MOST EFFECTIVE DRUGS FOR HIV/TB NOW OUT!

Erle Frayne Argonza

Tuberculosis could be a way to contract HIV, and cases encountered in the field are replete with this route to the dreaded disease.

From Cape Town comes a welcome news about a wonder drug that is most effective for treating patients who become sick of HIV precisely thru the TB way.

The good news is contained below.

[28 August 2008, Quezon City, MetroManila]

 

Scientists reveal ‘most effective’ drug for HIV/TB patients

Carol Campbell

15 August 2008 | EN | 中文

Efavirenz capsules

Flickr/MikeBlyth

[CAPE TOWN] The antiretroviral drug efavirenz has been recommended for tuberculosis patients who then contract HIV.

Researchers compared the effectiveness of the antiretroviral drugs efavirenz and nevirapine in 4,000 South African HIV patients. Some already had tuberculosis (TB) and were taking rifampicin.

Nevirapine — the cheaper of the two drugs — was found to be less effective in patients with existing TB, with higher HIV loads in their blood than those on efavirenz.

HIV-infected patients who were already on antiretroviral drugs when they subsequently developed TB were unaffected, highlighting the complexity of treating concurrent HIV and TB infections.

Researchers from the Western Cape provincial health department, Médecins Sans Frontières and the University of Cape Town (UCT) published their findings in the Journal of the American Medical Association (6 August).

Study leader Andrew Boulle warns that the research is not a rejection of nevirapine, which is popular in the developing world because of its low cost, simplicity of use and its safety for pregnant HIV-infected women.

“Four out of five of our patients in the study continued to do well on nevirapine,” said Boulle, a public health specialist from the School of Public Health and Family Medicine at UCT.

The long-standing anti-TB drug rifampicin slows down the liver’s ability to process nevirapine, making the anti-HIV drug less effective and causing an increase in virus levels.

Efavirenz is only slightly affected by rifampicin, said Katherine Hildebrand, another UCT researcher. But it costs twice the price of nevirapine. “We need to get the price of efavirenz down in places with high HIV/TB co-infection,” she told SciDev.Net.

The research also disproves earlier assumptions that people with both TB and HIV may need increased doses of efavirenz. Researchers found that efavirenz in normal doses was ideal for HIV patients regardless of whether they had TB or not.

“Efavirenz should be used unless there are compelling reasons not to use it. Unfortunately many developing countries do not have access to efavirenz which is more expensive,” said Gary Maartens from UCT medical school’s clinical pharmacology division. Botswana and South Africa both use efavirenz extensively.

Link to abstract in Journal of the American Medical Association

 

EPIDEMIC CONTROL VIA EDUCATION: SRI LANKA’S KIDNEY DISEASE CASE

Erle Frayne Argonza

 

Kidney diseases are potentially fatal, and I’d say this from out of experience. I suffered from nephritis at Age 8, and lucky was I to survive a two-year agony due to medication availability in my home town (it was almost a 4^th World town then!). That ailment ruined my chance to do athletics in grade school, it made me shrink in esteem, and the weak kidney (aside from weak tonsils) contributed to my sickliness since then.

 

So it pays not only to understand the ailment, its diagnostics and medication. It pays all the more to know the preventive side of the ailment or any ailment for that matter. If the diagnostics side shows some shades of grey, then that could surely baffle the experts (medical scientists) and specialists, as a case proves in Sri Lanka.

 

Read the news below about Sri Lanka. The ‘good’ news about it is that the ailment has provided some nice research problems for the public health experts and pharmacologists.

 

[28 August 2008, Quezon City, MetroManila. Thanks to SciDev database news. This expert/analyst was former Silver Medal, National Powerlifting Class A Competitions, Middleweight Division, early 90s, Philippines. He is also a yogi & health buff.]

 

 

Sri Lanka kidney disease epidemic leaves doctors baffled

Chesmal Siriwardhana

12 August 2008 | EN | 中文

Almost all those affected are men from farming families

Flickr/World Bank

Doctors and researchers are puzzled by a sharp rise in chronic kidney disease among farming communities in the North Central province of Sri Lanka.

The number of cases has been steadily rising since the disease first came to light around eight years ago. Over 18,000 cases have now been reported, with cases in Eastern and Uva provinces as well as North Central.

In 2003, almost 200 hundred patients died from renal failure in the North Central province and the figure is increasing every year. Over half the population there is engaged in agriculture.

Almost all those affected are men from farming families without pre-existing conditions than can lead to renal disease, such as hypertension or diabetes.

