DEPARTEMENT KLINISCHE WETENSCHAPPEN

 
INHOUD

1. Inleiding
2. Focus on
PROJECTS
Publications in international peer-reviewed journals
Other publications and abstracts

1. Inleiding

Het nog jonge Departement Klinische Wetenschappen overdacht in 2002 zijn toekomst, aan de hand van de evaluaties door de Wetenschappelijke Raad van Advies en de geplande personele versterking. Als een van de belangrijke besluiten herschikten we de structuur van de onderzoekseenheden. De samenvoeging van de Eenheden Tropische Geneeskunde en Tropische Klinische Biologie was de consolidatie van een de facto-situatie. Gezamenlijk zullen ze zich vooral op klinisch onderzoek in de tropen richten. De Eenheid Reisgeneeskunde (met eveneens een verlengde in het Laboratorium voor Klinische Biologie) concentreert zich specifiek op reizigers en migranten in België en Europa. De Eenheid HIV / Seksueel Overdraagbare Ziekten (SOA) verricht klinisch onderzoek zowel in Europa als in het Zuiden. Nu antivirale behandelingen in ontwikkelingslanden eindelijk op gang komen, vormt deze overlapping juist een cruciale meerwaarde. Hoewel ieder zijn specifieke interesse en focus heeft, dragen de meeste stafleden bij aan onderzoekslijnen in verschillende eenheden.

Dr. Gotuzzo and his team at the Instituto de Medicina Tropical, Cayetano Heredia, Lima, Peru.

Dr. E. Gotuzzo and one of his patients. This boy recovered from a very severe infection with extensive brain involvement caused by Balamuthia mandrillaris, a free-living ameba endemic in Peru.

Het onderzoek in het Zuiden zal zich in de toekomst vooral structureren in de institutionele samenwerkingsverbanden met klinische of diagnostische centra in Lima, Peru (Instituto de Medicina Tropical Cayetano Heredia), Phnom Penh, Cambodja (HOPE Hospital), Kigali, Rwanda (Centre Hospitalier Universitaire) en Kinshasa, D.R. Congo (Laboratoires de Références nationaux - INRP, PNLS) (zie ook hoofdstuk Ontwikkelingssamenwerking). HIV/AIDS en TB zijn evidente prioriteiten in al deze centra. Samen met onze partners boeken we in de drie zuid-continenten vooruitgang in de behandeling van AIDS-patiënten met anti-retrovirale middelen, en trachten we ook de aanpak van (multiresistente) TB te optimaliseren. Naar gelang de locatie nemen ook malaria, slaapziekte en andere parasitaire en tropische ziekten een belangrijke plaats in. Het Departement zal ook bijdragen aan andere institutionele samenwerkingsverbanden met een klinische component, en in principe de verantwoordelijkheid nemen voor alle klinische trials van het ITG.

Bacteriology Lab, CHK, Kigali, Rwanda.

Het werk van de Eenheid Reisgeneeskunde werd verder gestroomlijnd en gebundeld langs een beperkt aantal assen. Voortdurende follow-up en actualisering van nationale en internationale consensusvorming over importpathologie blijft een belangrijk deel van de wetenschappelijke opdracht. De Eenheid zette een langlopende studie van koorts bij reizigers consequent voort, en werkt hierin ook samen met andere Europese centra binnen het netwerk TropNetEurop. In samenwerking met de Universiteit van Leiden en andere centra verbeteren we ook de moleculaire en serologische diagnostiek en differentiatie van Entamoeba-infecties, en gaan we de rol na van protozoaire parasieten bij darmstoornissen in reizigers. We zijn ook betrokken bij een Europees netwerk voor de diagnostiek en het management van ingevoerde Virale Hemorragische Koortsen. Nationaal onderzoeken we de evolutie van de incidentie van gonorroe, in het bijzonder van antibiotica-resistente stammen, en van ingevoerde dengue-infecties.

L. Gahimbare, consultant clinical biology, M. Van Esbroeck and Ch. Sasita, director of the CHK laboratory, Kigali, Rwanda.

Het overzeese onderzoek van de Eenheid Tropische Geneeskunde speelde zich in 2002 vooral af in Rwanda en de D.R. Congo. In het Centre Hospitalier Universitaire van Kigali loopt een tiental gezamenlijke onderzoeksprojecten in de klinische epidemiologie. De onderwerpen zijn, onder meer, het nut van paraklinisch onderzoek, drempels in klinische besliskunde, analyses zonder gouden standaard, meta-analyses van courante behandelingen en validering van algoritmen voor behandeling van opportunistische infecties. In Kinshasa, D.R. Congo, ondersteunen we de ontwikkeling van het Institut National de Recherches Biomédicales tot een nationaal diagnostisch referentiecentrum voor de gezondheidsdiensten en de bestrijdingsprogramma’s, met initiële nadruk op parasitaire infecties. In het verlengde van deze activiteiten ligt ook een meer beleidsmatig onderzoeksproject over “De rol van het microbiologisch laboratorium in districthospitalen in ontwikkelingslanden”.

Fake anti-malaria drugs, Cambodia.

Ook de sub-eenheid medische mycologie bleef actief in het nationale en internatonale onderzoek, in nauwe samenwerking met het Laboratorium voor Mycologie van het Wetenschappelijk Instituut voor Volksgezondheid te Brussel. Overzee werkte ze vooral samen met het laboratorium voor mycologie van het Instituut voor Tropische Geneeskunde te Lima, maar ook met andere partners in Zuid-Amerika, Marokko en Oeganda. Bijzondere aandachtspunten zijn cryptococcose, sporotrichose en opportunistische schimmelinfecties bij AIDS-patiënten.

Prof. R. Colebunders, Dr. L. Lynen and Dr. L. Bunse at the International AIDS Conference in Barcelona, July 2002.

Het onderzoek van de Eenheid SOA/HIV in België bestaat vooral uit deelname aan multicentrische klinische trials, de verbetering van de zorg voor HIV/AIDS-patiënten en de surveillance van SOA. De lopende trials gaan over behandeling van AIDS met interleukine, atazanavir en fusieremmers, en van chronische hepatitis C – HIV co-infectie met PEG-interferon. Hiernaast loopt een “compassionate use”-protocol met tenofovir (TDF). Het Eurosupport-project, dat onder coördinatie van het ITG al loopt sinds 1996, onderzoekt de veranderende noden van HIV/AIDS-patiënten in verschillende Europese landen, ook die welke de huidige diensten niet dekken. De surveillance van SOA onthulde onder meer een verontrustende toename van syfilis en andere geslachtsziekten, mogelijk wijzend op een verzwakking van het “veilig vrijen”.

