Also In Global Health News: Cholera In Haiti; Treating Recurring TB; Preventing Malaria Deaths; Cash Incentives For Women in Africa; Traditional Birth Attendants In Malawi; PMTCT In Namibia

Cholera Epidemic In Haiti Could Affect Twice As Many As Previously Estimated

The cholera epidemic in post-quake Haiti could affect as many as 800,000 people and kill 11,000 by December, twice the number the U.N. estimated would be affected, according to a study published in The Lancet, National Journal reports. Jason Andrews of the Harvard School of Public Health and colleagues used data from Haiti’s Ministry of Health to predict the spread of cholera in the country, and they present a three-tiered approach to fighting the waterborne disease, which until last year’s earthquake response had not been seen in the country for a century. The researchers recommend “reducing consumption of contaminated water by 1 percent; vaccinating 10 percent of the population; and giving antibiotics to all patients with severe dehydration and to half of patients with moderate dehydration to avert 177,000 cases and 3,700 deaths,” National Journal writes. 

The Pan American Health Organization, which opposed cholera vaccinations until December 2010 in part because of a lack of vaccines, said up to one million doses of cholera vaccine could become available in the second half of 2011, according to the publication (Edwards/Fung, 3/15). The WHO “says everything possible is being done to contain the disease and warns that modeling estimates can be inaccurate,” BBC News reports (Roberts, 3/15). So far, the U.S. has contributed more than $45 million to cholera relief in Haiti, “with most going to maintaining sanitation, according to USAID,” National Journal writes (3/15).

Standard Approach To Treating Recurring TB Failing In Low-, Middle-Income Countries, Study Finds

The standard approach recommended by WHO for treating recurring tuberculosis (TB) in developing countries is failing in low- and middle-income countries, according to a study published Tuesday in PLoS Medicine, ANI/Sify News reports. The researchers studied “140 HIV-infected patients and 148 HIV-uninfected patients [and] found that the re-treatment TB regimen failed to work effectively in a significant proportion of patients – 26% of HIV-infected patients and 20% of HIV-uninfected patients. Nearly a quarter (23%) of patients died, whilst 6% saw their TB disease return,” according to a press release (3/15). “These findings indicate that the standard retreatment approach to TB as implemented in low- and middle-income settings is inadequate and stress the importance of new, more effective, strategies,” the study authors write. “Improved access to rapid diagnostics for TB drug-resistance, second-line TB treatment, and antiretroviral therapy is urgently needed, along with a strong evidence base to guide clinicians and policy makers on how best to use these tools” (Jones-Lopez, 3/15).

Artesunate More Effective Than Quinine At Preventing Malaria Deaths, Review Shows

The “antimalarial drug artesunate … is more effective than quinine at preventing death in patients with severe malaria,” according to an updated review published by Cochrane researchers, ANI/Sify News reports (3/16). “According to the results, taking artesunate reduces the risk of death by 39% in adults and 24% in children compared to quinine. In adults, deaths caused by severe malaria were reduced from 241 per 1,000 with quinine to 147 with artesunate. In children, deaths were reduced from 108 per 1,000 with quinine to 83 with artesunate,” according to a press release. “There is now enough evidence to be confident of these results in adults and children,” said Peter Olumese of the WHO’s Global Malaria Program, according to the release. “Intravenous artesunate is now being recommended as the treatment of choice for adults and children with severe malaria anywhere in the world,” he added (3/15).

Cash Incentives Have Potential To Prevent HIV Among Young Sub-Saharan African Women

In sub-Saharan Africa, some young girls take payments from older men, known as “sugar daddies,” in exchange for sex, a practice that exacerbates the spread of HIV and other sexually transmitted infections, Bloomberg News reports in an article examining the potential of and controversy over programs that offer cash incentives to such women so they will not feel the pressure to take such payments. One and a half years into a World Bank-led study in Malawi, infection rates among a group of women who received an average of $10 a month and school fees if they attended class “were 60 percent lower among schoolgirls who got cash: 1.2 percent, compared with 3 percent,” who received no incentives, according to the news service (Clark, 3/15).

IPS Looks At Implications Of Traditional Birth Attendant Ban In Malawi

Inter Press Service examines the debate over the role of traditional birth attendants (TBA) in Malawi. In 2007, the Ministry of Health imposed a ban on TBAs, “attributing the country’s high maternal mortality rate to a lack of skills on” their part. Though the ban resulted in positive outcomes for maternal health during the three years it was in effect, Malawi President Bingu wa Mutharika “caught everyone by surprise when he reversed the decision to ban TBAs” last September after the U.N. Millennium Development Goal summit. “But the gynecologists’ association is not impressed. … The unbanning also provoked concern in several communities,” IPS writes, noting that the “National Organisation of Nurses and Midwives in Malawi insists that the long-term solution must be to increase the number of trained midwives to fill the gap imperfectly filled by traditional birth attendants” (Ngozo, 3/15).

Namibia Launches National Program To Promote Men’s Involvement In PMTCT Services

New Era/ reports on a national program launched last week in Namibia that aims to encourage male partners’ involvement in antenatal care and services to prevent mother-to-child transmission of HIV. According to the newspaper, the 10-month campaign is “the brainchild of first lady Madam Penehupifo Pohamba.” At the program’s kickoff last Thursday, Namibian President Hifikepunye Pohamba described the importance of PMTCT in driving down new HIV/AIDS infections in the country, and WHO Country Representative Magda Robalo addressed the role PMTCT services play in improving the overall health of the entire family (Kapitako, 3/14).

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