Information on the compulsory elective module “Medicine in the Tropics and Global Health”

This subject is offered ONLY during the summer semester.

Brief description and covered topics

In this course we will illuminate how classical "tropical medicine" or "medicine in the tropics" which originated in colonial times and was largely focused on diseases primarily endemic in these regions, is now embedded in the concept of "Global Health", which takes a holistic perspective on globally acting determinants of health. Thus, this is based on the moral principle of health equity, and “health for all” as stated in the Sustainable Developmental Goal (SDG) 3 of the United Nations. SDG3 cannot be achieved in isolation. It is closely linked to other SDGs, such as SDG1 (No Poverty), SDG2 (Zero Hunger), SDG4 (Quality Education), and SDG5 (Gender Equality), among others. Therefore, it is important to highlight that health outcomes are influenced by a complex array of social, economic, and environmental factors, which cannot be addressed by a single discipline alone. Rather, a comprehensive and integrated approach is necessary to achieve these SDGs supported by (future) professionals such as yourself, that have developed the competencies to work in interdisciplinary way. This course can be seen as a first step, and it aims, to foster your understanding of the particularities of certain diseases next to the healthcare needs and practices of people in tropical regions, and how healthcare providers and policymakers can design interventions that are culturally appropriate, locally relevant, and sustainable over the long-term.

As a team with broad diagnostic, clinical and scientific experience, we have compiled an attractive portfolio of topics (see attached program). These range from the special requirements for surgery in LMIC (low-middle income countries), the special challenges of women's health, to the implementation of nationwide anti-infective therapy campaigns. We will delve into geographical, climatic, and cultural aspects that healthcare providers in the tropics encounter and which play an important role in anamnesis, examination, conversation, diagnostics, and therapy.

Key pathophysiological, epidemiological and socioeconomic issues of infectious diseases like malaria, tuberculosis and viral infections (HIV, hepatitis and dengue virus) and of certain neglected tropical diseases will be discussed. Thus, a dedicated session will explore helminthic neglected tropical diseases (NTD), emphasizing their unique health impact and the global importance of addressing these diseases to reduce health and socioeconomic inequities, and specific strategies needed to integrate their management into broader health systems. Further, one session will cover viral infections such as Dengue virus, which is identified as the world's fastest‐growing vector‐borne disease, with increasing geographical distribution as a result of global warming. An increase in dengue and other climate sensitive viruses will challenge global health systems as there are no specific treatments, and the mainstay of treatment in the critical phase is still careful fluid management. Another session will cover hepatic diseases, mainly focusing on viral hepatitis, starting from historical descriptions and clinical presentation to the causative viruses, relevant diagnostics, pathophysiology and epidemiology. Relevant treatment options, both current and in development will also be discussed, along with an overview of how other hepatic diseases can interact with viral hepatitis. Finally, a comprehensive case study of how hepatitis C was eliminated in Egypt will be discussed; providing students with an insight into disease elimination programs. You will also learn from an experienced practitioner and/or scientist working in LMIC about the importance of local traditional healing and medicine and how bridges to classical Western medicine can be built to achieve integrative, locally adapted healthcare.

As mentioned, “Health for all” cannot be accomplished without tackling both poverty and hunger alongside it. This will be illustrated by a session focused on nutrition in LMICs and how infections and environmental variables such as the use of biomass fuels and poor sanitation interact with nutrition. We will discuss westernisation, the “Nutrition Transition” and how many LMICs are now facing a “double burden of malnutrition” as obesity levels rise. Lastly, we will look at the surprising ways in which the microbiota affects aspects of nutrition such as stunting and anaemia, and whether we can harness this knowledge to find new treatments.

The course concludes with a teaching unit in which you will be instructed to carry out independent blood and stool diagnostics in a "mini-laboratory" customary in the tropics. During the course, we will also demonstrate live disease-transmitting vectors such as Anopheles, freshwater snails and Tsetse flies, a chance not to be missed!

We also always enjoy the active participation of our students!

Responsible for the course/contact data:

Dr. Fabien Ulrich Prodjinotho, fabien.prodjinotho@tum.de

Prof. Dr. med. Clarissa Prazeres da Costa, clarissa.dacosta@tum.de

  Requirements:

In principle, this elective is open to all interested medical and public health students. As the course is intended to prepare for upcoming clinical and public health traineeships/PJ Tertial in the subtropics / tropics, students with some previous experience will profit the most. In any case, the course offers plenty of room for interaction in order to deepen the topics and their understanding. From the summer semester 2019 onwards, with a few exceptions, the course will be held in English in line with the internationalisation efforts of the TUM.

  Day/Time/Place: every Friday during the summer semester from 11-13h in the „Kurssaal“ of the Institute for Medical Microbiology, Immunology and Hygiene, located on the ground floor at Trogerstrasse 30. 

Absence times: One missed date

Grade determination:

The elective participation is graded.

Depending on the number of participants, at the end of the semester the students present a subject of their choice in a short presentation or a short certificate is issued during the last lesson. Further information will follow during the course.