Public health systems may be losing their monopoly on data about outbreaks of disease.
Researchers at Harvard Medical School and Childrens Hospital Boston found that news reports and social media can also collect accurate data, and deliver those results faster than government agencies
When the cholera epidemic began in Haiti in late 2010, clinics and hospitals began sending reports to the Ministry of Public Health, which tracked the spread of the disease.
But at the same time, cholera stories began appearing in news reports, and social media users started talking about cholera in their Internet and mobile phone messages
So we found that there were similar patterns, like when the number of cases went up, so did the amount of this informal media, and as well when the number of cases was coming down, this pattern continued in the informal media, she says.
For their study, Chunara and her colleagues looked at news reports and other online information aggregated on the four-year-old website HealthMap.org, plus Twitter messages that mentioned cholera using the Research.ly search platform.
Chunara says official public health reports and information from informal media both have their uses.
Official statistics are carefully validated but can take time to be processed and released. In contrast, news and social media reports can be much quicker, but it doesnt go through a rigorous evaluation process. So it would be a good kind of indicator that somethings about to happen or maybe a way to calculate epidemiological patterns in real time to just get an assessment of whats going on and to be able to deploy control measures a lot quicker.
As social media and other new information sources expand, Chunara says, their usefulness in the field of public health is also likely to grow.
India Achieves Milestone in Global Polio Eradication
(Published on Fri, 13 Jan 2012 23:59:49 GMT)
As India marks an important milestone in its fight against polio, international health experts say that it is too soon to declare victory. Mass vaccination has eradicated the crippling disease in many parts of the world. But polio transmission and sudden outbreaks remain a challenge in large regions of the Indian subcontinent, including Pakistan and Afghanistan, as well as in west and central Africa.
International reaction
To help India celebrate one year since its last reported case of polio, U.S. Health Secretary, Dr. Kathleen Sebelius, came to administer oral polio vaccine to Indian children. Health officials see the polio-free anniversary as a turning point in the global polio eradication program.
The number of polio cases reported in India dropped from 741 in 2009 to only 42 in 2010, and just one case was reported in 2011
What we are seeing today after 12 months without a child paralyzed by polio is that proof-positive that polio can be eradicated, said The World Health Organizations Assistant Director-General, Dr. Bruce Aylward, who leads the groups global polio eradication program. We can overcome the biological challenges, we can overcome the operational challenges to ensuring this disease is eradicated once and for all.
Out of list
In the coming weeks, India will be removed from the WHOs list of countries where polio is endemic, unless a new or previously unreported case emerges. Dr. Aylward says polio endemic countries can take lessons from the strategies that worked in India.
Northern Nigeria and Pakistan are now the key to completing global eradication, said Dr. Aylward. The challenge now, the priority now is applying the same lessons, the same ingenuity, the same innovation, the same accountability framework, the same kind of perseverance that we saw in India to get the job finished in those two countries.
Dr. Neeraj Mistry, the managing director at the Sabin Vaccine Institute says Indias success against its unique public health challenge is critically important to the global eradication effort
In India they worked with imams to actually put out the messages - that [produced] greater local acceptance and cultural acceptance of these health interventions, said Dr. Mistry.Similarly, in other parts of the world, we can find community leaders that maybe in the form of traditional healers or even faith-based leaders in communities, that will be able to put out the messages that give greater cultural acceptance to such interventions.
Danger
Polio, which can be prevented only by immunization, is caused by the wild polio virus, which attacks the central nervous system and can cause paralysis, muscular atrophy, and permanent deformity. It can also cause death. It infects mostly children living in unsanitary conditions. Experts say as long as even one child is infected there is a danger of others contracting the debilitating infection.
WHO Calls for Action on Non-Communicable Diseases
(Published on Mon, 16 Jan 2012 23:57:01 GMT)
The director-general of the World Health Organization says non-communicable diseases are among the most pressing public-health challenges of the future
Obesity, diabetes, heart attacks, cancers and other chronic diseases are growing globally. Once considered as diseases of the wealthy, they increasingly are threatening the lives of people in poor and middle-income countries
In an opening speech to the annual WHO Executive Board meeting, Director-General Margaret Chan presented an overview of the global health situation and called for action on a number of important issues
Dr. Chan urged the 34-member board to tackle the root causes of non-communicable diseases. She says the impact of non-communicable diseases comes in waves, and much of the developing world now is experiencing the first wave of chronic, debilitating, often fatal illnesses.
This is marked by growing numbers of people with raised blood pressure, raised cholesterol and the early stages of diabetes, she said. The growing prevalence of obesity and overweight, seen nearly everywhere, is the warning signal that big trouble is on its way. The second wave, which is yet to come, will be much more horrific.
For example, Chan notes more than half of the estimated 346 million people who suffer from diabetes are unaware of their disease status. Unfortunately, she says many of these people will not seek treatment until the disease has reached an advanced stage and they start to go blind or need a limb amputated. She says WHO is giving the highest priority toward the prevention of this tragic outcome.
Dr. Chan also listed a number of significant health accomplishments in the first decade of this century.
She notes the epidemics of HIV/AIDS and tuberculosis have peaked and begun to decline. Malaria also is on the decline. She says young child mortality has dropped below 10 million deaths a year for the first time in nearly six decades, with great strides being made in sub-Saharan Africa. She says the number of maternal deaths worldwide has finally begun to go down.
The global eradication of polio also is reaching its endgame. Efforts to wipe this crippling disease off the face of the earth received a boost recently with the announcement that India, one of four endemic countries, has not had a case of polio in one year.
Dr. Chan says this is the time to intensify efforts. She says governments must not become complacent. They must stay the course.
Should commitment falter, polio will come roaring back. Should our resolve waver, this will be the most expensive failure in the history of public health, she said
WHO chief Chan expressed concern at the growing inequality in income levels and opportunities, especially among young people
She cites a report from the Organization for Economic Cooperation and Development, which finds income inequality in wealthy nations has reached the worst levels seen in nearly 25 years. The report concludes that societies with the least inequality have the best health outcomes, regardless of how much they spend
Good policies that promote equity, she says, have a better chance to improve health.
US Doctor Prescribes Food as Medicine
(Published on Tue, 17 Jan 2012 15:49:24 GMT)
When patients go to see Dr. Daphne Miller, they are more likely to leave with a recipe for a wholesome meal than a drug prescription.
In 2000, Ronnie Sampson, 52, was diagnosed with neurosarcoidosis, a disease that tricks the immune system into attacking certain parts of the body.
Sampsons doctor put him on prednisone, a corticosteroid that helps to suppress the immune system.
But while the drug helped eliminate symptoms of his disease, the self-employed graphic artist started having headaches, gained weight, developed insomnia and even became diabetic.
The regular physician wasnt really spending much time with me, so I wanted to get away from my regular physician and find somebody who was more attuned to a combination of western medicine and alternative medicine, Sampson says, and my acupuncturist recommended Dr. Miller.
Ross Levy
Family physician Daphne Miller believes food - along with exercise and giving up tobacco - should be the first line of defense against modern chronic diseases.
Combination healing approach
Sampson started seeing Miller in late 2001. The family physician combines conventional and alternative healing approaches in her San Francisco medical practice
After taking an in-depth look at Sampsons medical history and lifestyle, Miller designed a customized regimen of nutrition and exercise she believed would improve his health and make him less dependent on medication
Sampson says its done both. My regular doctor had been focusing on making sure that I take my medication, and I think that Dr. Millers approach of combining medicine and lifestyle is really what turned things around for me.
Miller originally pursued traditional medical training. She studied at the prestigious Harvard Medical School and did a two-year research fellowship, funded by the National Institutes of Health, at the University of California, San Francisco.
Filling the gaps
But after she finally opened her own practice in 2000, she recognized significant gaps in her training.
I got into my private practice and suddenly realized that I really did not have the proper training to take care of the most salient issues that I was seeing every day, Miller says, which were issues related to heart disease and diabetes and cancer, all of which in some way could be traced back to nutrition and lifestyle issues.
Reuters
Dr. Miller sampled ndole - a stew made of dried bitterleaf, shrimp, peanuts and spices like ginger and garlic - in Cameroon, which has little incidence of colon cancer.
Motivated by a desire to offer her patients more holistic medical treatment, Miller set out on a three-year journey around the globe to study the traditional diets of her patients ancestors - time-tested food combinations which, in many cases, had demonstrable health benefits.
I really was surprised to see how different different cultures were in their approach to food, she says. From Iceland, which really had a fairly high animal product-based diet, to a place like Okinawa in Japan, where it really was a lot of vegetables, to a place like Copper Canyon in Mexico where it was a lot of whole-grain carbohydrates
For example, Miller found that Icelanders use their traditional fish diet, rich in omega-3 oils, to fight depression. Impressed by this kind of indigenous medical knowledge, she decided to organize it and use it in her practice. She started modifying traditional recipes with easy-to-find local ingredients to help her patients eat more nutritiously.
