#global health

bklynmed:

Approval sought for world’s 1st malaria vaccine

BBC News: GlaxoSmithKline is seeking regulatory approval for the world’s first vaccine against malaria, after promising trial data showed that it cut cases of the often-fatal disease in African children.

The company has been developing the vaccine for 3 decades and plans to submit a regulatory application to the European Medicines Agency.

Malaria kills hundreds of thousands of people every year.

Photo: Malaria infected mosquitoes (AFP)

The vaccine has only modest efficacy compared to other approved immunizations. And it’s a bit costly. But still, it has the potential to save hundreds of thousands of lives each year – which is great progress

It’s Time To Rediscover The IUD, Women’s Health Advocates Say

What will it take to make intrauterine devices sexy?

IUDs are highly effective forms of contraception, but fear of side effects, lack of training for doctors and costs can keep women away. Health organizations and private companies are trying to change that by breaking down misconceptions and broadening access.

The contraceptives are inserted into the uterus and can prevent pregnancy for years. And they’re reversible. Shortly after they’re taken out, a woman can become pregnant.

IUDs are more than 99 percent effective. The World Health Organization reports they are “the most widely used reversible contraceptive method globally.” But few women in the U.S. use them; the percentage is only in the single digits, in part because IUDs have a checkered past. The Dalkon Shield IUD, marketed nationwide beginning in 1971, was found to raise the risk of pelvic inflammatory disease. Medical complications and deaths sparked lawsuits with thousands of claimants.

“So we had a whole generation in the ‘70s and '80s … where doctors and clinicians weren’t trained and women didn’t have that option,” says Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University in St. Louis.

The two common intrauterine devices in the U.S. are ParaGard, which releases copper to interfere with sperm, and Mirena, which prevents pregnancy with the hormone progesterone. There is still a slight risk of pelvic inflammatory disease. But Bayer Healthcare Pharmaceuticals, the maker of Mirena, says fewer than 1 percent of users of its device get the infection. More common side effects for women using IUDs are irregular bleeding or cramping.

Upfront costs also limit access; the price of the device and getting it inserted can cost hundreds of dollars.

But Mirena works for up to five years, and the copper IUD up to 10. So over time, they can actually be cheaper than monthly payments for, say, the pill. And IUDs, like other contraceptives approved by the Food and Drug Administration, are expected to be covered for most users under the Affordable Care Act.

Continue reading.

Image: An IUD is seen on pelvic X ray (© Nevit Dilmen found at Wikimedia commons)

A DEET-Like Mosquito Spray That Smells Like Jasmine Or Grapes?

California scientists are reporting a pair of victories in the epic struggle between man and mosquito.

A team at the University of California, Riverside, appears to have finally figured out how bugs detect the insect repellent known as DEET. And the team used its discovery to identify several chemical compounds that promise to be safer and cheaper than DEET, according to the report in the journal Nature.

Three of the new repellents are already approved by the Food and Drug Administration as food additives. “One of them is present in plum," says Anandasankar Ray, of the University of California, Riverside, who led the study. "The other is present in orange and jasmine oil. Some of them are present in grapes. And, as you can imagine, they smell really nice.”

The new repellents, if they pan out, could make a huge difference in developing countries where mosquito-borne diseases such as malaria and dengue fever are common, says Craig Montell, a researcher at the University of California, Santa Barbara, who is not connected to the new research.

Though effective, DEET is too expensive for many people in developing countries, Ray. Also, he says, consumers have to be careful how they use the repellent. It can dissolve plastics, including nylon.

Even so, DEET has been the gold-standard bug repellent since the U.S. Army developed it in the 1940s, Ray says, despite many efforts to find something better. “The main reason why scientists haven’t been able to improve upon DEET is because they just didn’t know how DEET is detected by the insects,” he says.

Now, it appears, they do know, thanks to experiments with some genetically modified fruit flies in Ray’s lab. These custom-made flies have special nerve cells in their antennae that glow a fluorescent green when they react to DEET, Ray says.

Continue reading

The illustration shows four DEET-like mosquito repellents discovered by the team at the University of California, Riverside. Three of them are safe to eat. Courtesy of Pinky Kai/University of California, Riverside

How Do You Really Save Children In Ethiopia? 

Through a government program that provides universal, bare-bones, health care, perhaps?

Ethiopia’s network of 30,000 health extension workers provides basic health care across the country.

By treating diarrhea, pneumonia, malaria and other common ailments, these health extension workers have been the driving force in reducing Ethiopia’s child mortality rate. They also assist with births and provide routine immunizations to children.

Twenty years ago 1 in 5 kids born in Ethiopia would die before their 5th birthday. Now that rate has been cut in a third to only 1 in 15. The credit for that dramatic drop goes largely to women like health worker Foos Muhamed Gudaal (top) and the government officials who had the vision and conviction to set up such a program.

