Category: Health

{Rwanda has lessons to offer the United States when it comes to vaccinating girls against human papillomavirus (HPV)—which can cause cervical and head and neck cancers, says Dr. James Conway, associate director for health sciences at the University of Wisconsin-Madison Global Health Institute.}

Rwanda has vaccinated 95 percent of 12- to 15-year-old girls against HPV, the most common sexually transmitted disease. In the United States, less than 40 percent of 13- to 17-year-old girls receive needed doses of the vaccination.

“Rwanda is an example of the amazing things that can be done with collaboration, prioritization and removal of barriers,” says Conway, an international champion for the HPV vaccine. He is working to improve vaccination rates in Wisconsin and his team has trained immunization workers in many sub-Saharan African countries.

Rwanda began its HPV vaccine program in 2011 after recognizing the burden and suffering associated with cervical cancer and deaths from the disease. A collaboration of the Rwandan government, cancer control groups, community health workers and pharmaceutical companies resulted in a program to vaccinate girls in schools and reach out to girls not in school.

“If we follow Rwanda’s lead with collaboration and creative problem solving, we can reduce cancer rates in Wisconsin and the U.S. dramatically. We also have the opportunity to even broader in our impact, by immunizing both girls and boys. This could be a game-changer for an entire generation of individuals.” — Dr. James Conway, GHI associate director for health science.

While Rwanda’s school-based approach would not be practical here, the UW Health Immunization Task Force HPV Workgroup—Conway chairs the task force—has taken a page from the country’s program by collaborating with groups from across the UW Health system. This cooperative approach is striving to increase awareness among parents, patients and providers about the importance of routine HPV immunization for all pre-teen boys and girls. A similar collaboration organized by the Wisconsin chapter of the American Academy of Pediatrics (AAP), the Wisconsin Department of Health Services and the Wisconsin Comprehensive Cancer Coalition is working with 19 immunization coalitions, health systems and county health departments around the state to increase vaccination rates.

“It’s like a thousand-piece puzzle,” says Conway, who also chairs the Wisconsin AAP Committee on Immunizations and Infectious Disease. “We have all the pieces but we haven’t put them all together yet.”

{{Putting the puzzle together to save lives}}

One of the puzzle pieces is convincing primary care providers to give stronger recommendations to families of both girls and boys for the three-dose series. Conway says providers have little problem following the current recommendations for 11 to 12 year olds, for the meningococcal and tetanus, diphtheria and pertussis (T-dap) vaccines.

“Yet HPV is the most-common sexually-transmitted disease and meningococcal disease is very rare,” said Conway. “We have a vaccine to prevent this very common disease that causes a variety of cancers, but providers hesitate to strongly recommend it.”

HPV can be transmitted by a variety of activities like kissing, not just by sexual intercourse.

“People are still not connecting the dots that HPV causes cancer, and yet it is preventable.”—Dr. James Conway

“In teens, the infection is likely to become more chronic, which is why early immunization is so critical,” Conway says. Chronic HPV infections are the eventual cause of pre-cancerous conditions and cancers.

Cervical cancer is most commonly associated with HPV infection. But Conway says HPV can also cause many head and neck cancers, and rates are rising steeply in the United States. In 2012, the Wisconsin Cancer Reporting System said there were nearly 800 new cases of oral cancers and 175 deaths. Cervical cancer was second with 191 new cases in Wisconsin and 54 deaths.

“If we follow Rwanda’s lead with collaboration and creative problem solving, we can reduce cancer rates in Wisconsin and the U.S. dramatically,” Conway says. “We also have the opportunity to be even broader in our impact, by immunizing both girls and boys. This could be a game-changer for an entire generation of individuals.”

By Toni Morrissey at UW Health/ July 14, 2015

Source: University of Wisconsin/ GHI

{{Editor’s note}}: {{Dr. Agnes Binagwaho, Rwanda’s Minister of Health, responds here to Angus Deaton’s entry in a recent forum, “The Logic of Effective Altruism.”}}

{ {{Source: Boston Review}} }

I spend a lot of time explaining and promoting Rwanda’s record on public health to audiences around the world. Together with our research and funding partners, Rwanda has made unprecedented strides on almost every health measure. We are one of the few developing countries that will meet all MDG targets. All Rwandans have access to health insurance, and maternal mortality has fallen at historically unprecedented rates.

