IGIHE

Category: Health

  • Scientists: Bats are Source of Saudi Arabia’s Deadly Virus

    {{The source of a new virus that has killed 39 people in Saudi Arabia has been discovered as hundreds of local Muslims prepare to visit Mecca for Hajj.}}

    While the Saudi government has not placed travel restrictions on those wishing to make the annual pilgrimage, it has advised people aged over 65, children under 12, pregnant women and those with chronic diseases to postpone their plans for Hajj this year because of fears of the new virus.

    Kenya Airways has indicated it will be offering additional flights for the October – November Hajj period to meet an expected high demand. The airline will increase the number of flights to Jeddah from the current two per week to four.

    Since the emergence of the so-called ‘coronavirus’ last year, which is causing the disease, Middle East Respiratory Syndrome or MERS, teams of medical detectives from all over the world have been combing the Middle East for it.

    Of the 47 deaths so far caused by the disease, 39 have been in Saudi Arabia indicating this to be the possible ground zero. A total of 96 cases have been recorded so far in eight countries.

    On Wednesday, researchers from Columbia University, US, said they have pinpointed the source of the virus as the insect-eating bat called Egyptian Tomb Bat, somewhere close to the first known case of the disease in Saudi Arabia.

    {{Genetic match}}

    Although there were earlier reports that the virus had been detected in domestic camels in Saudi Arabia, this according to the researchers is the first time the find has been a 100 per cent genetic match.

    “There have been several reports of finding MERS-like viruses in animals. None were a genetic match. In this case, we have a virus in an animal that is identical in sequence to the virus found in the first human case.

    Importantly, it’s coming from the vicinity of that first case,” Dr Ian Lipkin, one of the researchers said in a statement from the university.

    Last month, a team set up by the World Health Organisation (WHO) to keep an eye on the MERS virus advised that the disease has not reached pandemic potential and hence there was no need for the world to panic or issue travel restrictions.

    However, the global health body has advised its members to be on the lookout for the new virus and wants all doctors to be especially vigilant with patients with severe respiratory infections and to carefully review any unusual patterns.

    {agencies}

  • Cocaine ‘Rapidly Changes the Brain’

    {{Taking cocaine can change the structure of the brain within hours in what could be the first steps of drug addiction, according to US researchers.}}

    Animal tests, reported in the journal Nature Neuroscience, showed new structures linked to learning and memory began to grow soon after the drug was taken.

    Mice with the most brain changes showed a greater preference for cocaine.

    Experts described it as the brain “learning addiction”.

    The team at University of California, Berkeley and UC San Francisco looked for tiny protrusions from brain cells called dendritic spines. They are heavily implicated in memory formation.

    {{Cocaine hunting}}

    The place or environment that drugs are taken plays an important role in addiction.

    In the experiments, the mice were allowed to explore freely two very different chambers – each with a different smell and surface texture.

    Once they had picked a favourite they were injected with cocaine in the other chamber.

    A type of laser microscopy was used to look inside the brains of living mice to hunt for the dendritic spines.

    More new spines were produced when the mice were injected with cocaine than with water, suggesting new memories being formed around drug use.

    The difference could be detected two hours after the first dose.

    Researcher Linda Wilbrecht, assistant professor of psychology and neuroscience at UC Berkeley, said: “Our images provide clear evidence that cocaine induces rapid gains in new spines, and the more spines the mice gain, the more they show they learned about the drug.

    “This gives us a possible mechanism for how drug use fuels further drug-seeking behaviour.

    “These drug-induced changes in the brain may explain how drug-related cues come to dominate decision making in a human drug user.”

  • Fast Moving Snails Spread Deadly Dog Disease

    {{Despite their lethargic reputations, snails can travel at a relatively speedy one metre per hour, say researchers.}}

    By attaching multicoloured LED lights, the scientists were able to track their movements over a 24-hour period.

    The gastropods were fast enough to explore the length of an average UK garden in a single night.

    But scientists are worried that the fast-moving snails are spreading a parasite that is deadly for dogs.

    Over the past few years the wet summers enjoyed across the UK have proved the ideal breeding grounds for snails.

    According to the Royal Horticultural Society, their numbers increased by 50% last year.

    As well as being a pest for gardeners, snails can also spread a parasite called Angiostrongylus vasorum.

    This lungworm is a particular threat to dogs, which can become infected by accidentally eating slugs or snails which they come across in the garden or on dog toys.

    {{Painted snails}}

    Researchers at the University of Exeter were commissioned to look into the scale of the threat by the Be Lungworm Aware campaign, which was set up and funded by Bayer Animal Health.

