Posted on

Text Messages Advance Malaria Care

Text messages could be a cost effective way of improving care for African children with malaria, according to researchers.

A six month study involving 119 health workers in Kenya, published by The Lancet, showed texts increased the number following government guidelines.

Half of children received the correct treatment at the end of the study, more than double the starting figure.

Researchers said there was “huge potential” to improve care.

There has been concern that government guidelines on malaria treatments are not always followed in the field.

Guidelines include the correct prescription of anti-malaria drugs – artemether-lumefantrine (AL) – and advice to parents.

Health workers in the study were sent text messages twice a day, five days a week, for six months.

An example of the sort of sent was: “advise mother to finish all AL doses over three days even if the child feels better after two doses”.

Improvement

At the beginning of the study, 20.5% of children were correctly managed, this increased to 49.6% after the six month study.

Continue reading the main story

“Start Quote

We need to explore ways of scaling up such intervention to all health workers in the country”

End Quote Dr Willis Akhwale Ministry of Public Health and Sanitation

The effect appeared to persist after the texts stopped. Six months after the trial ended, 51.4% of children were receiving the correct treatment.

Professor Bob Snow, who headed the research group, said: “The role of the mobile phone in improving health providers’ performance, health service management and patient adherence to new medicines across much of Africa has a huge potential.”

The cost of the texts was estimated at £1.59 for the whole six months for each worker.

However, the authors acknowledge that “we do not fully understand why the intervention was successful”.

They suspect it may act as a reminder or reinforce the importance of the messages in the texts.

Dr Willis Akhwale, from the Kenyan Ministry of Public Health and Sanitation, said: “We need to explore ways of scaling up such intervention to all health workers in the country.”

Bruno Moonen and Justin Cohen, from the Clinton Health Access Initiative in Nairobi, said: “A combination of interventions will most likely be needed to improve adherence to national guidelines.”

The study provides “strong evidence that text message reminders can be an effective, low-cost component of such a package”.

Share
Posted on

‘Dirty sock smell’ Lures Mosquitoes to a Sticky End

Researchers in Tanzania have chemically reproduced the stench of smelly feet in an innovative new approach to combat the spread of malaria in the country.

The scientific team at Tanzania’s Ifakara Health Institute has developed a potent serum — similar to that of human foot odor — to lure and kill mosquitoes, which can carry malaria and other diseases.

Four times more powerful in attracting mosquitoes than natural human odor, the synthetic smell is now being used in a pioneering research program aimed at killing mosquitoes outdoors using a “mosquito landing box.”

“The goal is to eliminate malaria,” said scientific researcher, Fredros Okumu, who is developing the technology. “We are going to do this by tackling the transmission of disease outside the house.”

Mosquitoes are lured inside the boxes by the synthetic odor, which is dispersed by a solar-powered fan. Once inside, the insects are either trapped or poisoned and left to die.

“We know mosquitoes don’t see people, they smell them.” Okumu said.

“Substances we omit when we sweat, such as lactic acid, act as a signal to mosquitoes … The aim here was to produce a mixture that would mimic a human being.”

The result, said Okumu, was a chemical blend that “smelt just like dirty socks.”

“If you came to our lab when the research was being done, you would have thought that someone had just come off a soccer field,” he admitted.

Okumu, who is currently completing a PhD from the London School of Hygiene and Tropical Medicine, in England, plans to develop the mosquito landing boxes over the next two years, thanks to a $775,000 joint grant from the Bill and Melinda Gates Foundation and the not-for profit organization Grand Challenges Canada.

“This is a great example of an African innovator, with an African innovation, tackling an African problem,” said Dr Peter Singer, CEO of Grand Challenges Canada.

“Malaria kills about 800,000 people a year, mostly children, in Africa. At the moment existing technologies, such as bed nets and sprays, tend to repel mosquitoes inside the home.

“This technology attracts mosquitoes outside the home to kill them, and could be complimentary to what is there now,” Singer continued.

Working closely with villagers in remote communities where malaria is endemic, Okumu is aiming to produce a practical and sustainable technology that will be easy to run and operate.

Okumu is keen to explore further cost-saving measures in order cement the mosquito boxes as part of everyday Tanzanian life. Ideas include using the boxes’ solar-panel technology to supply energy to people’s homes and substituting the costly chemical mosquito lure with actual foot odor collected from specially designed cotton pads placed in people’s socks.