MSF car in Angkor temple complex, Cambodia.

Het klinische HIV/AIDS-onderzoek in ontwikkelingslanden speelt zich vooral af in bovengenoemde centra. In het Sihanouk Hospital Centre of HOPE in Phnom Penh, Cambodja, ligt de nadruk op de therapiemodaliteiten voor patiënten met HIV-AIDS en tuberculose. Het AIDS-Impulsprogramma maakte belangrijke bijkomende investeringen in capaciteitsversterking mogelijk, onder meer door vorming, laboratoriumuitrusting, ontwikkeling van klinische algoritmen en van thuiszorg, inventarisering van het bestaande gebruik van antivirale middelen, en formulering van diverse projecten (o.m. voor het Global Fund for the Fight against Aids, Malaria and Tuberculosis). Een nauwe coördinatie met de Cambodjaanse activiteiten van het Departement Microbiologie en met diverse terreinprojecten van Artsen zonder Grenzen levert voor alle partijen een belangrijke meerwaarde op. Ook in Lima heeft het AIDS-Impulsprogramma zijn stempel gedrukt op het klinische onderzoek, met belangrijke investeringen in het laboratorium voor immunologie (zie Departement Microbiologie), de informatisering van de HIV-patiëntenpopulatie, het opstarten van een preventiecampagne in middelbare scholen in Lima, de verdere uitbouw van het klinische onderzoek naar (multiresistente) TB en naar de relatie tussen HIV en andere infecties. In Rwanda konden we door het AIDS-Impulsprogramma een aantal opleidingen organiseren, een cohorte van met ARV behandelde patiënten opstarten, en algoritmen voor de detectie en behandeling van opportunistische infecties ontwikkelen. In Kinshasa, D.R. Congo, werkten we nauw samen met het Departement Microbiologie (zie aldaar) in de ondersteuning van het Programme National de Lutte contre le SIDA (PNLS). De Eenheid verleende ook meer punctuele ondersteuning van onderzoeks- en bestrijdingsprogramma’s in Marokko en Ghana.

Clinical practice in the field.

De dienstverlening concentreerde zich vooral op de patiëntenzorg in de Medische Diensten van het ITG (zie betreffende verslag). Hierbij horen ook belangrijke en intensieve inspanningen voor preventieve en ondersteunende doeleinden: de Travelphone; de website en diverse brochures “Gezond op Reis”; lidmaatschap van de Hoge Gezondheidsraad (werkgroep Vaccinaties en Bioterrorisme); coördinatie van de nationale werkgroep Reisgeneeskunde; adviezen aan artsen en andere reisklinieken; coördinatie van de KAR, het overlegorgaan van de Vlaamse Aids Revalidatiecentra; enz.

Father washing child.

Het Departement verzorgt de uitgebreide lesopdrachten tropische geneeskunde, laboratoriumdiagnostiek en HIV/AIDS in de diplomacursussen van het ITG, en deels ook in de zustercursus voor tropenartsen in Nederland. Verder organiseren we ook de bijzondere opleiding in de Medische Mycologie en de bijscholingen voor HIV/AIDS-zorg aan het ITG, en werken we mee aan de ITG-Mastercursussen en vele vormingsprojecten in ontwikkelingslanden. Het Departement verzorgt ook de meertalige uitgave van de multimedia-CD “Tropische Geneeskunde”, met in 2002 als belangrijk resultaat de unieke en aangepaste Spaanstalige versie. Voor dit alles verwijzen we verder naar het hoofdstuk “Onderwijs”.


A page of the Spanish CD-Rom “Medicina Tropical”.


2. FOCUS ON: Antwerp Diner-fonds 2002:
‘Geef-om-AIDS-fonds’ en Instituut voor Tropische Geneeskunde



Frank De Neef, Chairman of the Antwerp Dinner.

Address of the Chairman, Mr. Frank De Neef, at the Antwerp Dinner 2002

Dear Friends of the Antwerp Dinner,
Receiving guests, organising parties, accommodating people from ´abroad’, ensuring a safe and restful night and serving up a healthy breakfast: the activities of a hotel never stop. The hotel industry is thus a business that never stops and where people are on the move day and night, all year long. It is a labour-intensive, energy-consuming, but also a very fascinating business.
In spite of their busy agenda, a number of Antwerp hotel managers found the time and enthusiasm in 1995 to set up an organisation for gathering funds. All the forces within, and also partly outside the sector, were addressed and mobilised to organise a dinner, the proceeds of which would go to AIDS research and direct assistance.
As someone who was relatively new in Antwerp 3 years ago, I saw how a close group of people in their rare moments of spare time enthusiastically devoted themselves to this noble cause. From the start, the task force around the hotel managers could also count on a number of outsiders who have now joined the organising committee. The same can be said of our guests who always lend a hand when Antwerp Dinner calls on them. It all looks self-evident and well-consolidated, yet the opposite is true. Each edition is only possible thanks to the heart-warming and selfless efforts of everybody involved.
And independently of the funds collected each year thanks to Antwerp Dinner, there is also a message conveyed at the same time. The AIDS crisis is far from resolved, despite the hopeful media reports. It is still a desperate race against time. And therefore Antwerp Dinner continues to count on you. For which, our heartfelt thanks.