The absence of clinical symptoms until the late stages of renal failure is also puzzling researchers and making early diagnosis difficult, leading to many deaths.

Local researchers have come up with several possible risk factors for the disease, including high groundwater fluoride content in some affected areas, leaching of heavy metals such as cadmium from agricultural chemicals into water sources, exposure to inorganic pesticides and fertilisers, and usage of aluminium vessels to store drinking water.

Several studies conducted by local researchers have found a strong link between high cadmium concentrations in water sources and high disease prevalence.

A team of medical experts from the WHO visited Sri Lanka to assess the situation in May this year. They recommended that non-affected agricultural regions be used as control areas in studies to find the disease’s cause, and preventative measures such as using clay pots to store water are used.

A long-term clinical study was also proposed by the WHO but has yet to be implemented, Rohana Dayaratne, a geneticist and physician attached to the National Hospital of Sri Lanka in Colombo, told SciDev.Net. 

He says local and international researchers should lead a combined effort to identify the causes and preventive measures, and that local researchers have a good knowledge about ground realities that should be combined with the financial and other resources of the international community.

The majority of the affected farming communities were settlers from different parts of the country, he says, meaning that there could be a genetic component to the disease.

The growing number of patients suffering from chronic renal disease is becoming a heavy burden on the health sector, as the treatments — dialysis and organ transplants — are costly procedures.

Efforts are underway to educate the public about risk factors, maximise early diagnosis with weekly clinics and field visits to vulnerable areas, and introduce preventive measures.

SAHARAN AFRICA’S AMBITIOUS S & T DEVELOPMENT PROJECTS: SOME UPDATES

Erle Frayne Argonza

In the sub-Saharan region, so many exciting developments are going on that deserve our attention. Among these are gigantic projects that are funded by the billions of dollars.

Below is a news briefer about Kenya, Nigeria, and the entire region concerning both ongoing projects and assessment reports about problems that need to be addressed.

Happy viewing!

[14 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]

 

Sub-Saharan Africa news in brief: 19 June–3 July

3 July 2008 | EN

Kenyan and Nigerian researchers will bioengineer improved cassava

CGIAR

Below is a round up of news from or about Sub-Saharan Africa for the 19 June–3 July 2008.

Kenya and Nigeria plan bioengineered cassava trials
The International Institute of Tropical Agriculture will next year begin field trials in Kenya and Nigeria on long-lasting cassava roots fortified with vitamins, minerals and protein, bioengineered to resist damaging viruses and requiring less processing time. Kenya’s Agricultural Research Institute and Nigeria’s Root Crops Research Institute will provide support. More>>

DRC benefits first from US$5 billion African hydropower project
Aluminium smelters in the Democratic Republic of Congo (DRC) will, in 2010, be the first to receive power from a US$5 billion hydroelectric project on the Congo river. The project, planned since 2003 and jointly owned by the energy ministries of Angola, Botswana, the DRC, Namibia and South Africa, should be complete by 2015. More>>

Yaws disease remains a threat
The crippling and disfiguring yaws disease remains a threat in developing countries, including those in west and central Africa, despite almost being eradicated in the 1960s. WHO specialist Kingsley Asiedu says[171kB], the disease needs to be considered a priority once again — especially since one injection is all a cure needs. More>> [138kB]

South African telescope bid receives boost
Africa’s chances of hosting the Square Kilometre Array — the largest and most sensitive radio telescope in the world — has received a boost with South Africa’s approval of the Astronomy Geographic Advantage Bill. The bill gives the country’s science and technology ministry the power to protect astronomical research regions, including the proposed South African site for the array, from development. More>>

‘Non-recommended drug use raising resistance fears in Mozambique
Researchers have expressed ‘concern’ that Mozambican authorities continue to treat malaria with a combination of sulphadoxine-pyrimethamine (SP) and artesunate drugs. All neighbouring countries have abandoned antimalarial drug combinations using SP due to drug resistance problems. Conditions are now ideal for artesunate drug resistance and may even endanger second-line drugs. More>> [205kB]

Couple counselling can help cut HIV risk, African research reveals
Counselling for couples could cut the rate of HIV transmission between partners in long-term relationships by up to 60 per cent, researchers say. Based on the results of their study, conducted in Lusaka, Zambia, and Kigali in Rwanda, they say all African governments should urgently scale up HIV testing, condoms, circumcision and antiretroviral drugs for cohabiting couples. More>>*