The Jungle Effect
She also chronicled her journey in a book called The Jungle Effect, which serves as both a nutrition cookbook and a personal travelogue.
HarperCollins
Daphne Millers book, The Jungle Effect, chronicles her visits to areas around the world which are still relatively free of modern chronic diseases.
But while Miller uses food for the prevention and treatment of modern illnesses, she believes that drugs can still play an important role in her patients lives
In some instances, I feel that diet can absolutely replace medication, and then there are other times where medication is necessary and diet is there to enhance or augment it. And that is the art of medicine.
According to Miller, many medical studies have shown the important role nutrition plays in overall well-being.
So, for example, there are studies showing that nutrition, in particular within Japan, has a lot to do with the lower rates of breast cancer amongst the elderly female population, and that nutrition, in particular in western South Africa, has a lot to do with the low rates of colon cancer amongst the rural, traditional African populations.
Food as medicine
A growing number of physicians agrees with Millers approach, including Dr. Dariush Mozaffarian, a cardiologist and associate professor at Brigham Womens Hospital at Harvard Medical School.
Reuters
Scientists are discovering that a diet rich in omega-3 fats is linked to less depression and other psychiatric problems, including bipolar disease, schizophrenia and aggressive or anti-social behaviors.
Theres lots of research which has come together to tell us that our focus should be on healthy foods, and those overall healthy, food-based dietary patterns should really be the focus of our priorities in the U.S. and globally, says Mozaffarian
Ronnie Sampson would certainly agree. After a short time on his personalized nutrition and exercise program, the San Francisco native started feeling better. And although his neurosarcoidosis is not cured, Sampson has been able to reduce his reliance on prednisone by half, and has essentially reversed his diabetes
I feel better than Ive felt in many, many years, he says. At 52, I feel healthier than I did at 40.
Sampson continues to see Miller about twice a year for checkups. He believes everyone could benefit from her holistic, integrated approach, in which food is often the best medicine.
Illinois Nightclub Caters to Mentally Challenged
(Published on Tue, 17 Jan 2012 16:48:45 GMT)
We in America no longer lock away people with mental illness or intellectual disabilities as routinely as we once did, unless their impairments are profound or theyre considered a danger to themselves or others.
People with schizophrenia, bipolar disorder, obsessions and severe anxiety or depression now often live in group homes, with their parents, or sadly, in many cases, on the street. They are among us, and sometimes we find them unsettling, strange, and even a little scary.
So people with mental illness must struggle not only with their impairments and demons, but also with the stigma of being different. Theyre watched and studied and counseled. And rarely do they find a place, as other Americans can, to just be themselves, to get together and hang out with friends, hear some tunes and share some laughs
But there is such a place in Lockport, Illinois. Each Wednesday and Saturday night at a most unusual nightclub called The Roxy, 60 or so people with mental illness, who live in group homes run by Trinity Services, can just chill out with friends and invited guests
They drink sodas and coffee at an old, wooden bar; eat snacks and watch live baseball on TV from cafe tables, listen to professional bands that come in, or grab a guitar themselves and take the stage
Couples can share romantic conversations, sometimes a kiss. A few counselors and social workers tend bar, calm fears, defuse squabbles. Some of the folks receiving services have become helpful bartenders themselves.
Its been going on like this for 14 or 15 years. And social-service agencies in other towns are copying the idea. The Roxy is so comforting a haven that parents whose troubled children are not in Trinitys group homes beg the agency to let their kids in, too
Such is the appeal of the social nights at The Roxy in Lockport, Illinois, where people with mental illness can relax and be themselves, just like everybody else.
Antibiotics Breed Drug Resistance in Pigs
(Published on Tue, 17 Jan 2012 18:45:39 GMT)
Pigs given low doses of antibiotics had more E. coli in their guts, and that bacteria showed an increased resistance to antibiotics, according to new research
The study confirms the routine practice of feeding antibiotics to food animals increases drug resistance in the bacteria living in those animals
The practice is common at large livestock operations worldwide. But experts say it is helping spawn new types of antibiotic-resistant disease organisms, fueling a global public health crisis
California executive Tom Dukes had a close call with one such superbug. He got painful stomach cramps a couple years ago. His doctor said it was a serious intestinal condition called diverticulitis and prescribed antibiotics.
Started those on Monday morning and by Tuesday night, I really felt like a million bucks, he says
But a few months later, Dukes got the symptoms again. Again, he got antibiotics. Drug failure
This time, though, they did not work. He wound up in the emergency room, in incredible pain.
Id never encountered anything like this before, Dukes says. Out of all the sports injuries and broken arms and things like that, that all paled in comparison.
Drug-resistant E. coli bacteria were escaping into his abdomen through a tear in his colon. Emergency surgery removed a 20-centimeter section
Doctors had only one type of drug left that would kill the germs. That saved his life.
Dukes is a self-described workout fanatic who spends a couple hours a day in the gym. So how does an otherwise-healthy person get a life-threatening superbug
Although well never know for sure exactly, it seems that the probable cause was basically from eating tainted meat, he says.
Healthy animals vs. sick people
Animals raised for meat at large livestock operations around the world are commonly given antibiotics to prevent disease and to help them grow bigger with less feed. In the United States, more antibiotics are used for healthy animals than for sick people.
Its a controversial practice. In a new study, U.S. Department of Agriculture researcher Thad Stanton and colleagues looked at bacteria coming out of pigs fed some of those antibiotics.
They saw increases in about 20 different antibiotic resistance genes, he says, including genes for resistance to one type of antibiotic that was not even fed to the pigs
We also saw increases in E. coli populations, which were unexpected, he says
Stanton notes that most E. coli are harmless, but some do cause disease. And even the harmless ones can pass resistance genes to their not-so-harmless cousins. Long-running debate
This study, in the Proceedings of the National Academy of Sciences, is just the latest round in a debate that stretches back four decades. It has been known for at least that long that feeding livestock antibiotics generates resistance.
But Liz Wagstrom, chief veterinarian for the National Pork Producers Council says, The bottom line is, what does that mean for either animal health or public health
Wagstrom doubts there is much impact at all. She says controls are in place at every step of the journey, from farm to slaughterhouse to market, to keep bacteria out of the food supply.
The potential adverse effects of that bacteria being resistant are just very, very small. Close to zero.
Over his 25-year career in medicine, he has watched one drug after another fall to antibiotic resistance
The resistance thats showing up in the E. coli that are coming in on meat products from antibiotic-fed farm animals is extremely concerning, he says
U.S. regulators recently restricted the use in livestock of one vital group of antibiotics and are recommending other limits. Critics say much tighter controls are needed
Control issues
But the threats are even greater in the developing world, where regulations and enforcement are weaker, says Bernard Vallat, head of the World Organization for Animal Health, OIE.
More than 100 countries have no appropriate legislation to implement control on those products, he says. In those countries, there is no control on importation, no control on registration, no control on distribution and use.
And Vallat says resistant bacteria can travel anywhere in a globalized world
Experts note that livestock are far from the only source of resistant bacteria. Use and misuse of antibiotics in people is at least as big a problem - perhaps more so
For people like Tom Dukes, who carries the bacteria in his gut, where the bacteria came from is less important than where they go.
I kinda live every day knowing its still there, he says. And if it ever gets out again, that they may not have anything to combat it this time.
Its a fear thats growing for patients and doctors around the world.
Scientists Provide Template for Developing New Anti-malarial Drug
(Published on Wed, 18 Jan 2012 21:25:28 GMT)
In a medical breakthrough, scientists have determined the workings of a protein vital to the parasite that causes malaria, a disease that annually sickens more than 200 million people around the world, and kills more than 500,000. Researchers say their analysis of the protein reveals an important weakness in the microscopic parasite, and provides a good starting point for new anti-malarial drugs.
A team of scientists at Washington University in St. Louis, Missouri, spent six years trying to understand the structure and function of a protein essential to the survival of Plasmodium falciparum. Thats the single-celled protozoan that lives inside mosquitos and is responsible for the most lethal form of malaria. The microscopic parasite needs the protein, an enzyme called PMT, to make its cell membranes, and it cannot survive without it.
Dr. Joseph Jez, who led the research team, says cracking the code of PMTs design is like finding malarias fatal weakness:
If you can target the protein and basically kill the activity of the protein, you shut down the production of building blocks for membranes which will then make the organism die off, or slow down the progression, said Jez.
