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                                                                                                                                                                                                             Global Health for more than 25 years

Institute of Tropical Medicine and International Health

SARS-CoV-2 („Coronavirus“): Video consultation

We are pleased to offer a video consultation people who are worried to be infected by the SARS-CoV-2 (Coronavirus) but asymptomatic or with common cold symptoms without fever like cough, runny nose, sore throat. If reccomended we offer the possibility to be tested.


Travel clinic open

Dear travelers,

The travel clinic is open Mon-Fri from 3:00 p.m. to 7:00 p.m. A visit is only possible by prior arrangement (030 450 565 712; 8a.m.-3p.m.). You will find the travel clinic at the old location, but separate from the patient area, entrance Südring 2, ground floor, room 0.0011.

In exceptional cases, travel medicine advice and vaccinations can also be carried out in the tropical medical outpatient clinic (entrance Südring 2, ground floor, room 5, Mon-Fri, 8:00 a.m.-2:00 p.m.)

The travel clinic in Berlin Buch (Helios Clinic) is currently closed.


 

The Institute of Tropical Medicine and International Health of Charité – Universitätsmedizin Berlin contributes nationally and internationally to health promotion as well as prevention and treatment of tropical diseases.

In our Travel Clinic you will be individually consulted before your travel by specialized doctors on all relevant medical questions including current recommendations on malarial prophylaxis. All necessary vaccinations are offered. The Institute is also an official yellow fever vaccination center.

In our Outpatient Clinic we offer specialized services for the diagnosis and treatment of tropical diseases. In addition, our diagnostic laboratory offers a variety of investigation with a focus on parasitic infections, including rare parasitic infections.

The main Research areas of the Institute are malaria, helminthiases, diabetes, HIV/AIDS and other infectious diseases in developing countries. On behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ) the Institute of Tropical Medicine conducts partnership projects with clinics in Rwanda, Sierra Leone and Uganda. Globally, the Tropical Institute advises and supports institutions dealing with neglected tropical diseases.

Teaching at the Institute of Tropical Medicine and International includes the internationally recognised post-graduate Master of Science in International Health Program, Diploma- and Certificate degrees. The training and further education program of the Institute addresses clinicians and other health-related professions.

News

Update on the Institute of Tropical Medicine in Pandemic Response

In addition to patient care and travel medicine, the Institute of Tropical Medicine and International Health has been active for decades in the control, containment and research of infectious diseases in the Global South. The Institute is bringing this experience to bear on the current response to the SARS-CoV-2 pandemic. Previous activities, some of which were part of the Berlin testing strategy, are summarized here:

Patient care

  • Conception, medical supervision and operation of the Corona Examination Unit (CUS) of Charité
  • Conception, establishment and operation of the CUS video consultation hour
  • Coordination and cooperation in the Charité employee examination (CUS-MA)
  • Collaboration in the coordination of the Charité internal SARS-CoV-2 vaccination campaign
  • Conception, establishment and implementation of the screening of teachers and educators for SARS-CoV-2 (until 12/2020)
  • Support of the Berlin City Mission during the outbreak in homeless shelters

Conceptions

  • Collaboration in the Berlin testing strategy
  • Distribution systems for self-swab kits
  • Conceptual design, fine tuning CoVApp and CoVMap
  • Digital tools for syndromic surveillance of respiratory disease in Berlin schools
  • Mobile teams in care facilities

Committees

  • Hygiene advisory board of the Senate Department for Education, Youth and Family Affairs
  • Berlin Test Strategy: Working group Educational Institutions (until 12/2020)

Validation of laboratory methods

  • Rapid antigen testing of patients, incl. alternative swabbing methods
  • Non-invasive PCR swabbing methods (BECOAB)
  • Antibody levels of dry blood cards (with Labor Berlin)

Studies

  • BECOSS: Berlin Corona School and Kindergarten Study
  • University Medicine Network: B-Fast: sub-project Homeless People. Support of rapid antigen testing during cold relief and digital knowledge transfer.
  • Network University Medicine: B-Fast: sub-project Returning Travelers.
  • Infect-Control: Development of building structures for infection prevention control points; PI: Institute for Industrial Building and Structural Design, TU Braunschweig.
  • Collaboration in the screening of Charité employees