Africa lagging on Clean Development Mechanisms
Only 25 of the 1,090 registered Clean Development Mechanism projects in developing countries are in Africa, with 11 in South Africa. Projects in the mechanism aim to reduce greenhouse gas emissions, but companies in South Africa have complained that the amount of time to set up projects is double that stated in provided guidelines. More>>

Namibia moves to boost hydropower
Namibia is negotiating with Angola to store water alongside the Kunene River during the rainy season to help boost its electricity capacity through hydropower. Namibia’s only hydroelectricity station, the Ruacana power plant, stops in the dry season when the river runs dry. Analyst Moses Duma says Namibia also has a good market for wind, solar and gas power. More>>

South African satellite wait continues
South Africa is still waiting to launch its Sumbandila environmental monitoring satellite. A delegation from Russia’s civilian space agency Roskosmos is due to visit South Africa to discuss alternative options after the Russian government blocked the planned launch last year. Meanwhile, South Africa has held its first two public consultation sessions on a proposed space strategy. More>>

*Free registration is required to view this article.

Compiled by Christina Scott. Additional reporting by Frederick Baffour Opoku, Onche Odeh and Sharon Davis.

If you would like to suggest a story for this news in brief, please contact the Africa News Editor Christina Scott (christina.scott@scidev.net). 

 

DRUG-RESISTANT TB NEARS END WITH POWERFUL NEW TOOL

DRUG-RESISTANT TB NEARS END WITH POWERFUL NEW TOOL

Erle Frayne Argonza

 

In the domain of field epidemiology comes a very brightening news about a powerful new tool that can diagnose drug-resistant tuberculosis or TB.

 

TB had ravaged many countries for centuries, and was only curbed for a while after the 2^nd world war. But flawed policies and practices led to the near-catastrophic return of TB to near-pandemic levels.

 

The news about the powerful new tool is contained below.

 

Happy reading!

 

[12 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]

 

 

 

Powerful new tool to diagnose drug-resistant TB

Sharon Davis

2 July 2008 | EN

Mycobacterium tuberculosis

Flickr/AJC1

[DURBAN] Clinical trials of a new molecular technique have found it to be effective at quickly identifying multidrug-resistant tuberculosis (MDR-TB) in resource-poor settings.

As a result, the WHO has endorsed the use of the test in all countries with MDR-TB.

South Africa’s National Health Laboratory Service and Medical Research Council (MRC), and the Foundation for Innovative Diagnostics (FIND) collaborated to test 30,000 patients suspected to have MDR-TB in South Africa between 2007 and 2008. They used both the rapid test and conventional testing.

They announced the results at the opening of the 2008 South African Tuberculosis conference in Durban this week (1 July).

The test uses polymerase chain reaction (PCR) technology to amplify Mycobacterium tuberculosis DNA and look for genetic mutations that cause resistance to drugs.

It is the first of its kind to be used against TB and the first new tool for TB in 50 years, says Martie van der Walt, acting director of the TB Epidemiology and Intervention Research Unit at the MRC.

The new TB test yielded results on 92 per cent of all samples compared with about three-quarters (77.5 per cent) of samples tested by conventional methods. It takes between eight hours and two days to get a result, compared to six to eight weeks for conventional testing.

Patients who receive appropriate drugs sooner minimise their risk of acquiring additional drug resistance, van der Walt told SciDev.Net. Earlier diagnosis also cuts the chance of infecting others.

Seventeen countries will receive the tests over the next four years through the WHO Stop TB Partnership’s Global Drug Facility. FIND and the WHO’s Global Laboratory Initiative will help countries build the capacity — such as laboratory equipment and trained staff — to carry out tests based on PCR techniques.

Mario Raviglione, director of the Stop TB Partnership said in a teleconference this week (30 June) that laboratories in Lesotho, where MDR-TB rates are among the highest in the world, would be ready to use the test within three months.

Laboratory technicians in Ethiopia have been trained, and facilities upgraded, and rapid testing is expected to begin by the end of 2008. Technicians in the Democratic Republic of Congo, the Ivory Coast, Kenya, Nigeria and Uganda have also been trained and are using the test on a smaller scale.

The new tests will be phased in from 2009–2011 in Bangladesh, Indonesia Myanmar and Vietnam.

Developed by Hain LifeScience in Germany, and Innogenetics in Belgium, the test has previously been used on a limited scale by researchers and private laboratories in resource-rich countries, said Richard O’Brien, head of product evaluation and demonstration at FIND.

At US$5 per patient, the test halves diagnosis costs — excluding associated infrastructure and laboratory capacity costs necessary for molecular testing. Using the tests will still be cheaper than treating a larger epidemic, according to O’Brien.