Jez and his colleagues used a complex and painstaking method called protein crystallization to view PMTs molecular structure in three dimensions. He says the method was critical to their study.
If you can understand what the molecules look like in three dimensions, you can start to design or develop pharmaceuticals that target it specifically, Jez noted. The uniqueness of it is that this is a new potential anti-parasitic target for Plasmodium and also in terms of nematodes or worms, which are parasites as well.
Jez adds that because Plasmodium PMT is NOT found in human cells, any drug that targets the protein could be safely administered to humans.
Dr. Neeraj Mistry is managing director of the Global Network for Neglected Tropical Diseases. He says the research is an important step toward powerful and safe new drugs to fight the worldwide malaria plague:
It opens the door to developing new drugs that specifically affect the parasite - will not affect the host - that will not have severe side effects - will only affect the parasite, Mistry noted. Which means that upon identification of that pathway, we might be able to come up with a unique drug that actually affects that malaria parasite.
The work of identifying compounds that target the Plasmodium PMT is just beginning. But the Washington University research provides new hope not only for new anti-malarial drugs, but for compounds that can destroy a variety of disease-causing parasitic worms as well as weedy plants that all depend on the same PMT protein.
Abortion Weighs Heavily in Reproductive Rights Debate
(Published on Thu, 19 Jan 2012 17:56:04 GMT)
Its estimated there are more than 45 million abortions worldwide every year. Reproductive rights advocates say more than half are unsafe, causing many injuries and deaths among young women. They say protecting adolescent women should be part of the development agenda. The issue was discussed at an event at a Washington think tank.
Many unintended, many unsafe
Leila Hessini is director of community mobilization at Ipas, an NGO working to end preventable deaths and injuries from unsafe abortions. She spoke at a recent event at the Woodrow Wilson Center in Washington, DC.
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Every year, there are 87 million unintended pregnancies. So this is 41 percent of all pregnancies. And this is really a figure that we need to unpack and understand because so much contributes to that. Its about unmet need for contraception. Its about sexual violence. Its about contraception being unaffordable. So there are a lot of reasons that go into this, she said.
Hessini said 33 million of the unintended pregnancies are among women using contraceptives. She says that means either a failure of the contraceptive itself or in the way in which its used.
Every year there are 46 million abortions. Half of these, 21.6 million, are unsafe. The vast majority of these unsafe abortions are in the Global South. Theyre in developing countries. And 30 to 60 percent of adolescent pregnancies end in abortion, she said.
In sub-Saharan African countries, a high percentage of deaths from unsafe abortions are among adolescent women.
Abortions take place in countries where laws range from allowing easy access to no access at all.
Hessini said, Forty percent of the worlds women live in countries where abortions are available, what we say, on request. Even though theres always, as we know, different limitations and restrictions to abortion. Another 26 (percent) live in countries where abortion is only available to save a womans life or is prohibited altogether. And those you who follow the abortion debates know that abortions are totally prohibited in certain countries like Nicaragua, El Salvador, Chile, Dominican Republic, Malta and the Vatican City.
Protection of women needed
Jennifer Redner, a consultant for the International Womens Health Coalition, said too often basic rights are not protected.
In too many places, the fundamental right of every woman and girl to control her body simply isnt recognized. For a girl, control over her body and her sexual life requires more than access to health services. Her most basic human rights freedom from violence, discrimination and coercion must be protected both in their own right and to enable her access to services, she said.
Redner said solutions to the problems are not new. They just havent been fully implemented.
Multi-sectoral programming that works with adolescent girls and their communities to address the multiple barriers that girls face accessing health services, attending school, preventing early marriage, preventing violence and building the economic assets of girls will contribute to our collective goals of ensuring that girls can safely transition to adulthood and can be economically productive members of their community, she said.
Fiercely debated
Abortion, whether legal or illegal, safe or unsafe, remains a controversial, hotly debated and fought-over issue.
Taryn Hodgson is the international coordinator of the Christian Action Network based in Cape Town, South Africa.
She said, Firstly, abortion is never safe, especially not for the baby, who is killed in the process. So whether its legal or illegal abortion is never safe for the baby. Its also never safe for the woman. Statistics from the Elliott Institute, whove done peer reviewed research into post abortion issues, have found that at least over 60 percent of women are coerced into having abortions.
She said that coercion comes from parents, husbands or boyfriends. Hodgson says consequences of having an abortion include depression, nightmares and grief. She added legal abortions do not lower maternal death rates.
Maternal deaths can be prevented with adequate nutrition, basic health care and good obstetric care throughout the pregnancy at delivery and post-partum, she said.
The Christian Action Network official said this is especially true in many African countries with poor health care systems. As for women having control over their own bodies, Hodgson said, Its not a question of whether she should have control over her body. She now has a child, not a choice. The issue of childrens rights, right from conception, needs to be addressed.
South Africa legalized abortions in 1997. Hodgson says despite that theres been an increase in illegal or back street abortions because the government has not cracked down on them. Whats more, she says, pills to induce abortion are now readily available on many street corners in South Africa.
She said abortion should be banned under all circumstances, adding that cases in which the mothers life is in danger are rare. In that case, however, she said the doctor should try to save both lives and not choose who will live.
The Elliott Institute mentioned by Hodgson is in Springfield, Illinois. It says its strategy is to end abortion with compassion. And that the welfare of a mother and her unborn child are inseparable.
New Drug Makes Surgery Safer For Patients With Stents
(Published on Fri, 20 Jan 2012 01:13:01 GMT)
People who have had heart surgery often take blood-thinning drugs to prevent life-threatening blood clots from forming. But if these patients ever need surgery again, they face a dilemma. They must stop taking the anti-clotting medication several days before surgery to avoid bleeding to death in the operating room. Once off the medication, though, they risk a deadly blood clot. The ideal solution would be an anti-clotting drug that leaves the body quickly so patients can have surgery without delay. VOAs Carol Pearson reports just such a drug is on the horizon.
Heart stents open blocked arteries and restore blood flow. They can also help support weak arteries and keep them open. Stents are implanted during a common procedure called angioplasty
During this procedure, the doctor threads a thin, flexible tube with a balloon or a similar device on the end through a blood vessel to the narrow or blocked artery.
After stenting, patients are put on a blood-thinning medicine to prevent clots in the stent. The problem comes when patients taking these drugs have to have heart surgery. Cardiologist Eric Topol sums up the dilemma.
The stakes are really high once a stents been placed in an artery of the heart and if a stent clots it either results in a heart attack or the patient dying, Topol said
Dr. Topol is the director of the Scripps Translational Science Institute. He co-authored a study involving 200 patients who had heart stents and who needed open heart surgery. Half the group was given a placebo. The other half received a medication called cangrelor which patients receive intravenously
We were testing to see whether or not we could inhibit their platelets, which are the cells that form a blood clot, Topol said.
Cangrelors anti-clotting property loses effect within a few hours, so it can be discontinued just prior to surgery
The results were pretty striking on the side of being able to inhibit clotting. We were able to do that in all the patients, virtually, with this medicine cangrelor as compared to the placebo, Topol said
Not only were the patients able to have surgery sooner, Dr. Topol says, but they didnt have any trouble with bleeding.
So now we have an intravenous medication that was tested which can be used in those days between stopping the oral medications and actually undergoing the major operation, Topol said.
A report on the successful trial of the new anti-clotting drug, cangrelor, appears in the Journal of the American Medical Association.
In Senegals Prisons, a Small Victory for AIDS Awareness
(Published on Thu, 19 Jan 2012 18:42:36 GMT)
At Camp Penal maximum-security prison in Dakar, Amadou, who withholds his real name to protect his identity, is talking to his sixth and last group of prisoners about AIDS. Since early this morning, the young Senegalese activist has spoken with more than 150 detainees -- men from all over the world, some from as far away as El Salvador and France, imprisoned for everything from petty theft and fraud to rape and murder.
Amadou is no stranger to many of these inmates, having given talks and helped out at a Dakar health clinic since 2007. In December 2008, he was even arrested along with eight other men during what he calls an AIDS meeting on the outskirts of the capital. The men were charged and convicted for indecent sexual behaviour, and their eight-year sentences made international headlines. Amnesty International and Human Rights Watch intervened, and, after serving four months -- half of which was spent in Dakars notoriously overcrowded Reubeuss prison, and half at Camp Penal -- the men were freed.
Ever since, Amadou has been leading AIDS awareness talks with prisoners, one of the most vulnerable groups in this predominantly Muslim nation where prison authorities and even members of the National Alliance Against Aids -- the two groups who permit the talks -- often refuse to acknowledge the issue of men who have sex with men.
But whether they admit it or not, Amadou says, everyone knows there are sexual relations among male prisoners.