Frank De Neef, Chairman, Antwerp Dinner


Counseling voor mensen met een precair verblijfsstatuut

Een grote groep HIV-positieve mensen met een precair verblijfsstatuut maakt dagelijks gebruik van de medische diensten van het Instituut voor Tropische Geneeskunde. Het gaat voor een groot deel om mensen uit Afrika, maar het aantal Oost-Europeanen neemt sterk toe. De helft van het Antwerp Diner-fonds 2002 gaat naar de verdere uitwerking van de counseling en opvang van deze groep. De expertise die we zo opdoen, gebruiken we voor de projecten in derdewereldlanden.
HIV en AIDS slaan hard toe in derdewereldlanden. Meer dan 30% van de volwassenen in zuidelijk Afrika is bijvoorbeeld besmet. Mensen weten dat er in de ‘eerste’ wereld zeer krachtige virusremmers bestaan. Ze maken het verschil uit tussen overleven of een gewisse dood. De vraag naar behandeling vanuit de arme landen is enorm. Niet-gouvernementele organisaties en de HIV/AIDS-afdeling van de Verenigde Naties (UNAIDS) onderhandelden hard over lagere prijzen voor de HIV-remmers. De geneesmiddelen kosten nu tot 90% minder. De prijs van producten is maar één factor in het geheel. Naast het toeleveren van geneesmiddelen is er immers een enorme nood aan correcte en actuele informatie voor artsen, gezondheidswerkers en patiënten in derdewereldlanden.
Mensen met HIV en AIDS moeten jarenlang en haast supergemotiveerd de middelen innemen. Deze producten hebben neveneffecten. De motivatie kan hierdoor dalen. Er is met andere woorden ook een grote nood aan ondersteuning. Counseling noemt men dat. Het is een complex proces. Er bestaan verschillende types counseling. Een therapiecounselor geeft patiënten de meest actuele informatie over de HIV-behandeling. Verder past hij/zij de therapie aan de levensstijl en achtergrond van de persoon aan. Factoren zoals leeftijd, geslacht, etnie, opleidingsniveau, werksituatie van patiënten spelen mee. Psychosociale counselors hebben oog voor de leefwereld van mensen, voor hun gevoelens, voor relaties met ‘betekenisvolle derden’, zoals ze dat noemen. Ze steunen patiënten bij praktische vragen. Een goede counseling is cruciaal om de motivatie op peil te houden.
Het budget van het Antwerp-Diner 2002 schraagt de verdere uitwerking van de counseling voor patiënten met een precair verblijfsstatuut op raadpleging in het Aidsreferentiecentrum Antwerpen.

Antwerp Dinner Party 2002


PROJECTS

Diagnosis of intestinal amoebiasis
Entamoeba histolytica, as it was previously known, is comprised of two genetically distinct but morphologically indistinguishable species: one pathogenic, E. histolytica, the other nonpathogenic, E. dispar. Less than 10% of patients with cysts of E. histolytica/E. dispar in their stools are actually infected with E. histolytica. 90% of cyst carriers receive unnecessary or inappropriate treatment. The objectives of this prospective study are: to differentiate between E. histolytica and E. dispar cyst carriers with serology and antigen detection; to evaluate treatment of non-dysenteric E. histolytica infection with luminal agents; to compare the cost-effectiveness of PCR, antigen detection and serology for distinguishing between E. histolytica and E. dispar
ITM promoters: T. Vervoort, J. Van den Ende
ITM collaborators: J. Clerinx, M. Van Esbroeck
External collaborators: L. Visser, A. Polderman (Leiden University); Bronovo Hospital, Den Haag, The Netherlands
Support: IMTA, LUMC

Febrile Illnesses after a stay in the tropics
Fever after a stay in the tropics is a common cause of post-travel consultation, with a broad differential diagnosis and potentially severe causative disease. This fever study investigates the causes and outcomes of febrile imported illnesses seen at the ITM. The objectives are the evaluation of the diagnostic value of clinical and non-clinical investigations; the development and validation of algorithms for primary health care physicians; an in-depth analysis of specific cohorts of patients with malaria, dengue and Katayama syndrome; within a European network, to monitor epidemiological trends in import pathology. More than 1000 patients have been included since the beginning of this prospective study (April 2000), with complete follow-up data for 97 % of the febrile episodes.
ITM promoter: J. Van Den Ende
ITM collaborators: E. Bottieau, J. Clerinx, W. Schrooten, A. Van Gompel,E. Van den Enden, R. Colebunders, M. Van Esbroeck, T. Vervoort
Support: ITM

European Network on Imported Infectious Disease Surveillance (TropNetEurop)
TropNetEurop was set up to establish and maintain an electronic network of clinical sites for the surveillance of imported infectious diseases. The network also tries to effectively detect emerging infections of potential regional, national or global impact at their point of entry into the domestic population. Sentinel Surveillance reporting is carried out through a standardised and computerised reporting file. In the present configuration, systematic reporting of imported infectious diseases is currently running on a centralised database for three major diseases: malaria, schistosomiasis and dengue fever. Network partners include major travel clinics as well as in- and outpatient sites throughout Europe. Each reporting centre has its own site manager responsible for data transmission. Network meetings are held every year and several sub-projects are currently ongoing. The ITM participates actively in the network; so far it has reported data from more than 350 cases to the network (www.tropnet.net).
Promoters: J. Clerinx (ITM), T. Jellinek (Berlin University, network co-ordinator)
ITM collaborators: All clinicians and clinical biologists
External collaborators: 47 European clinical infectious disease units (www.tropnet.net)
Support: ITM

Spanish CD-ROM on tropical medicine
The Department produced a Spanish CD-ROM on tropical medicine entitled “Medicina Tropical”, version 2002. It can be used as teaching material in educational courses on tropical medicine in Latin America and contains more than 50 illustrated chapters with 800 colour illustrations on tropical diseases. The texts can be printed in a user-friendly way; a complete printout consists of 1000 pages. The final translation, proofreading and integration of texts and images were completed in 2002. A beta version was tested and debugged.
ITM promoter: E. Van den Enden
ITM collaborators: Clinical and scientific staff of ITM
External collaborators: E. Gotuzzo (Instituto de Medicina Tropical Heredia Cayetano, Lima, Peru); T. Faustino (Universidad Mayor de San Simon, Cochabamba, Bolivia)
Support: DGDC, ITM

HIV clinical trials
The Unit of HIV/STD Care is involved in several multi-centre clinical trials:
- SILCAAT: A Phase III Multicentre Randomised Study of the Biological and Clinical Efficacy of Subcutaneous Recombinant, Human Interleukin-2 in HIV-infected Patients with Low CD4+ Counts under Active Antiretroviral Therapy
- T20-302/BV16052: A Phase III open-label, randomised, active-controlled study. It assesses the efficacy and safety of T-20/Ro 29-9800 (HIV-1 fusion inhibitor) in combination with an optimised background regimen, versus optimised background regimen alone, in patients with prior experience and/or prior documented resistance to each of the three approved classes of antiretrovirals (nucleoside reverse transcriptase, non-nucleoside reverse transcriptase and protease inhibitors)
- P02394: Treatment of Chronic Hepatitis C patients, co-infected with HIV, with weekly PEG-INF (Peg-Intron®) and Ribavirin (Rebetol®)
- AI424-043: A randomised open-label study of the antiviral efficacy and safety of Atazanavir versus Lopinavir/Ritonavir (LPV/RTV), each in combination with two nucleosides in subjects who have experienced virologic failure with prior protease inhibitor-containing HAART regimens
- T20-305/NV16391: Open-label Safety study of T-20 in patients with advanced HIV disease who are unable to construct a viable antiviral regimen
- AI424-900: Atazanavir (BMS-232632) for HIV-infected Individuals: an Early Access Program
- MV16721: Multicentre Open-Label Early Access Program of enfuvirtide (T-20 / Ro29-9800, HIV Fusion Inhibitor) in combination with Free Choice Antiviral Regimen in Patients with Advanced HIV-infection
- Tenofovir (TDF): Compassionate Use protocol
ITM promoter: B. Colebunders
ITM collaborators: HIV/STD Unit
External collaborators: P. Michielsen (University Hospital Antwerp - Promoter P02394)
Support: ITM, Chiron Corporation; Hoffman-Laroche Ltd; Bristol Myers Squib Ltd; Schering Plough Ltd.