The success has rekindled commercial and research interest in creating a test tailored for extremely drug-resistant TB. A prototype should be available later in 2008. 

BOOSTING HEALTH RESEARCH IN AFRICA

Erle Frayne Argonza

The Millenium Development Goal has been seriously reflected upon and guiding the actions of member states of the UN since its release earlier this decade. The target of halving poverty by 2015 is a tall order, as the key result areas for intervention are legion.

The countries of Africa are surely working their way in a most cooperative manner across the continent, via their regional/continental formations such as the African Union. From the continent comes the news about planning to draw a common framework for health research, and the challenge to put them into action.

Enjoy your read!

[06 August 2008, Quezon City, MetroManila]

Time to turn words into deeds on health research

27 June 2008 | EN

An Ethiopian doctor conducting research

WHO/TDR/Crump

African ministers have committed themselves to a set of actions to boost health research in their countries. Now they must implement them.

There is much encouragement to be gained from the commitment to health research demonstrated by Africa’s health and science ministers at a meeting in Algeria this week (23–26 June). At the meeting, ministers from 17 African countries announced a collective commitment to ensuring a higher priority for health research at both a national and regional level, and across the continent.

Improving health in the developing world is one of the key Millennium Development Goals (MDGs). These include, for example, reducing the mortality rate among children under five by two-thirds and maternal mortality by three-quarters, and making a significant impact on malaria and other tropical diseases. None of these targets will be achieved without extensive research into new methods of diagnosis and treatment.

The Algiers meeting was organised as a preparatory meeting for the Global Ministerial Forum on Research for Health that takes place in Bamako, Mali, in November 2008.

Its key outcome was the ‘Algiers Declaration’, a commendable list of 22 actions that ministers agreed to implement before the end of 2009, and intended to ensure that the potential contribution of health research to achieving the MDGs is delivered.

The actions include increasing funding for health research and research capacity-building by African governments, and boosting mechanisms for scientific and ethical oversight of all such activity. The ministers also agreed to “support the translation of research results into policy and action by creating appropriate mechanisms and structures, including promoting networks of researchers, decision-makers and policymakers for evidence-based public health action”.

Communication challenges

Provided these commitments are met, Africa’s health will receive a significant boost. But it became clear from the discussions in Algiers that there are several key issues that must be tackled urgently if this is to happen.

One is the need for better information about the health priorities of the continent — and a clearer idea within African countries themselves about how these priorities can best be addressed through research.

Donor agencies from the developed world — who provide much of the funding for such research — are frequently criticised by African stakeholders for seeking to impose an agenda that reflects the donor’s own priorities. But many of these agencies insist that they would be delighted to engage in a more informed, two-way dialogue on what their research priorities should be.

This means that African nations need to develop their own capacity for setting research priorities. Two essential components of this are adequate information about current research efforts and the development of professional skills among both research administrators and government officials — part of a broader need to develop a robust research infrastructure.

Another necessity is the development of stronger networks to ensure that African researchers and politicians — including particular ministers — communicate with each other more effectively. Far too often, gaps remain between scientists’ understanding of what is needed for health research to be put into practice, and the willingness of decision-makers to implement the steps that make this possible.

Ethical considerations

An additional need is to boost national capacities to address the ethical dimensions of health research — particularly at a time when the activities of researchers from the developed world, including those carrying out large-scale clinical trials for pharmaceutical companies, are under closer scrutiny.

A survey of capacity to conduct ethical reviews in 634 research institutes in 43 countries was presented at the Algiers meeting by a WHO team. They found that half of those who have a “high research activity” don’t have written policies requiring researchers to obtain informed consent from trial participants.

There is still much debate to be had about how the situation can be improved. Nevertheless, it is clear that health research in Africa needs to be conducted in a more ethical manner than in the past. And building the capacity to achieve this must form an integral part of future plans. 

Closer collaboration

A third priority to emerge from the meeting was the need to encourage more research collaboration. The final declaration calls for promotion of equitable cooperation, technology transfer and collaboration, emphasising that this requires both North–South and South–South dimensions. 

But it became clear at the meeting that delegates — mostly African ministers and researchers — had a greater interest in the second of those. They were more interested in how African countries could transfer knowledge between themselves than in receiving knowledge from Northern institutions, a sentiment echoed by Elias Zerhouni, the director of the US National Institutes of Health.

Finally there was general acceptance among the Algiers delegates that none of these aims could be achieved without adequate funding.

