The Hospital for Tropical Diseases (HTD) is a specialist tropical disease hospital located in London, United Kingdom. It is part of the University College London Hospitals NHS Foundation Trust and is closely associated with University College London and the London School of Hygiene & Tropical Medicine. It is the only NHS hospital dedicated to the prevention, diagnosis and treatment of tropical diseases and travel-related infections. It employs specialists in major tropical diseases including malaria, leprosy and tuberculosis. It also provides an infectious disease treatment service for University College Hospital.
BACKGROUND:Cardiovascular disease screening faces significant challenges in resource-limited settings, where infrastructure and computational constraints preclude advanced assessment. These constraints are particularly acute for people living with human immunodeficiency virus (HIV), who experience elevated cardiovascular risk yet often receive care in clinics without specialist diagnostic capacity. Pretrained physiological foundation models offer potential for low-cost screening using wearable sensors, though their applicability in resource-constrained settings remains unclear. METHODS:We evaluate pretrained physiological embeddings from foundation models for cardiovascular disease detection using photoplethysmography signals from 80 people living with HIV in Ho Chi Minh City, Vietnam. Of 80 participants, 13 (16%) had cardiologist-confirmed cardiovascular disease. We compare strictly zero-shot deployment (NormWear without local training) with frozen PaPaGei embeddings plus locally trained classifier, alongside traditional approaches. RESULTS:Here we show that the PaPaGei-embedding approach achieves area under the receiver operating characteristic curve 0.769 (95% confidence interval: 0.70, 0.84) and average precision 0.489 (0.37, 0.61) in this pilot cohort, numerically higher than zero-shot NormWear (0.610; 0.226), principal component analysis features (0.651; 0.208), and supervised clinical models (0.744; 0.433). This approach requires local labels for classifier training but avoids computationally intensive foundation model fine-tuning. However, given the small positive class size (13 cases), these findings require validation in larger cohorts. PaPaGei embeddings capture clinically coherent structure: patients on dolutegravir-based regimens cluster in low-risk regions, while those with high cholesterol variability occupy high-risk areas. CONCLUSIONS:These preliminary findings provide a potential methodological framework for deploying foundation models in resource-constrained settings, though adequately powered, multi-centre validation is essential before clinical implementation.
Peripheral eosinophilia (>0.5×109/L) in the full blood count is caused by a variety of infectious and non-infectious aetiologies. Of particular importance to the UK military are parasitic infections, especially in individuals recruited from overseas and those who have deployed to areas that are highly endemic for schistosomiasis, strongyloidiasis and soil-transmitted helminths. These infections may persist for decades without causing symptoms. UK Armed Forces (UKAF) personnel have recently presented with more severe forms of strongyloidiasis, which can be fatal, especially following immunosuppression for chronic non-communicable diseases. Most uncomplicated infections respond to oral ivermectin or oral praziquantel, which are easy to take and generally well tolerated. We present the histories of three UKAF personnel to raise awareness of these infections, and we describe a framework for the initial investigation and management of people found to have eosinophilia in military primary care settings, together with indications for onward referral to infection or haematology specialists. Furthermore, given their relatively unknown prevalence in the UKAF Forces population, increased awareness and seroprevalence studies may be beneficial.