EuroSIDA cohort study
The EuroSIDA study is a prospective observational cohort study of more than 9,700 patients followed in 72 hospitals in 26 European countries. The main objective of the study is to assess the impact of antiretroviral drugs on the outcome of HIV-infected patients in Europe. The Unit of HIV/AIDS Care took part in the subsequent cohort II-IV studies.
ITM promoter: B. Colebunders
ITM collaborators: HIV/STD Unit
External collaborators: 72 European hospitals

ITM HIV cohort database
The ITM HIV cohort database started in January 2001. Data on the patients at the outpatient clinic of the ITM were collected. The goal of the cohort is to have general information about the patient population, reliable data for scientific questions and to report valid data to the government. Currently the database consists of two modules: epidemiological data and treatment history. In the past 2 years, records from 1300 patients were collected and entered. At the end of 2002, 1078 of these were still being actively followed. 222 dropped out of the cohort: 44 (20%) died, 55 (25%) were referred to another hospital, and 123 were lost to follow-up. Most patients are male; the average age is 41 years and the time since diagnosis is 6 years. 59% are Belgians, 28% originate from sub-Saharan Africa. The main route of infection is sexual, 47% homosexual and 42% heterosexual. In total, 753 patients had received therapy at some time; of them, 682 are currently still taking a combination therapy. 323 never took any anti-retroviral medication. Currently, the most frequent cocktail is a combination of nucleosides and non-nucleosides, whereas previously a combination of nucleosides and protease inhibitors was most frequent. Only 10% of the naive patients have an undetectable viral load, while 86% of the patients on therapy are undetectable. 40% of the naive population has a CD4 cell count higher than 500 cells/mm3, for 47% of the population on therapy. The database is currently being expanded with a module on clinical data. Where appropriate, the technology will also be put to use in our collaborative HIV projects in the South.
ITM promoters: A. De Roo, C. Dreezen, W. Schrooten
ITM collaborators: HIV/STD unit and Department of Microbiology, unit of virology
Support: ITM and private funding

Eurosupport III: HIV prevention among people living with HIV/AIDS
The Eurosupport III project is a continuation of the Eurosupport initiative started in 1996, co-financed by the European Commission and co-ordinated by the ITM. The general aim is to evaluate the needs of people living with HIV and to detect shortcomings in the actual service provision. Eurosupport III concentrates on problems related to the adherence to highly antiretroviral therapy (HAART) and to safe sex guidelines. A survey was organised among people living with HIV infection, using an anonymous questionnaire in 8 European countries on the topic of sexual dysfunction. Sexual dysfunction was found to be a frequent complaint of men and women with HIV infection. Among men, an association between sexual dysfunction and the use of HAART was demonstrated. Among women, mainly psychological factors associated with the diagnosis of HIV infection contributed to the development of sexual dysfunction. Whether sexual dysfunction in persons with HIV infection could lead to unsafe sex practices in certain individuals should be the topic of further studies.
Two workshops were organised at the Institute of Tropical Medicine, one on the optimisation of the delivery of antiretroviral treatment during hospitalisation, and one on sexual dysfunction and safe sex counselling. The results of EUROSUPPORT III have been converted into recommendations and guidelines. In several centres, activities were initiated to promote safe sex and treatment counselling in order to improve adherence to antiretroviral therapies.
ITM promoter: R. Colebunders
ITM collaborators: C. Dreezen, W. Schrooten
External collaborators: 10 HIV treatment centres in 8 European countries (Austria, Belgium, Germany, Greece, Italy, Spain, Sweden, United Kingdom)
Support: EU, ITM

Cambodia: clinical AIDS Care
Cambodia has the highest HIV prevalence in Asia. Approximately 170,000 people are infected with HIV, and the seroprevalence rate in the general population for the age group 15-49 years old is 2.8%. The projected number of AIDS cases is expected to escalate from about 8,000 annual cases in 1999 to 25,000 in 2005. The ITM is guiding an AIDS care project in the Sihanouk Hospital Centre of HOPE (SHCH), in Phnom Penh. This is a privately-funded NGO hospital which opened in December 1996 and whose mission is “to provide a centre for the further education and clinical training of medical professionals, while delivering 24-hour high-quality, free medical care for the poor and needy in Cambodia”. Currently the hospital receives 5000 outpatients and some 60 in-patients monthly. The objective of the project is to evaluate the use and applicability of existing clinical care guidelines for AIDS care in a resource-poor setting and to strengthen the Cambodian capacities in HIV/AIDS care. Specific objectives are: the organisation of health services in response to the needs of HIV/AIDS patients; the development and evaluation of clinical algorithms in HIV/AIDS care; to train Cambodian staff in the clinical management of AIDS-related pathologies, epidemiology and statistics, reproductive health; and to perform other research related to ARV therapy in developing countries. In 2002, an antiretroviral treatment project was prepared, including investments in new laboratory equipment for proper follow-up. Doctors and pharmacists, counsellors and nurses were trained in all aspects of antiretroviral therapy. A working group on research and data-collection was established, and its members were trained in research methodology. Four research protocols were developed.
ITM promoter: L. Lynen
ITM collaborators: B. Colebunders, L. Kestens, J. Van den Ende
External collaborators: S. P. Prey (Cambodian promoter); J. Hines, (SCHC); Brown University (Rhode Island)
Support: DGDC