    The scientists attempted to track the movements of snails in garden situations.

    To do this they attached tiny, multicoloured LED lights to the backs of about 450 snails and used UV paint to track their movements.

    The researchers found that the snails could cover distances up to 25m in a 24-hour period.

    “They are so slow that people don’t even think about them moving, but it turns out they do, and they can go a long way in a night,” said Dr Dave Hodgson, who led this study and was also involved in a BBC amateur science experiment in 2010 that sought to discover if snails had a homing instinct.

    The researchers say their new work indicates that snails pose a growing threat to pets.

    “They are not just lettuce munchers, they are carriers of parasites that can kill your dogs,” said Dr Hodgson,

    A recent survey of veterinary surgeons indicated that the lungworm parasite was now endemic across the UK, where once it was mainly found in the south.

    “It is becoming a real problem not just in the south of England, it is moving north to Scotland,” said Dr Hodgson.

    “It is a national problem and we all have to pay attention to the interactions between dogs and snails,” he said.

    {{Happy trails}}

    In the new work, the scientists were surprised to see so many snails followed the slimy trails laid by others. Dr Hodgson says it is all about conserving energy.

    “We know that snails use about 40% of their energy budget producing slime.

    “Given a chance, a snail will prefer to follow a trail that has been laid by another, it is a form of cheating like slipstreaming,” he said.

    As to what pet owners should do, the scientists suggested they should regularly check the nooks and crannies in their gardens for snails and try to reduce exposure to the species.

    “I wouldn’t be too happy suggesting that there should be a snail apocalypse and everyone should get rid of them,” said Dr Hodgson.

    “I think awareness is a better idea, people need to understand the wildlife in their gardens and that no organism is totally harmless.”

    source:BBC

  • Counterfeit Medicine Trade Targets Africa’s Poor

    {{From Cameroon to Ivory Coast, Kenya to the DR Congo, traders in counterfeit drugs do a thriving business with the utmost cynicism and sometimes at the cost of human lives.}}

    “Street medication kills. The street is killing (safe) medication,” declares a banner outside a pharmacy in the Cameroonian capital Yaounde, where the dangerous trade is rampant.

    The market is saturated with counterfeit anti-malaria drugs, painkillers, antibiotics and even rehydration serum. No domain of the pharmaceutical industry is spared by illicit manufacturers and traffickers, according to media reports.

    “That’s powerful Diclofenac (an anti-inflammatory), which is the bestseller,” says Blaise Djomo, a street vendor at Yaounde’s central market. “And this is Viagra, which Cameroonians are really wild about.”

    About 100 traders like Djomo are set up under parasols in full view of everyone, their boxes heaped with medicines. Bubble-pack strips of pills are lined up in the wooden stalls.

    People can even buy single pills at this market or even at some grocery stores. Vendors often mix fake medication with the real thing, which has either been legally acquired or stolen from supplies meant for hospitals and clinics.

    At best, fake prescription drugs have no effect, acting like placebos, but at their worst, they are highly toxic. Either way they bring in vast sums of money for those behind the illicit traffic.

    The UN Office on Drugs and Crime (UNODC) warned at a conference last February that counterfeit drugs are a multi-billion dollar business accounting for 30 percent of the pharmaceutical market in parts of Africa.

    “Fraudulent medicines have proven to be harmful and at times fatal, as well as an increasingly lucrative area for organised criminal networks,” the agency said in a press release.

    “The supply routes are of two kinds. Alongside the small-scale smugglers, there are international criminal networks that undertake the supply of drugs from distant manufacturers in China and India,” said Parfait Kouassi, who chaired the National Order of Pharmacists in Ivory Coast from 2005 to 2012.

    Kouassi, who made a priority of fighting the dangerous trade in fake medicines, escaped two murder bids at the headquarters of the Order of Pharmacists. “That’s a sign that major interests are in play and that it’s not just a matter of small-scale local traffickers,” he said.

    The phenomenon is spreading and represents between 20 and 25% of the drug market in Ivory Coast, adds Kouassi.

    In Kenya, 30% of drugs sold in 2012 were either fake or counterfeit, according to the Pharmacy and Poisons Board of Kenya. Cameroon health officials give a similar figure.

    However, in the Democratic Republic of Congo, as in many other African countries, there are no national statistics, just records of frequent drugs seizures.

    In Nigeria — once known as a major source of counterfeit medicines — phony drugs and real ones that had passed their expiry date made up 70% of sales in 2002, according to the World Health Organisation.