Opportunistic infections (OIs) in patients with advanced HIV disease remain a serious health issue, particularly in low-and middle-income countries. This study aims to describe the clinical characteristics and factors associated with mortality among hospitalized advanced HIV-infected men who have sex with men (MSM). A prospective cross-sectional study was conducted at the Hospital for Tropical Diseases in Ho Chi Minh City between March and June 2023. Data was collected through interviews and medical record reviews. A multivariate logistic regression model was employed to assess factors associated with hospitalization outcomes, with statistical significance set at p < 0.05. The study included 121 participants, with 61.3
BACKGROUND:Lower respiratory tract infection (LRTI) remains the leading infectious cause of morbidity and mortality globally. Key bacterial pathogens include Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus and Streptococcus pneumoniae. This study examined the prevalence and antimicrobial resistance patterns of major bacterial pathogens from community- and hospital-acquired LRTIs across six major hospitals in Vietnam. METHODS:Between January 2022 and May 2023, 1000 bacterial isolates were collected through an isolate-based surveillance. Species identification and antimicrobial susceptibility testing were performed by VITEK-2/Phoenix M50, with MICs determined by E-test or broth microdilution. Multiplex PCRs were used to detect common AMR genes. RESULTS:A. baumannii (49.6%), P. aeruginosa (21%), K. pneumoniae (18.6%) were predominant, followed by S. aureus (6.7%), E. coli (3.9%) and S. pneumoniae (0.2%). Most isolates (94.4%) were identified from hospital-acquired cases. High prevalence of MDR and carbapenem resistance were identified in A. baumannii (96% and 95%), P. aeruginosa (56.7% and 57.1%), and K. pneumoniae (78% and 69.2%), respectively. Notably, resistance to ceftazidime-avibactam was detected in K. pneumoniae (34.3%), P. aeruginosa (29%), and E. coli (7.7%), while colistin resistance was found in K. pneumoniae (18.2%) and A. baumannii (2.8%). MRSA prevalence was 79.1%, though S. aureus remained susceptible to vancomycin, linezolid and ceftaroline. Most blaNDM-positive K. pneumoniae (62/71, 87.3%), E. coli (2/2, 100%), and P. aeruginosa (23/25, 85.2%) showed resistance to ceftazidime-avibactam. Whole genome sequencing revealed that the blaNDM-positive but ceftazidime-avibactam susceptible isolates (9 K. pneumoniae and 2 P. aeruginosa) carried truncated blaNDM. Overall, ceftazidime-avibactam was effective against K. pneumoniae, E. coli, and P. aeruginosa isolates carrying ESBL, ESBL and blaOXA-48, or ESBL and blaKPC. Alternatively, no detectable AMR genes were found in 35 ceftazidime-avibactam resistant P. aeruginosa isolates. CONCLUSIONS:Carbapenem-resistant Gram-negative pathogens were predominant among hospital-acquired LRTIs in Vietnam, with notable resistance to ceftazidime-avibactam and colistin. The lack of effective treatment for A. baumannii remains a major concern. We found a strong correlation between AMR phenotype and genotype among K. pneumoniae and E. coli, supporting gene-based therapy to guide ceftazidime-avibactam use. However, the presence of disrupted blaNDM underscores the need to re-evaluate commercial PCR assays for carbapenemase detection.
Background: Low-dose oral minoxidil (LDOM- MINOGAIN) has emerged as an alternative treatment for hair loss, demonstrating potential efcacy in promoting hair growth. This study aimed to evaluate the effectiveness and safety prole of OM over a 24-week period. Materials & Methods: A total of 50 participants (mean age: 30.76 ± 7.71 years; 70% male, 30% female) were enrolled. Hair counts and blood pressure measurements were recorded at baseline, 12 weeks, and 24 weeks. Statistical analysis was performed using the z-test to determine signicant differences. Hair count increased signicantly from baseline (249.7 ± 64.3) to 12 weeks (266.8 ± 61 Results: , p < 0.001) and further at 24 weeks (279.3 ± 65.3, p < 0.001). The mean difference between 12 and 24 weeks (12.46, p = 0.003) conrmed continuous hair growth. Systolic blood pressure decreased at 12 weeks (-2.64 mmHg, p < 0.001) and 24 weeks (-3.58 mmHg, p < 0.001), while diastolic blood pressure also showed a reduction at 12 weeks (-2.28 mmHg, p = 0.002) and 24 weeks (-2.68 mmHg, p < 0.001). Adverse effects included hypertrichosis (6%) and postural hypotension (2%). Low-dose OM effectively promotes hair growth with a mild reduction in blood press Conclusion: ure and minimal adverse effects. Further studies are needed to conrm long-term efcacy and safety
