African Press International (API)

"Daily Online News Channel".

Posts Tagged ‘Tuberculosis’

Switzerland: The fight against malaria, HIV/AIDS and tuberculosis

Posted by African Press International on December 15, 2013


Switzerland steps up its commitment to the fight against malaria, HIV/AIDS and tuberculosis

 

BERN, Switzerland, December 13, 2013/African Press Organization (APO)/ The Federal Council has approved a contribution of CHF 60 million for the 2014-2016 period for the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). Switzerland was one of the founders of the Geneva-based fund in 2002 and has been one of its key partners since the beginning. Malaria, HIV/AIDS and tuberculosis remain the leading causes of death in sub-Saharan Africa. These three diseases are among the most important factors hampering development.

 

Three diseases – malaria, HIV/AIDS and tuberculosis – are among the most frequent causes of death worldwide, and especially in Africa. Malaria remains the leading parasitic disease worldwide. In 99 countries, approximately 219 million new cases are registered every year. About half of the world’s population lives in areas affected by malaria. The WHO estimates that in countries in Africa with endemic malaria the disease lowers economic growth by 1.3 percentage points per year.

 

Some 2.5 million people are still becoming newly infected with HIV every year and more than 1.7 million people die of AIDS-related illnesses every year worldwide. In the case of tuberculosis, the estimated number of annual deaths is 1.4 million. HIV/AIDS and tuberculosis frequently occur in combination, making them very difficult to treat in developing countries.

 

Nevertheless, considerable progress has been made in the fight against these three diseases over the past ten years. For example, new HIV infections declined by 33% worldwide, and by more than 50% among children in medium-income countries. Some 8 million people in Africa are currently receiving antiretroviral therapy – a twenty-fold increase from 2003. Significant progress has also been made in the fight against tuberculosis: the TB mortality rate has fallen by approximately 41% since 1990. The UN’s millennium development goal of stopping the spread of HIV/AIDS, malaria and other major diseases by 2015 and gradually reversing their incidence is thus within reach.

 

The fight against malaria, HIV/AIDS and tuberculosis is a high priority for international development cooperation as well as for Switzerland. The significant progress achieved so far can no doubt be attributed amongst others to the efforts of GFATM, which is the biggest backer in the fight against these three diseases.

 

SOURCE

Switzerland – Ministry of Foreign Affairs

 

Advertisements

Posted in AA > News and News analysis | Tagged: , , , , , , , | 1 Comment »

Norway: Government to step up global health efforts

Posted by African Press International on October 19, 2013

The GAVI Alliance (the Global Alliance for Vaccines and Immunization) and the Global Fund to Fight AIDS, Tuberculosis and Malaria will together receive an additional NOK 330 million in the national budget for 2014. The Government wishes to intensify its efforts to promote child and maternal health globally, to fight deadly diseases and to help to eradicate polio.

“Six million fewer children died in 2012 than in 1990. Deaths from malaria have fallen by 25 % since 2000. Deaths from tuberculosis have fallen by more than 40 % since 1990. And deaths from AIDS fell by 30 % from 2005 to 2012 alone. This shows that the global health effort is producing results. But much remains to be done,” said Minister of Foreign Affairs Espen Barth Eide.
Polio is in the process of being eradicated. Norway is increasing its support to this work by more than fourfold, with a total allocation of NOK 240 million for 2014. These funds will be administered mainly by the GAVI Alliance, but also by the World Health Organization (WHO).
“There is a close link between the use of resources and the results achieved. The money is reaching those for whom it is intended, and is being used effectively. This is why we are increasing our support, knowing  that this work is benefiting women and children, as well as men, all over the world,” said Mr Eide.
The fight against the major deadly diseases AIDS, tuberculosis and malaria is being intensified. The Global Fund to Fight AIDS, Tuberculosis and Malaria will receive an additional NOK 50 million. It is planned that this funding should be increased by a further NOK 100 million in 2015. Altogether it is proposed that NOK 1.7 billion should be allocated to the Global Fund for the period 2014–16.
Norway’s allocation to the GAVI Alliance is to be increased by NOK 100 million. So far 370 million children have been vaccinated through GAVI-supported programmes, and the aim is to reach many more. Norway’s contribution now totals more than NOK 1 billion per year.
“The increase in this year’s budget shows that Norway is shouldering its part of the responsibility for bringing the world closer to achieving the health-related Millennium Development Goals by 2015,” said Mr Eide.
In total, Norway now spends more than NOK 4 billion of its international development budget on global health. Norway intends to increase focus on universal health coverage. It is the responsibility of individual countries to provide basic health services to their populations, while the role of the international community must be to provide support for national efforts under national ownership.

