International Journal of Travel Medicine and Global Health
Volume:10 Issue: 3, Summer 2022

Antibiotic resistance is primarily propagated by mobile genetic elements (MGEs) around the world. As a result, antibiotic resistance genes can be found in a wide spectrum of environmental microorganisms. Environmental bacteria are not resistant to all antibiotics now accessible, despite long histories of antibiotic development and exposure. As a result, obtaining a complete resistance arsenal will be challenging. The goal of this study is to look at how the mobility of resistance determinants influences antimicrobial resistance spread. The sources, distribution, and development of resistance mechanisms in various microorganisms and bacterial populations are mosaic features that act as barriers to the spread of bacterial pan-resistance. This is critical information for a better understanding of the genesis of resistance in hazardous bacteria, which could lead to improved antibiotic therapy and the creation of new medications.

Following the discovery and identification of Vibrio cholerae, cholera disease continues to be a burden on the global community, including Nigeria. In this article, we provide an inclusive review on antimicrobial resistance (AMR) in cholera and the need for its quick interventions. Cholera spread over Asia and other continents, majorly because of poor hygiene practises since 1817, and still exists. This agent secretes a toxin called cholera toxin (CT) after ingestion of contaminated water and/or food, which adheres to the cells in the intestinal epithelial, leading to symptoms such as watery diarrhea, fever, and even death if not treated. Many antimicrobials such as tetracycline, trimethoprim/sulfamethoxazole, and ampicillin, previously effective in cholera therapy, are now reported ineffective due to emerging and developing AMR strains of V. cholerae. AMR in cholera continues to be a major public health concern. Various outbreaks have been reported in Nigeria since the 1970s. This is as a result of the acquisition of resistance genes and/or mutation. Also, irrational usage of antibiotics by people. Promising approaches such as probiotics, vaccines, phage therapy, provision of safe water and proper hygiene are ways to avert the outbreak of cholera and resistant strains in Nigeria.

Brain drain is a term used to describe the migration of highly skilled or educated people from their home country to other locations across the world. One of the existing strategies to combat the brain drain of medical students and graduates from poorer countries is the practice of conditional or bonded scholarships. Conditional scholarships have been relatively successful in stemming brain drain and have been implemented all over the world, even in developed nations such as the USA, Kuwait, and Australia, although this perspective focuses on Nepal and Malaysia as developing countries. While bonding has proven to be effective in reducing the emigration of medical graduates from poorer to wealthier countries, it is not a perfect solution. In this policy review we argue on ethical grounds that it may not be truly justifiable to limit the freedom of movement of medical graduates. Another problem associated with bonding schemes is that they further widen the gap between rich and poor in developing nations. Most countries that implement this compulsory service following graduation allow a means to escape the bond through monetary payments, which may be equivalent to the cost of their undergraduate medical education. The problem arises when wealthier graduates can pay this cost and emigrate to countries with better resources, salaries, and opportunities, while poorer students remain in their home countries. An analysis of the factors that push medical graduates away from their home countries and pull them to countries abroad is provided.

Points of entry (POE) in Pakistan serve as key conduits for international travel, transport, and trade. Central Health Establishment (CHE) is a key stakeholder in the implementation of the International Health Regulations 2005 (IHR) core capacities at POE and National Action Plan 2020 against COVID-19. A comprehensive screening plan for COVID-19 was carried out effectively despite limitations.

A descriptive study on CDC guidelines for health screening at POE was conducted from February 2020 to March 2021. Guidelines are based on 11 attributes to be implemented; these include legal and regulatory bodies to detain the travelers as suspect, isolate, and coordinate at POEs, funds for screening, well-equipped quarantine facilities, referral health care facilities, protocols for primary and secondary screening, capacity building, supply of personal protective equipment and screening tools, and provision of basic facilities at isolation areas. Data were collected using both qualitative and quantitative methods from health officers and quarantine assistants of PoEs. The analysis of CHE’s information system was performed to assess the management of traveler surveillance.

Eleven attributes were addressed for health screening according to CDC guidelines and well implemented at POE by CHE under the flagship of the MNHR&C. Primary health screening of 4,088,119 inbound travelers was conducted. Secondary health screening led to the referral of performed at airports for inbound travelers, with a positivity rate of 0.32.

Preparedness and response for COVID-19 at POE are in line with the National Action Plan of the Government of Pakistan and IHR (2005).