Participants broadly agreed that not only should African countries seek to boost their spending on research and development to at least one per cent of their gross domestic product — a target endorsed by last year’s African Union summit — but that at least ten per cent of research spending should be dedicated to health research.

But, as science ministers are already aware, there is a large step between putting forward a wish list and ensuring that those who control the purse strings are prepared to listen and act. The Algiers Declaration has provided a framework within which action can occur. What is now required is the political commitment within individual African countries to turn those words into deeds.

David Dickson, Director, SciDev.Net

Link to the full Algiers Declaration [25kB]

PERU’S SERPENT BITE SERUM

Erle Frayne Argonza

That serpentine fire can burn you or rather kill you. Make no joke about snake bites, as they are among those killers in our planet.

From Peru comes a heartwarming news about a new innovation in serum development to address the problems attendant to serpentine bites.

Happy reading!

[05 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]

Perú produce suero en polvo contra veneno de serpientes

Zoraida Portillo

24 junio 2008 | ES

[LIMA] El Perú aspira a convertirse en pionero en la región andina en investigaciones científicas para la producción de sueros en polvo contra las mordeduras de serpientes y otros animales ponzoñosos.

Así lo señaló Patricia García, jefa del Instituto Nacional de Salud, durante el lanzamiento del primer suero antibotrópico liofilizado producido en el Perú, el que contrarresta los efectos del veneno por mordedura de las serpientes bótrox (Bothrops atrox.), cuya mordedura tiene la más alta prevalencia en el país.

El suero es producto de ocho años de investigaciones y pruebas por científicos del Centro Nacional de Productos Biológicos, y fue lanzado oficialmente el 17 de junio en Lima. Con la misma fórmula maestra de los inmunosueros antiofídicos, no requiere refrigeración pues es en polvo, y tiene una vida activa de cinco años.

Durante el lanzamiento del producto, el ministro de salud, Hernán Garrido Lecca, informó que el suero está destinado principalmente a los pobladores nativos e indígenas de la amazonía peruana, donde ocurre la mayor cantidad de mordeduras de estas serpientes.

El primer lote, con 800 dosis, será despachado en los próximos días a los lugares más remotos.

Según el ministerio de salud,el año pasado 2.585 personas fueron mordidas por la bótrox. Por falta de atención inmediata, 52 murieron.

Un estudio realizado por Alfonso Zavaleta, de la Universidad Cayetano Heredia, al que SciDev.Net tuvo acceso, afirmaque el botropismo constituye la primera causa de envenenamientos fatales producidos por animales ponzoñosos cada año. Un tercio de los pacientes son niños.

La introducción del producto irá acompañada de capacitaciones a los proveedores de salud y agentes comunitarios de las regiones con ocurrencias de accidentes ofídicos, con el fin de estandarizar y mejorar el manejo de las mordeduras de serpientes e iniciar el registro de casos y uso de los sueros, para adecuar la producción a la demanda, indicó el ministro.

COMMUNITY-DIRECTED HEALTH CARE

Erle Frayne Argonza

Who says that community-based health care systems won’t work? In the Philippines this has been an on-going effort, with the University of the Philippines leading. Couples of communities were adopted by the U.P. Manila in other regions precisely to study the effects of intervention via community organization.

Below is a news caption about a study that shows the effectiveness of community-based health care. Community-based health care has already been revolutionizing access to health care by many poor folks in the south.

Enjoy your read!

[02 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]

Community-directed healthcare ‘effective’, finds study

Abiose Adelaja

23 June 2008 | EN

In the strategy, family members help deliver drugs and administer treatment, instead of patients visiting a clinic

Flickr/CharlesFred

Community-administered healthcare is effective in combating a range of illnesses including river blindness and malaria as well as micronutrient deficiencies, according to a study of over two million people in three African countries.

The researchers say restrictive health department policies on who can administer medications should be altered so that other illnesses can be tackled in a similar fashion.

Community-directed drug intervention (CDI) has proved successful in delivering the drug Ivermectin to treat river blindness, also known as onchocerciasis. In the strategy, family members help deliver drugs and administer treatment, instead of patients visiting a clinic.

The study looked at the effectiveness of CDI in strategies to fight river blindness, later pairing it with treatments against malaria, tuberculosis and micronutrient deficiencies, in Cameroon, Nigeria and Uganda. Community dispensing of drugs, vitamin A supplements and insecticide-treated mosquito nets was compared with conventional delivery strategies over three years.

Researchers found that the number of feverish children receiving the right antimalarial treatment doubled, exceeding the 60 per cent target set by the Roll Back Malaria campaign. The use of insecticide-treated bednets also doubled.