For Angus Deaton, these gains only served to entrench dictatorship and repression in Rwanda. How? By threatening to let our children die unless altruistic and gullible Westerners pay our government to keep them alive.

Deaton believes that we ‘provide health care for Rwandan mothers and children’ in order to ‘insulate ourselves from the needs and wishes of our people’. I can’t tell if he means that Rwandans don’t wish for good health, or that our country would be more democratic if we neglected basic needs.

As a Rwandan, and as a physician, I have heard a lot of outrageous statements in my life. But Professor Deaton has invented an entirely new genre of absurdism.

How does one begin to reply? More facts and figures about Rwanda’s progress would only reinforce Deaton’s grotesque logic. Testimonials from the donors and researchers who know Rwanda best would be dismissed as compromised.

Moreover, Rwanda is not the issue here, and I would feel no satisfaction if Deaton apologized to Rwanda and then went to pick on a different country that better exemplifies his stereotypes.

The issue is moral, and it concerns all of us. Deaton’s theory rests on the assumption that Africans don’t feel love for their children. It follows that President Kagame, being an African, sees children as a commodity, like copper or sweet potatoes, to be sold to people in the West who value their lives more highly. Rwandans have a proverb for such impertinence – Urusha nyina w’umwana imbabazi aba ashaka kumurya: “Whoever shows more compassion for a child than its own mother only wants to exploit it.”

Angus Deaton doesn’t know Paul Kagame from Kunta Kinte. The president is just a cartoon character he uses to argue against foreign aid. Deaton isn’t referring to the real Paul Kagame or the real Rwanda, but to a generic ‘other’ whose moral inferiority is so self-evident that it requires no elaboration.

In other words, Deaton knew his readers would share in the contempt. In point of fact, Peter Singer replied complaining about Deaton’s criticisms of his work; but he made no mention of the scandalous libel of President Kagame.

This is neither ignorance or carelessness. It is an ideology of moral superiority, a form of racism that is all the more pernicious because it has no name and leaves no marks on its victims. Eventually the victims internalize it and come to despise themselves.

By dropping the mask a little, perhaps Angus Deaton has done us all a favor. We need to have more honest conversations about the assumptions implicit in the judgments we make about each other.

Rwanda’s story is tragic and hopeful in equal measure. Maybe the first step is for Angus Deaton, Peter Singer, and anyone else who feels concerned by this exchange, to visit Rwanda and see for themselves what kind of people we are, and how we care for our children. They would not be the first visitors to Rwanda who left with a deeper appreciation for our common humanity.

Dr. Agnes Binagwaho
Minister of Health, Rwanda

{Women with symptoms of posttraumatic stress disorder (PTSD) may be at an increased risk for heart attacks and strokes, suggests a new study.
}

Women with the most symptoms were about 60 percent more likely to develop cardiovascular disease, compared to women who never experienced trauma, researchers report in the American Heart Association journal Circulation.

“Women who have PTSD should be aware they are at increased risk of cardiovascular disease or stroke,” said Jennifer Sumner, the study’s lead author from the Columbia University Mailman School of Public Health in New York.

She also said doctors treating women with PTSD should take note of their cardiovascular risk factors.

PTSD can occur after a traumatic experience. People with PTSD may relive the trauma, avoid certain situations, be overly aware in certain situations or become emotionally numb.

About 10 percent of women are thought to develop PTSD over their lifetimes, compared to about 5 percent of men, the researchers write.

PTSD has been linked to cardiovascular disease before, but most studies have involved male military veterans, Sumner told Reuters Health.

For the new study, the researchers used data on close to 50,000 female nurses whose health was tracked for over 20 years, starting in 1989 when they were 25 to 42 years old.

During that time, the women had 277 heart attacks and 271 strokes.

In 2008, the women were sent questionnaires about their exposure to traumatic events and seven potential symptoms of PTSD.

These symptoms included, for example, staying away from places or activities that are reminders of the traumatic event, or losing interest in activities that were once important or enjoyable, or finding it hard to feel love or affection, or becoming jumpy or easily startled by ordinary noises or movements – with these symptoms and others persisting long after the traumatic event occurred.

The researchers found that being exposed to a seriously traumatic event without having symptoms of PTSD was linked to a 45 percent increased risk of having a heart attack or stroke, compared to those not exposed to trauma.