Projects in Africa

  • Establishment of SARS-CoV-2 diagnostics, Rwanda Biomedical Centre/Ministry of Health, Kigali, Rwanda, with RKI and TIB Molbiol.
  • COVID-19 emergency response: Provision of diagnostics and protective materials (GIZ/BMZ) to partner clinics in five sub-Saharan African countries.
  • Staff training on COVID-19 and purchase of protective materials in partner clinic in Sierra Leone.
  • Study on COVID-19 knowledge and health behavior among pregnant women in Fort Portal, Uganda.
  • Project SicoR (with RKI): study on knowledge status and health behavior: Infection prevention and control (IPC) and COVID-19 specific IPC among healthcare providers in Public Health facilities in Rwanda.
  • SicoR: Preparation of additional support measures in Rwanda: specialist training, protective equipment, oxygen concentrators
  • Preparation of a study on SARS-CoV-2 seroprevalence and viral mutations in Africa.

Teaching

  • MSc International Health: conversion to digital teaching
  • WP24 Tropical Medicine: conversion to digital teaching

Publications/ Preprints as to SARS-CoV-2 (as of 27.01.2021)

Theuring S, Thielecke M, van Loon W, Hommes F, Hülso C, von der Haar A, Körner J, Schmidt M, Böhringer F, Mall MA, Rosen A, von Kalle C, Kirchberger V, Kurth T, Seybold J, Mockenhaupt FP (2021). SARS-CoV-2 infection and transmission in school settings during the second wave in Berlin, Germany: a cross-sectional study. medRxiv.

Lindner AK, Nikolai O, Rohardt C, Burock S, Hülso C, Bölke A, Gertler M, Krüger LJ, Gaeddert M, Tobian F, Lainati F, Seybold J, Jones TC, Hofmann J, Sacks JA, Mockenhaupt FP, Denkinger CM (2021). Head-to-head comparison of SARS-CoV-2 antigen-detecting rapid test with professional-collected nasal versus nasopharyngeal swab. medRxiv (in press Eur Respir J)

Lindner AK, Nikolai O, Kausch F, Wintel M, Hommes F, Gertler M, Krüger LJ, Gaeddert M, Tobian F, Lainati F, Köppel L, Seybold J, Corman VM, Drosten C, Hofmann J, Sacks JA, Mockenhaupt FP, Denkinger CM. Head-to-head comparison of SARS-CoV-2 antigen-detecting rapid test with self-collected anterior nasal swab versus professional-collected nasopharyngeal swab. Eur Respir J 2020 Dec 10:2003961.

Maechler F, Gertler M, Hermes J, van Loon W, Schwab F, Piening B, Rojansky S, Hommes F, Kausch F, Lindner AK, Burock S, Rössig H, Hartmann C, Kirchberger V, Thieme A, Behnke M, Gastmeier P, Mockenhaupt FP, Seybold J. Epidemiological and clinical characteristics of SARS-CoV-2 infections at a testing site in Berlin, Germany, March and April 2020-a cross-sectional study. Clin Microbiol Infect 2020;26(12):1685.e7-1685.e12.

Kurth F, Roennefarth M, Thibeault C, Corman VM, Müller-Redetzky H, Mittermaier M, Ruwwe-Glösenkamp C, Heim KM, Krannich A, Zvorc S, Schmidt S, Kretzler L, Dang-Heine C, Rose M, Hummel M, Hocke A, Hübner RH, Opitz B, Mall MA, Röhmel J, Landmesser U, Pieske B, Knauss S, Endres M, Spranger J, Mockenhaupt FP, Tacke F, Treskatsch S, Angermair S, Siegmund B, Spies C, Weber-Carstens S, Eckardt KU, Schürmann D, Uhrig A, Stegemann MS, Zoller T, Drosten C, Suttorp N, Witzenrath M, Hippenstiel S, von Kalle C, Sander LE. Studying the pathophysiology of coronavirus disease 2019: a protocol for the Berlin prospective COVID-19 patient cohort (Pa-COVID-19). Infection 2020;48:619-626.