Vitamin A supplementation coverage was also significantly higher in districts using CDI compared with those that did not. But community-directed interventions for tuberculosis proved only as effective as treatment from clinics.

Samuel Wanji, a researcher at the University of Buéa who conducted the southwest Cameroon part of the study, says the African Programme for Onchocerciasis Control — linked to the WHO and with 19 health ministers on the board — has given the go-ahead to extend the use of CDI for river blindness in countries that have lower, but still significant, levels of the disease.

The expanded programme will investigate whether CDI works as well in places where disease infection is less intense, and is scheduled to begin before the end of the year. Dispensing of other medications will be added as the programme progresses.

“The study’s approach is very useful for increasing access to health and will reduce the burden on health facilities,” says Hans Remme of the WHO Special Programme for Research and Training in Tropical Disease.

But a shortage of drugs and other materials remains a drawback, according to a WHO report of the study.

 

Link to WHO CDI report

VIETNAM, INDIA PIONEER CHEAPER CHOLERA VACCINE

Erle Frayne Argonza

Good morning from Manila!

A heartwarming news from India and Vietnam concerns the reduction of prices of vaccines for cholera. To recall, India is among the countries that lead in bringing down pharmaceutical costs, thus saving the day for many poorer folks in the south who are relentlessly victimized by the rent-seeking practices of Western drug companies.

Enjoy your read!

[02 August 2008, Quezon City, MetroManila]

Cheaper cholera vaccine passes pilot trial

Sanjit Bagchi

23 June 2008 | EN | 中文

The current international cholera vaccine is too expensive for developing countries

Flickr/larskflem

A reformulated oral vaccine against cholera promises to be an affordable and effective weapon to combat the disease for people living in endemic areas of developing countries, according to a new study.

The internationally licensed cholera vaccine currently available is too expensive for use in developing countries, where it is most needed.

Vietnam produces its own two-dose oral cholera vaccine and distributes it through its public health system at US$0.40 a dose. Nine million doses have been delivered so far.

To kick-start the process of scaling up this vaccine in developing countries around the globe, the vaccine was reformulated to comply with WHO standards.

Researchers from India, Korea and Sweden conducted a pilot trial of the vaccine at Kolkota’s Infectious Diseases Hospital in eastern India. Cholera is endemic in Kolkota.

The study evaluated the vaccine’s safety and efficacy outside Vietnam.

Participants were healthy and included 101 adults aged 18–40 years and 100 children aged 1–17 years. They received two random doses of either the vaccine or a placebo, 14 days apart.

After immunization, 53 per cent of the adults and 80 per cent of the children showed at least a four-fold increase in their antibody levels against Vibrio cholerae O1, the predominant strain of cholera-causing bacteria.

Safety tests revealed that “no adverse event occurred more frequently in the vaccinated than in the placebo group”, say the researchers. 

“Cholera affects a large number of children in developing countries, and so a vaccine that is safe and effective for children sounds impressive, and the development as a whole appears to be a step towards global rolling out of the cholera vaccine,” says Sumana Kanjilal, associate professor of paediatric medicine at Calcutta National Medical College Hospital, India.

The reformulated vaccine is now undergoing a trial in around 70,000 people in Kolkata. “If the vaccine is found to be safe and protective, this could pave the way for the use of this vaccine in the control of cholera worldwide,” the researchers write.

The study was published in PLoS ONE.  

 

Link to full paper in PLoS ONE

MALARIA CROSS-BORDER RESEARCH IN LATIN AMERICA

Erle Frayne Argonza

Cross-border malaria research is a new thing in health services and epidemiology. The conduct of this requires first of all an established people-to-people relationship in order to prosper, this relationship being the base for an expert-to-expert and state-to-state relationships.

Incidentally, cross-border relations are increasing in the South, a pattern that is observed likewise among Latin American states. Cross-border research in malaria is a representative instance of the multiplying cross-border relations, the good news being that it is even rewarded among certain countries, as reported in the news below.

Enjoy your read.

[26 July 2008, Quezon City, MetroManila. Thanks to SciDev database news.]

Cross-border malaria research rewarded in Africa

Bibi-Aisha Wadvalla, Esther Tola and Christina Scott

12 June 2008 | EN

The money will go into further research, including final-stage trials of a malaria vaccine for children

Flickr/aheavens

Four African institutions carrying out malaria research have won an international cooperation award from the Prince of Asturias charitable foundation in Spain for their joint efforts.