Photograph:

Top: Health worker Foos Muhamed Gudaal at a rural health post in the eastern Somali Region of Ethiopia (Jason Beaubien/NPR)

What did world leaders say about women and girls at the United Nation’s General Assembly last week?

U.N. Women has created a Flickr gallery with the top quotes and beautiful photographs to go along with them. 

Vaccine Refusals Fueled California’s Whooping Cough Epidemic

When the whooping cough vaccine was invented in the 1940s, doctors thought they had finally licked the illness, which is especially dangerous for babies. But then it came roaring back.

In 2010, a whooping cough outbreak in California sickened 9,120 people, more than in any year since 1947. Ten infants died; babies are too young to be vaccinated.

Public health officials suspected that the increased numbers of parents who refused to vaccinate their children played a role, but they couldn’t be sure.

Vaccine refusal was indeed a factor, researchers now say. They compared the location and number of whooping cough, or pertussis, cases in that outbreak with the personal belief exemptions filed by parents who chose not to vaccinate for reasons other than a child’s health. (Some children with compromised immune systems aren’t able to be vaccinated.)

Pertussis is very contagious, spreading quickly through a community. So the researchers had to map not only the location of outbreak clusters, but also when they appeared.

They found that people who lived in areas with high rates of personal belief exemptions were 2 ½ times more likely to live in a place with lots of pertussis cases. “The exemptions clustered spatially and were associated with clusters of cases,” Jessica Atwell, a graduate student at Johns Hopkins Bloomberg School of Public Health and lead author on the study, told Shots. It was published online in the journal Pediatrics.

Continue reading.

The photograph above show Bordetella pertussis, the bacterium that causes whooping cough, under the electron microscope. Image by Sanofi Pasteur/Flickr.com.

nursingisinmyblood:

pubhealth:

Kit Yamoyo

We know how to treat diarrhea. Zinc and oral rehydration solution (ORS) are proven, affordable treatments, yet diarrhea still kills nearly 600,000 children annually. In rural areas, it’s often easier to find a bottle of Coca-Cola than these lifesaving medicines. ColaLife developed Kit Yamoyo to bundle and deliver zinc and ORS to African children by piggybacking on the beverage company’s delivery system and local social marketing. The kit contains zinc, ORS, and soap, and the packaging serves multiple purposes: a measuring guide, a mixing and storage device, and a cup.

(FromPATH)

This awesome. I love to see this kind of stuff!

For $3,400, Volunteers Get Doused With The Flu

What would it take to persuade you to allow government researchers to squirt millions of live flu viruses up your nose?

A recently concluded project at the National Institutes of Health found, among other things, that $3,400 each was enough to attract plenty of volunteers.

“I am happy I could contribute in some way,” says Kelli Beyer, 24, one of 46 healthy people who volunteered for the project. To get the money, the research subjects had to commit to several days of testing, then nine days in a hospital isolation ward once the virus was administered in a nasal spray.

All the subjects got varying amounts of a laboratory-synthesized version of the H1N1 strain of swine flu that touched off a pandemicback in 2009 that sickened millions and contributed to the deaths of more than 18,000 people.

Since one aim of the study was to see how much virus it takes to make people moderately sick, researchers ramped up the dose given to seven successive groups of volunteers. Beyer was in the last of seven groups, so she got the highest dose.

More on what happened to her later. First, you might be wondering why scientists felt they needed to give people the flu.

“Despite 100 years of studying influenza, we still have somewhat limited knowledge of how flu causes disease in humans,” study director Matthew Memoli tells Shots. “These kinds of studies have been done before, but not since the early 1990s.”

Continue reading.

Image above shows influenza viruses (blue) attaching to the cells of the upper respiratory tract. Viruses floating in the air are breathed in and bind to the hair-like microvilli and cilia on the surface of the cells that line the trachea. Image by R. Dourmashkin,Wellcome Images.

How Money Worries Can Hamper Performance At Work

There’s no question that dealing with mortgages, car payments and other bills takes up time and energy. But having a tight budget may also zap our ability to think clearly, scientists recently reported in the journal Science.

In a series of clever experiments involving farmers in India and shoppers in New Jersey, scientists found that people are worse at solving puzzles — similar to those on the IQ test — when they’re first reminded of money problems.

“Financial constraints capture a lot of your attention,” says Eldar Shafir, a psychologist at Princeton University, who helped lead the study. “Then there’s less bandwidth left to solve problems. Your cognitive ability starts to slow down, just like a computer.”

And the effect is big. After a quick reminder about money issues, people’s performance on the puzzles drops down by at least a quarter — or approximately the same mental hit a person takes after staying up all night.