Lindner AK, Nikolai O, Rohardt C, Kausch F, Wintel M, Gertler M, Burock S, Hörig M, Bernhard J, Tobian F, Gaeddert M, Lainati F, Corman VM, Jones TC, Sacks JA, Seybold J, Denkinger CM, Mockenhaupt FP (2021). SARS-CoV-2 patient self-testing with an antigen-detecting rapid test: a head-to-head comparison with professional testing. medRxiv.

Lindner AK, Sarma N, Rust LM, Hellmund T, Krasovski-Nikiforovs S, Wintel M, Klaes SM, Hoerig M, Monert S, Schwarzer R, Edelmann A, Martinez GE, Mockenhaupt FP, Kurth T, Seybold J (2020). Monitoring for COVID-19 by universal testing in a homeless shelter in Germany: a prospective feasibility cohort study. medRxiv.

Thielecke M, Theuring S, van Loon W, Hommes F, Mall MA, Rosen A, Böhringer F, von Kalle C, Kirchberger V, Kurth T, Seybold J, Mockenhaupt FP (2020). SARS-CoV-2 infections in kindergartens and associated households at the start of the second wave in Berlin, Germany – a cross sectional study. medRxiv.

Hommes F, van Loon W, Thielecke M, Abramovich I, Lieber S, Hammerich R, Gehrke-Beck S, Linzbach E, Schuster A, von dem Busche K, Theuring S, Gertler M, Martinez GE, Richter J, Bergmann C, Bölke A, Böhringer F, Mall MA, Rosen A, Krannich A, Keller J, Bethke N, Kurzmann M, Kurth T, Kirchberger V, Seybold J, Mockenhaupt FP (2020). SARS-CoV-2 infection, risk perception, behaviour, and preventive measures at schools in Berlin, Germany, during the early post-lockdown phase: A cross-sectional study. medRxiv.

Krüger L, Gaeddert M, Tobian F, Lainati F, Gottschalk C, Klein J, Schnitzler P, Kräusslich H, Nikolai O, Lindner A, Mockenhaupt F, Seybold J, Corman V, Drosten C, Pollock N, Knorr B, Welker A, de Vos M, Sacks J, Denkinger C (2020). Evaluation of the accuracy and ease-of-use of Abbott PanBio - A WHO emergency use listed, rapid, antigen-detecting point-of-care diagnostic test for SARS-CoV-2. medRxiv.

Krüger L, Gaeddert M, Köppel L, Brümmer LE, Gottschalk C, Miranda I, Schnitzler P, Kräusslich H, Lindner A, Nikolai O, Mockenhaupt F, Seybold J, Corman V, Drosten C, Pollock N, Cubas-Atienzar A, Kontogianni K, Collins A, Wright AH, Knorr B, Welker A, de Vos M, Sacks J, Adams E, Denkinger C (2020). Evaluation of the accuracy, ease of use and limit of detection of novel, rapid, antigen-detecting point-of-care diagnostics for SARS-CoV-2. medRxiv.

Specht A, Sarma N, Hellmund T, Lindner A (2020). Charité COVID-19 Projekt für und mit Obdachlosen in Berlin - Unterstützung der Antigen-Schnelltestung während der Kältehilfe und digitale Wissensvermittlung. Zeitschrift „wohnungslos“. Verlag BAG Wohnungslosenhilfe e.V. Berlin.

 

Inclusion of over 3,500 patients in rapid antigen testing studies

From May 2020 to February 2021, more than 3,500 patients were enrolled in studies of SARS-CoV-2 antigen rapid tests at the Coronavirus Investigation Unit of Charité at Campus Virchow-Klinikum. The studies were conducted in cooperation with the University of Heidelberg and the Foundation for Innovative New Diagnostics, the WHO collaborating partner for COVID-19 diagnostics. The studies included independent clinical validation of various rapid antigen tests, testing of simplified swabbing procedures, up to self-swabbing and test use by lay persons. The study data contributed to the WHO recommendation of the first rapid SARS-CoV-2 antigen tests and paved the way for new testing concepts through the evaluation of nasal swabbing procedures and self-administration.

Publications / Preprints (as of 26.01.2021):

1.            Lindner AK, Nikolai O, Kausch F, et al. Head-to-head comparison of SARS-CoV-2 antigen-detecting rapid test with self-collected anterior nasal swab versus professional-collected nasopharyngeal swab. Eur Respir J. 2020 Dec 10.