The award, announced last month (28 May) and worth €50,000 (around US$77,000), went to Ghana’s Kintampo Health Research Centre, Mali’s Malaria Research and Training Centre, Mozambique’s Manhica Centre of Health Research and the Ifakara Health Research and Development Centre in Tanzania. They are scheduled to receive their awards in October this year.

The centres carry out biomedical research, vaccine trials, demography research and local training of personnel.

Ogobara Doumbo, director of the Mali centre, told SciDev.Net the award would help expand successful strategies such as insect-repellent mosquito nets and occasional (intermittent) preventative drug treatment for children and pregnant women.

About 80 researchers have been working on clinical trials of malaria vaccines at four sites in Mali since 2003, including molecular biologist Abdoulaye Djimdé, who developed simple techniques to monitor drug resistant malaria parasites from a drop of blood on filter paper.

Doumbo says they are now working on candidate vaccines targeting the early phase in the parasite’s life cycle in the human bloodstream.

The money will be ploughed straight back into further research, says John Aponte, head of the statistics unit at the Barcelona Hospital Clinic and a member of the team at the Manhiça Centre of Health Research.

Aponte said final-stage (phase three) trials of the RTS,S malaria vaccine for children under five years should begin in late 2008 or early 2009 at 11 centres in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania. 

Commentators say that the awards are a sign of Africa being at the forefront of solving African health problems.

“Mozambique and Africa are starting to lead the path toward solving their own health problems, and to deliver useful solutions to the rest of the world,” Graça Machel, president of nongovernmental organisation the Community Development Foundation in Maputo, who has worked with the Manhiça Centre for 12 years, said in a press statement.

”The work of the recipients reflects their respective commitment to cooperation across national and institutional boundaries — the type of cooperation that will be needed to effectively combat malaria at the global level,” said Christian Loucq, director of the PATH Malaria Vaccine Initiative, in a press statement.

CLINICAL TRIALS IN AFRICA

Erle Frayne Argonza

Magandang hapon! Good afternoon!

From Africa comes a heartwarming news about boosting their respective capacities for clinical trials. The shot in the arm will be through grant funds provided by the European and Developing Countries Clinical Trials Partnership (EDCPT). Entry points for project engagements will be certain specific diseases.

Enjoy your read.

[24 July 2008, Quezon City, MetroManila. Thanks to the SciDev database news.]

Clinical trials in Africa receive funding boost

Naomi Antony

6 June 2008 | EN | 中文

A malaria clinical trial investigator

WHO/TDR/Crump

The European and Developing Countries Clinical Trials Partnership (EDCTP) announced this week (3 June) that it will inject over €80 million (around US$124 million) into African medical research.

Half of this sum has already been approved and will go towards malaria research and the development of tuberculosis (TB) vaccines. The remainder, expected later this year, has been earmarked for HIV and TB treatment and for the provision of vaccines and microbicides.

The combined sum will be the largest approved by the EDCTP since it was established in 2003, and should reinforce the European Union’s partnership with Sub-Saharan Africa.

The EDCTP links 14 member states of the European Union, as well as Norway and Switzerland, to countries in Sub-Saharan Africa, largely by providing resources for joint clinical trials, capacity building and networking activities.

In particular, EDCTP funds projects to create and develop capacity for ethical review of clinical trials and to improve regulatory frameworks for drug approval.

Charles Mgone, executive director of EDCTP, told SciDev.Net that the new funding will go to help all these activities, with the “lion’s share” being given over to clinical trials.

“Quite often when there is North–South collaboration, the ideas come from the North, the money comes from the North, even the principal investigators come from the North,” says Mgone.

“These [EDCTP-funded] projects empower Africans, enabling them to take ownership over the projects and do the work. Looking at the 27 projects we have approved, around 24 of them have African principal investigators working in Africa.”

Victor Mwapasa from the Malawi College of Medicine is one such example. He and his colleagues are looking at whether antimalarial drugs, specifically artemisinin-based combinations, are safe to use in two particular groups — those who are HIV positive and children aged under six months.

“Most studies looking at the safe use of antimalarials have tended to omit very young children, those who weigh less than five kilograms or are under six months old,” Mwapasa told SciDev.Net. “But this is a high-risk malaria group.”

Mwapasa says he is excited to be part of such a large collaboration with African and European researchers.

His team’s research will also be carried out in Mozambique and Zambia. “We rarely do research together, despite sharing the same problems,” he adds.

HIV TREATMENT RESPONSE VIA PHARMACY RECORDS (FROM AFRICA)

Erle Frayne Argonza

 

Good day!

