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Abstract Background Health status is one of the basic factors of a high quality of life and the problem of the acceptance of illness is important for adaptation to the limitations imposed by it. The purpose of the study was the evaluation of the quality of life, satisfaction with life and the acceptance of illness by malaria patients, as well as the discovery of a relationship between studied parameters. Methods The study was undertaken in August 2010, on 120 Nigerian patients with confirmed malaria. A method of diagnostic survey, based on standardized scales - Acceptance of Illness Scale, The Satisfaction With Life Scale and a standardized survey questionnaire World Health Organization Quality of Life/BREF - was used in this study. Descriptive statistics, variability range, 95% confidence interval, correlation analysis, Spearman’s non-parametric correlation coefficient, Mann–Whitney test and Kruskal-Wallis test were applied and the, so called, test statistics was calculated, followed by the calculation of the test probability p. Results of analyses were presented in a box graph, and a graph of dispersion. Results A dominating share in the adjective scale of the AIS scale was the category of “no acceptance”, given by 71.7% of respondents. The average level of a “somatic domain” was 41.7, and of a “social domain” was 62.8. The mean satisfaction of life evaluation in the SWLS scale was 18 points. The correlation between acceptance of the disease and quality of life for the psychological domain was 0.39***, and between acceptance of the disease and satisfaction with life was 0.40***. The correlation between satisfaction with life and quality of life for the psychological domain was 0.65***, and between satisfaction with life and quality of life for the environment domain was 0.60***. The mean level of AIS for the studied population of men was 16.5, and test probability: p = 0.0014**, and for the environment domain the level was 50, and the test probability: p = 0.0073**. For quality of life in the social sphere the test probability: p = 0.0013** in relatively older individuals. Conclusion The majority of people do not accept their condition. Evaluation of the quality of life was the highest in the social domain, and the lowest in the somatic domain. There is a statistically significant correlation between the level of acceptance of illness and the quality of life and satisfaction with life. The strongest correlation is found between satisfaction with life and the evaluation of the quality of life in psychological and environmental domains. Men evaluate their quality of life in the environmental domain higher and demonstrate a higher acceptance of their disease. There is a correlation regarding a significantly higher quality of life in the social sphere in relatively older people.

Introduction: The mobility of people between continents is more and more common. Traveling of masses of Polish tourists and missionaries delegated to pastoral work and employees of business entities includes the destinations in Africa, Asia, South America and Australia. Undoubtedly, the essential thing for health care staff, including nurses, who are increasingly often contacting the clients/patients, or who want to travel to tropical countries, or returning from such countries, is having the necessary knowledge in such respect. Aim of study: The purpose of the study is assessing the level of knowledge of nurses in Podlaskie Voivodeship in the field of tropical medicine. Material and methods: The study was conducted based on survey questionnaire among 500 nurses at the age from 20 to 60. Results: More than 60% of nurses assessed the knowledge on tropical diseases as poor and the interest in additional training in the field of tropical medicine was shown by 48% respondents. More than half of the respondents (52%) are of the opinion that one needs to learn more at the area of tropical medicine and 58% declare the willingness to participate in an additional training. A slight number of respondents (10%) conducted the education of patients on topics related to tropical medicine, and according to 59% respondents, a patient should be educated in the scope of tropical medicine by an epidemiological nurse. Most people were not able to propose any tropical medicine matter worth including in the training for healthy people. Most frequently proposed was prevention (18% of the surveyed group of nurses). Internet is the predominating (68%) source from which the respondents draw their knowledge in the field of tropical medicine. Conclusions: The knowledge of nurses in the field of tropical diseases is insufficient. They are unable to specify the scope of educational activities in relation to sick people regarding raising the level of their knowledge on tropical diseases; however, the nurses express interest in improving their knowledge in the aforesaid respect. [ABSTRACT FROM AUTHOR]

Dengue is a viral disease caused by an RNA virus of the genus Flavivirus, family Flaviviridae, occurring as four serotypes (DEN-1, -2, -3, -4). It is transmitted to humans by the Aedes mosquitoes, mainly A. aegypti. The occurrence of dengue is strictly related with their preferred breeding areas. Dengue endemic regions are inhabited by some 2.5 billion people. 50-100 million cases of dengue fever and up to 1 million cases of dengue haemorrhagic fever are noted worldwide in more than 100 countries every year. The aim of the reported examinations was to diagnose dengue virus infections in returning travellers. In the years 2006-2009 serological tests were performed in 753 persons. In the diagnostics we used ELISA to find IgM and/or IgG class of antibodies against dengue virus, rapid immunochromatographic (cassette) test, NS1 viral antigen detection by ELISA, and virus RNA detection by RT-PCR method. IgM or IgG class antibodies, and both classes simultaneously, were detected in 19.8% of the examined cases. The greatest number of infections came from India and the Far East, next from South and Central America, and the smallest number from Africa. Sixteen patients with diagnosed dengue, including three cases of dengue haemorrhagic fever, were hospitalized.