 

End

Posted in AA > News and News analysis | Tagged: , , , , , , , | Leave a Comment »

Tun Aung Kyaw says his TB was misdiagnosed

Posted by African Press International on August 22, 2013

Tun Aung Kyaw says his TB was misdiagnosed

WANGPHA,  – Struggling to breathe, Burmese migrant Tun Aung Kyaw sits up slowly in bed for a routine check-up at a Thai tuberculosis (TB) clinic along the 1,800km Thai-Burmese border.

This is the third round of treatment for the 29-year-old, who believes Burmese health workers misdiagnosed him with regular TB twice when he actually had multi-drug-resistant TB (MDR-TB), a form of the infectious disease harder to diagnose and cure.

“Even though I was on TB treatment I got weaker and eventually I was bed-ridden,” Tun Aung Kyaw told IRIN.

After 14 months of treatment, Tun Aung Kyaw’s condition never improved as the disease had destroyed his left lung. He now faces a two-year regimen of care to see if he can finally defeat the MDR-TB strain, which has a treatment success rate of almost 60 percent in South-East Asia, according to the Global Tuberculosis Report 2012 by the World Health Organization (WHO).

Inadequate detection and treatment are major obstacles and can result in cases of drug-resistant TB (DR-TB) such as MDR-TB, say health experts.

“Drug-resistant TB is a very significant health concern for Myanmar,” Peter Paul de Groote, the country’s head of mission for Médecins Sans Frontières (MSF), told IRIN.

Around 8,900 new cases of DR-TB are reported each year, but only 800 patients had access to treatment at the end of 2012, he said.

TB burden

Myanmar is among the world’s top 22 TB-burden countries with a prevalence rate of 525 cases per 100,000 people, more than three times the global average.

It is also a high burden country for MDR-TB, a complex strain immune to first-line drugs that requires two years of treatment, four times longer than non-resistant TB.

MDR-TB treatment costs nearly US$5,000 per patient, roughly 100 times more than the regular strain, according to an October 2012 WHO report.

From 22 to 23 August, WHO, along with MSF and Myanmar’s Ministry of Health, plan to hold a DR-TB symposium in Yangon aimed at ramping up services throughout the country, including neglected border regions.

“There are immense challenges in providing DR-TB treatment, and health care in general, to the remote border areas of Myanmar,” de Groote said.

Health experts fear countless more cases remain hidden in rural eastern Myanmar where armed conflict, rough terrain, lack of awareness and scarcehealth care can discourage TB-infected people from seeking care.

Proposed approaches for battling DR-TB include counselling to help patients cope with long and toxic courses of treatment, decentralized care in home communities, and rapid diagnosis to treat patients correctly and prevent further cases.

To do this, Thandar Lwin, manager of Myanmar’s National TB Programme, has urged the Burmese government to step up efforts to support TB measures, 94 percent of which are donor funded.

TB-infected patients live in these huts for the duration of their treatment at the Wangpha TB clinic

“The government budget is not enough and it is difficult to increase more than the previous year,” she said during an international TB workshop earlier this year. “There is a need for evidence to persuade the government that investment in health is worthwhile.”