2.            Lindner AK, Nikolai O, Rohardt C, et al. Head-to-head comparison of SARS-CoV-2 antigen-detecting rapid test with professional-collected nasal versus nasopharyngeal swab. medRxiv. 2021:2020.12.03.20243725. (in press Eur Respir J)

3.            Krüger LJ, Gaeddert M, Tobian F, et al. Evaluation of the accuracy and ease-of-use of Abbott PanBio - A WHO emergency use listed, rapid, antigen-detecting point-of-care diagnostic test for SARS-CoV-2. medRxiv. 2020:2020.11.27.20239699.

4.            Krüger LJ, Gaeddert M, Köppel L, et al. Evaluation of the accuracy, ease of use and limit of detection of novel, rapid, antigen-detecting point-of-care diagnostics for SARS-CoV-2. medRxiv. 2020:2020.10.01.20203836.

5.            Lindner AK, Nikolai O, Rohardt C, et al. SARS-CoV-2 patient self-testing with an antigen-detecting rapid test: a head-to-head comparison with professional testing. medRxiv. 2021:2021.01.06.20249009.

Kontakt: andreas.lindner(at)charite.de

Berlin Corona School Study (BECOSS): SARS-CoV-2 Infections in Schools and Kindergardens

The SARS-CoV-2 pandemic particularly affects children and adolescents, as schools and daycare centers are temporarily closed as part of lockdown measures. The health, psychological, social, and economic harms of such closures are significant. In contrast, data actually collected in schools and daycare centers on the frequency and transmission of the virus are rare.

The aim of this long-term study is to record infection and transmission in the environment of educational institutions through repeated screening. For this purpose, students, day-care center children, teachers, educators and their family members are repeatedly examined over a period of one year. At regular intervals, tests (PCR detection and antibodies) are carried out at each 12 randomly selected primary schools, secondary schools and daycare centers. In addition, extensive data on health, hygiene-related and social behaviors are collected.

The first two rounds of testing in 24 school classes were conducted in June and November 2020, and in daycare centers in September 2020 and January 2021, with additional rounds of testing planned for February and early summer 2021. Data from summer 2020 indicate a very low incidence of infection in educational settings. Surveys of schools at the peak of the second pandemic wave in November 2020 point to the occurrence of commonly asymptomatic infections and the absence of secondary infections in classrooms, as well as isolated spread to household settings.

Project management: Prof. Dr. Frank Mockenhaupt

Core team: Dr. Franziska Hommes, Jennifer Körner, Dr. Marlene Thielecke, Dr. Stefanie Theuring, Welmoed van Loon, Annkathrin von der Haar.

Cooperation partners: Charité: Institute for Public Health, Medical Directorate, BIH, Department of Pediatric Pulmonology, Immunology and Critical Care Medicine; Berlin Testing Strategy; Laboratory Berlin; German Red Cross Blood Transfusion Service, Frankfurt.

Funding: Senate of Berlin

Kontakt: teststrategie(at)charite.de

Publications / Preprints (as of 29.01.21)

Theuring S, Thielecke M, van Loon W, et al. SARS-CoV-2 infection and transmission in school settings during the second wave in Berlin, Germany: a cross-sectional study.

Hommes F, van Loon W, Thielecke M, et al. SARS-CoV -2 infection, risk perception, behaviour, and preventive measures at schools in Berlin, Germany, during the early post-lock down phase: A cross-sectional study.

Thielecke M, Theuring S, van Loon W, et al. SARS-CoV-2 infections in kindergartens and associated households at the start of the second wave in Berlin, Germany – a cross sectional study.

Charité COVID-19 project for and with homeless people

The Charité COVID-19 project for and with homeless people supports emergency shelters during cold weather relief in outbreak risk management, especially through the use of rapid antigen testing. The project is part of the nationwide University Medicine Network, funded by the German Federal Ministry of Education and Research. A pilot study on universal testing in an emergency shelter for homeless people has already been conducted in summer 2020.