    Since then, in the continent’s biggest market with some 160 million people, officials say that high-profile efforts have greatly reduced the number of fake or adulterated drugs, but reliable figures are hard to obtain.

    “Most of these fake and adulterated drugs come from China and India, from where we import more than 50 percent of the drugs we use in Nigeria. We don’t import much drugs from the US,” says Abubakar Jimoh, spokesman of the National Agency for Food and Drug Administration and Control (NAFDAC).

    “They no longer bring … illicit drugs in large containers but in small packs. They also change the labels of the drugs from outside the country to make them look original,” Jimoh said.

    Health authorities have set up a service to enable consumers to check the authenticity of drugs by verifying the PIN serial number on the product label via an SMS message.

    {{Safe vs. cheap: the cost factor}}

    The outstanding exception on the continent in fighting the illicit drug trade is South Africa, which has a strictly enforced licencing system, according to Griffith Molewa, head of law enforcement at the Medicines Control Council.

    “We have dedicated ports of entry for medicines, restricted to Durban, Cape Town, Port Elizabeth and OR Tambo airport in Johannesburg,” Molewa said. “We also have a vertically integrated system, meaning only manufacturers can sell to the wholesalers, and then the wholesaler to the retail outlets, and then the pharmacies can only serve the patients.”

    “Any product found on the street is seized and given to the police for prosecution. The penalty is a fine or up to 10 years of imprisonment or both.”

    In most other countries, measures against the counterfeit drug trade are limited to police raids on public markets to seize fake or adulterated products, along with public information and awareness campaigns, which appear to have little effect on consumers.

    For in countries where medical expenses — from drugs to hospitalisation — are not even partly reimbursed by the state, the relatively cheap price of street medication trumps the risk factor for many.

    “I’m here to buy a worm treatment and something to protect my children from malaria,” customer Nadine Mefo told media at Yaounde’s central market. “It costs less than in the pharmacy and it soothes the children.

    “Doctors say that street market medicines are dangerous, but since I’ve been coming, I’ve not yet had a problem,” she adds, clutching two packs of pills of unknown origin.

    AFP

  • UN Says Polio outbreak in Somalia Worse

    {{Aid workers in war-torn Somalia are struggling to contain a dangerous outbreak of the crippling polio virus, with rampant insecurity hampering efforts, the United Nations said Friday.}}

    Six years after the Horn of Africa nation was declared free of the virus, at least 105 cases have been confirmed in Somalia, the “worst outbreak in the world in a non-endemic country,” the UN Office for the Coordination of Humanitarian Affairs said in a statement.

    “The polio outbreak plaguing Somalia has spread despite significant efforts to curb the disease,” OCHA added.

    While some four million people have been vaccinated, getting drugs to more than 600,000 children in southern and central Somalia — areas partly under control of the Al-Qaeda linked Shabaab, who block vaccination efforts — is “extremely challenging”, it added.

    “The inability to fully access these areas constitute a major threat to the control of the outbreak,” the statement read, warning that “Somalia remains one of the most difficult and dangerous environments in the world for aid workers.”

    While over 100 cases of children have been recorded, “the fact that this number of children show symptoms of paralysis means that there are probably thousands more with the virus, who do not have symptoms, but are capable of spreading it,” OCHA added.

    Around 10 cases have also been reported in northeastern Kenya, which hosts almost half a million Somali refugees in sprawling camps.

    In Somalia, while the bulk of cases are in the southern and central regions, the outbreak has also spread to self-declared independent Somaliland in the northwest.

    Polio is spread by person-to-person contact, exacerbated by poor sanitation and a lack of clean water.

    Multiple armies are fighting for control of southern Somalia, including rival warlords, Islamist extremists and a rag-tag national army backed by a 17,700-strong African Union force.

    Aid workers report growing attacks on their staff.

    {Nation}

  • Women above 30 more Likely to Have Babies with Heart Defects

    {{A woman who gives giving birth at older age, above 35 years, has higher chances of her having babies with heart problems.}}

    This is because there are increased health risks associated with later-age pregnancies, according to Dr. Twalib Aliku, a paediatric cardiologist at the Uganda Heart Institute,

    “Taking of excessive amounts of alcohol, or having chronic medical diseases like diabetes can result in congenital heart problems,” he adds.

    According to Dr. Sulaiman Lubega, a paediatric cardiologist, the major cause of heart defects among children is unknown. Even mothers who are very cautious during pregnancy, for instance by staying away from alcohol and smoking, can still have a child with a heart defect.