Among women who reported four or more symptoms of PTSD, the risk of having a heart attack or stroke was 60 percent greater than among women who never experienced trauma.

After adjusting the results for the women’s health behaviours, the researchers found that about half of the association between PTSD symptoms and the increased risk could be explained by weight, cigarette and alcohol use, physical activity and diet.

“Right now it’s not routine practice for people with PTSD to be screened for heart risk factors, and we hope this is something that might change,” Sumner said.

She also said PTSD may lead to actual changes within the body that put women at higher risk for cardiovascular disease.

“We tried to conceptualise it as two potential pathways,” she said.

The heart attacks and strokes observed in this study are considered “early onset,” because the women were so young, Sumner said.

She added that they will continue to follow the women’s health.

“We’re very interested in looking at interventions that treat PTSD and see if that reduced cardiovascular risk,” she said.

{{Source: Agencies}}

{The Kigali University Hospital (CHUK) will conduct a countrywide special program of treating about 3200 patients who have been struggling to get special treatment of their illness.}

Among the patients there is the son of Nyiramuhire Marie Odette residence of Kayonza district in eastern province, who have been struggling for medical operation service for her Son.

Her 8 years old son got a problem of testicles that entered inside the body and there has been two months since the Ruli and Rwinkwavu Hospitals tried to treat him; unfortunately nothing has changed to that illness.

Nyiramuhire has been waiting for her son’s treatment for long time and she is also expecting her son who has also backache which pains him very much to be opearted.

Another one waiting to be treated by this hospital is Kanamugire Jean Nepomuscene also who has an illness that caused the inside part of his nose to come out.

He came for treatment in CHUK, after trying Mayange Hospital in Bugesera District.

In the meantime patients are suffering due to the the delay of medical services as the hospital is still organizing the special program which starts from 15 June 2015.

These patients and others say that they have different problems such as lack of shelters as they wait for their schedules, they met coldness outside as well as lacking food and some other different things.

However in collaboration with the Ministry of Health, CHUK is going to start with such patients as it was confirmed by director of CHUK, Doctor Theobald Hategekimana, on Thursday 21 may 2015.

He said slow service is caused by few employees they have, that in all 700 staffs at CHUK there are only ten surgical specialists which is the problem behind the delay in operation services for the patients.

It was observed that the hospital takes into consideration on how serious of the disease the patient has, when she/ he has given local treatment service then he must be operated in a certain period of time “there is no problem we do it and we start with those who are seriously sick.” Hategekimana said

Meanwhile there is a big number of patients that are received by this hospital due to the fact that many patients are referred to CHUK for such serious illness.

It is said 75% of patients with such illness from 29 district hospitals are sent to this main hospital. This number joins to another in Kigali who don’t have the district hospital.

As a solution to this problem the hospital has planned a special program of treating abaut 3200 patients who have problems of operation.

The program of operation which is being prepared starts from 15 June 2015.

Currently there is a consultation program to show well who are those that need to be operated or those who need another usual assistance which can be given by district hospitals.

The program will be conducted in CHUK with hospitals in Ruhengeri, Kibuye, Nyagatare, Nyamata and Kibungo.

In collaboration with U.S doctors and Rwandan government at least 500 specialists will be trained within seven years so as to be able to cope with the growing number of patients.

{{ ( By Umutoni Zaharah, Edited by Ange de la Victoire D.) }}

{Drinking two to three cups of coffee every day could lower a man’s risk of erectile dysfunction. This is according to a new study published in the journal PLOS ONE.}

{{Erectile dysfunction (ED)}}, or impotence, is the inability to get and sustain an erection that is firm enough for sexual intercourse. It is the most common form of sexual dysfunction in men, affecting more than 18 million aged 20 and older in the US.

ED can be a devastating condition for men, causing lack of self-confidence, stress and relationship problems. The majority of ED cases are caused by physical problems, including high blood pressure, overweight, obesity, diabetes and high cholesterol, though it can also be triggered by psychological issues.

The researchers of this latest study, led by Dr. David Lopez of The University of Texas Health Science Center at Houston (UTHealth), note that previous studies have hypothesized that caffeine – commonly consumed via coffee, soda and energy drinks – may improve ED, though there is a scarcity of population-based studies investigating this association.