Comparative HIV-infection rates
Senegal has one of the lowest rates of HIV in sub-Saharan Africa: less than one percent of the population. But among men who have sex with men, HIV, the virus that causes AIDS, is estimated at twenty-two percent. Inmates are thought to be especially susceptible to HIV transmission due to the prison systems high incidence rate of hard drug use and forced sexual relations.
Brendan Hanlon, chief executive at AVERT, an AIDS charity based in Britain, says there are no studies showing HIV rates in Senegals prisons specifically, but that in other African countries, such as Zambia and South Africa, rates among prisoners are twice that of the general population.
The first thing is that when tackling the HIV epidemic, prisoners are often neglected and overlooked -- a phenomenon which happens worldwide, he says. And so within prisons it is difficult to obtain, for example, clean equipment for injection, and also, of course, ... condoms and also education about HIV.
Alassane Balde, head of medical staff at Camp Penal, says use of hard drugs such as crack cocaine and heroin are infrequent at the prison mostly because of its high cost. When asked about sexual relations among prisoners, he is reluctant to comment.
Their religion does not permit this sort of activity, and they are very strict about it, because it is a taboo, he says via translator. The authorities have given Amadou and his colleagues the opportunity to give these talks, but once that is finished, they do not want to continue talking about men having sex with men, because not everyone is this way.
There are currently 13 known HIV cases among Camp Penals population of more than 800 prisoners. There is no mandatory testing in place, and anonymity is strictly enforced. The men who are infected receive free anti-retroviral treatments and have monthly check-ups. But the lack of prevention strategies at the prison means other inmates may inadvertently be exposing themselves to the disease.
Hanlon says HIV reduction has been proven in prisons that offer needle-exchange programs or condom distribution.
But the issues ... especially in Muslim countries is that, for governments and for a particular prison to introduce programs such as needle exchange, such as condom distribution, it admits to an issue which the laws and the rules say shouldnt be there, he says. So its quite a difficult situation, but that is often what happens.
Winning a battle, but not the war
Although Amadou considers his prison talks a step forward in Senegals struggle against HIV, he is quick to point out that the fight cannot be won in a country where gay rights are continually shunned.
The work they are doing is not for themselves, he says via translator. It is for everyone. But is there any person of authority who would dare give this message
After Amadous talks, many prisoners asked to be tested. In the coming weeks, a medical team is expected to visit Camp Penal for voluntary HIV testing.
Meanwhile Amadou will continue giving his talks.
Charities Say Africa Drought Aid Delay Cost Tens of Thousands of Lives
(Published on Fri, 20 Jan 2012 18:57:02 GMT)
Two international aid agencies say tens of thousands of lives could have been saved if the international community had responded earlier to the 2011 drought in the Horn of Africa. A report on the investigation by charities Oxfam and Save the Children says there were clear warning signs of an impending crisis, but claims many donors wanted proof of a humanitarian catastrophe before acting to prevent one. And the charities are now issuing early warnings of a food crisis in parts of West Africa
Its estimated that between 50,000 and 100,000 people died in the drought and food crisis that hit the Horn of Africa last year - more than half of them children under five.
The U.S. government says 29,000 young children died in the space of just 90 days when the famine was at its peak.
An investigation by aid agencies Oxfam and Save the Children says many of the victims could have been saved if the world had acted earlier.
There were warnings of a food crisis issued in early 2011 and those warnings stated that the crisis would probably hit in the summer of 2011. But those warnings werent heeded and there are a number of reasons why. Essentially at the beginning of the year there were many competing priorities such as the Arab Spring, the crisis in Ivory Coast and the Japanese tsunami that had just occurred. So the attention of the international community was elsewhere, said Rocco Blume.
Rocco Blume says the international community gave very generously once the scale of the catastrophe was clear. But sophisticated early warning systems forecast a likely emergency as early as August 2010 - well before the first signs of famine surfaced.
Currently, the international aid system and the international community tend to respond to figures of malnutrition or statistics of malnutrition, said Blume. The world gets into gear when television pictures start showing starving children. Its possible to respond far earlier and to prevent that situation from occurring.
The report concludes that a culture of risk aversion caused a six-month delay in the aid effort - costing lives and money
Aid agencies have in the past been accused of crying wolf when they issue warnings before a crisis has actually hit, he said. There is a difficult balance we have to strike in giving the early warnings but also making very clear what the impact will be.
The timing of the report is no accident. Aid agencies warn another crisis is looming, this time in West Africa and the international community needs to act fast.
Right now in West Africa there are warnings that this year there will be a food crisis, said Blume. Across the countries of Niger, Mali, Mauritania and Burkina Faso, there are very low food stocks, high food prices. And the implication of this is that right now the international community needs to be providing funding and support to prevent this from becoming a dire food emergency.
Poor harvests, drought and pest infestations have been blamed for the shortages. Aid agencies warn the last food crisis in West Africa in 2010 hit 10 million people and action is needed to stop a crisis turning into a catastrophe.
NGO Warns of Effects of AIDS Funding Shortfall
(Published on Fri, 20 Jan 2012 19:21:56 GMT)
The Global Fund to Fight AIDS, Tuberculosis and Malaria is celebrating its 10th Anniversary. The fund says it has saved more than 7 and a half million lives by supporting prevention and treatment programs. However, in November, it announced it had cancelled its next funding round and that no new grants would be approved until 2014. An NGO is warning of the consequences if donors dont step forward.
De Capua report on the Global Fund to Fight AIDS TB and Malaria
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The global fund began collecting donations from governments and private foundations in January 2002. Since then, it has approved over $22 billion dollars for hundreds of programs in more than 150 countries.
About 50 countries have contributed. The United States has been the biggest donor, providing 33-percent of the funds pledged each year. In 2010, it pledged more than one billion dollars.
However, when the funds board met in Accra, Ghana, in November, officials decided to cancel the next funding round, round 11. Along with the global economic crisis came a sharp drop in donations. Officials now say most of the more than $8 billion in donations expected to arrive by the end of 2013 will be needed to renew existing grants. That leaves no money for round 11.
Dont stop
The International HIV/AIDS Alliance has released a new report on the global fund called Dont Stop Now. Alvaro Bermejo is executive director of the NGO.
We are at a point where science and the tools that we have allow us to think of a world with no AIDS and to plan it within a generation. But at that particular time, donors are faltering on their commitment. The global fund might go without enough funding and this vision will not materialize. So were calling on the donors not to stop now when were at such a crucial point in the battle against HIV, he said.
Bermejo praised the funds efforts over the last 10 years.
The global fund has been key to the response to HIV, as well as for TB and malaria. The great progress thats been achieved in these three diseases just wouldnt have been possible without it, he said.
The economic crisis has forced many AIDS-related organizations to rethink funding priorities and to become much more efficient.
Bermejo said, I think its true that we have to be as efficient as one can be and there are certainly opportunities to be more efficient still. And I think everybody is trying their best. But not funding the global fund now is a major inefficiency because you dont only lose the momentum you have, you actually slide backwards and many of the gains that weve made will be wasted.
Filling the gap
The International HIV/AIDS Alliance estimates the shortfall to be about $2 billion.
The gap that we have now is mainly produced because donors that pledged to give money to the global fund when it had its replenishment conference in New York in 2010 those pledges that were made have not been fully met. So donors havent lived up to the promises they made, said Bermejo.
The alliance report examines the potential effects of the funding shortfall in 5 countries.
In Zambia, for example, an estimated 130,000 people that need lifesaving access to antiretroviral therapy today will not be able to access it. In South Sudan, the newest country in the world, which has a very good HIV/AIDS prevention strategy that has been costed, 80 percent remains unfunded, he said.
Similar conditions are reported in Zimbabwe, Bolivia and Bangladesh.
The alliance makes three recommendations. First, it calls on donors to honor existing pledges to the global fund. Next, it says national governments must increase their own investment in HIV programs. And finally, it recommends bilateral donors fill critical service gaps not covered by existing programs. Bilateral donors are U.N. member states that provide aid directly to other countries.
The head of the International HIV/AIDS Alliance said hes still hopeful a new round of funding will be held this year, possibly even before the 19th International AIDS Conference is held in Washington, DC in July. The conference is the worlds largest AIDS related gathering.
Caffeine Safely Stimulates Premature Infants
(Published on Fri, 20 Jan 2012 18:51:23 GMT)
Caffeine is a safe and effective treatment for premature babies with breathing problems, a new study confirms.
Almost all babies who are born very prematurely have trouble breathing. For decades, doctors have treated them with the stimulant caffeine, even though there was little scientific evidence to justify it
Breathing delivers oxygen to the brain, so when an infants breathing is disrupted, it can have a critical impact on the childs development
In an earlier stage of this study, some 2,000 premature babies in nine countries were randomly assigned to get caffeine or a placebo. At 18 months, researchers found numerous advantages for the caffeine group. Those babies had half as many cases of cerebral palsy as well as lower rates of blindness, deafness and delayed mental functioning.
