ITM’s medical services are accredited points of reference in their niche of tropical medicine, nationally and internationally. Its polyclinic, probably the most renowned part of ITM’s work in Belgium, has thousands of travellers, migrants and people with HIV or other sexually transmitted infections (STI’s) passing through its doors every year. The medical services are a part of the Department of Clinical Sciences that include academic units, medical units and reference laboratories. These laboratories are highly specialised with experts working to support direct patient care and diagnostics in Belgium and abroad.
In total, ITM is involved in more than
4 out of 5
Belgian malaria cases.
2017 was another busy year in the clinic. 35,719 patients came to ITM for consultations – 68% of these for travel health and vaccinations, 18% for HIV and 6% for STIs. Along with its day-to-day activities of offering patient services; running ITM’s accredited national reference laboratories; developing and validating diagnostic tests and implementing clinical trials, highlights shone. These included increasing its role as a reference partner in Belgium in rabies, expanding its HIV care and prevention, contributing to a multicentric Médecins Sans Frontières study on HIV testing algorithms and investigating anonymous partner alert services after STI diagnosis.
Expanded reference responsibilities to include rabies
In 2016 ITM counted 15 of its medical and research laboratories as national or international reference centres, 3 of which being WHO collaborating centres and one WHO testing laboratory. In 2017 ITM added another such activity to its arsenal. In July the Institute became Belgium’s expert centre for the treatment of rabies and the only reference partner of the Belgian health authorities for the treatment of rabies using post-exposure prophylaxis (PEP) with immunoglobulins against rabies in patients potentially exposed to the disease. This is in collaboration with the Antwerp University Hospital (UZA) in order to allow 24/7 access to the immunoglobins.
ITM study contributes to prophylactic HIV drug access
ITM praised the Belgian government’s decision to reimburse TRUVADA® as preventive medication for people who run a high risk of getting HIV-infected as of July 2017. In 2015, the Institute started a demonstration study on the use of preventive HIV medication among gay men (www.be-prep-ared.be). The preliminary study results, along with extensive consultation with Belgium’s 11 AIDS Reference Centres of which ITM is one, laid the basis for the decision of the Minister of Health Maggie De Block. The prescription of the drug goes exclusively via the AIDS Reference Centres, which have the necessary expertise and offer guidance in the process.
Evaluating HIV test accuracy
Along with their day-to-day contributions to various clinical drug and vaccine trials ITM’s HIV reference laboratory also notably supported Médecins Sans Frontières in its study to evaluate the accuracy of HIV tests in five sub-Saharan African countries. The study was conducted in collaboration with ITM, and co-investigators from the respective Ministries of Health. It confirmed the need to carefully select multiple HIV rapid diagnostic tests in an algorithm/sequence for making an HIV diagnosis. The study was published in the Journal of the International AIDS Society in March 2017.
68% of ITM’s 35,719 patients came for consultations regarding travel health or vaccinations in 2017
1. Yellow fever 53%
2. Hepatitis A 53%
3. Polio 32%
4. Tetanus & diphteria 31%
5. Typhoid fever 23%
Testing anonymous partner notification
As a part of its work to contain the spread of HIV and other STIs, ITM is currently investigating whether more people will inform their sexual partners through an anonymous platform called Partneralert after contracting HIV or another STI. Our clinicians are often told that people find it difficult to inform sexual partners about their diagnosis. Partner notification is recommended by the World Health Organization and the European Centre for Disease Prevention and Control as a key preventative tool in the control of HIV and STIs.
Diagnosed patients receive a code that allows them to inform their sexual partners via www.partneralert.be anonymously. In a first phase, anonymous partner notification for HIV and STIs is happening exclusively via the Belgian AIDS Reference Centres. Should the new tool indeed meet an important need, other healthcare providers can join.
Reaching the 40 births quota
A MEETING WITH JONI AND TIFFANY IN OUR TRAVEL CLINIC
We’re happy to introduce you to Joni and Tiffany. They’re preparing for a trip to Rwanda and Zanzibar – not on a short holiday but for three long months to discover what it’s like to bring babies into the world in Africa. And not because they’re pregnant but because they’re midwifery students from the Thomas More University at the Lier Campus in Belgium. Before they graduate each of them needs to have counted 40 births to their repertoire. Joni still needs 25 and Tiffany 17, which they hope to accrue in their three-month visit to Africa. Here, they will also experience the less technologically well-equipped births that the Kabutare District Hospital in Butare, Rwanda has to offer. Zanzibar is for the last week where they will enjoy the beach and a “chic hotel” before returning to their studies in Lier.
This is a tiny taste of the visitors ITM welcomes to its travel clinic in Antwerp where our medical staff administered 38,446 vaccinations in 2017. Because of where they’re going and their contact with people in a health care setting, Joni and Tiffany have to be vaccinated against yellow fever, typhoid fever, polio, hepatitis A and rabies. They are also equipped with pills in case of traveller’s diarrhoea and antimalarials. On the day of their visit they were having their first of three rabies shots – the next one is in a week followed by the third after 21 days. They leave the clinic smiling with a plaster on their arms and the second and third rabies vaccination vials in their hands – their local doctor will administer these for them.
Did it hurt? “No, we’re used to having to do this to other people,” answers Joni laughing.
As with all our travellers, we wish them safe travels and especially for Joni and Tiffany the very best of luck with their next (African) births knowing they leave well prepared and protected.