Employment is a major social determinant of health (SDoH) and core socioeconomic status (SES) indicator. This study used a nationally representative sample of American adults to test the association between employment and self-rated health (SRH) overall and by race.
Using data from the Health Information National Trends Survey (HINTS 2020) Cycle 4, this analysis included 1403 individuals including 1109 (79%) non-Latinx White and 294 (21%) non-Latinx Black participants. The dependent variable was SRH, the independent variable was employment, and age, sex, marital status, education, and income were the covariates. Race was the moderator.
Employment was associated with better SRH overall. A significant statistical interaction reflected racial differences in the effect of employment (above and beyond education and income) on SRH by race. The protective health effects of employment on SRH were weaker for non-Latinx Black than non-Latinx White individuals.
The association between employment and SRH varies across racial groups, and this difference can also be seen during the COVID-19 pandemic. Diminished health returns of SES indicators such as employment in non-Latinx Black individuals compared to nonLatinx White people may reflect some additional health risk for middle-class non-Latinx Black communities in the US. Sustainability of marginalization-related diminished returns (MDRs), defined as weaker effects of social determinants and resources such as employment on health outcomes for marginalized than privileged social groups, is another risk for underserved populations during pandemics. These MDRs that reflect systemic inequalities may hinder our efforts to secure equality during pandemics.

Angiotensin-converting enzyme 2 (ACE2) is the central receptor of coronavirus disease 2019 (COVID-19) in host cells. Genetic polymorphisms in the ACE2 gene may promote cardiovascular disease and systemic inflammatory injury in a patient affected by COVID-19. Thus, the genetic background may account for the substantial inter-individual diversity in illness susceptibility or severity. Our study was conducted to find a significant relationship between ACE2 rs4646142 and rs2285666 polymorphisms and susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
In this study, we randomly selected 230 samples, including 76 patients with severe clinical symptoms and 154 patients with mild clinical symptoms (the positive case of COVID-19 was confirmed by real-time reverse transcriptase polymerase chain reaction [RTPCR] assay). Then, we performed DNA extraction and investigated the polymorphisms of rs2285666 and rs4646142 by RFLP-PCR method with TaqI and Alu1 restriction enzymes.
The study population included 107 men and 123 women, and the mean (±SD) age of the participants was 42.66±10.2. First, the levels of IgM and IgG were examined, and a significant association was observed in the level of IgM between the two groups of COVID-19 patients with mild and severe symptoms, as opposed to IgG. Meanwhile, no significant difference was observed between ACE2 rs4646142 and rs2285666 polymorphisms and the severity of COVID-19.
To better understand the genetic variations in people’s susceptibility to COVID-19, this study was designed to evaluate the association between various ACE2 polymorphisms and the infection risk of SARS-CoV-2. However, no statistical difference was discovered.

The African Americans’ health paradox can be defined as better subjective health held of African American individuals compared to White individuals, despite their higher objective and medical adversities such as chronic medical conditions (CMCs). This phenomenon depicts African Americans’ relative resilience (advantage). However, most of the existing literature on this topic is limited to studies comparing African Americans and Whites. There is little research, if any, on this phenomenon among other ethnic groups. To fill this gap in the literature, this study tests the African Americans’ health paradox with consideration of Latinos as the control group. This cross-sectional study collected demographic data, socioeconomic status, CMCs, and subjective health of 734 African American and Latino older adults residing in south Los Angeles. Logistic regression was used for data analysis. 118 Latino and 616 African Americans entered our study. Overall, a higher number of CMCs was associated with lower subjective health, however, a statistically significant interaction between ethnicity and the number of CMCs suggested that this association is weaker for African Americans than Latinos, which is the African American health paradox. African Americans with a higher number of CMCs report better subjective health compared to Latinos with the same number of CMCs. This finding is indicative of a relative advantage of African Americans compared to other ethnic groups.

Blastomycosis is an endemic granulomatous fungal infection involving multiple organ systems predominantly the lungs. The diverse clinical spectra of the pulmonary disease encompass a subclinical infection, an acute infection mimicking a bacterial pneumonia and a chronic variant masquerading as tuberculosis or malignancy.

Here we report a case of a middle-aged gentleman who was evaluated for a malignant pulmonary mass which was later identified as pulmonary blastomycosis. The diagnosis of blastomycosis was made through histopathology and was retrospectively corelated with a travel history to an endemic region.

The endemicity of this infection contributes to the diagnostic dilemma in the non-endemic setup. This warrants a high clinical suspicion in patients with a chronic pulmonary syndrome with a travel history to an endemic area.