Leishmania parasites are the etiological agents of leishmaniosis, with severe course and often fatal prognosis, and the global number of cases has increased in recent decades. The gold standards for the diagnosis of leishmaniosis are microscopic examinations and culture in vitro of the different clinical specimens. The sensitivity of these methods is insufficient. Recent development in specific and sensitive molecular methods (PCR) allows for detection as well as identification of the parasite species (subspecies). The aim of the study was to estimate the usefulness of molecular methods (PCR) for detection of Leishmania species and consequently for the implementation of such methods in routine diagnostics of leishmaniosis in Polish patients returning from endemic areas of the disease. In our investigations we used 54 known Leishmania positive DNA templates (from culture and clinical specimens) received from the CDC (Atlanta, GA, USA). Moreover, 25 samples of bone marrow, blood or other tissues obtained from 18 Polish individuals suspected of leishmaniosis were also examined. In PCR we used two pairs of primers specific to the conserved region of Leishmania kinetoplast DNA (kDNA) minicircle (13A/13B and F/R). Using these primers we obtained amplicons in all DNA templates from the CDC and in three Polish patients suspected for Leishmania infection. In one sample from among these cases we also obtained positive results with DNA isolated from a blood specimen which was previously negative in microscopic examinations.

The study carried out aboard a cruise ship in the years 1993-1998 involved ship passengers of various nationalities including 3872 Germans aged 23-94 years and 1281 Americans aged 25-94 years. Both nationality groups were divided into two age subgroups: till 64, and 65-94 years. The German younger age subgroup (mean age 53.2 years) consisted of 59% of the passengers, whereas the 65-94 years subgroup (mean age 72 years) was made up of 41% of the ships passengers. On the other hand, 73% of the Americans belonged to the 65-94 years subgroup (mean age 73,4 years), whereas 27% to the younger one (mean age 52.8 years). The number of onboard consultations and their causes were determined. The occurrence of chronic illnesses in both 65-94 years subgroups was assessed by means of a questionnaire. A higher frequency of consultations was found in the Germans (24.38%) than in the Americans (14.05%) (p=0.001). The difference was particularly striking in the people over 65 years of age (30.87% of the Germans as compared with 14.22% of the Americans, p=0.001). The Germans were nearly 4-times more frequently seen than the Americans for cardio-vascular diseases and almost 3-times more often because of gastrointestinal disorders. The discrepancies in the consultation rates were mainly caused by the different insurance systems of both nations. Chronic illnesses as estimated by means of the questionnaire prevailed in the German passengers. The statistically significant differences (13.3% versus 20%, p=0.01 and 0.001) regarded the locomotor system, urinary tract diseases and a group of illnesses including neurological, ophthalmological, ear, skin, malignant diseases and diabetes.

In the period 1991-2005, 169 patients with the diagnosis of malaria were hospitalized in the Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine in Gdynia (from 2003--the Academic Centre of Maritime and Tropical Medicine, Medical University of Gdańsk). All the cases were analysed for severity, occurrence of complications and permanent sequelae of the disease. According to the criteria set by the WHO (5), malaria was classified as severe in 36 cases. All of them were Plasmodium falciparum infections or mixed infections: P. f. and another species of the parasite. Patients in this group developed a number of complications, inter alia shock, acute respiratory distress syndrome (ARDS), acute renal failure, blackwater fever, severe anemia, disseminated intravascular coagulation, myocarditis, consciousness disorders of varied degree, acute transient psychoses, and exacerbation of ischemic heart disease. In one case of a pregnant woman, necrosis of the fetus occurred in the course of disease in the 4th month of pregnancy. Moreover, meningoencephalitis was diagnosed in two patients--in one of them concurrently with symptoms and signs of malaria, while in the other one-3 weeks after the symptoms subsided. In 6 patients, permanent sequelae of the disease developed and in 4 patients the disease was fatal. The cause of death was multi-organ failure, with the first sign of poor prognosis being rapidly progressing renal failure resistant to treatment in three men; in one case death resulted from cerebral malaria. In cases of suspected malaria, relapsing malaria or in mixed infections, molecular testing was a valuable complementary tool of diagnosis, which helped in beginning the appropriate treatment.

