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.

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.

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.