Homeless people have less access to digital media. The so-called "digital gap" shows that digitalization is accompanied by technical and socioeconomic barriers for many people without shelter. Part of the structural exclusion from society is also that homeless people are hardly ever directly addressed via digital offerings. The project has therefore created digital information offers on COVID-19 that are suitable for the addressees. They were developed and implemented with and for people with lived experience on the street. 

The interdisciplinary team (medicine, public health, social work, media communication, people with lived experience) works closely together with the Robert Koch Institute and the shelters. 

Publications / Preprints (as of 26.01.21)

Lindner AK, Sarma N, Rust LM, et al. Monitoring for COVID-19 by universal testing in a homeless shelter in Germany: a prospective feasibility cohort study. medRxiv. 2020:2020.10.04.20205401.

Specht A, Sarma N, Hellmund T, Lindner AK. Charité COVID-19 Projekt für und mit Obdachlosen in Berlin - Unterstützung der Antigen-Schnelltestung während der Kältehilfe und digitale Wissensvermittlung. Zeitschrift „wohnungslos“, Dezember 2020, Verlag BAG Wohnungslosenhilfe e.v.  Berlin.

Kontakt: andreas.lindner(at)charite.de

 

eHealth: university and clinic partnerships in Sierra Leone and Rwanda

Projects on the use of digital strategies in African hospitals

The digitization of health cares has also and especially in middle and low income countries the potential to overcome long-standing problems. The Institute for Tropical Medicine and International Health has acquired two projects of the Federal Ministry for Economic Cooperation and Development on eHealth in Africa. Sierra Leone focuses on the quality of care in obstetrics. Peripheral health care facilities will be connected to the reference maternity clinic in Freetown through a telemedicine counseling app. In Rwanda and a network with five other German-African clinic partnerships, mobile technologies are used to transfer findings from the laboratory to the hospital bed. This should ensure early and targeted antibiotic therapy and thus counteract the emergence and spread of antibiotic resistance.

Contact: stefanie.theuring(at)charite.de

Ebola emergency preparedness in Rwanda

Training, consulting and installation of isolation stations at hospitals

"The Ebola outbreak in the eastern Congo is still not under control and the danger of a regional spread high." (Federal Foreign Office, Berlin, 28.8.2019).

Since August 2018, in the Democratic Republic of Congo more than 3000 people have contracted Ebola, and 2000 people died. Rwanda too is feared for spreading the epidemic. For this reason, the Institute of Tropical Medicine and International Health has been supporting training and counseling measures there since 2018, and is also carrying out training courses within the framework of the 10-year clinic partnership with the University Hospital in Butare.

At the moment we are working together with the Robert Koch Institute, the Technical University of Braunschweig and the Rwandan health authorities to improve the protection of infection for the medical staff in bordering hospitals. This can help to detect, isolate and treat Ebola cases early in the event of a spillover epidemic. Most recently in August 2019 Dr. Maximilian Gertler from the Institute of Tropical Medicine and International Health in a joint mission with the local partners mentioned. At five hospitals in the west and south of the country as well as in the capital Kigali assessments of infection protection and counseling were made. At several locations, training-related and structural measures and measures for the optimization of infection control are now in preparation.

Contact: maximilian.gertler(at)charite.de

Summer School „Climate Change and Global Health“

Climate change affects health especially in the poorest countries

Climate change has significant consequences for individual and global health. In the framework of the Alumni Network of the Master Program International Health, the Institute of Tropical Medicine and International Health at the end of August 2019 will give a one-week summer school on climate change and global health. The participants from 20 countries discussed not only the health effects, but also aspects of air pollution, economy and justice. The Summer School is planned in the next years.

Contact andrea.stanglmair(at)charite.de

New WHO treatment guidelines for African trypanosomiasis

A new oral therapy for African trypanosomiasis allows a simplification of the therapy. The new WHO guideline has been prepared in collaboration with the Institute of Tropical Medicine and International Health.

The sleeping sickness (African trypanosomiasis) is a neglected tropical disease that leads to death without treatment. After devastating epidemics in the last century, intensive control measures are being carried out on a historically low number of 977 reported cases in 2018. A simplification of the diagnosis and therapy are essential elements. However, the current standard therapy for stage II of the West African form (NECT: nifurtimox-eflornithine combination therapy) requires inpatient care and complex logistics for the transport of the drugs.