In 2013, Myanmar is projected to have a US$22 million funding gap for TB care and control services, the WHO report said. On the other hand, rapideconomic growth may help ease the problem in the longer term.

Border run

Many Burmese are forced to seek TB care at donor-funded clinics along the Thai border, home to roughly one million migrants and displaced persons.

Two health clinics run by Shoklo Malaria Research Unit (SMRU), a Mae Sot-based field station for the Mahidol University-Oxford University Tropical Medicine Research Programme in Bangkok, offer free treatment and are inundated with patients.

From 2010 to March 2013, SMRU supported more than 810 TB patients, but had to refer 70 percent of them, and pay for their care at local Thai hospitals due to limited capacity.

About 18 percent of patients tested for first-line drug susceptibility at SMRU clinics had some form of DR-TB. Almost half have already been successfully treated, with others still on the regimen.

In June 2013, SMRU opened a specialized TB clinic in the village of Wangpha, near the Thai border town of Mae Sot, to handle the overflow. Plans are also under way to expand in-patient care at the second clinic since 60 percent of TB patients, especially those with drug resistance, need to be supervised by clinic staff.

Sein Sein, manager of the TB clinic, said several patients initially came in after showing symptoms for several months, when treatment should be sought if persistent coughing lasts for at least two weeks.

“Many patients only come for treatment when they are really sick, so they stay in the community and continue to spread the disease,” she said.

According to WHO, there were an estimated 650,000 cases of MDR-TB among 12 million TB cases worldwide in 2012.

sk/ds/cb source http://www.irinnews.org

Posted in AA > News and News analysis | Tagged: , , , , , , , , , | Leave a Comment »

Food insecurity opens door to TB

Posted by African Press International on May 2, 2013

Waning donor support for food assistance is seeing increasing food insecurity. Malnutrition and the susceptibility to tuberculosis (TB) are directly linked

TOLIARA,  – Health experts fear the interruption of food assistance in Madagascar is increasing incidence of tuberculosis (TB) in Toliara, the capital city of Madagascar’s southern Atsimo-Andrefana region.

Malnutrition and TB are intimately linked: Malnutrition weakens the immune system, increasing susceptibility to the disease, while TB reduces appetite, worsens the absorption of micronutrients and alters patients’ metabolism.

Donors suspended all but emergency assistance to Madagascar in 2009, after President Marc Ravalomanana was deposed in a coup d’etat. The paucity of donor funding has seen food assistance dwindle “to a very serious level”, said Xavier Poncin, head of the TB programme at the UN World Food Programme (WFP) in Madagascar.

The impact of Cyclone Haruna, which struck the country in February, has compounded the problem. Since the cyclone, the donors’ food supply chain has been intermittent, Poncin told IRIN.

TB cases are already appearing to increase. Voangy Rasoarinindrime, head of the TB treatment centre in Toliara, told IRIN that in the first three months of 2012, 56 new cases were registered for treatment, compared to 68 cases for the same period this year.

“Many people can come into contact with TB, but [do] not become sick if they are healthy enough to fight off the illness. But now that food is scarce after the cyclone, many people have low immunity and so the illness takes root,” she said.

Less food aid, less treatment

Madagascar’s National Programme Control of TB (PNLT) said 2012 saw 26,182 confirmed cases of TB, although the total number of infections is thought to be about 50,000.

About five percent of cases are fatal. Nine percent of those treated for TB do not complete the six-month treatment regime, risking the onset of multidrug-resistant tuberculosis (MDR-TB). WFP estimates that about 0.49 percent of all TB cases in Madagascar are MDR-TB.

Food supply at the TB treatment centre in Toliara was depleted in February, in the aftermath of Cyclone Haruna, said Rasoarinindrime. “People are unable to work during treatment, and they still need to feed themselves. We have some patients who left. They said since there was no more food aid here, they would have to go back to work to feed their families,” she said.