Now, University of Pennsylvania researchers report on an additional three and a half years of follow-up, mainly to look for possible safety issues, which might take time to develop
Lead researcher Barbara Schmidt says the new study confirms the effectiveness of the caffeine treatment, and underscores its lack of side effects.
Not only is it safe, it is more effective than any other drugs we give to babies in the nursery when they are very preterm, Schmidt says.
There were some changes in the results between the two groups of children at age 18 months and then at five years, notably that the advantage children treated with caffeine had in mental development seemed to have evaporated.
There is some residual benefit [to] the quality of the childrens motor function - if they had impaired motor function - but there is no longer any effect whatsoever on the rates of cognitive impairment, she says.
Schmidts research, published in the Journal of the American Medical Association, shows rates of cognitive impairment at five years were much lower than at 18 months - what she calls a potential for remarkable catch-up in the very premature babies as they get older, whether they get caffeine therapy or not.
Nano Tool Watches Teardrop Protein Destroy Bacteria
(Published on Fri, 20 Jan 2012 16:06:28 GMT)
California scientists attached a tiny electric circuit to a protein in the human teardrop and watched it destroy invading germs
The unique experiment, a marriage of nanotechnology and microbiology, could lead to new ways of diagnosing cancers and other illnesses in their very early stages
About a hundred years ago, a Scottish biologist discovered that proteins called lysozymes in human tears can kill bacteria. Scientists have studied the enzyme extensively, but molecular biologist Gregory Weiss at the University of California, Irvine set out to learn more
What we didnt know is that once the enzyme latches on to the side of the cell wall of the bacteria, he says, it eats all the way across the bacteria without letting go.
The tiny lysozyme breaks down the cell wall of the much bigger bacterium. Associate physics professor and collaborator Philip Collins says the scientists designed a way to study that by listening in on a molecule.
Collins and Weiss assembled columns of carbon atoms called nanotubes into a tiny transistor - an electronic switch that regulates current, just like what youd find in a computer or a smart phone. Then, Weiss says, they attached it to a single lysozyme molecule.
PG Collins, UC Irvine
University of California, Irvine scientists built an electronic nano circuit and attached it to a lysozyme molecule, to track how it kills bacteria.
The carbon nanotube is conducting electricity and as the enzyme starts going about its motion, as it starts chewing on the walls of bacteria, it changes the conductance and flow of electrons through the carbon nanotube.
Collins says the nanotubes are the worlds smallest wires. You might think of our wiring as being a tiny microphone, thats so small that we can reach and tap into the signal from a single molecule.
Weiss and Collins recorded the signals, and say the data confirmed what is already known about the enzyme
In addition Weiss says, they observed it in different chemical environments. Our technique allows us to see that. [In] previous techniques, reporter molecules would fade and prevent you from watching it for long periods of time. Whereas our technique lets us watch for a really long period of time.
Collins says the work is expanding the envelope to where these circuits can be thought of, not just as transistors or memory, but as real tools for doing new science.
Weiss adds that the research, published this week in Science, could lead to improvements in medical diagnostics
The system were describing in this paper is amazingly sensitive. And so, we think that we can drive this to the point of being able to look for single individual molecules associated with cancer, Weiss says. That means cancer or chronic illnesses could be detected very early and treated with better outcomes.
Stampedes, Heat Pose Biggest Threats in Crowds
(Published on Fri, 20 Jan 2012 20:08:47 GMT)
When vast numbers of people gather for political or sporting events, or for concerts or pilgrimages, not everyone goes home healthy. But a new analysis finds that infectious disease is not the biggest culprit
It may be a papal mass or the Hajj in Mecca, the World Cup, a rock festival, or a campaign rally. Mass gatherings like these often attract hundreds of thousands, even millions of people.
Traditionally, doctors and health authorities were concerned about the risk of infectious disease, like influenza, spreading through these large crowds
Thats still a concern, but no longer the biggest fear, says Robert Steffen of the University of Zurich. The risk has actually been dominated by sprains or lacerations, or the mortality risk due to stampedes and heat exhaustion in periods of extreme heat.
Steffen is the lead author of one of several articles in The Lancet Infectious Diseases about health issues surrounding mass gatherings.
He says some age groups are at particular risk: children are more vulnerable in stampedes, for example, and older people can be at higher risk when temperatures soar.
At the Hajj, its particularly senior adults who attend, and so they have great risk of suffering of heat stroke and of dying, Steffen says.
Stampedes and crushings at mass gatherings have claimed 7,000 lives over the past three decades. Panic often plays a role, as does the physical layout of the facility, such as narrow passages or other choke points. The mood of the crowd can also be a factor
If suddenly they get agitated, for instance, fireworks being launched within the football stadium, then they get very much afraid and try to escape.
Steffen says organizers need to avoid creating conditions that might lead to panic, stampedes, and heat stroke, as well as minor injuries such as cuts and sprains. And they have to be ready to provide medical assistance.
For those attending large gatherings, Steffen suggests steering away from any large mass of people as much as possible, and getting the necessary vaccinations before traveling. And he says people should be careful with alcohol and drugs, which can increase the risk of physical injuries.
Study Links Flu Pandemics to La Nia
(Published on Fri, 20 Jan 2012 19:42:53 GMT)
A newly-identified link between pandemic flu and the weather phenomenon known as La Nia, may one day permit advance warnings of severe influenza outbreaks.
Most of the time, influenza is a temporary annoyance. But every so often a super flu bug comes along, killing millions and sickening many more.
Jeffrey Shaman, of the Columbia University School of Public Health, notes there were four documented flu pandemics in the past century.
When we look at those four events, we see that all four of them began directly after a La Nia event in the Pacific, he says.
La Nia is a periodic cooling of Pacific ocean waters that triggers changes in global weather patterns. Among other things, that altered weather disrupts bird migrations
Birds can carry flu virus, and when their migratory patterns change, they can come into contact with other avian species they dont normally meet - birds which might carry a different strain of flu virus.
In the process, the viruses genetic material can get intermingled to create new influenza strains - in a process known as reassortment.
And its this reassortment, this creation of new sub-types that takes place - and we think its in the bird population - that generates, potentially, these pandemic strains that can infect humans and to which most of the worlds population will be susceptible, Shaman says.
La Nia events happen every few years, and most are not followed by a pandemic. But because the risk of a pandemic appears to increase after a La Nia, the next step for researchers is to get a better understanding of how birds and the flu viruses they carry are affected.
One result, Shaman says, may be the ability to improve prediction of an influenza pandemic.
Thats the thing thats exciting about it, he says. I mean, it offers this sort of tantalizing possibility that you can say, we have a La Nia coming, we need to make these preparations because we know theres an increased likelihood that a pandemic flu strain could arise and infect humans.
Bird Flu Researchers Postpone Work Amid Bioterrorism Concern
(Published on Sat, 21 Jan 2012 15:22:28 GMT)
Two separate teams of scientists trying to develop a vaccine for the H5N1 strain of bird flu have agreed to temporarily postpone their research because of growing concern that a highly-infectious version of the virus the researchers are working with could fall into the hands of terrorists or trigger a deadly pandemic
The laboratory-altered strain the scientists are working with is a potent airborne variety of H5N1 that easily could spread among humans. The original H5N1 strain of avian influenza has killed 340 people worldwide since it was first detected in 2003.
Scientists at the University of Wisconsin in the United States and at Erasmus University Medical Center in the Netherlands say they are voluntarily halting their work for 60 days. They say the two months will give governments, international organizations and the scientific community time to determine whether the research can be conducted safely
Biosecurity officials and health experts say that if the potent altered virus reached the general public, it potentially could cause a devastating pandemic. Some fear a worldwide epidemic of airborne bird flu could rival the 1918 Spanish flu outbreak that killed between 20 million and 40 million people in less than two years
The U.S.-based journal, Science and the British journal, Nature, both published the researchers announcement on Friday.
The original H5N1 strain of avian influenza is not transmitted through the air, and it does not spread easily among humans. H5N1 usually only infects people that come into direct contact diseased birds
In December, the journals, Science and Nature, reluctantly agreed to a U.S. government request not to publish key details of the H5N1 experiments because terrorists could use the information to make a biological weapon. It is not clear if or when studies will be published. Washington is funding the H5N1 research
Most H5N1 deaths have occurred in East and Southeast Asia, including China, Cambodia and Vietnam.
Some information for this report was provided by AP, AFP and Reuters.