Institutional collaboration with the Instituto de Medicina Tropical Heredia Cayetano, Lima, Peru
The clinical component within this broad institutional collaboration includes research and teaching activities (CD-ROM) on several infectious and tropical diseases. Peru still has one of the highest TB incidence rates in Latin America, due to poverty, social inequality and overcrowding. Moreover, co-infection with HIV and drug-resistant strains is on the rise. This project investigates the risk factors of drug resistance and the clinical and radiological characteristics of co-infection HIV/TB. In a first stage, the research is based on the patient population of the institute. Later it will be extended to health centres in northern Lima. There is close co-operation with the laboratory component of this institutional collaboration, including a validation study of PCR for the diagnosis of lymph node tuberculosis and methods to improve the sensitivity of sputum smear examinations. The HIV prevalence in the general population in Peru is still low, but as a reference centre for infectious diseases affiliated with a public hospital, the ITM Lima has an important population of HIV-seropositive patients, with some 215 new cases annually. The clinical and epidemiological information about all seropositive patients attending the hospital has now been computerised. Improved knowledge of this patient population will lead to better clinical management within the limits of what is economically feasible. The collaboration has also made it possible to establish an immunology laboratory capable of monitoring CD4 cell counts. Additionally, a pilot project on HIV prevention by empowering adolescents has been set up in secondary schools in northern Lima. Other clinical research subjects within this collaboration include HTLV-I, with a particular focus on opportunistic infections and the differential diagnosis of chronic skin ulcers; studies on malaria treatment and bartonellosis are being set up.
ITM promoter: J.C. Dujardin
ITM collaborators: J.C. Dujardin, E. Van den Enden, F. Portaels
External collaborators: E. Gotuzzo (promoter), T. Verdonck (ITM), C. Seas,F. Samalvides, C. Maguiña, A. Llanos, M. Cabada, M. Vidal (Instituto de Medicina Tropical Heredia Cayetano, Lima, Peru)
Support: DGDC

Institut National de Recherche Biomédicale (INRB), D.R. Congo
The general objective of this institutional collaboration is to establish the INRB as a genuine national reference laboratory for the health services and diseases control programmes of D.R. Congo. Given the poor conditions of the Congolese health system and the society in general, this is obviously a long-term commitment, which will be pursued gradually. The initial focus is therefore on the reference laboratories for parasitic diseases. In order to stimulate the national collaboration, the project also includes several collaborative projects between INRB and the national control programmes of sleeping sickness, malaria and other infectious diseases. Major investments are being made in equipment and maintenance, training and quality control, human resources and general management.
ITM promoters: T. Vervoort
ITM collaborators: P. Büscher, M. Van Esbroeck, M. Boelaert, F. Portaels,M. Borchert
External collaborators: J.J. Muyembe Tamfun (promoter), A. Lukuka,Ch. Kibonge (INRB, D.R. Congo)
Support: DGDC

Institutional collaboration with the Centre Hospitalier Universitaire de Kigali (CHUK), Rwanda
This collaboration focused mainly on clinical research, in particular HIV and associated infections. Different algorithms for diagnosis and treatment of opportunistic infections were analysed, evaluated and validated. In a first stage, improved diagnostic capabilities and equipment were put into place. The Dynabead method for CD4 counting was compared to FACSCount. A cohort of ARV-treated patients was established to evaluate the feasibility and efficacy of treatment and to investigate reasons for non-compliance.
The actual prevalence of different forms of TB was analysed with “latent class analysis”, and compared with thresholds and actual in-ward treatment. Common therapeutic problems in the hospital setting were studied with meta-analyses for pyothorax, Pott’s disease and urethral stricture, and with in-house cohorts for vesico-vaginal fistulas, fractures of elbow in children and osteomyelitis. Malaria research concentrated on attributable fraction analysis, quinine loading dose and anaemia. The value and utility of different paraclinical examinations were evaluated by decision analysis, and a start was made with the theoretical fundamentals of flow-charts.Z-score based prediction rules for mortality were evaluated.
ITM promoter: J. Van den Ende
IMT collaborators: L. Lynen, L. Kestens, L. Boel, M. Van Esbroeck, T. Vervoort.
External collaborators: J. Mugabekazi, L. Kabura, J. Vyankandondera,
E. Kayibanda, J.C. Karasi, R. Banamwana (CHUK, Rwanda)
Support: DGDC, BTC, ITM

Wuchereria bancrofti filariosis, chyluria (normal, uncentrifuged and centrifuged urine).