“I’m afraid fewer people will actually be completely cured and that this will cause an augmentation in the amount of cases”

Food aid “also encouraged people to come here and receive treatment in the first place. Now they are very upset that there is no more food. Some still come from the remote regions with their baskets ready to receive their rations,” Rasoarinindrime continued. “I’m afraid fewer people will actually be completely cured and that this will cause an augmentation in the amount of cases.”

Some of Madagascar’s TB patients receive food aid from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Others receive food from WFP’s Food by Prescription (FBP) programme, which targets 23,000 beneficiaries – both TB patients and their families – during the six months of treatment. But the FBP programme has been temporally suspended in 22 of 51 health facilities due to WFP Madagascar’s funding shortage.

“If the lack of funding persists, the situation might even worsen as food availability in the pipeline allows for programming in the few remaining partner health centre until September 2013,” said WFP’s Poncin.

Senaz Ratsimbazafy, a 26-year-old waitress in Toliara told IRIN she began feeling sick in November 2012. “I couldn’t breathe and I coughed all the time,” she recalls.

After she was diagnosed with TB, she left her job and was put on the six-month course of antibiotics. In the first months of treatment, she received food assistance for her and her 80-year-old grandmother. “Now, my father’s family have to help us, as there is no more food aid, and I can’t go back to work for another two months,” she said.

Waiting for improvement

According to a 28 March 2013 country briefing by the UN Food and Agriculture Organization’s (FAO) Global Information and Early Warning System (GIEWS), Cyclone Haruna affected about 42,000 households. Meanwhile, a locust infestation is thought to have affected half the country, and rains have been erratic. “An estimated 13 million persons [of the country’s 20 million people] are potentially at risk” from food insecurity in 2013-14, the briefing said.

“Despite an increasing number of people living below the poverty line, most international donors are still limiting their support due to the political situation”

“Despite an increasing number of people living below the poverty line, most international donors are still limiting their support due to the political situation. And this has direct consequences on WFP programmes,” Poncin said.

More than three-quarters of the population now live on less than US$1 a day, according to government figures – up from 68 percent before the political crisis. Elections are scheduled for July; if they are judged “free and fair”, more donor support could be unlocked.

There are other barriers to TB treatment, as well. Eighty percent of the population is rural, and 65 percent live 10km or more from a health centre.

“We had a woman here recently who refused treatment completely,” Rasoarinindrime said. “She lived in a remote region and insisted she had to go back and take care of her family. I told her, ‘You will die and you will contaminate your family.’ Moreover, it might create and contribute [to] spreading multidrug-resistant TB, which is much more difficult to treat – but she left anyway.”

Laundry worker Celerine Ravaonirina, 46, lives 14km from the clinic where she is receiving treatment for TB. Because she has to care for her four children, she travels to the clinic and back each day. “In the beginning, we paid for a pousse-pousse [rickshaw], but now I’m able to walk,” she said. “However, I’m still not able to work.”

ar/go/rz source http://www.irinnews.org

 

Posted in AA > News and News analysis | Tagged: , , , , , , , | Leave a Comment »

Technology revolutionizes TB management

Posted by African Press International on April 22, 2013

NAIROBI,  – The use of technology is revolutionizing the way Kenya manages tuberculosis (TB). Through a computer- and mobile-phone based programme called TIBU, h ealth facilities are able to request TB drugs in real-time and manage TB patient data more effectively, health officials say. They also use the platform to carry out health education.

“One of the challenges we have had with TB treatment is people defaulting [on treatment], but this will reduce significantly because through TIBU we will be able to track down patient treatment progress,” Joseph Sitienei, head of the Division of Leprosy, TB and Lung Disease at Kenya’s National AIDS Control Programme, told IRIN.

“By being able to track a patient, the health workers can send them reminders on their mobile phones when they fail to appear for drug refills,” Sitienei added.

Information sharing

In Kenya, a dearth of information on TB among patients and poor management of patient data have always been a challenge.