    Aliku says some heart conditions may not be noticed during pregnancy and can cause death of the baby a few days after birth. A heart condition can also result from an infection such as streptococcus. “But some infections can be avoided,” Lubega adds.

    Aliku says premature birth also affects the growth of a baby’s organs like the heart; the blood vessels may not have developed fully resulting in a congenital heart disease called patent ductus arteriosus. A mother having infections like HIV, rubella, syphilis or even malaria can cause pre-term birth, predisposing the babies to heart disease.

    “When a pregnant woman takes strong medication like epilepsy drugs, it may damage the heart of the unborn baby,” he adds.

    {Newvision}

  • Tanzania in Sickle Cell Dilema

    {{The world has celebrated the Sickle Cell Day in a bid to bring public awareness on the disease and ensure people take precautions against it.}}

    Tanzania was named as the fourth country (worldwide) for having many sickle cell patients after Nigeria, India and the Democratic Republic of Congo (DRC) with the highest number of sickle cell disease cases per year (of up to 11,000).

    According to the sickle cell clinical coordinator at Muhimbili National Hospital (MNH), Dr Deogratius Soka, apart from the increasing number of patients, there is little awareness being created on the problem.

    “We started with 800 patients back in 2004, but currently we have about 4,000 of them who attend our clinic. This has brought more challenges in terms of finance, human resources and space,” said Dr Soka.

    NMG

  • Severe Measles Epidemic in CAR

    {{A severe measles epidemic has affected the whole territory of the Central African Republic, which lacks any strong health infrastructure, Health Minister Aguid Sounouk has said.}}

    “I call on the national transitional government and all partners in health care to mobilise for urgent measures … to minimise the impact of this epidemic,” Sounouk said in a radio broadcast on Tuesday.

    The minister blamed the spread of the disease on “outbreaks of measles in several administrative districts of the country where no action was organised to contain the epidemic” since December 2012.

    At the time, the landlocked nation was undergoing an insurgency that led to the overthrow of president Francois Bozize in March and placed power in the hands of a rebel coalition, which has since joined with other forces to form an interim government.

    ‘Highly contagious’

    Doctors without Borders, a humanitarian-aid non-governmental organisation, warned in early July that the country was on the verge of a public-health catastrophe, since widespread unrest and the coming to power of the rebels had been accompanied by the systematic plundering of health facilities.

    The Geneva based NGO said that this situation would likely lead to an “increase in the mortality rate in coming months”, including from “common and curable” diseases such as measles, which can kill people in developing countries if they develop complications without adequate care.

    Sounouk warned of the risk for very young people, because of “the highly contagious nature of measles” and since “the affected children have for the most part not been vaccinated against this disease”.

    A vaccination campaign took place in the capital Bangui in May this year and reached 122,000 children, but nothing has been done for about 1.5 million children who live in other parts of the country.

    Source: AFP

  • Fonterra apologises for tainted milk scare

    {{Fonterra, the New Zealand based company at the centre of a contaminated milk scare, has apologised to its customers, saying it is doing everything it can to rectify the situation.}}

    The world’s biggest dairy exporter said on Monday that it had found bacteria in some products that could cause botulism.

    China, company’s largest customer, has banned imports of milk powder from New Zealand over fears of botulism.

    The company said contaminated whey protein concentrate had been exported to China, Malaysia, Vietnam, Thailand and Saudi Arabia and used in products including infant milk powder and sports drinks.

    At a media briefing in Beijing Fonterra’s chief executive, Theo Spierings, said food safety was the company’s top priority.

    “We really regret the distress and anxiety which this issue could have caused,” he said.

    “We totally understand there is concern by parents and other consumers around the world. Parents have the right to know that infant nutrition and other dairy products are harmless and safe.”

    Aljazeera

  • “Freedom from Pain is Human Right”

    {{The need for worldwide palliative care coverage has never been greater. As the incidence of non-communicable diseases like cancer is rising in resource-limited settings, the need for palliative care alongside curative treatment is also growing.}}

    Basic symptom control and holistic support are not expensive and do not require highly specialized personnel, but are often lacking even where health structures and home based care programs are in place.

    Inadequate drug supplies are partly to blame, but equally important area lack of basic understanding of palliative care amongst healthcare workers at all levels, a lack of confidence in communication skills and a lack of knowledge of symptom control techniques. All of these may compound the inadequate procurement of the needed palliative care drugs.

    For these reasons communities and health workers can be overwhelmed by palliative care needs that they do not feel equipped to meet. Despite these challenges, it is not acceptable that we have to suffer and die without dignity solely because of the place we are born and live.