Publications in international peer-reviewed journals

Bauters TGM, Swinne D, Boekhout T, Noens L, Nelis HJ. Repeated isolation of Cryptococcus laurentii from the oropharynx of an immunocompromized patient. Mycopathologia 2002; 153: 133-135.
Blaxhult A, Fox Z, Colebunders R, Francioli P, Ben-Ishai Z, Fätkenheuer G, Parkin JM, Vanhems P, Phillips AN, Kirk O, EuroSIDA Study Group. Regional and temporal changes in AIDS in Europe before HAART. Epidemiol Infect 2002; 129: 565-576.
Boelaert M, Lynen L, Van Damme W, Colebunders R. Do patents prevent access to drugs for HIV in developing countries? [letter]. JAMA 2002; 287: 840-841.
Borchert M, Muyembe-Tamfum JJ, Colebunders R, Libande M, Sabue M, Van der Stuyft P. A cluster of Marburg virus disease involving an infant. Trop Med Int Health 2002; 7: 902-906.
Bottieau E, Noe A, Florence E, Ostyn B, Colebunders R. Development of multiple abscesses in an HIV/TB co-infected patient after initiation of antituberculous and highly active antiretroviral therapy. Acta Clin Belg 2002; 57: 219-222.
Colebunders R, Florence E. Neuropsychiatric reaction induced by clarithromycin [letter]. Sex Transm Infect 2002; 78: 75-76.
Colebunders R, Hilbrands R, De Roo A, Pelgrom J. Neuropsychiatric reaction induced by abacavir [letter]. Am J Med 2002; 113: 616.
Colebunders R, Kint I, Bastian I, Mortelmans E, Jacobs W, Van Marck E. Renal abscess due to Mycobacterium avium complex in a human immunodeficiency virus-positive patient. Int J Infect Dis 2002; 6: 238-239.
Colebunders R, Lambert ML. Management of co-infection with HIV and TB [editorial]. Br Med J 2002; 324: 802-803.
Colebunders R, Mariage JL, Coche JC, Pirenne B, Kempinaire S, Hantson P, Van Gompel A, Niedrig M, Van Esbroeck M, Bailey R, Drosten C, Schmitz H. A Belgian traveler who acquired yellow fever in The Gambia [electronic only]. Clin Infect Dis 2002; 35: e113-e116.
Colebunders R, Van Esbroeck M, Moreau M, Borchert M. Imported viral haemorrhagic fever with a potential for person-to-person transmission: review and recommendations for initial management of a suspected case in Belgium. Acta Clin Belg 2002; 57: 233-240.
De Baere T, Claeys G, Swinne D, Massonet C, Verschraegen G, Muylaert A, Vaneechoutte M. Identification of cultured isolates of clinically important yeast species using fluorescent fragment length analysis of the amplified internally transcribed rRNA spacer 2 region. BMC Microbiol 2002; 2(21): 8 pp.
Donners H, Willems B, Beirnaert E, Colebunders R, Davis D, van der Groen G. Cross-neutralizing antibodies against primary isolates in African women infected with HIV-1 [letter]. AIDS 2002; 16: 501-503.
Dreezen C, Schrooten W, de Mey I, Goebel FD, Dedes N, Florence E, Colebunders R, Eurosupport Study Group . Self-reported signs of lipodystrophy by persons living with HIV infection. Int J STD AIDS 2002; 13: 393-398.
Florence E, Bottieau E, Lynen L, Colebunders R. Patients with HIV infection and fever: a diagnostic approach. Acta Clin Belg 2002; 57: 184-190.
Florence E, Dreezen C, Desmet P, Smets E, Fransen K, Vandercam B, Pelgrom J, Clumeck N, Colebunders R. Ritonavir/saquinavir plus one nucleoside reverse transcriptase inhibitor (NRTI) versus indinavir plus two NRTIs in protease inhibitor-naive HIV-1-infected adults (IRIS study). Antiviral Ther 2002; 6: 255-262.
Florence E, Schrooten W, Verdonck K, Dreezen C, Colebunders R. Rheumatological complications associated with the use of indinavir and other protease inhibitors. Ann Rheum Dis 2002; 61: 82-84.
Jelinek T, Mühlberger N, Harms G, Corachán M, Grobusch MP, Knobloch J, Bronner U, Laferl H, Kapaun A, Bisoffi Z, Clerinx J, Puente S, Fry G, Schulze M, Hellgren U, Gjorup I, Chalupa P, Hatz C, Matteelli A, Schmid M, Nielsen LN, da Cunha S, Atouguia J, Myrvang B, Fleischer K, European Network on Surveillance of Imported Infectious Diseases. Epidemiology and clinical features of imported dengue fever in Europe: sentinel surveillance data from TropNetEurop. Clin Infect Dis 2002; 35: 1047-1052.
Jelinek T, Schulte C, Behrens R, Grobusch MP, Coulaud JP, Bisoffi Z, Matteeli A, Clerinx J, Corachán M, Puente S, Gjorup I, Harms G, Kollaritsch H, Kotlowski A, Björkmann A, Delmont JP, Knobloch J, Nielsen LN, Cuadros J, Hatz C, Beran J, Schmid ML, Schulze M, Lopez-Velez R, Fleischer K, Kapaun A, McWhinney P, Kern P, Atougia J, Fry G, da Cunha S, Boecken G. Imported falciparum malaria in Europe: sentinel surveillance data from the European Network on Surveillance of Imported Infectious Diseases. Clin Infect Dis 2002; 34: 572-576.
Lindenburg CEA, Stolte I, Langendam MW, Miedema F, Williams IG, Colebunders R, Weber JN, Fisher M, Coutinho RA. Long-term follow-up: no effect of therapeutic vaccination with HIV-1 p17/p24:Ty virus-like particles on HIV-1 disease progression. Vaccine 2002; 20: 2343-2347.
Magnus E, Lejon V, Bayon D, Buyse D, Simarro P, Verloo D, Vervoort T, Pansaerts R, Büscher P, Van Meirvenne N. Evaluation of an EDTA version of CATT/Trypanosoma brucei gambiense for serological screening of human blood samples. Acta Trop 2002; 81: 7-12.
Martins-Nishikawa M, Trilles L, Symoens F, Swinne D, Nolard N. Prevalence of Candida dubliniensis in the BCCM/IHEM biomedical fungi/yeasts culture collection (isolates before 1990). Med Mycol 2002; 40: 443-445.
Mocroft A, Phillips AN, Friis-Möller N, Colebunders R, Johnson AM, Hirschel B, Saint-Marc T, Staub T, Clotet B, Lundgren JD, EuroSIDA Study Group. Response to antiretroviral therapy among patients exposed to three classes of antiretrovirals: results from the EuroSIDA study. Antiviral Ther 2002; 7: 21-30.
Ostyn B, Noë A, Swinne D, Ieven M, Colebunders R. A multidrug, including voriconazole, resistant oral candida infection in an AIDS patient effectively treated with echinocandin [letter]. J Infect 2002; 44: 57-58.
Schrooten W, Dreezen C, Borleffs J, Dijkgraaf M, Borchert M, De Graeve D, Hemmer R, Fleerackers Y, Colebunders R, Eurosupport Study Group. Financial situation of people living with HIV in Europe. Int J STD AIDS 2002; 13: 698-701.
Vanderveken OM, Colebunders RL, Collier I, Vandevenne JE, Hubens G. Successful iterative drainage and partial hepatectomy for pyogenic liver abscess in a HIV seropositive patient. Acta Chir Belg 2002; 102: 59-62.
van Gool T, Vetter H, Vervoort T, Doenhoff MJ, Wetsteyn J, Overbosch D. Serodiagnosis of imported schistosomiasis by a combination of a commercial indirect hemagglutination test with Schistosoma mansoni adult worm antigens and an enzyme-linked immuno-sorbent assay with S. mansoni egg antigens. J Clin Microbiol 2002; 40: 3432-3437.


