NEWS: HIV researchers target an African-focused agenda

HIV researchers target an African-focused agenda


from NEW VISION ONLINE
Sunday, 24th January, 2010

Students interact with Scientists at UVRI. The centre hopes to train future scientists to help fight the disease

By Gladys Kalibbala


THE World Health Organisation (WHO) has proposed to change the time when people living with HIV start on ARVs. Dr. Kihumuro Apuuli, the director of Uganda Aids Commission, says WHO recommends that people living with HIV start on ARVs when their CD4 count is below 350 and not 250 as has been the case. “This means about 700,000 people will be eligible for the drugs which we cannot afford,” he explained. Kihumuro was speaking at the recently concluded 5th African Aids Vaccine Programme (AAVP) conference at Serena Hotel in Kampala. He said, currently, of the 400,000 people in Uganda who require ARVs, only 191,500 access them. Kihumuro said: “This is a big challenge on the African continent and we need a vaccine to be found urgently.” Participants at the conference noted that Africans needed to take advantage of the AAVP Secretariat’s shift to Uganda to concentrate on finding an AIDS vaccine and reduce the spread of the disease on the continent. The headquarters of AAVP which have been based in Geneva since 2000 will soon be transferred to Uganda Virus Research Institute (UVRI), Entebbe. Uganda beat Botswana and South Africa to host the organisation. Uganda was selected because of the Government’s commitment and the good research environment. AAVP is a network of African HIV vaccine stakeholders led by Africans across the continent, with a vision for an AIDS-free Africa. It was created with the specific intention of mobilising support and advocating a more African-focused vaccine agenda. The programme intends to involve Africans in the development of the vaccine supported by WHO and United Nations Programme on HIV/AIDS (UNAIDS). During the conference, it was noted that the AIDS pandemic continues to be the most serious public health challenge facing the world today, with Africa having the highest infections with unprecedented medical and socio-economic consequences. “The best hope to end the AIDS pandemic remains in the development of an effective HIV vaccine and its distribution to all communities,” said Dr. Ponsiano Kaleebu, the acting director of UVRI. He says 30 years after the first cases of AIDS were reported and HIV identified as a the cause, Africa, with only 10% of the world’s population, is home to more than 65% of the 33 million people living with AIDS worldwide. Researchers say the annual rate of new infections continues to rise. For instance, in 2007, about 2.5 million people were infected. According to the 2006 UNAIDS report, about 40 million people worldwide are infected with HIV, 62% of them in Sub-Saharan Africa. The report adds that about 25 million people have so far died worldwide as the infection rate increases to an estimated 4.3 million people annually. However, only about one million HIV-infected people currently receive antiretroviral therapy in sub-Saharan Africa. “This shows that treatment alone cannot help, we need a vaccine to halt the spread,” Dr Sam Okware, the commissioner for health services at the health ministry observes. He adds that developing an effective HIV vaccine is the greatest challenge in biomedical research. Prof. Fred Wabwire of Makerere University Walter Reed Project noted that many women drop out of the vaccine trials and called for their participation. “It will be unfortunate if we come up with a vaccine which works for men without knowledge of how it works for women,” he said. The researchers urged African leaders to embrace the programme by showing their support through funding. Jeannette Kagame, the First Lady of Rwanda, was appointed AAVP’s ambassador and will represent the association at various meetings and policy forums. Kagame urged leaders to raise an awareness of Africa’s concerns at the international level and stop downplaying the gravity of the pandemic since this may hinder the vaccine’s development process. Likewise, Janet Museveni, the First Lady of Uganda, called for other preventive measures alongside the ABC (abstinence, be faithful and condom use) strategy if the pandemic is to be curbed. There was also a call to control TB which has become more challenging. It was noted that the existing BCG vaccine is ineffective against the disease and poses risks in HIV-infected children. There was also a call to control TB which has become a challenge with the emergency of multi-drug resistant strains, especially in people living with HIV. Researchers highlighted the need for boosting BCG vaccine to meet this challenge

NEWS: Alcoholism is on the increase in Uganda and needs to be curbed

Alcoholism is on the increase in Uganda and needs to be curbed

There are growing concerns among health workers over Ugandans’ drinking patterns. Surveys have shown an alarming rate of alcohol consumption across the country, writes Egan Tabaro.
“I had never lived on my own before and this school had so much freedom and this was the time I was discovering myself,” he says. In his S.2, he joined the school’s Scripture Union, where he prayed and studied the Bible as he often did at home.

Soon, he made new friends and together, they would sneak out of school, mostly to watch a movie and eat roast pork in Mbarara Town and have a drink in the name of “experimenting”. By S.4, he had begun to drink regularly as he had both the company and money for it. For his A’levels, he joined Greenhill Academy, an elite day school in Kampala. His drinking continued and he often sneaked alcohol in sachets into school but still managed to perform well enough in class to escape notice from his teachers and parents.

In his S.6 vacation, Bosco broke up with his girlfriend. He was devastated and it was then that he says he lost control over his drinking. He was drinking daily and quite heavily and one time drank himself into a coma before he was admitted to a hospital. “But I still didn’t realiseI was a rehab case,” Mugisha says, adding that he was in denial. What followed then was a two-month dry spell (in which he didn’t take alcohol) but this didn’t last. when he joined university, the drinking started all over again.

