BrightWorld

Dreams, Optimism, Wisdom

MOST EFFECTIVE DRUGS FOR HIV/TB NOW OUT! September 8, 2008

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

 

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EPIDEMIC CONTROL VIA EDUCATION: SRI LANKA’S KIDNEY DISEASE CASE September 4, 2008

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 4th 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 September 2, 2008

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>>

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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 August 31, 2008

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 2nd 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 August 28, 2008

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 August 27, 2008

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 August 22, 2008

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