Other publications and abstracts

Antonopoulou S, Husson M, Gantois S, Seel I, Heymans C, Crokaert F, Swinne D, Nolard N, Aoun M. Comparison of three methods for testing susceptibilities of Candida spp strains [abstract]. In: Antifongiques: an updating; Société Belge de Mycologie Humaine et Animale, réunion annuelle, samedi 20 avril 2002. [Yvoir]: [U.C.L. de Mont-Godinne, Cliniques Universitaires], 2002: 19.
Antonopoulou S, Swinne D, Gantois S, Seel I, Heymans C, Husson M, Crokaert F, Nolard N, Aoun M. In vitro activity of FK-463, voriconazole, ravuconazole and posaconazole against Candida spp in cancer patients [abstract]. In: Antifongiques: an updating; Société Belge de Mycologie Humaine et Animale, réunion annuelle, samedi 20 avril 2002. [Yvoir]: [U.C.L. de Mont-Godinne, Cliniques Universitaires], 2002: 20.
Basinga P, Van den Ende J, Bisoffi Z. Intuitive versus calculated thresholds for the treatment of tuberculosis in Rwanda [abstract]. Acta Trop 2002; 83(Suppl.1): S66, Abstract Nr.TUPS042.
Bottieau E, Stevens A, Van Gompel A, Van Esbroeck M, Wuytack C, Swinne D. Remission of Fusarium solani mycetoma (Madura foot) with terbinafine [abstract]. Acta Trop 2002; 83(Suppl.1): S113, Abstract Nr.P016.
Colebunders R. Caso N. 172 [descripción, preguntas & respuestas]. Casos Microbiol Clín 2002; 4: 21-22.
Colebunders R. Vooruitgang op gebied van HIV/SOA behandeling. In: 10de Symposium Infectieziektengroep Antwerpen: Seksueel overdraagbare aandoeningen, 5 oktober 2002, Universitaire Instelling Antwerpen; proceedings. [s.l.]:[ s.n.], 2002: 55-60.
Colebunders R, Kayembe PK, Nelson AM. Opportunistic infections; 2nd ed. In: Essex M, Mboup S, Kanki PJ, Marlink RG, Tlou SD, editors. AIDS in Africa. New York: Kluwer Academic/Plenum Publishers, 2002: 355-372.
Colebunders R, Perriëns J, Van Praag E. Management of HIV disease and its complications in resource-constrained settings. In: Lamptey PR, Gayle HD, editors. HIV/AIDS prevention and care in resource-constrained settings; a handbook for the design and management of programs. Arlington: Family Health International (FHI), 2001: 603-628.
Derdelinckx I, Van Laethem K, Maes B, Schrooten Y, Dewit S, Florence E, Fransen K, Ribas SG, Marissens D, Moutschen M, Van Wijngaerden E, Vaira D, Zissis G, Van Ranst M, Vandamme AM. Drug resistance among therapy-naive HIV-infected patients studied by sequencing and VERSANT (TM) HIV-1 resistance assays (LiPA) has limited impact on treatment response [abstract]. Antiviral Ther 2002; 7(Suppl.1): S181, Abstract Nr. 167.
Dierick J, Mareen P, Sijs A, Van Houthegem H, Demey K, Van Gompel A. Hemoglobinopathiën. Folia Diagn 2002; : 68-75.
Dohmen S, Ostyn B, Collier I, Noë A, Kint I, Colebunders R. Tuberculeuse meningitis bij personen met HIV-infectie. Tijdschr Geneeskd 2002; 58: 1416-1421.
Hoerée T, Van Haegenborgh T, Colebunders R, Avonts D, Van Verseveld N, Engels R. Integrating HIV care: networking with family doctors and AIDS specialists; lessons learned from a pilot pro-ject in Flanders [abstract]. In: Integration and disease control; international colloquium, Antwerp, 26-27-28 November 2002; abstract book. Antwerp: Institute of Tropical Medicine, 2002: 56.
Honoré P, Colebunders R, Parent M, Bottieau E, Niedrig M, Schmitz H. A Belgian traveller who acquired yellow fever in the Gambia [abstract]. Acta Trop 2002; 83(Suppl.1): S38, Abstract Nr. MOPS017.
Jelinek T, Mühlberger N, Behrens R, Grobusch MP, Matteelli A, Bisoffi Z, Puente S, Coulaud JP, Clerinx J, Gascon L, Gjorup I, Harms G, Beran J, Kotlowski A, Kollaritsch H, Björkmann A, Lopez-Velez R, Nielsen LN, Hatz C, Cuadros J, Schmid M, Knobloch J, Fleisher K, Laferl H, Kapaun A, Delmont JP, Hellgren U, McWhinney P, Schulze M, Kern P, Fry G, Myrvang B, da Cunha S, Atougia J, Paul M, Stanley P, Boecken G. Clinical and epidemiological characteristics among travellers and immigrants with imported falciparum malaria in Europe: sentinel surveillance data from TropNetEurop [abstract]. Acta Trop 2002; 83(Suppl.1): S32, Abstract Nr. MOPS005.
Jelinek T, Mühlberger N, Harms G, Corachán M, Grobusch MP, Knobloch J, Bronner U, Laferl H, Kapaun A, Bisoffi Z, Clerinx J, Puente S, Fry G, Schulze M, Hellgren U, Gjorup I, Beran J, Hatz C, Matteelli A, Schmid M, Nielsen LN, da Cunha S, Atougia J, Myrvang B, Fleischer K. Imported dengue fever in Europe: sentinel surveillance data from TropNetEurop [abstract]. Acta Trop 2002; 83(Suppl.1): S145-S146, Abstract Nr. P102.
Lukuka KA, Kibonge MC, Mumba ND, Lokombe BJ, Muyembe TJJ, Van der Veken W, Büscher P, Vervoort T, Makabouza M, Betukumeso JK, Bilenge MM. Integrated serological screening for human African trypanosomiasis by first line health services in Kinshasa, D. R. Congo [abstract]. In: Integration and disease control; international colloquium, Antwerp, 26-27-28 November 2002; abstract book. Antwerp: Institute of Tropical Medicine, 2002: 57.
Lynen L, Suos PP, Leang B, Frederix K, Colebunders R, Wilson D. Management of abdominal pain in PLHA in a resource-poor setting; development and evaluation of a treatment guideline [abstract]. In: XIV International AIDS Conference: “Knowledge and commitment for action”, Barcelona, July 7-12 2002; abstract book. [s.l.]: [s.n.], 2002: 636-637, Abstract Nr. ThPeF8217.
Mühlberger N, Jelinek T, Behrens R, Grobusch MP, Weitzel T, Zoller T, Coulaud JP, Matteelli A, Puente S, Clerinx J, Gjorup I, Bisoffi Z, Corachán M, Burchard G, Kotlowski A, Kollaritsch H, Beran J, Iversen J, Schmid M, Björkmann A, Hatz C, Fleisher K, Guggemos W, Laferl H, Delmont J, Lopez-Velez R, Knobloch J, Cuadros J, Schulze MH, Hellgren U, Kapaun A, Kern P, McWhinney P, Myrvang B, da Cunha S, Atougia J, Fätkenheuer G, Zieger BW, Fry G, Weinke T. Falciparum malaria in elderly patients; observations from TropNetEurop and SIMPID surveillance data [abstract]. Acta Trop 2002; 83(Suppl.1): S31-S32, Abstract Nr. MOPS002.