Untreatable New Forms of TB Raising Alarm
(Published on Tue, 24 Jan 2012 22:08:43 GMT)
In the world of tuberculosis (TB) control, it is the worst-case scenario. Doctors in Mumbai, India, reported last month they are seeing a group of patients infected with what they called totally drug-resistant tuberculosis. Indian health officials are still investigating those cases, but untreatable strains of the bacterial respiratory disease have turned up before: in 15 patients in Iran in 2009 and in two patients in Italy in 2007. Public health experts responding and there is new hope some for new weapons against a disease that is killing 5,000 people every day.
The World Health Organization (WHO) lists 69 countries that have reported what is officially called extensively drug-resistant tuberculosis (XDR-TB). Its a form of the mycobacterium that, like the one reported in India, isnt killed by first- and second-line anti-TB injectable drugs. The WHO says at least 25,000 cases of XDR-TB are reported worldwide every year.
Dr. Margaret Chan, WHOs director-general, views the emergence of drug-resistant tuberculosis with alarm.
Call it what you may, a time bomb or a powder keg. Any way you look at it, this is a potentially explosive situation, she said
Officials say drug-resistant TB has been a growing problem in countries such as India and China because patients are frequently misdiagnosed and often receive inappropriate or inadequate treatment with antibiotics. Misuse of these drugs increases the danger that the target pathogen will gradually develop resistance to them.
Dr. Neeraj Mistry, a public health physician, says surveys show that very few Indian doctors are actually treating TB patients with the right drugs for the right length of time.
The emergence of totally-resistant TB is a result of failed public health intervention strategies, said Mistry. When we deliver ineffective treatment regimens and when we dont have full adherence and compliance to treatment, it enables the emergence of resistance within the individual.
Experts say that with the current arsenal of drugs failing to hold the line against TB, the need for new drugs and compounds has become more urgent. Preventing TB through vaccination is one promising strategy.
The ideal would be to develop a vaccine that works in all age groups. Everyone from newborn through the elderly, noted Dr. Ann Ginsberg of the Aeras Global TB Vaccine Foundation.
Ginsberg and her colleagues are running clinical trials on two TB vaccines they hope will provide long-lasting immunity to TB and stop transmission of the disease. If all goes as planned, she says, the vaccine will be ready by 2020.
The clinical development program for a TB vaccine is a very long process, and its long because, first of all, its the nature of the disease itself - people get infected with TB and often dont get sick for years, added Ginsberg. So when you do a vaccine trial, you have to vaccinate people and watch them for years to see whether or not they will get the TB. So that makes these clinical trials very long.
While the world waits for that TB vaccine, the WHO says a new line of TB drugs - fortified with a new class of potent anti-mycobacterial agents - could be available by the end of this year or early next.
Chemical Pollutant Reduces Effectiveness of Childhood Vaccines
(Published on Tue, 24 Jan 2012 23:59:54 GMT)
Childhood vaccinations are a staple of disease prevention. But a new study finds that when children are exposed to elevated levels of common industrial chemicals called perfluorinated compounds or PFCs, their immune systems become less responsive to routine vaccines, putting them at risk for serious illness
PFCs are everywhere in the environment. The industrial compounds are used as water repellents in rain gear, cloth, carpeting, and food packaging. The chemicals are stable and extremely persistent. Almost everyone has a detectable level of PFCs in their body from exposure through clothing or food products, or from drinking PFC-contaminated drinking water. Although the health effects of PFCs are still a poorly understood problem, a team of scientists has identified at least one very serious adverse effect on childrens immune systems
Doctor Phillipe Grandjean, at the Harvard School of Public Health in Massachusetts, and his colleagues found that children exposed to PFCs in the womb, and later exposed to elevated levels of the chemical in the environment, showed evidence of reduced immune protection against two diseases, tetanus and diphtheria
Grandjean and his team determined the effectiveness of the childhood vaccines by measuring the concentration of blood-borne antibodies against the two illnesses in a group of vaccinated children
Vaccines stimulate the bodys production of antibodies, or protective proteins, by exposing the immune system to tiny, harmless amounts of a disease-causing microorganism. Later on, if the antibodies encounter that microbial invader in force, the protein sentries alert the immune system to the presence of disease-causing organisms and specialized cells are dispatched to destroy them.
Grandjean says many children in the study who had been exposed to high levels of PFCs showed very low concentrations of tetanus and diphtheria antibodies in their blood. And some of these kids had such low concentrations that they were essentially unprotected by age seven, despite the fact that they had had four vaccinations by that time, he said
Grandjean says these children were re-vaccinated, though it is uncertain how well the vaccines will protect them from tetanus and diptheria. And he says the evidence suggests their immune system deficits might create vulnerabilities to other disease organisms as well
I mean this is the mainstay of prevention. We want our kids to be vaccinated. But the problem is if the vaccines dont work because the immune system has become sluggish because of pollution, then we have a problem, he said
The study involved 587 children, born between 1999 and 2001, in the Faroe Islands, a country in the Norwegian Sea that lies between Scotland and Iceland. Researchers chose the Faroe Islands because the diet of residents is rich in seafood, which is known to contain high concentrations of PFCs.
Grandjean says pollution by perfluorinated compounds is a global problem in need of an international solution. He notes that while the U.S. has stopped manufacturing PFCs, the chemicals are now produced in countries like China and used in a variety of imported and American-made products.
An article by Phillipe Grandjean and colleagues on the reduced effectiveness of childhood vaccinations is published in the Journal of the American Medical Association.
Childrens Asthma Not Eased by Anti-Reflux Drug
(Published on Thu, 26 Jan 2012 00:10:51 GMT)
Asthma is a chronic disorder that makes it difficult to breathe. Acid reflux is a condition in which stomach acids leak upward and irritate the esophagus. Two very different medical problems, but for some reason they often go together, making a difficult situation worse. Studies have shown that treating acid reflux in adults helps reduce the severity of their asthma attacks. Researchers wanted to find out if the same would hold true for children.
Seventeen-year-old Alaina Kvapil was diagnosed with asthma when she was 13.
When you have an asthma attack, your airways actually close up and people dont realize that you cant breathe, you cant get the air out, Kvapil said.
The World Health Organization says asthma is the most common chronic disease among children. No one knows exactly why, but studies show a link between asthma and acid reflux disease. Up to 70 percent of people with asthma have gastroesophageal reflux disease, or GERD, which occurs when food and stomach acids leak back up into the esophagus, the tube that connects the mouth to the stomach.
Children and babies can suffer from gastroesophageal reflux disease. In children, as in adults, the most common symptom is heartburn
Alaina Kvapil participated in a study to see if treating her acid reflux disease would also treat her asthma. She was one of more than 300 children who participated in the study. The study involved treating some of the children with powerful drugs called proton pump inhibitors, which reduce the amount of acid in the stomach
Dr. Janet Holbrook from Johns Hopkins School of Public Health is one of the studys co-authors. This study is important because proton pump inhibitors are widely used drugs and theres been a lot of conflicting data about whether theyre effective for the treatment of asthma, Holbrook said.
Half of the children were given a proton pump inhibitor, or PPI, along with an inhaled steroid that helps with breathing and digestive problems. The other half were given a placebo
Although medication that treats acid reflux disease often helps to relieve asthma symptoms, the children without acid reflux symptoms who took PPIs did not see any reduction in their asthma symptoms. In fact, the drugs were shown to do some harm.
In the children who were taking the active drug they tended to have more upper respiratory infections during the study. So not only is the treatment not effective...it may also come with some risk, Holbrook said.
Even in the children who had documented acid reflux, the PPI did not help their asthma symptoms
The American Lung Association helped support the study. Journal of the American Medical Association published its findings.
First Lady Announces Healthier US School Meals
(Published on Thu, 26 Jan 2012 02:37:44 GMT)
With rates of childhood obesity and hunger on the rise nationwide, the U.S. government has announced new rules for healthier school meals.
First Lady Michelle Obama announced new Department of Agriculture standards for school meals that double the portions of fruits and vegetables, cut the fat and salt, and use more whole grains, rather than white flour or white rice.
When we send our kids to school, we have a right to expect that they wont be eating the kind of fatty, salty, sugary foods were trying to keep from them when theyre at home, the first lady said.
The aim is to tackle two growing problems in the United States and around the world. On the one hand, rates of childhood obesity have nearly tripled in the U.S. since 1980. On the other, two-thirds of the 32 million children in the lunch line rely on government-subsidized or free school meals - more than ever before.
For many kids whose families are struggling, school meals can be their main or only source of nutrition for the entire day. So when we serve higher quality food in our schools, were not just fighting childhood obesity. Were taking the important steps that are needed to fight childhood hunger as well, Mrs. Obama said.