 

From the African continent comes welcome developments about HIV treatment response. The results of studies across countries show intervention processes could be one possible area for improving treatment response altogether.

 

Happy reading.

 

[22 July 2008, Quezon City, MetroManila. Thanks to SciDev updates.]

====================================================

 

Pharmacy records ‘can predict HIV treatment response’

Carol Campbell

27 May 2008 | EN | 中文

A doctor at a HIV treatment clinic in Swaziland

Website/HIV-AIDS

New research suggests that pharmacy records can be accurate, and cost-effective, indicators for predicting whether HIV patients in the developing world are at risk of treatment failure.

Failure of first-line antiretroviral drugs (ARVs) is detected in the developed world by measuring the amount of HIV circulating in a patient’s blood. In resource poor settings, however, the WHO recommends that CD4 cell testing — a measure of the health of the immune system — is used.

But CD4 tests indicate treatment failure after it has occurred, while using pharmacy records to measure treatment adherence could indicate patients at risk of treatment failure before it happens, the researchers say.

Using medical insurance data from the private insurance programme Aid for AIDS, researchers tracked adherence to medication among nearly 2000 HIV-infected adults in nine southern African countries — Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.

The researchers calculated adherence by comparing the number of months a patient was prescribed drugs with the number of months the drugs were actually dispensed from pharmacies.

“We assessed the ability of a simple measure — whether the patient collected their monthly medication on time — to predict virological failure,” says clinical pharmacologist Gary Maartens from South Africa’s Groote Schuur Hospital at the University of Cape Town and an author of the research.

They found that monitoring adherence was more accurate than monitoring changes in CD4 levels to determine whether a patient’s treatment had failed in the first year after starting ARVs.

“If the patient’s adherence to medication was tracked, potential health problems could be red-flagged immediately,” co-author Michael Hislop from Aid for AIDS told SciDev.Net.

He said the system could work within the public health system with the correct technology and systems. At present, however, only the private health sector has the resources to track adherence, and the researchers say more research needs to be carried out into the effectiveness of adherence monitoring in public health clinics.

Tracking adherence in order to identify and intervene with vulnerable patients should mark a policy switch, the researchers write, “a reason for clinics to organise these data in a way that can be used in simple algorithmic approaches to patient care”.

The research was published in PLoS Medicine last week (May 20).

Link to paper in PLoS Medicine

 

MEDICAL IMAGING INNOVATIONS (FROM ISRAEL)

Erle Frayne Argonza

In the lands of the Semites comes brightening news about medical imaging. This news is particularly great for poorer families of developing economies, who can do their own information gathering and monitoring of health-related problems right in their palm.

Happy reading.

[20 July 2008, Quezon City, MetroManila. Culled via SciDev news.]

======================================

Researchers devise ‘mobile’ medical imaging system

Wagdy Sawahel

16 May 2008 | EN | 中文

The new system transfers medical images via mobile phones

Flickr/johnmuk

Researchers have developed a new system enabling medical images to be transferred via mobile phones, which could make imaging technology cheaper and more accessible to poor countries.

According to the WHO, three quarters of the world’s population does not have access to medical imaging and more than half of available medical equipment in developing countries is not used due to maintenance problems and lack of trained personnel.

To address this, Boris Rubinsky at the Hebrew University of Jerusalem, Israel, and colleagues separated the components required in a medical imaging system.

A simple device ― one measuring electrical impulses for example ― collects data from the patient in the field. This is transmitted via the mobile phone to a central site where the data is processed, an image produced and sent back to the field, again via the mobile phone.

Using the system, the researchers successfully produced a clear image of a simulated breast cancer tumour.

“The wide availability of cellular phones has suggested that imaging devices do not have to be all in one physical place and that their components can be spread around the world and connected through cellular phones, rather than connected physically with electrical wires,” Rubinsky told SciDev.Net.

“The physicians can use their own cellphones to plug into [the data collection device] and send the raw data, in the form of a text message or email, to a geographically distant central facility — that can serve thousands of users — and within seconds sends back the processed image the way you would send a picture to your cellphone,” he says.

“This system is economical as the cost of [the data collection device] near the patient site is not a major part of the cost of the entire system, making it less expensive and easier to maintain,” he adds.

Rubinsky hopes they can develop a more advanced prototype for the detection of breast cancer within a year.

Morad Ahmed Morad, a professor of medicine at Tanta University, Egypt, says the device is an “ideal example of turning information and communication technology into solutions making a real health impact on lives of poor people in developing countries”.

The study was published in PLoS ONE last month (30 April).

Link to full paper in PLoS ONE