Institute of Tropical Medicine and International Health

Institute of Tropical Medicine and International Health

Kopfzeile

The Institute of Tropical Medicine and International Health Berlin at the Charité - Universitätsmedizin Berlin is the largest tropical medicine institution in Germany in relation to the number of outpatients and travelers. The Institute is focused on the diagnosis and treatment of tropical diseases, travel medicine consultation and vaccinations, as well as research and teaching in tropical medicine and international/global health.

History

The Institute has its origins in the Royal Prussian Smallpox Vaccination Institute, which was founded in 1802. In 1965, the increasing number of long-distance travelers and growing international relations motivated the Berlin Senate to expand the existing smallpox vaccination institution into the "State Vaccination Institute with Tropical Medicine Consultation Center." Name changed to Institute for Tropical Medicine in 1995, the institution belonged to the Berlin Operation for Central Health Tasks until 2011 and has been an institute of the Charité - Universitätsmedizin Berlin since 2012. Today, the institute employs around 50 employees and includes Germany's largest tropical medicine and travel medicine outpatient clinics, a laboratory with a parasitology focus, as well as research and teaching areas.

Outpatient care

In the Tropical Medicine Outpatient Clinic, ill travelers, migrants and patients with parasitological diseases present themselves (2019: 7,000 new visits). The most frequently complained health disorders after foreign travel include diarrhea and digestive disorders, fever, and skin lesions. The Outpatient Clinic also carries out tropical screening and participates in several european and international networks for the registration of imported diseases, e.g. GeoSentinel. The institute laboratory provides diagnostics of parasitic, bacterial and viral infectious diseases and is able to identify numerous specific tropical pathogens.

Travel clinic

The specialized physicians of the travel clinic advise on medical concerns before traveling, give recommendations for malaria prophylaxis and carry out recommended or obligatory vaccinations. This includes the administration of yellow fever vaccinations (official yellow fever vaccination center). In 2019, about 33,000 travelers visited the travel clinic.

Research

The scientific activities are focused in a rapidly changing area between basic research, clinical tropical medicine and global health. Central to these activities are cooperative collaboration with partners in the so-called global south or in low- and middle-income countries (LMICs), support for local capacity building, interdisciplinarity, transsectorality and a focus on poverty-related diseases. Adaptations to global trends such as climate change, environmental degradation, aging and the increase in so-called non-communicable diseases such as diabetes are continuously taking place.

Current focus areas include malaria, HIV/AIDS, infection control, antibiotic resistance, and public health in LMICs. Current field studies are being conducted with partners in Rwanda, Democratic Republic of Congo, Tanzania, Uganda, South Africa, and Sierra Leone. The funding for research activities is primarily provided by German Federal Ministry of Education and Research (BMBF), German Research Foundation (DFG) and German Federal Ministry for Economic Cooperation and Development (BMZ).

The HIV and Reproductive Health Working Group was established in 1999. The research focuses on analyzing factors that influence vertical HIV transmission, treatment response, treatment compliance, and resistance formation under conditions of resource-poor regions in Africa. Clinic partnerships are also being conducted to improve patient care related to HIV/AIDS and co-infections.

With collaborative partners in Africa and Asia, the Malaria and Infectious Disease Epidemiology Group conducts clinical epidemiological studies. The focus is on genetic influence on susceptibility to infections and manifestations, therapy studies and resistance markers. A current topic is the identification and containment of resistance to the antimalarial drug artemisinin, recently identified in East Africa. Other areas of research include the epidemiology of intestinal parasites, the spread and introduction of antibiotic-resistant bacteria, type 2 diabetes in Africans, and patterns of disease in migrants and refugees.