The new standards get a round of applause from nutrition advocates like Margo Wootan with the private Center for Science in the Public Interest. Its terrific. The new standards from USDA are a very important advancement for our nations kids. Itll mean healthier school lunches for 32 million kids around the country, Wootan said.
Wootan says it will cost more to use more fruits and vegetables, leaner meats and whole grains. Schools will get more government funding to help cover the cost. Wootan says it will pay off in the long run.
That investment is so important. We either pay now or we pay later. Because obesity costs this country about $150 billion a year, Wootan said.
So while the students at Parklawn got a special visit from the First Lady, school children around the country will get a longer-lasting treat: better meals on their cafeteria trays.
Medical Agency Says Thousands of AIDS Victims at Risk in Congo
(Published on Thu, 26 Jan 2012 17:51:12 GMT)
The medical aid agency Doctors Without Borders is calling on international donors and the government of the Democratic Republic of Congo to beef up funding and other resources for HIV/AIDS testing and treatment. The group estimates that some 85 percent of AIDS patients are not getting the treatment they need in that country. A statement from the group warns that up to 15,000 AIDS victims in DRC could die in the next three years because of difficulty getting life-saving drugs.
Dr. Laura Rinchey, who specializes in the treatment of HIV/AIDS, said 90 percent of her patients are virtually at deaths door when they come to her.
They often have malnutrition, as well as tuberculosis, as well as toxoplasmosis, as well as other bacterial infections or other complications such as meningitis. We are lucky in that we have a lab on site so we can identify many of the illnesses; many we treat by presumption, said Rinchey. But the problem is that the patients are so sick by that stage that the time it takes for the treatment to work is time that they do not have.
Dr. Rinchey works in a 29-bed health center in the capital Kinshasa, with more than 3,500 outpatients. She said that most Congolese do not have access to HIV testing facilities, getting tested only when they are very ill.
She said Congolese hospitals do not have an across-the-board policy to test people who are admitted to the hospital. As a result, she explained, it might be several weeks before doctors think of administering HIV tests to their patients.
The medical aid agency Doctors Without Borders this week raised the alarm on what they call a horrific situation largely ignored by international donors and the Congolese government.
Doctors Without Borders medical coordinator in DRC, Anja De Weggheleire, estimates that one and a quarter million Congolese are living with HIV, most of whom do not know they are carrying the virus. She said 350,000 people are in immediate need of life-saving anti-retroviral [ARV] treatment, but only 44,000 people - or 15 percent - have access to such treatment.
I think DRC does not receive the same emergency response to its epidemic as some other countries on this continent, said De Weggheleire.
De Weggheleire said that in her 10 years experience of being an HIV clinician, the situation in DRC is like it was in the early stages of the HIV/AIDS epidemic, long before the availability of ARVs and other treatments.
The situation as it is currently, and the state in which we see the patients arriving today, is unacceptable. The suffering that people have to undergo by delaying the treatment is unacceptable, and I hope therefore that donors will come forward very soon with more means to make treatment much [more] quickly available for all those patients, said De Weggheleire.
In particular, she called on the Global Fund to Fight AIDS, Tuberculosis and Malaria - forced to cancel its next round of grant-giving due to a shortfall of donor money - to reinstate its funding as soon as possible so that more ARVs can be provided for free. Also, she said she thinks the Congolese government needs to put more resources into treatment, covering expenses such as consultations and hospitalization.
According to Doctors Without Borders, the Democratic Republic of Congo has one of the lowest ARV coverage rates in the world. In Africa, only Somalia and Sudan have similar coverage rates. It also has among the lowest rates in western and central Africa of the prevention of mother-to-child transmission of HIV.
Only an estimated one percent of pregnant women living with HIV have access to treatment that would prevent them from passing HIV along to their unborn children. About one-third of babies exposed to HIV in the womb will end up being born with the virus.
The Bill and Melinda Gates Foundation renewed its commitment to the fund on Thursday during an annual meeting of the World Economic Forum in Davos, Switzerland.
Microsoft founder Bill Gates predicted the money will have a dramatic impact.
Its a commitment of an additional $750 million. And the way were doing that, it frees up funds for Global Fund and so they can immediately use the money and continue to save lives, whether its bed nets or TB treatment. Those are two diseases that dont get perhaps the visibility of the work done on HIV, but theyre every bit as important.
The Global Fund says its strategy has saved the lives of more than 6.5 million people around the world. It predicts the programs it supports will save more than one million additional lives this year.
The global fund was formed 10 years ago and has been used to help citizens, scientists and governments discover new and innovative ways to fight the diseases.
The fund says nearly half of all people receiving HIV treatment in low and middle-income countries receive its support. It also says 65 percent of all malaria treatments and nearly 85 percent of all tuberculosis treatments are provided by programs that it supports.
Global health organizations say the highest number of AIDS and malaria cases are in sub-Saharan Africa, and the continent also has one of the worlds highest tuberculosis-related death rates.
Gene Therapy Halts Vision Loss in Dogs
(Published on Fri, 27 Jan 2012 14:48:46 GMT)
Researchers have stopped vision decline in dogs with an inherited disease that causes blindness.
Retinitis pigmentosa (RP) is an eye disease that causes the light-sensitive cells in the retina - the rods and cones - to die.
The loss of eyesight normally happens slowly, over years or decades
RP is caused by a genetic mutation, so scientists at the University of Pennsylvanias Scheie Eye Institute and veterinary school teamed up to see if injecting a normal version of the mutant gene into dogs with the disease would stop the die-off of those light-sensitive cells
What we were able to show is that we can stop the degeneration, we can stop the cell death of both the rods and the cones, says University of Pennsylvania veterinary ophthalmologist William Beltran, the studys lead author. What the gene therapy approach is doing is, in fact, rescuing those cells that are diseased but have not died yet.
Canine RP is like the human variety, which makes dogs a good model for studying the disease and possible treatments.
Beltran says the gene therapy appears to be safe and effective in stopping the progression of the disease, but he cautions that it cant do much to reverse vision loss. It cant restore the light-sensitive cells that have died, and it cant grow new ones
Beltran says tests in humans are still an estimated four-to-five years off. He wants to do more animal testing to see, for example, if the gene therapy has a long-lasting effect
And the reason for doing so is that the likelihood is when we get to treat patients, we will be treating individuals that are at a rather later stage of degeneration.
Latrines Cut Parasite Infections in Half
(Published on Fri, 27 Jan 2012 15:05:16 GMT)
A new study shows that infection with hookworm, ringworm, and similar parasites can be dramatically reduced with a sanitation program.
The researchers found even installing simple latrines can cut infection rates in half.
Parasitic worms thrive in tropical and subtropical climates - areas that are home to some of the worlds poorest communities.
At least one billion people are thought to be infected. Sanitary facilities are frequently non-existent in these communities, and when infected people defecate in the open, the infection can spread to others who eat raw, unwashed vegetables or even just walk barefoot on contaminated soil.
The World Health Organization has endorsed a program of preventive medication. The pills, given once or twice a year, are very effective. But researcher Jrg Utzinger, of Switzerlands Tropical and Public Health Institute, says thats not enough.
Problem with this strategy is of course, after successful de-worming, the next day you can become re-infected, he said.
Removing the source of the infection can have an immediate and more lasting impact. Utzinger and his colleagues analyzed three dozen published studies and reported their findings in PloS Medicine
And what we then found [was] that people having access and use of sanitation facilities are approximately at half the risk of an infection than those people without sanitation facilities.
And when he talks about sanitation facilities, hes not talking about flush toilets. The studies indicate that even the very simplest and cheapest facilities - pit latrines - can have a dramatic impact on parasite infection rates.
Utzinger stresses that the biggest impact in combating parasite infection comes from combining different strategies.
And we need preventive measures, and sanitation is clearly one way forward. So then, the combination of sanitation, along with the drug component, [and] health education, this really should be the way forward.
Utzinger points out that these kinds of parasitic worms were once common in the southeastern United States, a region that was desperately poor until the mid-20th century. The fact that public health programs successfully eradicated these soil-transmitted parasites suggests that eliminating them in places like sub-Saharan Africa and Southeast Asia is an achievable goal.
US Called On to Lead Global Health Fund Replenishment
(Published on Fri, 27 Jan 2012 19:15:30 GMT)
The Global Fund to Fight AIDS, Tuberculosis and Malaria is marking its 10th anniversary. But celebrations have been subdued because of a lack of donations needed for future projects. The United States is being called on to lead efforts to replenish the fund, in a time of worldwide recession.
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Last November, the funds board decided to cancel its latest attempt to ask forpledges from donors. That put many planned projects in jeopardy.