Muyembe-Tamfum JJ, Borchert M, Swanepoel R, Bausch DG, Tshioko FK, Campbell P, Roth C, Sleurs H, Olinda LA, Libande M, Colebunders R, Rodier G, Leirs H, Zeller H, Van der Stuyft P, Rollin PE. Marburg hemorrhagic fever in Watsa/Durba (DRC): an endemo-epidemic phenomenon [abstract]. Infect Dis Rev 2001; 3: 43, Abstract 24.
Nulens E, Swinne D, Mullie G, Raes-Wuytack C, Gordts B, Van Landuyt HW. Primary cutaneous Cryptococcus neoformans serotype D finger infection in an immunocompetent pigeon keeper [abstract]. In: Antifongiques: an updating; Société Belge de Mycologie Humaine et Animale, réunion annuelle, samedi 20 avril 2002. [Yvoir]: [U.C.L. de Mont-Godinne, Cliniques Universitaires], 2002: 12.
Schoutens C, Rodriguez H, Catuzzo D, Swinne D. Primary cutaneous cryptococcosis after heart-lung transplantation [abstract]. In: Antifongiques: an updating; Société Belge de Mycologie Humaine et Animale, réunion annuelle, samedi 20 avril 2002. [Yvoir]: [U.C.L. de Mont-Godinne, Cliniques Universitaires], 2002: 11.
Schouteeten L, Van Damme P, Van Gompel A. Tétanos: stratégie de prévention à améliorer. Vax-Info 2002; 33: 2-4.
Schouteeten L, Van Damme P, Van Gompel A. Tetanus: vaccinatiebeleid kan beter. Vax-Info 2002; 33: 2-4.
Schrooten W, Dreezen C, Asboe D, Gordillo MV, Schönnesson L, Colebunders R. Sexual dysfunction in people treated with antiretroviral treatment [abstract]. In: XIV International AIDS Conference: “Knowledge and commitment for action”, Barcelona, July 7-12 2002; abstract book. [s.l.]: [s.n.], 2002: 72, Abstract Nr. MoPeB3254.
Schrooten W, Dreezen C, Florence E, Desmet P, Colebunders R, De Roo A. HIV clinical cohort database [abstract]. In: Health continuum and data exchange, 20th MIC Congress, December 6-7, 2002, Brussels. [s.l.]: [s.n.], 2002.
Soentjens P, Ostyn B, Florence E, Van Outryve S, Van de Velde A, Colebunders R. Portal thrombosis in a female HIV patient with acquired protein S deficiency and treated with protease inhibitors [abstract]. In: Sixth International Congress on Drug Therapy in HIV Infection, 17-21 November 2002, Glasgow, UK; abstracts. [s.l.]: [s.n.], 2002: 64, Abstract Nr. P157A.
Swinne D. Epidemiological survey on cryptococcosis in Belgium: some new features ! [abstract]. In: Antifongiques: an updating; Société Belge de Mycologie Humaine et Animale, réunion annuelle, samedi 20 avril 2002. [Yvoir]: [U.C.L. de Mont-Godinne, Cliniques Universitaires], 2002: 25.
Swinne D, Vervoort T, Nolard N. Epidemiological survey on cryptococcosis in Belgium: African imported cases [abstract]. Acta Trop 2002; 83(Suppl.1): S114, Abstract Nr.P018.
Swinne D, Wuytack C, Van Looveren K, Vervoort T, Van Esbroeck M. Imported tropical dermatophytes in Belgium: 1998-2001 [abstract]. Acta Trop 2002; 83(Suppl.1): S127, Abstract Nr. P050.
Urbain D, Belaiche J, De Vos M, Fiasse R, Hiele M, Huijghebaert S, Jacobs F, Malonne H, Speelman P, Van Gompel A, Van Gossum A, Van Wijngaerden E. Le traitement de la diarrhée aiguë; évaluation critique par un groupe interuniversitaire et recommandations; partie I: importance du problème. Louvain Méd 2001; 120: 354-361.
Urbain D, Belaiche J, De Vos M, Fiasse R, Hiele M, Huijghebaert S, Jacobs F, Malonne H, Speelman P, Van Gompel A, Van Gossum A, Van Wijngaerden E. Le traitement de la diarrhée aiguë; évaluation critique par un groupe interuniversitaire et recommandations; partie II: revues des options thérapeutiques. Louvain Méd 2001; 120: 362-372.
Urbain D, Belaiche J, De Vos M, Fiasse R, Hiele M, Huijghebaert S, Jacobs F, Malonne H, Speelman P, Van Gompel A, Van Gossum A, Van Wijngaerden E. Le traitement de la diarrhée aiguë; évaluation critique par un groupe interuniversitaire et recommandations; partie III: recommandations. Louvain Méd 2002; 121: 18-25.
Van den Enden E. Venomous snakebites [abstract]. Acta Clin Belg -2002; 57: 40.
Van den Enden E, Gotuzzo E, Torríco F, Eds. Medicina tropical [CD-ROM]. Antwerp: ITGPress, 2002.
Van Esbroeck M, Wuytack C, Van Looveren K, Vervoort T, Swinne D. Five cases of onychomycosis caused by Onychocola canadensis in Belgium [abstract]. Acta Trop 2002; 83(Suppl.1): S113, Abstract Nr.P015.
Van Gompel A, Ed. Conseils de santé pour voyageurs; édition destinée au corps médical. Brussels: MediMedia Belgium, 2002: 194 pp. (MEDASSO Headlines).
Van Gompel A, Ed. Gezondheidsadviezen voor reizigers 2002-2003; uitgave bestemd voor het medisch korps. Brussel: MediMedia Belgium, 2002: 194 pp. (MEDASSO Headlines).
Van Gompel A. Koorts bij terugkeer uit de tropen. Tijdschr Wetensch Comm Virga Jesse Ziekenhuis Hasselt 2002; 7(3): 4-9.
Van Gompel A. Malaria: diagnose, vaccinatie, geneesmiddelen. In: Ducoffre G, editor. Diagnose en surveillance van infectieuze aandoeningen, 18e seminarie, St.-Pieters-Woluwe, 22/11/02. [Brussels]: Wetenschappelijk Instituut Volksgezondheid (WIV), 2002: 21-28.
Van Gompel A. Rational approach of the indications for vaccination for the traveler “when the traveler does not have the time nor the resources” [abstract]. Acta Clin Belg 2002; 57: 41.
Van Gompel A, Ed. State of the art - behandeling importziekten; actualisering juni 2002. Ant-werpen: Instituut voor Tropische Geneeskunde (ITG), Medische Dienst - Polikliniek, 2002: 56 pp.
Van Gompel A, Ed. State of the art - traitement des maladies d’importation; actualisation juin 2002. Anvers: Institut de Médecine Tropicale (IMT), Service Médical - Polyclinique, 2002: 58 pp.
Van Gompel A, Peetermans W. Hépatite B; voyages internationaux. Vax-Info 2002; 33: 4-6.
Van Gompel A, Peetermans W. Hepatitis B; de internationale reiziger. Vax-Info 2002; 33: 4-6.
Wördemann M, Van Goethem C, Jonckheer T, Van Gompel A. Kinderen en reizen naar de tropen. J Péd Belg 2002; 4: 283-288.