The Epidemic Preparedness and Infection Prevention in Health Care Facilities Working Group was established in 2021 based on joint activities with partners in Rwanda and Germany that resulted from the Ebola fever epidemic in the Democratic Republic of Congo in 2018 and 2019. The objective is to explore and present solutions to better protect health workers and patients from highly contagious diseases and emerging infections, and to improve epidemic prevention in public health. The working group is addressing the impact of epidemics on healthcare workers, healthcare worker competencies in infection prevention and control, and the development of improved architectural and digital solutions for healthcare facilities and digital tools for outbreak-related health education.

In addition to the classic neglected tropical diseases (e.g., African sleeping sickness, cutaneous leishmaniasis), the main focus of the Neglected Diseases and Vulnerable Populations Working Group is on infections with PVL-bearing Staphyloccus aureus, a disease pattern that has received minimal attention in Germany. In addition, the working group aims to strengthen vulnerable groups - the homeless and refugees - in their health literacy and improve their medical care in Germany.

The COVID pandemic had brought numerous activities abroad to a standstill. In the meantime, numerous staff members were busy with conceptual work, diagnostics, test validation and COVID-related studies. Since 2022, the situation has largely returned to normal.

Clinical partnerships exist with the University Teaching Hospital of Butare, Rwanda, Holy Family Virika Hospital in Fort Portal, Uganda, and Princess Christian Maternity Hospital in Freetown, Sierra Leone.

Teaching

The Master Program International Health at Charité - Universitätsmedizin Berlin has been offered at the Institute of Tropical Medicine in Berlin since 1999. The program is integrated into the European "tropEd Network for Education and Training in International Health". Students are being prepared for management tasks in the field of International Public Health. The language of teaching is English. The degree of the program is the "Master of Science" (MSc) in "International Health".

Other courses include the diploma course "Tropical Medicine and Public Health" and the optional module "Tropical Medicine".

Directors

   1982–2006 Ulrich Bienzle
   2006–2019 Gundel Harms-Zwingenberger
   seit 2019 Frank Mockenhaupt (kommissarisch)

Weblinks

   Homepage (https://tropeninstitut.charite.de/ )

Charite Global Health (https://globalhealth.charite.de/ )

   GeoSentinel (https://www.istm.org/geosentinel )
  Deutsche Gesellschaft für Tropenmedizin, Reisemedizin und Globale Gesundheit (https://de.wikipedia.org/wiki/Deutsche_Gesellschaft_f%C3%BCr_Tropenmedizin,_Reisemedizin_und_Globale_Gesundheit )

International Health (https://en.wikipedia.org/wiki/International_health )

Global Health (https://en.wikipedia.org/wiki/Global_health )
   Interdisziplinarität (https://de.wikipedia.org/wiki/Interdisziplinarit%C3%A4t )
   LMICs (https://de.wikipedia.org/wiki/Bruttonationaleinkommenkategorisierung_(Weltbank) )
   Neglected Tropical Diseases (https://de.wikipedia.org/wiki/Vernachl%C3%A4ssigte_Krankheiten )
   tropEd (https://de.wikipedia.org/wiki/TropEd )

Literature

1: Uwimana A, Legrand E, Stokes BH, Ndikumana JM, Warsame M, Umulisa N, Ngamije D, Munyaneza T, Mazarati JB, Munguti K, Campagne P, Criscuolo A, Ariey F, Murindahabi M, Ringwald P, Fidock DA, Mbituyumuremyi A, Menard D. Emergence and clonal expansion of in vitro artemisinin-resistant Plasmodium falciparum kelch13 R561H mutant parasites in Rwanda. Nat Med. 2020 Oct;26(10):1602-1608. 2: Bergmann C, van Loon W, Habarugira F, Tacoli C, Jäger JC, Savelsberg D, Nshimiyimana F, Rwamugema E, Mbarushimana D, Ndoli J, Sendegeya A, Bayingana C, Mockenhaupt FP. Increase in Kelch 13 Polymorphisms in Plasmodium falciparum, Southern Rwanda. Emerg Infect Dis. 2021 Jan;27(1):294-296.

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