“We hope at the end of the two years we will be able to tell the world this is a good strategy to use and start involving industry and more communities and villages,” said Okumu.

The prevalence of malaria in Tanzania has decreased in the last 10 years and Okumu has seen rates in his region dramatically decline from 40% in 1997 to around 7% today.

“We are sure that the reduced rates are due to the improved delivery of bed nets, drugs, insecticides and living standards,” said Okumu. “But malaria is not going to disappear using these existing methods.”

Okumu says he hopes to see his boxes used across the region before existing methods become less effective.

“Mosquitoes can modify their behavior quite rapidly to deal with the added deterrents of sprays and bed nets,” he said.

“For example, instead of going into houses to bite people, mosquitoes are now starting to wait to bite people outside,” he said.

For Okumu, this is a personal as well as a scientific venture. Born in western Kenya, malaria has been apart of Okumu’s life for as long as he can remember.

“All the places I have lived have been malaria zones. When I was growing up I had malaria at least twice every year,” he said.

He continued: “Malaria has claimed so many lives and diseases like this are one of the biggest blocks to our social and economic development.”

CNN

Share
Posted on

Type 2 Diabetes in Newly Diagnosed ‘Can Be Reversed’

An extreme eight-week diet of 600 calories a day can reverse Type 2 diabetes in people newly diagnosed with the disease, says a Diabetologia study.

Newcastle University researchers found the low-calorie diet reduced fat levels in the pancreas and liver, which helped insulin production return to normal.

Seven out of 11 people studied were free of diabetes three months later, say findings published in the journal.

More research is needed to see whether the reversal is permanent, say experts.

Type 2 diabetes affects 2.5m people in the UK. It develops when not enough insulin is produced in the body or the insulin that is made by the body doesn’t work properly.

When this happens, glucose – a type of sugar – builds up in the blood instead of being broken down into energy or fuel which the body needs.

The 11 participants in the study were all diagnosed with Type 2 diabetes within the previous four years.

They cut their food intake drastically for two months, eating only liquid diet drinks and non-starchy vegetables.

Fat loss

After one week of the diet, researchers found that the pre-breakfast blood sugar levels of all participants had returned to normal.

MRI scans of their pancreases also revealed that the fat levels in the organ had decreased from around 8% – an elevated level – to a more normal 6%.

Three months after the end of the diet, when participants had returned to eating normally and received advice on healthy eating and portion size, most no longer suffered from the condition.

Professor Roy Taylor, director of Newcastle Magnetic Resonance Centre at Newcastle University and lead study author, said he was not suggesting that people should follow the diet.

“This diet was only used to test the hypothesis that if people lose substantial weight they will lose their diabetes.

“Although this study involved people diagnosed with diabetes within the last four years, there is potential for people with longer-standing diabetes to turn things around too.”

Susceptibility question

Dr Ee Lin Lim, also from Newcastle University’s research team, said that although dietary factors were already known to have an impact on Type 2 diabetes, the research showed that the disease did not have to be a life sentence.

“It’s easy to take a pill, but harder to change lifestyle for good. Asking people to shift weight does actually work,” she said.

However, not everyone in the study managed to stay free of diabetes.

“It all depends on how much individuals are susceptible to diabetes. We need to find out why some people are more susceptible than others, then target these obese people. We can’t know the reasons for that in this study,” Dr Lim said.

Professor Edwin Gale, a diabetes expert from the University of Bristol, said the study did not reveal anything new.

“We have known that starvation is a good cure for diabetes. If we introduced rationing tomorrow, then we could get rid of diabetes in this country.

“If you can catch people with diabetes in the early stages while beta cells are still functioning, then you can delay its onset for years, but you will get it sooner or later because it’s in the system.”

But Keith Frayn, professor of human metabolism at the University of Oxford, said the Newcastle study was important.

“People who lose large amounts of weight following surgery to alter their stomach size or the plumbing of their intestines often lose their diabetes and no longer need treatment.

“This study shows that a period of marked weight loss can produce the same reversal of Type 2 diabetes.

“It offers great hope for many people with diabetes, although it must be said that not everyone will find it possible to stick to the extremely low-calorie diet used in this study.”

Dr Iain Frame, director of research at Diabetes UK, which funded the study, said the diet was not an easy fix.

“Such a drastic diet should only be undertaken under medical supervision. Despite being a very small trial, we look forward to future results particularly to see whether the reversal would remain in the long term.”