    In Rwanda, we consider comprehensive health care as basic human right, and thus have decided to address these challenges by implementing a coordinated Palliative Care program.

    While this will certainly be a great undertaking, we will take it step by step. As a well-known Indian Proverb says “When you want to eat an elephant you need to decide where to start and then just eat a little bit at a time”.

    Since the National Policy of Palliative Care was adopted by Rwanda Ministry of Health in March 2011, Rwanda has devoted a great deal of time and energy toward improving the quality of life ofpatients with life-threatening illnesses.

    A center of excellence for Palliative Care (PC) has been set up at Kibagabaga Hospital with a success stories of task shifting in the community, all working hand in hand with Palliative care Association of Rwanda which made that dream possible.

    Two hospitals have already started to integrate PC as a routine activity using Kibagabaga hospital’s experience, Teaching Hospital (CHUK) and Rwamagana Hospital.

    The national plan has several parts, including training health professional to be more comfortable to manage patients in the Palliative Care program. This is included both clinical teaching and supply chain management.

    From 27th-28th June, 2013, the Ministry of Health in collaboration with the Rwanda Palliative care association organized a two day workshop to develop a national framework for the estimation, procurement and use of opioids in Rwanda.

    A group of Experts from Rwanda led by Dr. Muhimpundu Marie-Aimee, head of NCD Division, MOH Rwanda with Rose Gahire (Executive Director of PCAR), Grace Mukankuranga (Executive Secretary of PCAR), Dr. Christian Ntizimira (Kibagabaga Hospital), Dr. Jean Luc Nkurikiyimfura (Head of HIV/AIDS Clinic, Teaching Hospital CHUK), PhmTayari (Director of marketing and sales/ MPPD/ RBC), Phn Theogene (Pharmacy Desk/MOH), Dr. EvaristeNtaganda (RBC/ NCD/ Director of CVD Unit), Dr. Kayonde Leonard (RBC/NCD/Director of Cancer Unit), Dr. Jean Baptiste Nkuranga (Director of Rwamagana Hospital) and Diane Mukasahaha Expert in Palliative care, participated in the workshop.

    A team from Uganda Ministry of Health and palliative care association was invited to share the experiences, challenges and opportunities that would help the Rwanda team to develop their own plan.

    The team was led by Dr. Mhoira Leng (Mulago Hospital), Dr. Henry Luzze (Division of NCDs MOH, Uganda), Rose Kiwanuka (Executive Director of Palliative Association of Uganda) and Dr. Dan Knights Medical Student fellow from UK.

    Dr. Muhimpundu said that the aim of the workshop was to estimate the needs of the opioids and to define procurement, request, and monitoring channels and develop a national framework that will guide the MOH in the management of opioid use in Rwanda.

    Kibagabaga Hospital has developed a specialized palliative care service and has become a Centre of excellence in the field. In a 12 month period, Kibagabaga hospital, which sees 55,000 patients per year (inpatients & outpatients), is using 0.12kg of oral morphine.

    By using that experience we estimated the opioid needs for one year based in our administrative health sector and our decentralization, an approximate projection of realistic usage in the following eight facilities was made, taking in account expected numbers of patients per year.

    The following are the main hospitals and their estimation: CHUK (0,3 KG), Rwanda Military Hospital (0,2KG), King Faysal (0,2 KG), Butaro ( 0,2KG), CHUB (0,12KG), Rwamagana (0,12 KG), Rwinkwavu(0,12 KG), Kibagabaga (0,12 KG) accounting for 1.38 KG.

    In our decentralized health system, the level below referral hospitals is the District Hospitals. Rwanda has 42 District hospitals, all of which have a Multidisciplinary Team including physicians. At district level in its phase one of the Implementation plan, 10 hospitals and their catchment area will use the same amount of opioids as Kibagabaga Hospital and at the same time the 30 remains hospitals will use half of that amount: 0,6kg.This accounts to a morphine quantity estimated at 3.12 Kgs.

    Finally, with a buffer stock that accounts to 10% (0, 5 KG), the total morphine that is required during the period 2013-2014 for our National PC program is estimated to 5 Kgs.

    Dr. Agnes Binagwaho, Minister of Health of Rwanda, said that after having almost reached Millennium Development Goals 4&5 and doubling the life expectancy of our population, it is time to focus on improving the quality of life of Rwandans, and thus needing all health professionals to contribute to better management of chronic diseases and development of palliative care.

    {Author is a practicing doctor at Kibagabaga Hospital}