There is a crisis. The global fund is functioning, but it did not get in its donor replenishments an adequate amount of money for the period 2011 to 2014. And as a result of that, it actually suspended what they call Round 11, which was supposed to take place in 2011. And because of that, many programs in many countries are now in peril, said Jeffrey Sachs, head of The Earth Institute at Columbia University, who was among those who lobbied for the funds creation.
Estimates say about $2 billion in pledges is needed for Round 11.
Nay to naysayers
Sachs said the global fund is a success story that needs to be championed.
Since the financial crisis, governments have cut back in spending in general, but many have found it convenient to cut back on spending on the worlds poorest people. This is of course a double tragedy. Often waste goes unattended, but because the poor dont have a voice they dont get heard, he said.
Sachs and others want the United States to lead efforts to replenish the fund. Theyre calling on the U.S. to propose an emergency donor meeting. If that happens, they say, Round 11 could still take place.
Sachs said the global fund has proven all the critics and naysayers wrong.
It showed how every skeptic 10 years ago who said - you could not treat AIDS in Africa, you could not get ahead of the epidemic, you could not control malaria because bed nets would not be used and every other myth that was said - has been proved wrong, he said.
Two key donors
The fund did receive good news from the World Economic Forum in Davos, Switzerland.
Two key donors cast votes of confidence with their checkbooks. Bill Gates announced a $750 million promissory note to the fund and urged support for the fund. And Japan, despite an earthquake, tsunami and a nuclear crisis, reconfirmed its $800 million pledge. These contributions are a strong endorsement of the funds impact and effectiveness and a challenge to other donors to step up, said Joanne Carter, director of the RESULTS Educational Fund.
The Bill and Melinda Gates Foundation has been one of the worlds biggest contributors to health-related programs. Over the past 10 years, it gave the global fund $650 million. Gates described the promissory note as an innovative funding mechanism.
It frees up funds for (the) global fund and so they can immediately use the money and continue to save lives. He said.
Gates says the global fund can change the fortunes of the worlds poorest countries. Supporters estimate the fund saves 100,000 lives every month by funding programs and projects in 150 countries.
Mental Stimulation Might Cut Dementia Risk
(Published on Fri, 27 Jan 2012 15:50:20 GMT)
People who engage in mentally-stimulating activities over a lifetime have lower levels of a protein in the brain associated with Alzheimers disease, a new study finds.
That supports other research which suggests reading, writing and playing games may lower the risk of dementia
Researchers worked with a group of 65 older-adult volunteers with no symptoms of Alzheimers Disease
They answered questions about how often they engaged in stimulating mental activities throughout their lifetimes. They also got PET brain scans which can identify beta-amyloid deposits. Those deposits are found in the brains of people who have Alzheimers.
University of California-Berkeley research scientist Susan Landau says the study showed a link between the quantity of deposits and the lifetime level of brain stimulation.
People who were the most cognitively active throughout their life, they had the least amyloid in their brains, she says. So, based on this association between greater cognitive activity and less amyloid, we think that these people will go on to have a reduced risk of Alzheiemers Disease.
PET scans reveal amyloid plaques, which appear as warm colors such as red, yellow and orange. On the left is a patient with Alzheimers disease, and on the right is a person with no detectable amyloid deposits in the brain. The middle scan is of a normal person with no symptoms of cognitive problems, but with evident levels of amyloid plaque in the brain. (Credit: Susan Landau and William Jagust, UC Berkeley)
Keep in mind that the people in this study, many of them in their 70s and 80s, did not show any symptoms of Alzheimers. Scientists are still trying to understand the connection between beta-amyloid deposits in the brain and dementia
Aging and a family history of Alzheimers are both considered risk factors, but we cant control those. And even if your brain hasnt been particularly active up until now, Landau says its not too late to start ratcheting up your mental activities.
I think that cognitive stimulation is probably beneficial at any age. But, what our findings from this study show, is that the more cognitively active you can be over the course of your lifespan, the better
Landau says she and her colleagues plan to follow the volunteers in this study as they age, to see whether there is a link between lifetime mental activity and Alzheimers symptoms as some of them develop dementia in the years ahead. That may help the researchers better understand the relationship between stimulating mental activities, beta-amyloid deposits and dementia.
Scientists Develop Tool to Unmask Sleeping Sickness Resistance
(Published on Fri, 27 Jan 2012 00:36:01 GMT)
A special genetic screening technique is shedding new light on why drug treatment often is ineffective against a dreaded tropical disease called sleeping sickness. The work could lead to the development of new and better drugs to control this often fatal illness.
African sleeping sickness is caused by a parasite called Trypanosoma brucei that is transmitted by the bite of a tsetse fly. Left untreated, the disease attacks the central nervous system and is often fatal
Sleeping sickness, or trypanosomiasis, is endemic throughout sub-Saharan Africa. It killed an estimated 48,000 people in 2008. Experts say trypanosomiasis cases are largely underreported, so the death rate could be higher.
There are five drugs used to treat African sleeping sickness, but little is know about how and why they are effective, or how the parasite has managed to develop resistance to the drugs
An older drug, called melarsoprol, is a highly toxic arsenic-based compound that can cause symptoms of arsenic poisoning - convulsions, fever, loss of consciousness, nausea and vomiting. But because sleeping sickness can be a lethal illness and because some of the other drugs are so expensive and difficult to administer, melarsoprol continues to be used to treat trypanosomiasis patients.
David Horn is a molecular biologist at the London School of Hygiene and Tropical Medicine who led the effort to find the source of the parasites resistance to existing treatments
By understanding resistance, we can actually maybe develop tests for resistant parasites and that can guide the intervention strategies that are used in a particular patient, Horn said.
The single-celled trypanosome contains 7,000 genes. Researchers used a special technique that switched off each gene individually. That enabled them to find 50 genes that produce proteins associated with the parasites drug resistance.
Horn says the researchers immediate goal was to understand how the protozoan developed that resistance. In time, Horn says, the research could lead to the development of new drugs using the same mechanisms or pathways that render existing African sleeping sickness drugs ineffective.
If we understand how the current drugs work, we may be able to exploit that information to make new drugs that exploit similar pathways, Horn said.
An article on drug resistance in the treatment of African sleeping sickness is published in the journal Nature.
Study Shows PFCs Can Reduce Vaccine Effectiveness
(Published on Sat, 28 Jan 2012 05:53:04 GMT)
A new study finds that children exposed to common industrial chemicals, called perfluorinated compounds or PFCs, have a reduced immune response to vaccines intended to protect them from disease. PFCs are used around the world to make waterproof rain gear and food containers, and are known to pollute drinking water and seafood. PFC contamination could have a significant impact on the effectiveness of global immunization efforts.
When children are vaccinated their immune systems produce antibodies that protect them from debilitating and potentially deadly childhood infections, such as polio, measles, diphtheria and tetanus. The protection is supposed to last a lifetime
But scientists say the effectiveness of these vaccines is severely reduced when children are exposed to high levels of PFCs:
This was quite serious because we could also see some of the children were so low in antibody concentration that they were essentially not protected. They have been vaccinated four times and vaccines had not worked, said Dr. Phillipe Grandjean of the Harvard School of Public Health.
Grandjean led a team of scientists in a study of children living on the Faroe Islands between Scotland and Iceland.
The islanders were chosen as subjects because their diet is mainly seafood, known to have high concentrations of PFCs.
The scientists followed a group of more than 500 children whod been vaccinated against diphtheria and tetanus. But children who showed elevated levels of PFCs in their blood also had very low concentrations of antibodies against these infections
It was quite a striking fact, one that I would not have anticipated, said Dr. Peter Hotez, president of the Sabin Vaccine Institute, which promotes vaccine development and delivery around the world.
Hotez said if PFCs do, in fact, interfere with antibodies and immune system functions, then the public health problem is going to be much worse in the urban slums of low- and middle-income countries, where exposure to these industrial chemicals can be much higher.
Even a modest reduction in vaccine coverage and vaccine immune responses could lead to subsequent outbreaks of childhood disease. And there is a risk that we could see recurrences of childhood killers such as diphtheria or pertussis or other childhood diseases now becoming more common in the worlds poorest countries, said Hotez.
Scientists say PFCs are stable and persistent chemicals that have been in wide use for decades - so much so that everyone probably has detectable levels of the compounds in their body.
We have not done enough in regard to protecting the population against these old compounds, and now we are stuck because we all have them in our bodies and we are all using them, said Grandjean.
Critics note that since the study was done on island residents eating a mostly fish diet, it should have taken into account polyunsaturated fatty acids [PUFAs], which are found in fish and may suppress the immune system.
Researchers say there is an urgent need to study the adverse health effects of perfluorinated compounds on larger populations
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