Share
Posted on

Sleep Position During Pregnancy ‘Link to Still-birth’

Experts want urgent research to see if the position a woman chooses to sleep in during late pregnancy affects still-birth risk, as a study suggests a link.

The University of Auckland compared 155 women who had late still-births with 310 who had healthy pregnancies.

Sleeping on the back or right side, rather than the left, doubled the risk – but only to almost four in 1,000.

Left-side lying aids blood flow to the baby, as the mother’s major blood vessels are unimpeded by a heavy womb.

The New Zealand study, published in the British Medical Journal, called for larger studies to test the findings.

Ms Daghni Rajasingam of the Royal College of Obstetricians and Gynaecologists said: “There are many factors which are linked to still-birth including obesity, increasing maternal age, ethnicity, congenital anomalies and placental conditions. A significant number are unexplained.

Continue reading the main story

“Start Quote

We would like to see further research into sleep in pregnancy encouraged and funded as a matter of urgency”

Janet Scott of the stillbirth charity Sands

“This small-scale study looks at another possible factor. However, more research is needed into sleep patterns before any firm conclusions over sleeping positions can be made.

“In the meantime, women should speak to their midwives if they are concerned.”

The UK has one of the highest still-birth rates in the developed world. Every year here 4,000 babies are still-born.

A third of still-births have no clear cause.

Janet Scott, of the still-birth and neonatal-death charity Sands, said: “We would like to see further research into sleep in pregnancy encouraged and funded as a matter of urgency.

“The study will require further validation before any widespread public health campaign could be justified.

“Mums want to know what they can do to reduce the chance of this happening to their baby.

“A simple message which mums could follow, which would reduce their risk of still-birth, would be very welcome

By Michelle Roberts Health reporter, BBC News
Share
Posted on

Drug Firms Cut Vaccine Prices to the Developing World

Several major drugs companies have announced big cuts to the amounts they charge for their vaccines in the developing world.

GlaxoSmithKline (GSK), Merck, Johnson & Johnson and Sanofi-Aventis have agreed to cut prices through the international vaccine alliance Gavi.

GSK said it would cut the price of its vaccine for rotavirus by 67% to $2.50 (£1.50) a dose in poor countries.

Rotavirus-related diarrhoea kills more than 500,000 children a year.

The vaccine will be subsidised by higher prices being charged in richer countries.

The rotavirus vaccine, for example, would cost about $50 in the US.

‘Helped out’

“What we need is a return to invest in the next generation of new vaccines and drugs and that has to come from the profits of the medicines or the vaccines,” Andrew Witty, chief executive of GSK told the BBC.

“But it’s obvious that if you’re in Kenya or a slum in Malawi or somewhere like that there is no capacity for those people to contribute to it, so they have to be helped out by the contribution from the middle and the richer (countries).”

Gavi is a partnership representing public and private sector organisations that helps to fund mass vaccination programmes in developing countries.

It is committed to funding the introduction of rotavirus vaccinations in 40% of the poorest countries by 2015, but it faced a $3.7bn funding shortfall and so has been appealing for price cuts and donations.

It will be holding a pledging conference in London on 13 June.

Anti-poverty campaigners welcomed the move but also called on world leaders to act.

“The pricing commitments announced today help drive momentum, but Gavi’s ambition to save four million lives in the next five years is only achievable if the international donor community steps up to the plate on 13 June,” said Jamie Drummond, executive director of campaign group ONE.

Malaria vaccine

Merck has said it will provide its own rotavirus vaccine for $5 a dose, coming down to $3.50 once more than 30 million doses have been sold.

The price Gavi pays for pentavalent vaccines, which protect against diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type B will be cut by two Indian firms, Serum Institute and Panacea Biotec.

GSK also said it was very close to developing the world’s first malaria vaccine, which is unusual because there is no market for it in the West.

That means there is no opportunity for patients in richer countries to subsidise those in poorer countries.

As a result, GSK said that if the vaccine comes to market it would be sold at a price that provides a small return of 5%, which would be used to fund the next generation of malaria treatments.

Save the Children called on other companies to replicate the “landmark move” which it said could prevent hundreds of thousands of “needless deaths”.

“It’s important that Gavi now uses this to spur other vaccine producers to reduce prices and work to foster greater competition amongst producers to drive prices down even further and help even more children,” said chief executive Justin Forsyth.

Share
Posted on

Poverty Link to Starting Periods Younger

Girls from poorer backgrounds are more likely to start their periods at a younger age, thereby increasing their risk of breast cancer, a UK study says.