For him, university life was one long party - more drinking, more girls, and more beers. He often got into bar brawls and was twice locked up by police for violent behaviour. He suffered blackouts from binge drinking and even stole from family, friends and his girlfriends to finance his habit. His drinking changed his personality and an otherwise amiable fellow soon became rude, arrogant and distant. “Alcohol dehumanised me completely,” he says. Soon, he was unable to sit tests and exams at university and his parents often took him in and out of rehab. He dropped out of university. He had hit rock bottom. Now, as he nurses an injury sustained from a drunken fall, he has been sober for four months and is now born again. “The compassion of people around me, my involvement with Victory Rehabilitation Centre, Salongo Kanda Road, Bweyogerere Kampala and my faith in Christ have helped me remain sober,” he says.

The facts and statistics

Alcoholism is a chronic disease marked by a craving for alcohol; people who suffer from it, known as alcoholics, can’t control their drinking even when it becomes the underlying cause of serious harm including medical disorders, marital difficulties, job loss or car accidents. People tend to equate any kind of excessive drinking to alcoholism but doctors and scientists prefer to use the term alcohol dependence instead of alcoholism to designate less severe disorders resulting from immoderate drinking.

The World Health Organisation (WHO) estimates that 140 million people (approximately two per cent) suffer from alcohol related disorders. A WHO Global Status report on alcohol estimates that Ugandans consume an average 19.4 litres of alcohol per capita annually. A Ministry of Health baseline survey of 14 districts found the mean prevalence of alcohol abuse to be 17.4 per cent while surveys from hospital admissions found that up to 20 per cent of the cases are alcohol related.

According to psychiatrist Dr David Basangwa of Butabika Hospital, the average first age of drinking in Uganda is 10 to12 years and that 60 per cent of those who seek treatment at Butabika’s Alcohol and Drug Unit are aged 13 to 21. Research has shown that people who drink before the age of 15 are more likely to become alcohol dependent than those who delay their first drink to 21 years.

There are an estimated 26 registered breweries licensed to operate in Uganda although most of the alcohol consumed is produced informally in homes or from unregistered small scale distillers and brewers, making it difficult for authorities to regulate alcohol production, sale and consumption in the country.

Scientists have not identified a typical alcoholic personality, and they can’t predict with certainty which drinkers will progress to alcoholism. Statistics show that alcoholism affects a broad cross-section of society around the world, from labourers, homemakers, successful business executives and academics to church members of all denominations. Scientists cannot point out any single cause of alcoholism but research suggests that genetic, psychological and social factors influence its development.

Studies show that alcoholism runs in families - alcoholics are six times more likely than non-alcoholics to have blood relatives who are alcohol dependent. Research conducted in twins showed that patterns of alcoholism differed among identical twins who share identical genes and fraternal twins, who are genetically different. If one twin becomes alcohol-dependent, an identical twin is more likely to develop alcohol dependence than a fraternal one.

Environmental factors that may affect the development of the disease include personal
behavioural skills, peer influences early in life, parental behaviour, societal and cultural attitudes toward alcohol use and availability of alcohol beverages. It is argued that once a person has established a drinking pattern, environmental factors combined with physical changes induced by heavy drinking may reinforce the continued use of alcohol.

NEWS: Uganda stamps out Guinea worm disease

Uganda stamps out Guinea worm disease

from the DAILY MONITOR

Since 1991, Uganda has been campaigning to eradicate the Guinea worm. 18 years later, the ancient parasitic disease has been completely eliminated from the country, according to the World Health Organisation, making it the second major disease after smallpox to be wiped out.Guinea worm disease which is scientifically called dracunculiasis is a parasitic worm infection that has been endemic in African countries such as Uganda, South Sudan, Mali, Ghana and Nigeria. Health experts say the eradication of the disease will contribute to the reduction of the huge disease burden that the country still faces.

Costly parasite

According to Dr John Bosco Rwakimari, a former national coordinator for the Guinea worm eradication programme, treating the disease was costing the country up to $20m annually. “When we started interventions to fight the disease, we were spending $15m annually. In 1995, we intensified our campaign, drilling more than 2,000 at a cost of Shs15m in the affected areas,” Dr Rwakimari said.Dr Peter Langi, the coordinator of the Uganda Guinea Worm Eradication Programme (UGWEP) said although the worm rarely kills, blisters that occur from the effects of the worm can result in secondary infections including long term disability. People get infected when they drink water containing flea that is infected with the larvae of the Guinea worm.

Worm symptoms

When in the body, the larvae matures and grows as long as three feet, and after one year, it emerges through a painful cancerous blister in the skin, causing long term pain and suffering.“It starts with a swelling, then itching and a blister before the worm comes out. To get the worm out, you get a small piece of stick and roll the worm slowly out of the blister,” he explains.Dr Langi said that while the process of removing the worm is easy, complications can sometimes arise when it breaks into two and fails to come out. “Victims should not dare to speed the process of pulling out the worm because it may snap into two and the part left inside can cause permanent deformities,” he said.To stop its spread, health workers teach affected people to stay away from contaminated water supplies. Water filters have also been distributed to the communities to be used to block water fleas from water sources. This is largely the strategy that has been used to eradicate the disease.Dr Langi said in 1991, there were 126,369 cases of guinea worm reported in Uganda. The most endemic areas were Arua, Moyo, Kitgum, Kotido and Moroto.But these figures continued reducing until they reached 316 by 1999 and to single digits by 2002. In the last six years, starting in 2004, no single worm was found to have infected a person, thus clearing the country of the disease.

“When the survey was done , we found that most of the heavily affected areas had low water coverage and the people who had the disease were not seeking medical treatment and because they kept using the same contaminated water sources, they were repeatedly infected,’’ Dr Langi said.