“People at times default not because they want to but because they lack information, and health facilities do not share patient data and history. Now the government is beginning to appreciate the relevance of technology in managing diseases such as TB,” said Vincent Munada, a clinical officer at the Kenyatta National Hospital in Nairobi.

Sitienei noted that TIBU – which is Swahili for “treat” – has also helped health facilities better manage drug supplies.

“Initially, health facilities used to request for TB drugs manually, but with this new system, they can ask for the same and the request is relayed to the ministry headquarters immediately. That way, drugs are supplied on time,” he said.

Kenya is ranked at 15 on the UN World Health Organization (WHO) list of 22 countries with the highest TB burden in the world, and it has the fifth-highest TB burden in Africa.

The government says an estimated 250 district hospitals, out of the country’s 290, are using the programme, which was launched in November 2012.

The government is also using the technology to support multi-drug-resistant tuberculosis (MDR-TB) patients living far from medical facilities, sending money to patients via the Mpesa mobile phone money-transfer system to cover transport costs.

Enormous potential

Mobile phone platforms like TIBU could have even wider life-saving potential.

A recent report by multinational firm PricewaterhouseCoopers noted that mobile phone applications such as short text messages could, over the next five years, help African countries save over one million of the estimated three million lives lost annually across the continent to HIV/AIDS, TB, malaria and pregnancy-related conditions.

“SMS reminders to check for stock levels at the health centres have shown promising results in reducing stock-outs of key combination therapy medications for malaria, TB and HIV. For HIV patients, simple weekly text reminders have consistently shown higher adherence amongst the patients,” said the report.

According to the report, Kenya alone could save some 61,200 lives over the next five years by embracing mobile-based health information management.

On TB, PricewaterhouseCoopers said: “TB is a largely curable disease, but requires six months of diligent adherence to the medication regime. mHealth [mobile health] could help control TB mortalities by ensuring treatment compliance through simple SMS reminders.”

The report noted that mobile phone-based care for patients could reduce emergency visits to health facilities by up to “10 percent.”

“You know, at certain times, a patient doesn’t even need to come to a facility. You simply share what you have with them over the phone. It saves patients time and relieves the health worker to attend to other pressing issues,” Kenyatta National Hospital’s Munada said.

A 2012 study in Kenya found that the use of mobile phones between patients and health workers improved antiretroviral therapy adherence among people living with HIV.

In one mobile health project, community health workers were able to track their patients’ conditions through the use of text messages.

ko/rz source http://www.irinnews.org

Posted in AA > News and News analysis | Tagged: , , , , , , , | Leave a Comment »

TB vaccines: The options in terms of cost-effectiveness

Posted by African Press International on April 1, 2013

CAPE TOWN, 28 March 2013 (IRIN) – As researchers consider who might benefit most from the next wave of tuberculosis (TB) vaccines, some argue that we’re not doing enough with the vaccine we already have. 

The disappointing results of the first infant TB vaccine tested for efficacy in 40 years were published in February 2013, but new research suggests that while babies might be easier to reach, given existing childhood vaccination programmes, new vaccines will be more cost-effective if geared towards teens and adults.The findings by the London School of Tropical Medicine are based on mathematical modelling that compared the cost-effectiveness of potential TB vaccines in the top 22 countries with the highest burden of TB, as listed by the World Health Organization (WHO), including South Africa, India and China, which account for 82 percent of all TB cases globally.

Dr Gwen Knight and colleagues used information like the number of new TB cases recorded annually, population projections, and TB mortality. Where available, they also factored in TB treatment and vaccine delivery costs. Finally, they created various scenarios based on projections of, for instance, how well a future vaccine might protect people from active TB, and how long this protection would last.

Knight’s preliminary results were presented at the TB Vaccines Third Global Forum in Cape Town. They indicate that in most scenarios, TB vaccines given to teens and adults were about seven times cheaper than those administered to infants. The most cost-effective TB vaccine would be designed for adults and teens, and would confer 80 percent protection on recipients – a high level of protection compared to most vaccines today.