It found girls in lower socio-economic groups with typically poorer diets began at 12.1 years on average compared to 12.5 years for wealthier girls.

Their breast cancer risk was greater as they produced the hormone oestrogen longer, the study of 90,000 women says.

It was published in the journal Paediatric and Perinatal Epidemiology.

The research data being gathered from this group of women over 40 years is also helping to find the causes and risk factors associated with breast cancer.

The study is a partnership between Breakthrough Breast Cancer and the Institute of Cancer Research.

This research found that there was little change in the age of menarche (when a girl’s periods begin) for 40 years until the late 1980s.

Then the age dropped from 12.6 years to about 12.3 years, with the drop steepest in poorer areas.

Study author Danielle Morris, from The Institute of Cancer Research in Surrey, said the results suggested that girls, particularly from poorer backgrounds, are starting their periods younger.

“While we don’t know all the reasons behind this, changes in diet may have played a part.

“This decrease is important because the age at which a girl starts her periods can influence her chances of developing breast cancer later in life.”

Oestrogen effect

Dr Tabitha Randall, consultant paediatrician at Nottingham Children’s Hospital, said this was due to exposure to the hormone oestrogen.

“Girls who start their periods earlier are producing oestrogen for longer periods of time, although those who start their periods early normally finish early, but then they may start taking hormone replacement therapy.”

Previous research has shown that the female hormone oestrogen is linked to the growth of breast tumours.

Levels of oestrogen in the body are also influenced by diet and, therefore, body weight.

“Diet is important because fatty tissue turns male hormones into oestrogen,” said Dr Randall.

Previously, girls from higher socio-economic groups tended to start their periods younger because their affluence led to greater food intake and heavier body weight.

But researchers say the trend appears to have reversed.

Girls of lower socio-economic status are now starting their periods at a younger age (12.1 years) than girls from wealthier backgrounds (12.5 years) because they are the ones who tend to have poorer diets and are more likely to be overweight.

The age at which girls start their periods can be added to the list of risk factors for breast cancers, which are known to be a woman’s age, alcohol intake, weight and use of hormone replacement therapy and the contraceptive pill.

A family history of breast cancer may also increase the risk of developing the disease.

Professor Anthony Swerdlow, co-leader of the Breakthrough Generations Study, says that the incidence of breast cancer has risen progressively over a long time in the UK.

“We think these changes have come about through a combination of factors each of which individually makes a small difference.

“Understanding how these factors influence a woman’s risk of developing breast cancer should allow us to develop strategies for preventing the disease in the future.”

Share
Posted on

Higher Density Means World Forests Are Capturing More Carbon, News Release

University of Helsinki, Finland and Rockefeller University, USA

Study challenges carbon storage measurements based on forest area;

Several national increases of density and / or area signal “The Great Reversal”

is underway in forests globally after centuries of loss and decline

Forests in many regions are becoming larger carbon sinks thanks to higher density, US and European researchers say in a new report.

In Europe and North America, increased density significantly raised carbon storage despite little or no expansion of forest area, according to the study, led by Aapo Rautiainen of the University of Helsinki, Finland, and published by the online, open-access journal PLoS One.

Even in the South American nations studied, more density helped maintain regional carbon levels in the face of deforestation.

The researchers analyzed information from 68 nations, which together account for 72% of the world’s forested land and 68% of reported carbon mass.  They conclude that managing forests for timber growth and density offers a way to increase stored carbon, even with little or no expansion of forest area.

“In 2004 emissions and removals of carbon dioxide from land use, land-use change and forestry comprised about one fifth of total emissions. Tempering the fifth by slowing or reversing the loss of carbon in forests would be a worthwhile mitigation.

The great role of density means that not only conservation of forest area but also managing denser, healthier forests can mitigate  carbon emission,” says Mr. Rautiainen.

Co-author Paul E. Waggoner, a forestry expert with Connecticut’s Agricultural Experiment Station, says remote sensing by satellites of the world’s forest area brings access to remote places and a uniform method. “However, to speak of carbon, we must look beyond measurements of area and apply forestry methods traditionally used to measure timber volumes.”

Says co-author Iddo Wernick of The Rockefeller University’s Program for the Human Environment: “Forests are like cities – they can grow both by spreading and by becoming denser.”

