Infectious Diseases Updates - Vol 12 no 5 - 2023

Introduction

Travel medicine protocols

Global mobility has increased substantially over the last few decades, and travel by aircraft has reflected this trend. It is estimated that 4.5 billion passengers travelled on 42 million flights in 2019, with 1.5 billion crossing international boundaries.

Tuberculosis (TB) management and guidelines

Despite the World Health Organization (WHO) action plan that aimed to see a 80% reduction in TB incidence and a 90% reduction in TB deaths by the year 2030, the disease continues to be one of South Africa’s largest public health crises. South Africa has committed to the global 90-90-90 action plan, which aims to see 90% of all cases diagnosed, 90% be on treatment and 90% successfully complete treatment, but the recent pandemic has been a major obstacle in achieving that goal.

Sexually transmitted infections – an update on clinical management

South Africa has one of the largest epidemics of sexually- transmitted-infections (STIs) worldwide. The World Health Organization’s Spectrum STI model estimates the prevalence of Chlamydia trachomatis at 14.7% in women and 6.0% in men, and the prevalence of Neisseria gonorrhoeae infection at 6.6% and 3.5% respectively. Syphilis prevalence is estimated to be 0.50% in women and 0.97% in men.

The burden of infectious diseases in pregnancy

During pregnancy, women experience various physiological changes, including an enhancement of the humoral immune system and a suppression of cell-mediated immunity. These shifts are essential to tolerate fetal antigens, half of which originate from paternal DNA. Nonetheless, because cell-mediated immunity is crucial for defending against intracellular organisms like viruses and certain bacteria, this "immune tolerance" can make pregnant women more vulnerable to certain pathogens, potentially leading to more severe disease.