title: Spectrum and burden of neglected tropical diseases observed in an infectious and tropical diseases unit in Florence, Italy (2000-2015).
abstract: Neglected tropical diseases (NTDs) are a diverse group of acute and chronic conditions with distinct characteristics that thrive mainly among the poorest populations, almost exclusively in tropical countries. To evaluate the relevance and impact of NTDs in a temperate area, the number and features of patients diagnosed with NTDs at the Infectious and Tropical Diseases Unit (ITDU), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy between 2000 and 2015 were retrospectively reviewed. Overall 289 NTD cases were diagnosed in 283 subjects accounting for 2.4% of all patients accessing the center: 96 dengue, 62 schistosomiasis, 36 strongyloidiasis, 22 cystic echinococcosis, 19 Chagas disease, 14 leishmaniasis, 11 chikungunya, 10 cysticercosis, 6 soil-transmitted helminthiasis, 6 lymphatic filariasis, 3 trachoma, 2 onchocerciasis, and 2 leprosy. There was one fatal case of disseminated strongyloidiasis. According to the type of exposure, 145 (50.2%) NTDs were diagnosed in immigrants, 121 (41.9%) in travelers, 18 (6.3%) were autochthonous infections, while in 5 cases (1.7%), the type of exposure was unknown. The number of patients seen at the ITDU with a diagnosis of NTD increased over time (from 29 in 2000-2005 to 81 in 2006-2010, to 173 in 2011-2015). Late diagnosis and mismanagement before coming to the center were common features in several cases. Considering the increasing incidence and possible misdiagnosis of NTDs in non-endemic countries, to raise awareness about NTDs among health care providers seems to be of primary concern.
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134, Florence, Italy.|SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Zammarchi
authors.affiliation: Scuola di Scienze della Salute Umana, Corso di Studio in Medicina e Chirurgia, Università di Firenze, Florence, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Vellere
authors.affiliation: Scuola di Scienze della Salute Umana, Corso di Studio in Medicina e Chirurgia, Università di Firenze, Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Stella
authors.affiliation: SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Bartalesi
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Marianne
authors.initials: M
authors.lastname: Strohmeyer
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134, Florence, Italy. alessandro.bartoloni@unifi.it.|SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy. alessandro.bartoloni@unifi.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bartoloni
mesh_terms: D000328:Adult; D003715:Dengue / Q000453:epidemiology; D004443:Echinococcosis / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058069:Neglected Diseases / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012552:Schistosomiasis / Q000453:epidemiology; D013322:Strongyloidiasis / Q000453:epidemiology; D014330:Tropical Medicine / Q000639:trends*
keywords: Awareness; Europe; Immigrants; Italy; Mismanagement; Neglected tropical diseases; Non-endemic area; Travelers