The authors say most regions and almost all temperate nations have stopped losing forest and the study’s findings constitute a new signal of what co-author Jesse Ausubel of Rockefeller calls “The Great Reversal” underway in global forests after centuries of loss and decline.  “Opportunities to absorb carbon and restore the world’s forests can come through increasing density or area or both.”

To examine how changing forest area and density affect timber volume and carbon, the study team first focused on the United States, where the US Forest Service has conducted a continuing inventory of forest area, timberland area, and growing stock since 1953.

They found that while US timberland area grew only 1% between 1953 and 2007, the combined national volume of growing stock increased by an impressive 51%.  National forest density increased substantially.

For an international perspective, the research team examined the 2010 Global Forest Resources Assessment compiled by the UN Food and Agriculture Organization (FAO), which provides consistent figures for the years 1990-2010.

The data reveal uncorrelated changes of forest area and density. Countries in Africa and South America, which lost about 10% of their forest area over the two decades, lost somewhat less carbon, indicating a small rise in forest density.

In Asia during the second decade of the study period, density rose in 10 of the region’s 21 countries.  Indonesia’s major loss of density and sequestered carbon, however, offset any gain in carbon storage in other Asian nations.

Europe, like the US, demonstrated substantial density gains, adding carbon well in excess of the estimated carbon absorbed by the larger forested area.

Says study co-author Pekka Kauppi, of the University of Helsinki, Finland: “With so much bad news available on World Environment Day, we are pleased to report that, of 68 nations studied, forest area is expanding in 45 and density is also increasing in 45.  Changing area and density combined had a positive impact on the carbon stock in 51 countries.”

Finnish forest - then and now (Photo credit : I.K. Inha & K.A. Ennola
Share
Posted on

Coffee Cuts Cancer in Men, Shut up and Sip Your Thing

Coffee has been linked to a reduced risk of dying from prostate cancer in a study of nearly 50,000 US men.

Those who drank six or more cups a day were found to be 20% less likely to develop any form of the disease – which is the most common cancer in men.

They were also 60% less likely to develop an aggressive form which can spread to other parts of the body.

But charities say the evidence, reported in the Journal of the National Cancer Institute, is still unclear.

They do not recommend that men take up coffee drinking in the hope of preventing prostate cancer.

Unknown compounds

The study looked at about 48,000 men in the US who work as health professionals.

Every four years between 1986 and 2006, they were asked to report their average daily intake of coffee.

During this 20-year period, 5,035 of the men were diagnosed with prostate cancer, including 642 fatal cases.

Prostate cancer

  • Each year about 37,000 men are diagnosed with prostate cancer in the UK
  • Some 10,000 die from the disease
  • Symptoms include problems passing urine but they may be mild or non-existent

No difference was seen between caffeinated and decaffeinated coffee, suggesting caffeine itself was not the cause.

But even relatively small amounts of coffee – one to three cups per day – were found to lower the risk of lethal prostate cancer by 30%.

The researchers think there may be unknown compounds in coffee that protect against the disease.

Lead researcher Dr Kathryn Wilson, from the Harvard School of Public Health in Boston, said: “At present we lack an understanding of risk factors that can be changed or controlled to lower the risk of lethal prostate cancer.

“If our findings are validated, coffee could represent one modifiable factor that may lower the risk of developing the most harmful form of prostate cancer.”

Commenting on the study, Dr Helen Rippon of The Prostate Cancer Charity, said other studies had not shown the link and the research evidence was still unclear.

She added: “Although this study is a welcome addition to our knowledge, it is far from definitive and we would not recommend men who are not already habitual coffee drinkers to become so in the hope of preventing prostate cancer.

The data

  • Previous studies have shown no clear link between coffee and prostate cancer risk
  • Men who drank six or more cups of coffee per day had a slightly lower risk of any form of prostate cancer and a substantially lower risk of lethal prostate cancer compared with non-coffee drinkers, according to the researchers
  • Both caff and decaff were associated with similar risks

“Heavy caffeine intake is associated with other health problems and men with benign prostate problems might well make urinary symptoms worse.”

Yinka Ebo, senior health information officer at Cancer Research UK, said: “There’s no need for men to start drinking gallons of coffee in an attempt to lower their prostate cancer risk.

“A number of other studies looking at coffee and prostate cancer have found that drinking coffee does not affect the risk of the disease, and this study only found a lower risk of advanced prostate cancer in men who drank more than six cups a day.

“We would need to see these results repeated in other large studies before we can be sure whether coffee consumption affects the risk of prostate cancer.”

Share