As such, Dr. Lopez and colleagues used 2001-04 data from the National Health and Nutrition Examination Survey (NHANES) – a program of studies assessing the health and nutritional status of Americans – to investigate the role of caffeine intake in ED. Up to 42% reduced ED risk with two to three cups of coffee daily

The data analyzed involved 3,724 men aged 20 and older whose ED status was identified during a computer-assisted interview. Of these men, 40.9% were overweight, 30.7% were obese, 51% had high blood pressure and 12.4% were diabetic.

The researchers estimated the men’s caffeine intake by analyzing 24-hour dietary recall data, gathered from asking participants to report all food and beverages consumed in the past day. The caffeine sources assessed included coffee, soda, sports and energy drinks and tea.

Overall, the team found that men who consumed 85-170 milligrams (mg) of caffeine daily were 42% less likely to report ED, while those who consumed 170-303 mg of caffeine a day were 39% less likely to report ED, compared with men who consumed 0-7 mg of caffeine a day.

The team notes that the caffeine levels consumed among men with reduced risk of ED were the equivalent to drinking two to three cups of coffee a day.

In addition, higher caffeine intake was also found to reduce risk of ED in men who were overweight or obese and those who had high blood pressure – all of which are considered risk factors for the condition.

However, Dr. Lopez notes that caffeine did not lower the risk of ED for men with diabetes. “Diabetes is one of the strongest risk factors for ED, so this was not surprising,” he adds.

Still, the team concludes that their findings show a reduced likelihood of ED among men with a daily caffeine intake the equivalent to consuming two to three cups of coffee a day.

While the exact mechanisms behind this association are unclear, the researchers hypothesize that caffeine induces a series of pharmacological effects that causes relaxation of both the penile helicine arteries and the cavernous smooth muscle of the penis, increasing blood flow.

The researchers point to the large, nationally representative sample included in their study as a major strength, but they admit there are some limitations.

They point out that some risk factors for ED – such as cardiovascular diseases – were not addressed. In addition, they note that since NHANES is a cross-sectional study, their findings cannot imply a causal link between caffeine intake and reduced risk of ED. As such, further studies assessing this association are warranted.

Coffee has been hailed as having numerous other health benefits. Last month, Medical News Today reported on a study by researchers from Lund University in Sweden, which found coffee could halve breast cancer recurrence for some women, while another study found drinking up to five cups of coffee daily could reduce the risk of clogged arteries and heart attack.

{{Written by Honor Whiteman

Copyright: Medical News Today}}

{High blood pressure, commonly associated with adults, is slowly creeping up on children.}

And the triggers are inactive lifestyles and fatty diets, as well as exposure to alcohol and tobacco at home.

Dr Fred Bukachi, a cardiologist and lecturer at the University of Nairobi said on Monday that the rise in obesity in children and other risk factors exposes them to the silent killer — high blood pressure also known as hypertension.

Said Dr Bukachi: “High blood pressure in children doesn’t usually have symptoms. However, when they are diagnosed with it, they are immediately referred to a specialist who puts them on treatment.

“We are currently doing primordial prevention, that is, teaching pregnant women on the importance of avoiding alcohol and smoking.”

A child who was born prematurely, has low birth weight, congenital heart diseases and has certain kidney problems is at a higher risk of developing high blood pressure. Also, family history of high blood pressure raises the risk.

DAMAGE TO VESSELS

Blood pressure is the force of blood as it flows through the body’s vessels.

The heart pumps blood through the vessels that traverse the entire body. The vessels widen and contract, as needed, to keep blood flowing.

However, in a person with hypertension the blood pushes too hard against the blood vessels, which can cause damage to vessels, the heart, and other organs.

Dr Bukachi reveals that the Ministry of Health was working closely with the Ministry of Education to introduce health messages that create awareness on the issue, as well as promoting physical activities and stress reduction in the children.

While Dr Bukachi did not offer a case study or the number of children with hypertension in the country, he said it was a developing concern.

There is lack of a clear national program on how to manage the disease in children.

LIVING IN SLUMS

Hypertension in the country affects at least four in ten people and causes cardiovascular disease, stroke and organ failure.

In 2013, one in eight adults living in Nairobi’s slums battled high blood pressure and only half of them had been tested or received treatment in the past one year according to a research by the African Population and Health Research Centre.