An oral therapy, fexinidazole, was developed by DNDi (Drugs for Neglected Diseases Initiative), a non-profit organization, and its partners. Fexinidazole, effective in both disease states, greatly facilitates clinical practice; a lumbar puncture for staging can be avoided in many cases. By oral therapy the treatment finds place close to home, even in remote and unstable regions. However, NECT continues to be first-line therapy in a very advanced stage of the disease.

A new WHO guideline for the treatment of West African sleeping sickness was published in August 2019. Dr. Andreas Lindner from the Institute of Tropical Medicine and International Health was a member of the Guidelines Development Group. Congo (University of Kinshasa, Ministry of Health) and Uganda (Ministry of Health), the Tropical Institute in Lisbon, the University of Glasgow, the Institute for Development Research in Montpellier, the University Hospital Geneva, the Swiss Tropical and Public Health Institute in Basel and representatives of the WHO Secretariat of Brazzaville, Kinshasa and Geneva.

Contact: andreas.lindner(at)charite.de

PVL-CoCo: skin infections in travelers and contact persons

New study on the transmission of imported Staphylococcus aureus

Staphylococcus (S.) aureus is a bacterium that frequently affects humans. Normally it doesn't  lead to health problems. However in purulent skin and soft tissue infections S. aureus is a common pathogen. If S. aureus has the Panton-Valentine leukocidin (PVL) the virulence is significantly increased. PVL is especially associated with severe and recurrent skin and soft tissue infections (large skin abscesses).

Infections with a PVL strain are often described by travelers. At the Institute of Tropical Medicine and International Health of the Charité, about 30-50 patients every year are treated with one PVL strain. Diagnosis and treatment of infections with imported, PVL-producing S. aureus are hardly known in Germany and insufficiently researched.

StaphTrav (www.staphtrav.eu) is a network of 12 centers in 7 European countries that investigates the import of S. aureus with features such as MRSA and PVL toxin in intercontinental travelers with purulent skin infections. The Tropical Institute Berlin has included over 400 patients in this study since 2011. The resulting experience and insights form the basis of a new study, "PVL-CoCo" (contact cohort), which started in January 2019. "PVL-CoCo" investigates the extent to which PVL-positive staphylococci are transmitted from sick returnees to their close contacts and what measures should be taken. "PVL-CoCo" is a collaboration with the University of Heidelberg (Institute of Global Health and Department of Infectiology, Medical Microbiology and Hygiene).

Contact: andreas.lindner(at)charite.de

Echinococcosis: the importance of an early diagnosis

Tapeworms in dogs and foxes

Cystic (dog tapeworm) and alveolar (fox tapeworm) Echinococcosis may produce no symptoms many years and can show life-threatening development after years. The pathogens are present also in Germany. However, our examinations show that especially migrants from the Middle East and Afghanistan are particularly affected, how a specific screening of people from these regions show. At the Tropical Medical Outpatient Clinic, patients with suspected echinococcosis are examined and co-supervised. Our Outpatient Clinic cooperates with partners in Germany and abroad, especially with the Universities of Pavia / Italy and Ulm. Within the Charité we cooperate with various departments for optimal and sophisticated treatment including minimally invasive, percutaneous and surgical therapies.

Contact: joachim.richter(at)charite.de

Shistosomiasis rapid test of African migrants

New rapid test for often not diagnosed infection among migrants from Africa

Schistosomiasis, also known as bilharzia, is an infection caused by a parasitic worm that lives in fresh water in subtropical and tropical regions. The worm or fluke (Päarchenegel) affects preferentially the blood vessels of the intestines and the urinary system. Between contagion and outbreak pass often many year, during which this illness doesn't show symptoms. The diagnosis could be significantly simplified by a new rapid test, that could be done in peripheral clinics ad medical practices. The Institute for Tropical Medicine and International Health in cooperation with the Vivantes Hospital, University Hospital Homburg / Saar, "Charité helps", established colleagues and the Bernhard Nocht Institute tests the reliability of the Circulating Cathodic Antigen (CCA) rapit test. The results are expected by the end of the year.

Contact frank.mockenhaupt(at)charite.de

Institute of Tropical Medicine and International Health in Berlin