Noma, G. Fobi, J. H. Richardus, D. A. Bundy, D. Habbema, S. J. de Vlas and U. V. Amazigo. PLoS Negl Trop Dis. 2013; 7(1): e2032.
  • Travel-associated infection presenting in Europe (2008-2012): an analysis of EuroTravNet longitudinal, surveillance data and evaluation of the impact of the pre-travel consultation. Schlagenhauf P, Weld L, Goorhuis A, Gautret P, Weber R, von Sonnenburg F, Lopez-Vélez R, Jensenius M, Cramer JP, Field VK, Odolini S, Gkrania-Klotsas E, Chappuis F, Malvy JMD, van Genderen PJ, Mockenhaupt F, Jauréguiberry S, Smith C, Beeching N, Ursing J, Parola P, Grobusch MP, for EuroTravNet. Lancet Infectious Diseases 2015;15:55-64.

PhD theses of the last five years

  • Casper Rokx. HIV: treatment and co-morbidity. 14-06-2016
  • Astrid Heikema. Host-pathogen interactions in Guillain-Barré syndrome: The role of Campylobacter jejuni lipooligosaccharides sialylation. 8-2-2013
  • Saskia de Walick. Schistosoma mansoni and Host-parasite interactions. 22-05-2015
  • Sarah Abdallah Ahmed Ibrahim. New insights into a disfiguring fungal disease, eumycetoma. 11-02-2016
  • Hassabelrasoul Elfadil Hassan Abdelgadir. Eumycetoma: Drug Resistance and Plant-based Pharmacotherapy. 18-03-2013
  • Sabiena Feenstra. Leprosy and Social Environment. 16-01-2013
  • Jan Hontelez. The impact of antiretroviral therapy on the HIV epidemic in South Africa. 12-02-2013
  • Luc Coffeng. The health impact of Onchocerciasis control in Africa. 18-12-2013
  • Robert Jan Hassing. Combating antimicrobial resistance in gastrointestinal bacteria. 28-09-2016
  • Marga Goris. Leptospirosis: epidemiology, clinical aspects and diagnosis. 6-4-2016

Non-scientific publications related to the ACE

Principal coordinator(s)

Collaborating investigator(s)