By 2000, hypertension in Africa was affecting approximately 80 million adults, a figure World Health Organisation warns will soar and hit 150 million by 2025.

In Kiambu County, for instance, the number five cause of adult admissions in county hospitals is high blood pressure, while the disease ranks seven in fatalities.

The county’s Health Executive, Dr Jonah Mwangi, says it is a disease burden that can be controlled.

“We advise our patients and the community to reduce daily sugar and salt intakes, to pick an active lifestyle and reduce tobacco and alcohol consumption. These are all risk factors,” he explained.

The Ministry of Health and other partners last year launched a national initiative, Healthy Heart Africa, to support local health systems by increasing awareness and availing hypertension screening services.

Vice President of the Initiative Samer Al Hallaq said: “As we prepare to mark World High Blood Pressure Day (May 17), we acknowledge high blood pressure is a concern in the country and very few are aware of available treatment and how to manage it.

“We are working in 20 counties, with a pilot program in Kiambu, to see how to address this curable disease.”

{Different studies have shown that substance use among youth is a significant public health concern worldwide. }

However, little is known in Rwanda about the prevalence of drug use among youth.

Current study assessed the prevalence and determinants of substance use among youth in Rwanda.

A cross-sectional home survey was carried out with 2479 Rwandan youth ranging, in age from 14–35 years and was randomly selected from 20 out of the 30 districts in the country.

The youth were interviewed using a questionnaire that included socio-demographic information and self-reported substance use.

Misuse and dependence on alcohol, marijuana and tobacco were respectively assessed by the Alcohol Use Disorders Identification Test (AUDIT), the Cannabis Abuse Screening Test (CAST), and the Hooked on Nicotine Checklist (HONC).

Results Overall, the prevalence rate of substance use over the month prior to the survey was 34% for alcohol, 8.5% for tobacco smoking, 2.7% for cannabis, 0.2% for glue and 0.1% for drugs such as diazepam. 7.46% (one in thirteen) of the youth were alcohol dependent, 4.88% (one in twenty) were nicotine dependent, and 2.54% (one in forty) dependent on cannabis.

As a conclusions Study findings demonstrate that tobacco, alcohol, marijuana and other substance use are realities in the daily lives of youth in Rwanda.

However further research is needed to monitor the evolution of this phenomenon and its determinants and in order to initiate evidenced-based interventions.

The complete article is available [{{Here}}->http://www.biomedcentral.com/content/pdf/s13104-015-1148-2.pdf]

{{Source: BMC}}

{Many people use their voices for their work. Singers, teachers, doctors, lawyers, nurses, sales people, and public speakers are among those who make great demands on their voices. This puts them at risk for developing voice problems. As others can’t work without their arm so as those who use their voices for work can’t.}

Here want to share some of the elements that will help to keep safe the voice:

{{1. Drink plenty of water.}}

I guess you should’ve seen that coming. The best thing to do for your achy vocal chords is drink water. Nothing on the entire Earth is better for you than good of’ H2O. Keep it at room temperature to avoid shocking your throat with the freezing or burning liquid.

{{2. Maintain a healthy lifestyle and diet:}}

-Don’t smoke and avoid second-hand smoke. Smoke irritates the vocal folds. Also, cancer of the vocal folds is seen most often in individuals who smoke.

-Include plenty of whole grains, fruits, and vegetables in your diet.

{{3. Wash your hands often to prevent getting a cold or the flu}}.

{{4. Get enough rest}}: Physical fatigue has a negative effect on voice.

{{5 Exercise regularly}}: Exercise increases stamina and muscle tone. This helps provide good posture and breathing, which are necessary for proper speaking

{{6. Use your voice wisely:}}

-Try not to overuse your voice. Avoid speaking or singing when your voice is hoarse or tired.

-Rest your voice when you are sick. Illness puts extra stress on your voice.

{{7. Practice good breathing techniques when singing or talking.}}

Support your voice with deep breaths from the chest, and don’t rely on your throat alone. Singers and speakers are often taught exercises that improve this kind of breath control. Talking from the throat, without supporting breath, puts a great strain on the voice.

{{8. Consider using a microphone when appropriate.}}

In relatively static environments such as exhibit areas, classrooms, or exercise rooms, a lightweight microphone and an amplifier-speaker system can be of great help.

These are eight points that every voice user can use to maintain his voice healthy.
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Source: Websites
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