Neoplasm of B-cell origin is the most frequent malignant disease of the lymphatic tissue. It is usually presented as enlargement of lymph nodes, hepatosplenomegaly, skeletal pains and gastrointestinal dysfunction. Splenic lymphoma can cause the difficulties in diagnostic procedures (ultrasound and computed tomography). It may be nearly anechoic and mimic a cyst, abscess or parasitic mass. We describe a course of the disease and diagnostic troubles noted in 71-years-old patient, in whom splenic cysts enlarging rapidly were observed. Splenectomy due to presented difficulties in diagnosis such as clinical disquiet about subsequent course of the disease was performed. It let us to recognize malignant lymphoma and initiate a correct treatment strategy.

Pro- and anti-inflammatory cytokines are supposed to be involved in malaria pathogenesis. Their relationship with clinical manifestations of the disease, however, is rarely studied in adults from non-endemic countries with imported disease, particularly with severe malaria. In this study we compared serum levels of gamma interferon (IFNgamma) and interleukins: IL-12, IL-18, IL-10 in healthy adults and patients with severe or uncomplicated imported malaria, with predominance of Plasmodium falciparum and Plasmodium vivax infections within studied group. Severe malaria was shown to be associated with elevated serum levels of IFNgamma and IL-18 as well as with relative deficiency of IL-12 mediated response in comparison to uncomplicated malaria cases, while IL-10 was found to be higher in all malaria patients compared to the controls. Overall, the results of our study are consistent with the observations from the regions with holoendemic malaria transmission, suggesting a pivotal role of impaired IL-12 expression in severe malaria. On the contrary, patients with severe malaria included into our study presented with the pattern of excessive production of inflammatory IFNgamma and IL-18, what seems to be an unusual finding compared to the results of the studies on African children and may be the feature of severe malaria in non-immune adults.

Malaria still remains the main infectious cause of morbidity and mortality in the world. The majority of cases occur in tropical Africa, including Angola. The study was performed in Angola, in the Health Centre of St. Lucas in Kifangondo, near Luanda during the dry season, from May to October 1999. 168 patients with symptoms of malaria were referred for study enrolment. In the study we assessed the efficacy of treatment in falciparum malaria based on clinical, microscopic and polymerase chain reaction (PCR) examination, and estimated the prevalence of mutations in the pfcrt gene in the P. falciparum isolates from chloroquine-treated patients. In 159 (95%) patients P. falciparum malaria was diagnosed using microscopic methods. This was confirmed by PCR. We admitted 68 patients to the hospital; 13 patients died from complicated malaria. We have analysed 59 cases of P. falciparum malaria known to be chloroquine-treated. In 58 (98%) cases we have found P. falciparum isolates that carried gene polymorphisms typical for chloroquine resistance. In the group with such P. falciparum isolates, 8 people were treated successfully. Reasons for this response are discussed.

In this survey the use of OptiMAL test for rapid diagnosis of malaria was evaluated. It was proved that this test allowed to diagnose the Plasmodium sp. antigen in 72% of examined blood specimens, 82% for P. falciparum infection and 69% for P. vivax, whereas P. ovale was not detected at all. The test sensitivity depended on the parasitemia level. It showed a sensitivity of 100% for parasitemia density exceeded 1%, 95.4% with the parasitemia ranging from 0.1-0.99%. For lower parasite density, the test's sensitivity was of 32 and 60%. The OptiMAL test showed a 99.1% specificity thus it revealed to be significantly high.

The paper presents data on occurrence, diagnosis and treatment of alveolar echinococcosis in humans as well as possible methods of its prevention. Studies done in 2001-2003 in Poland have shown the high prevalence of the tapeworm in red foxes in the north-east (34.5%) and south-east (39.3%) of Poland with foci of infection in some counties (up to 70% foxes infected). It makes the high potential risk for human infection in these areas.

This study describes 14 cases of relapse and recrudescence of malaria, treated between 1991 and 2003. In that period, 146 patients were hospitalized in the Clinic of the Institute in Gdynia: 20 women and 126 men. In 103 cases the disease was caused by Plasmodium falciparum, in 31 cases by Plasmodium vivax, in 5 cases by Plasmodium malariae, and in 2 cases by Plasmodium ovale. Five patients were found to have mixed infections, with either P. falciparum and P. vivax or P. falciparum and P. ovale. Relapses in patients previously treated in the country or abroad accounted for 9.6% of all the treated cases of malaria. Recrudescences and relapses were diagnosed of both the tropical malaria (6 cases), and the tertian malaria caused by P. vivax (4 cases). Moreover, in 4 patients diagnosis was made of secondary malaria due to P. vivax infection, while the primary attack was caused by invasion of P. falciparum. Also discussed was the issue of drug-resistance of plasmodia and the resulting problems with the treatment.