In the study, Shafir and his colleagues approached people at a shopping mall in Lawrenceville, N.J., and asked them how much money they earn. “We had a pretty good selection of middle-to-low income Americans,” Shafir tells Shots. The lowest salaries were about $20,000 and the average was about $70,000.

Before the participants started the puzzles, they answered a question about money: “A person’s car breaks down, and they need X dollars to fix it. Tell me what are the options they have available?”

People with lower incomes did just as well on the tests as those with higher salaries when the amount of money required to fix the car was low, like $100. But when the scientists raised the amount to $1,500, the less affluent participants performed worse on the puzzles.

“The money question tickles that part of the brain that has to do with your own finances,” says Sendhil Mullainathan, an economist at Harvard University who also led the study. “Then you start thinking, ‘Gee, how I am going to pay rent this month?’ ” And that interferes with your ability to think through a problem, he says.

Continue reading.

Illustration by Katherine Streeter for NPR.

Africa’s ‘Brain Drain’ In Health Care Continues To Soar

The number of doctors from sub-Saharan Africa working in the U.S. has risen by nearly 40 percent in the past decade, researchers from Vanderbilt University reportedTuesday in the journal PLOS Medicine.

By analyzing data from the World Health Organization, Akhenaten Benjamin Siankam Tankwanchi and his team estimated that 10,819 physicians were born or trained in 28 sub-Saharan countries. For all of these countries, except South Africa, migration to the U.S. increased from 2002 to 2011. Nigeria and Ghana saw a more than 50 percent rise, while Ethiopia and Sudan suffered a more than 100 percent increase. Liberia was hardest hit with an estimated 77 percent of their doctors moving to the U.S.

Once the doctors leave sub-Saharan Africa, they don’t return home quickly. On average, the physicians trained in Africa have been in the U.S. for 18 years, the researchers said.

“Unless far-reaching policies are implemented by the U.S. and sub-Saharan countries, the current emigration trends will persist," Tankwanchi and his team wrote. "And the U.S. will remain a leading destination for SSA physicians emigrating from the continent of greatest need.”

Learn more.

Top graph: Since the 1960s, the number of sub-Saharan trained doctors who have moved to the U.S. (SSA-USMG) has increased exponentially.

Bottom graph: Length of service provided to the home country by medical graduates trained in sub-Saharan Africa before moving to the U.S.

nprglobalhealth:

Mapping The Diseases That Will Most Likely Kill You

Depending on where you live, these are the diseases that will most likely kill you. Using data from the World Health Organization, Simran Khosla at the GlobalPost labeled each nation with the disease that caused the most death in that country.

And it seems like much of the world will succumb to heart disease. Most prevalent in Africa is HIV/AIDS and tuberculosis. You can zoom in on the other regions at GlobalPost.

themedicalstate:

Escape

Miniature Art by Tatsuya Tanaka (Follow the artist here)

In advance of World AIDS Day 2018, Secretary of State Michael R. Pompeo will deliver keynote remarks at the PEPFAR Faith Communities and HIV Technical Summit at the Department of State at 9:00 a.m. Eastern Time on Tuesday, November 27, 2018. Watch the event live on www.state.gov.

The Secretary will announce the latest lifesaving results achieved under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), including additional progress that is being made under the PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020). Visit www.pepfar.gov to learn more.

nprglobalhealth:

Floating Toilets That Clean Themselves Grow On A Lake

Imagine you live on a floating lake house. Open air. Chirping crickets. Clear, starry nights. Everything seems great until you need to use the bathroom.

The natural instinct might be to make a deposit in the water. But that wouldn’t be safe. Microbes in your feces would contaminate the water and could cause outbreaks of deadly diseases, like cholera.

A group of engineers in Cambodia wants to solve that problem for the floating villages of Tonle Sap Lake, the largest freshwater lake in Southeast Asia. Over a million people live on or around it. Exposure to wastewater spawns diarrhea outbreaks each year. In Cambodia, diarrheal diseases cause 1 in 5 deaths of children under age 5.

To help clean the lake’s water, engineers at the company Wetlands Work! in Phnom Penh are developing plant-based purifiers, called Handy Pods. The pods are essentially little kayaks filled with plants. They float under the latrine of a river house and decontaminate the water that flows out.

Here’s how it works. When a person uses the latrine, the wastewater flows into an expandable bag, called a digester. A microbial soup of bacteria and fungi inside the digester breaks down the organic sludge into gases, such as carbon dioxide, ammonia and hydrogen.

Continue reading.

Photo: A pod to pick up your poo: The Handy Pod features floating hyacinth plants placed underneath a houseboat’s latrine. The blue tarp offers privacy. (Courtesy Taber Hand)