Algorithm-guided empirical tuberculosis treatment for people with advanced HIV (TB Fast Track): an open-label, cluster-randomised trial
Prof Alison D Grant, PhD et al.,
Tuberculosis, which is often undiagnosed, is the major cause of death among HIV-positive people. We aimed to test whether the use of a clinical algorithm enabling the initiation of empirical tuberculosis treatment by nurses in primary health-care clinics would reduce mortality compared with standard of care for adults with advanced HIV disease. Our intervention substantially increased coverage of tuberculosis treatment in this high-risk population, but did not reduce mortality. 930 (61·7%) of 1507 participants in the intervention group versus 172 (11·4%) of 1515 participants in the control group had started tuberculosis treatment by 2 months. At 6 months, the mortality rate was 19·0 deaths per 100 person-years for the intervention group versus 21·6 deaths per 100 person-years in the control group.
There's A Promising New Vaccine For One Of The World's Top Health Threats
A new vaccine to prevent dengue may be on the horizon. And health officials say it's desperately needed. The World Health Organization this year listed dengue as one of the top 10 threats to global health. The mosquito-borne disease is a growing threat for several reasons. First, the sheer number of dengue cases has been increasing dramatically in recent years. The WHO says there's been a 30-fold increase in infections since 1970. Last year nearly 100 million people came down with the disease. s Derek Wallace, who leads the Takeda Pharmaceutical Company think they're very close to having a marketable vaccine that could dramatically reduce the number of cases of the mosquito-borne disease. "We're thrilled with the results," Wallace says, about a large-scale study of a vaccine they're calling TAK-003. Staring in 2016, Takeda enrolled 20,000 people between the ages of 4 and 16 in a study of TAK-003. The vaccinations occurred at 26 sites in seven dengue-endemic countries. In results just published in the New England Journal of Medicine, Wallace and his colleagues found TAK-003 to be 80% effective in preventing participants from getting dengue and 95% effective in preventing cases of severe dengue.
Korea pledges more support for health sector
The government of Korea has pledged to invest more in Ghana’s health sector, which remains a priority area of development assistance and cooperation between the two countries. Korean International Cooperation Agency had also collaborated with the US Centre for Disease Control, the Ministry of Health and the GHS for the implementation of a $7.5 million Global Health Security Agenda (GHSA) project in Ghana last year, which was expected to end in 2021.
One Health in Action
An article in the current issue of the Veterinary Record (dated Saturday 2 November 2019) discusses ‘a new action report from the British Veterinary Association (BVA)’ that which focuses on ‘how One Health can work in the real world’. The article (Mills 2019) summarises a BVA report published to mark One Health Day (Sunday 3 November) and highlights ‘the integral part vets play in the One Health agenda’. The BVA report ‘aims to bring together experts from human and animal medicine, alongside environmental organisations to tackle pressing global issues, and has contributions from leading national organisations such as The Wildlife Trusts, the APHA, the Royal College of Nursing and the National Trust’.
There's A Promising New Vaccine For One Of The World's Top Health Threats
A new vaccine to prevent dengue may be on the horizon. And health officials say it's desperately needed. The World Health Organization this year listed dengue as one of the top 10 threats to global health. There's no specific treatment for the viral disease. When outbreaks occur, local clinics can get overwhelmed with patients experiencing severe flu-like symptoms. Third, the disease is moving in to new areas as the mosquitoes that carry the dengue virus expand their range. The Aedes aegypti mosquito basks in warm, wet, tropical areas, and shifting global temperatures have made more places to its liking.
African swine fever on Australia's doorstep, with outbreaks confirmed in Timor-Leste pig farms
The pig-killing disease known as African swine fever (ASF) is now on Australia's doorstep, with confirmation of several outbreaks in Timor-Leste. According to Timor-Leste's Ministry of Agriculture and Fisheries, there have been 100 reported outbreaks of African swine fever in smallholder pig farms in the Dili municipality, in which 405 pigs have died. Meat and livestock analyst Simon Quilty, who has been researching the disease's spread throughout China and South-East Asia, said ASF was now 650 kilometres from Australia. "The presence of African swine fever in Timor is alarming to say the least, having jumped 1,500 to 2,000 kilometres [from the Philippines and Vietnam] and puts the disease on Australia's doorstep," he said.
Medicines for Malaria Venture e-news
Do we need a Global Virome Project?
Olga Jonas et al.,
There is debate in the scientific community about whether the animal-human infectious disease nexus warrants substantially more funding, science effort, and global policy discussion. Michael Osterholm, the director of the University of Minnesota's Center for Infectious Diseases Research and Policy, is a noted doubter. Others look to many past and present spillovers of pathogens from animals to humans and see a pattern. Much like map-making for newly-discovered continents, the Global Virome Project would be a pathway to improve capacity to detect, diagnose, and discover viruses that potentially pose threats to human populations, particularly in low-income and middle-income countries. Cost estimates for the Global Virome Project range from an initial $1.2 billion to $3.4 billion over a 10-year period. The projected cost is modest when it is put in perspective, in at least four regards. Both the supporters of the Global Virome Project and its skeptics need to be heard. An objective, apolitical assessment would be helpful in deciding whether spending up to $3.4 billion over the next decade is likely to produce scientific knowledge whose benefits are greater than the costs. Side discussions at venues such as the G20 or the UN General Assembly, could be opportunities for policy makers to set out implementation arrangements. They will need to draw on the advice of knowledgeable experts.
The unwelcome return of polio
Fr. Ranhilio Callangan Aquino
Polio is, regrettably, back, and unless a combined effort of the public and the government picks up pace in the direction of immunization we may see a coming generation plagued and stunted by this debilitating health scourge. It is with the ethical and legal issues that I am concerned. More and more parents, it has been reported, not only here but even abroad, are refusing to submit their children to vaccinations, many times on the basis of some unconfirmed suspicion of some link between vaccines and autism.
In Cambodia, It’s a Bad Year for Dengue Fever
Huy Rekol, director of Cambodia’s National Centre for Parasitology, Entomology and Malaria Control, which is part of the Ministry of Health, said this year’s serious outbreak is part of “a regular cycle of every five to six years or 10 to 12 years” in tropical Asia. In Cambodia, hard hit during the rainy season that began in May and will not end until October, the treatment for dengue fever can be an enormous burden for poor villagers, who, like Lang Chanthoeun cannot find the money for blood tests and, if found needed, treatment. Some go into debt rather than see family members suffer.