The options in terms of cost-effectiveness

The cost per Disability Adjusted Life Year (DALY) for a vaccine for adults and teens could be as little as 85 US cents, making it comparable to the lowest prices for the rotavirus and human papillomavirus (HPV) vaccines. An infant TB vaccine conferring 50 percent protection for five years could cost as much as US$42,617 per DALY.

Vaccines for older people were modelled as much more effective in reducing TB cases, with deaths occurring at an infection level largely determined by the transmission dynamics within the group. For example, a vaccine offering life-long protection against active TB would avert almost eight times as many new cases as a TB vaccine given to babies.

The model may be important in helping researchers prioritize TB vaccine candidates and selecting groups to include in future clinical trials. “Previous modelling has shown that the global TB burden is unlikely to be controlled without new TB vaccines,” Knight told IRIN. “What we didn’t know is whether these vaccines would be economically valid, and what type of vaccine should be an economic priority in relation to others.”

In the absence of a TB vaccine, Knight and her team projected that as many as 19 million people would die from the disease between 2024 and 2050.

Making the most of what we have

The world relies on the Bacille Calmette-Guérin (BCG) TB vaccine, developed almost 100 years ago. Given at birth, BCG’s protective effect wanes as children grow to adulthood, but the vaccine has seldom been considered a candidate for global adult or teen vaccination programmes after poor results in trials.

“While drugs have had a clinical impact, they have failed to control the epidemic – that’s why we need vaccines and other tools”

Now there are growing moves in the vaccine community to move away from approaches based solely on infant immunization and to begin developing policies on immunizing adolescents and adults. Adolescents may also be a prime target for re-vaccination with the BCG TB vaccine, according to Christopher Dye, director of health information in the Office of HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases at WHO.

Dye says the world could do more with the only available TB vaccine in its arsenal. Citing examples from the United Kingdom and Norway, he presented instances in which adult BCG vaccination campaigns in the 1950s and 1960s had not only shown the vaccine to be as much as 80 percent protective, but that it had also reduced new TB cases by 20 percent.

“If those results were obtained today with a TB vaccine, they would be the subject of worldwide acclaim, and they form the basis of my claim that we don’t do enough with BCG,” he told IRIN.

In their search for a cure-all for TB epidemics, policymakers at the time may have dismissed results too readily. “The interpretation was pretty pessimistic,” he said. “In my reading, this was a search for a panacea and when that was not the result obtained, the results were pushed aside.” Disappointing results from India and Malawi could be explained by the presence of other tropical bacterial infections that could reduce BCG’s effectiveness.

Rethinking vaccines, rethinking TB control

Vaccinating teens and adults might also make sense in places like South Africa, where data collected in the Cape Town area in 2010 shows that people between the ages of 16 and 35 experience elevated risks of TB infection when compared to children and older adults.

“Children between the ages of five and ten are extremely resistant to developing active TB, but then become at risk when they move into adolescence,” Dye told IRIN. “Where possible, they need to be re-protected.”

He said adolescent BCG vaccination could easily be added to existing campaigns in countries where girls and, in some instances, boys, are vaccinated against HPV before they become sexually active.

Using mathematical models, Dye proposed that repeated mass vaccination campaigns to protect people as infants, and again as teens or young adults, could cut the annual number of new TB cases in South Africa by 50 percent over a 30-year period. In combination with improved case management and preventative TB therapy for people living with HIV, the models projected that revaccination with BCG could cut TB incidence by more than 90 percent by 2050.

“With all of these intense efforts put into TB control through treatment, the impact at the clinical level has been profound, but the trajectory of the TB epidemic has been [more or less flat],” he told IRIN. “It’s clear from analysis that while drugs have had a clinical impact, they have failed to control the epidemic – that’s why we need vaccines and other tools.”

llg/kn/he  source http://www.irinnews.org

 

Posted in AA > News and News analysis | Tagged: , , , , , , , , | 2 Comments »

 
%d bloggers like this: