Wednesday, February 24, 2010

NEWS: Coartem- A dose in time saves life


By Irene Nabusoba (NEW VISION)



A laboratory technician takes a child’s blood for testing. A baby suffering from malaria could die within 24 hours if not treated immediately


LITTLE Maliza could have probably died had it not been for the drug shop in her neighbourhood. Her mother, Maria Kirya, recounts how Maliza, aged 18 months, developed high temperature and diarrhoea in the evening, only to worsen at night.

“I gave her herbs because the nearest health facility is 20km away.” However, the herbs did not work and Maliza’s condition deteriorated. At 3:00am in the morning, Kirya, a resident of Kakoro village in Pallisa district, ran to the nearest drug shop where she was given panadol and ‘coartem with a green leaf.’

“That is how my little girl survived,” Kirya says. “I did not have money, so I gave the nurse four eggs.”

‘Coartem with a green leaf’ as the medicine is fondly referred to by the locals in Pallisa, is a subsidised and repackaged version of coartem, only found in private medical outlets.

The drugs are an initiative of Medicine for Malaria Ventures (MMV), a Swiss-based organisation. The organisation aims to reduce the burden of malaria in disease-endemic countries by developing and facilitating delivery of affordable antimalarial drugs.

Dr. Ambrose Talisuna, the MMVs country representative in Uganda, says they conducted a study that saw coartem going for between sh200, 400, 600 (for children’s doses) to sh800 for adults.

On average, coartem costs between sh15,000 and sh25,000. “We distributed coartem to outlets within 5km of households in Budaka, Pallisa, Kaliro and Kamuli,” he says.

Talisuna says five out of every 100 children aged five and below, who had fever in the last two weeks of their survey (over 1,000 households were surveyed per district), received treatment in all the pilot districts.

He said more than a half of all health facilities in Kamuli and Budaka and less than a half in Pallisa had no artemisinin combination therapy (ACT). Half of all the facilities had quinine.

Penny Grewal, MMV’s director for Global Access says they bought one million doses of coartem at $2.5m (about sh5b).

Grewal says the number of people purchasing artemisinin combination drugs in the private clinics rose from almost zero to 55% (over 60 % of the 251 outlets sampled had coartem) from almost zero to 51% while chloroquine dropped from 40% to 11% and quinine from 50% to 35%.

“MMV is extending the project until June when the Affordable Medicines Facility for malaria (AMFm), an initiative of the Global Fund to Fight AIDS, tuberculosis and malaria takes over,” Grewal says.

The UK government and UNITAID allocarted money to AMFm to subsidise Artemisinin drugs and make them affordable for the patients.

The health ministry has hailed MMV’s initiative, saying it will save about 320 lives a day; 70,000 — 110,000 lives a year. This will help every household save between sh85,000 and 150,000 per year in artemisinin treatment.

Richard Ndyomugyenyi, the programme manager malaria control programme at the ministry, says because of lack of laboratory services, there is a lot of wastage.

Out of 100 people who visit health facilities with malaria symptoms, he says, about 70 do not have malaria but are still treated for the disease.

He says a child with fever due to malaria can die within 24 hours thus the need for effective treatment. However, ministry records show that the number of children under five years receiving treatment within 24 hours of developing fever dropped from 55% in 2005 to 10% in 2008 because of coartem shortages in the country.

In 2009, about 12 million cases of malaria were reported by the Health Management Information System.
Ndyomugyenyi says the Government allocates sh60b for the drugs and ARVs, and soon they will include TB.

“The money can only last us six months. With TB on board we shall only get 20% (only sh12b) which can only last three months,” he argues.

The World Health Organisation remmended artemisinin drugs as the first-line treatment for uncomplicated malaria after the disease became resistant to chloroquine and quinine.

MMV officials recommend that all countries that participate in the AMFm remove barriers to ACT availability.
“Researchers should look for ways to upgrade unlicensed shops and consider granting over-the-counter status to artemisinin drugs,” Grewal says.

Dr. Myers Lugemwa, a senior medical officer at the health ministry, says they will consider the recommendations during roll-out but while the price may not be the same as the ‘green leaf ACTs’, it will still be affordable. He says a dose could cost sh400.

NEWS: Red Cross to Aid 6,000 expectant Mothers

Red Cross to Aid 6,000 expectant Mothers

Posted Wednesday, February 24 2010 at 16:02 (from THE MONITOR ONLINE)

6,000 expectant women in Uganda are to benefit from a specialized reproductive health project implemented by the Uganda Red Cross Society.


Catherine Ntabadde, the public relations officer of the Uganda Red Cross Society, says the women and children targeted are from the districts of Gulu, Pader, Kitgum and Amuru. She says they will be provided with education on good health and sanitation, professional pre- and post-natal care and medication.


The goal of the project, which is co-sponsored by the Japanese Red Cross Society, is to increase awareness on safe motherhood and to reduce the instances of child and maternal mortality in the four northern Uganad districts.
Michael Nataka, Secretary General of the Uganda Red Cross Society, says selected health center will be given basic maternal health related items for midwifery services. He says meetings will be held every three months to assess the improvement of services at the health centers in order to ensure that as many women as possible are benefiting from them.


Additionally, the Red Cross will train 60 volunteers in safe motherhood to support this initiative.
According to the Ministry of Health 435 of every 100,000 expectant mothers in Uganda die at child birth. The deaths are attributed to poorly equipped health units and ignorance on maternal health on the part of the mothers.

NEWS: Chasing Off the Leopard of Hunger in Uganda

from COMPASSION INTERNATIONAL:

In July 2009, a cry for help went up in parts of northern and eastern Uganda as many peoplesuccumbed to the severe and persistent drought that swept across half of the nation. Soroti district was one of the localities that was hardest hit. However, this cry was not new to this part of the country.

Every year Soroti district is listed as a statistic for emergency help. It is said to be one of the districts with the highest levels of poverty in the country, with a very low education level andinhabitants ignorant of cultivation skills. Many have painful memories of war.

With unpredictable weather, fromhot and dry conditions that lead to drought and famine, to strong winds and rain that destroy homes and crops, the inhabitants of the land never know what to expect of fickle nature and how to overcome the damage left behind.

To the local inhabitants, the hunger and famine that come with the changing seasons is a leopard looking for the helpless and hopeless to devour. But for a few people in the community, it is time to fight back.

For the beneficiaries of the Asuret and Victory Outreach Orwadai Child Development Centers, it is time to hunt down and chase the “leopard,” and banish it for good.

Mary has watched three of her children die of disease, neglect and ignorance. Her family has beenbrought to its knees with no hope. Being HIV-positive with no money for treatment, both she and her husband Emmanuel had no strength to work for a living, and even then no one to take a chance on them. Life was hard with hardly enough food to eat. Most nights the family went to bed with empty bellies.

Despairing and wracked with disease in 2004 when her husband lost his eyesight, Mary set aside her pride and dignity and resorted to begging on the streets and public buses coming in from outside of town. Her husband stayed at home with their remaining two children.

For four years this was the life she knew. She woke up every morning praying to God to touch the heart of one person whose generosity would extend to her, so her family would have something to eat that night.

In 2008, the Victory Outreach Orwadai Child Development Center opened a few meters from Mary’s home. Mary and her family were one of the first families whose children were identified to benefit from the sponsorship program.

As part of the assistance the family received, Mary and Emmanuel were given 50,000 Uganda shillings (about $27) to start up a business that they could manage. With this money they bought one pig and firewood, and started to sell fried pork to the community members in the town center.

As demand for their food has grown, the duo’s business has moved from selling one pig in two days to currently two pigs a day.

Whereas before they had no food and depended on the mercy of good Samaritans, the family nowis able to have three meals a day as well as a variety of food in their diet.

Out of the profits of the business, Mary and Emmanuel bought a bed, a goat and a sheep. They also joined a”savings” group of people like them benefiting from the program, and were able to save enough money to buy a second sheep. The family hopes the sheep and goats will reproduce, and thatthey will sell them and expandtheir business.

“We have so many plans. We are planning to expand the huts in the eating place and add Irish potatoes and cabbage with tomatoes,” says Mary, who isexcited at her future prospects. “We have great hope in the future.”

Life was not so different for the community of Asuret village, located about an hour away from Soroti town. They too experienced the harsh weather and stalking hunger and famine. When the Asuret Child Development Center opened, the prayers of many were answered.

When given the 50,000 shillings to start up their individual income-generating activities, the beneficiaries of Asuret Child Development Center decided instead to pooltheir money and start up a group activity. This helps also take care of the elderly and weak, who would not be able to maintain their own individual projects.

The group started a chicken and piggery farm, and the members each take turnstending to them daily.

All the beneficiaries in the group are HIV-positive,and being a part of this has given them a lifeline to hold onto.

For many, the profitsfrom the project have enabled them to start their own individual income-generating activities like tailoring, selling charcoal, and small-scale agriculture.

“My children are now happy because I can now go home with something for them every day, unlike before,” says Naome, a widow with seven children, the youngest of whom is HIV-positive and also in the Asuret Child Development Center. Naome started a tailoring business that is now thriving.

The success of the group income-generating activity as well as each person’s individual activities are helping manygroup members pay for their other children’s needs, even thosewho are not registered in the sponsorship program. Most of the group members have also returned the initial investment given to them by the church.

The group’s success has filtered into the community, and the association had had requests from people who are not HIV-positive to join in the investment.

With the weather erratic and difficult to predict in this region, a more sustainable solution found in the income-generating activity programs seems to be the answer for the beneficiaries of both these development centers. They are determined not to remain a statistic, but to be the exception when the “leopard” comes calling next year.

Thursday, February 4, 2010

NEWS: Malaria in new areas requires fresh eradication strategy

COMMENTARY

Malaria in new areas requires fresh eradication strategy

By Pascal Odoch (email the author)
Posted Thursday, February 4 2010 at 00:00

Malaria mosquitoes do not breed above 1,500-2,000 metres and this knowledge has made large tracts of mountainous sub-Saharan Africa to be regarded non-malarial zones. It is against this backdrop that not many people have been able to establish the remote linkage between global warming, climate change and the escalating spread of malaria.
But as temperatures rise, the WHO’s prediction that more land would come under threat has become a fact. Malaria cases are nowadays reported from remote towns and villages in Uganda on account of the global warming regime.

What many of us learnt about Ankole region during geography lesson in primary school days i.e. terracing on the hill slopes, has suddenly now added to its geography lesson menu – shaded areas of malaria prevalence in Uganda. It is bizarre to find the residents of Ankole these days dealing with a disease that until recently was the preserve of the warmer corners of Uganda such as Nebbi, Soroti, Oyam, and Amolatar.

Nonetheless, the Museveni administration has confronted malaria without lying down. It removed user fees at public health facilities; it has deployed a multi-thronged information and education strategy to targeted vulnerable communities; and indeed incrementally increased funding allocation to the health sector to combat the diseases including malaria that prevent children enjoying their fifth birthdays.

RELATED STORIES

The impact of malaria is felt most in the agriculture, education and health sectors of Uganda’s economy. In agriculture, farmers are bed-ridden for most part of the growing season and lose out to wild animals such as baboons and monkeys on account of lack of tending their gardens.

Malaria is a leading cause of absenteeism in the primary education sector and strains the health sector resources given the surges in reporting malarial cases at the country’s health centres and hospitals. But of course the surging trend in malaria prevalence is exacerbated by other contributing factors such as political strife, poor cultural practices and lack of seriousness on the part of the population in preventive measures against malaria, migrant labourers moving from malarial zones, environmental degrading, especially the slash and burn practices of the peasant farmers.

Recently, brewers of a local drink have been reported to have used treated mosquito nets for sieving a popular drink called kwete in mainly Luo communities such as Alur in Nebbi and Zuobo districts as well as in the Acholiland.

The Draft National Development Plan, whose formulation is being spearheaded by the National Planning Authority, has articulated that negative cultural practices are among the underlying causes of poor health seeking behaviour in Uganda. Indeed, these practices undermine the very fundamentals by the government in the fight against the dreaded malaria.

The foregoing aside, of all the amazing advances in medical science, malaria is one of those diseases that has flatly refused to go away. While other major-league killers such as smallpox and yellow fever have given-in, the magic bullet to confront malaria the world over, remains elusive. Now global warning adds to its complexity and indeed demands for a new strategy.

All the same, there is a new and dedicated effort to confront malaria through the Bill and Melinda Gates Foundation in partnership with the GlaxoSmithKline. Under the well funded Path Malaria Vaccine Initiative (Path MVI), trials have singled out seven Sub-Saharan African countries including our neighbouring Kenya to establish effectiveness of the vaccine in causing immunity to its prey - humans.
This is a significant development that may result into achieving the Millennium Development Goal, where Malaria is a deterrent, much faster.

Dr Odoch is a Member of Daily Monitor Panel of Experts
gstarinternational@yahoo.com

NEWS: New malaria vaccine shows promise in children

New malaria vaccine shows promise in children


(from DAILY MONITOR)
By By Julie Steenhuysen (Reuters) (email the author)
Posted Thursday, February 4 2010 at 10:5

IN SUMMARY

The results were strong enough to start a second round of testing in 400 children to see if the vaccine can blunt the infection.

CHICAGO
A new vaccine showed promise at protecting young children from malaria, offering a potential new weapon against a disease that kills at least 1 million people each year, U.S. researchers said on Wednesday.

In a study of 100 West African children aged 1 to 6, the experimental vaccine produced immune responses similar to or even higher than those of adults infected by malaria all their lives.

The vaccine, which uses an immune system booster called an adjuvant from British drugmaker GlaxoSmithKline Plc, targets the malaria parasite as it is actively infecting red blood cells and causing fever and illness.

RELATED STORIES

This so-called blood stage vaccine acts at a later stage in the malaria parasite's life cycle than Glaxo's experimental vaccine Mosquirix.

"What jumps out to me about this vaccine is the antibody response," said Christopher Plowe of the University of Maryland in Baltimore and a Howard Hughes Medical Institute investigator whose study appears in PLoS ONE, a journal of the Public Library of Science.

"When you just look at the antibodies before you immunize anybody, the adults in Mali who have been exposed to malaria life-long, they don't get sick from malaria any more. They get infected but they don't get sick," Plowe said in a telephone interview.

"That is exactly what you want a blood stage vaccine to do."

SECOND ROUND OF TESTING

Plowe said children start out with fewer antibodies -- the immune system proteins that recognize invaders such as viruses or parasites. But after they were vaccinated, the children's antibody levels were just as high, or even a bit higher, than adults in their community.

The results were strong enough to start a second round of testing in 400 children to see if the vaccine can blunt the infection.

The new vaccine targets the malaria parasite after it has made its way though the bloodstream and into the liver, where it transforms into a new form called a merozoite, which can infect new red blood cells and cause fever and illness.

Plowe said he thinks the adjuvant from Glaxo, the same one used in Mosquirix, is priming the children's immune system to develop such a robust response.

"The hope would be that you could get two or more such first-generation vaccines, especially when you have the same adjuvant, and be able to come up with a multi-stage vaccine," he said.

Last month, Glaxo said Mosquirix is expected to complete late-stage testing in 2011 and, if proven effective, the company will seek regulatory approval by 2012.

Plowe's study was funded by the National Institute of Allergy and Infectious Diseases and the U.S. Agency for International Development. The vaccine was invented and made by the Walter Reed Army Institute of Research and formulated with an adjuvant by GlaxoSmithKline Biologicals.

Most of the 1 million or more people killed every year by malaria are young children and most live in Africa. The World Health Organisation says a child dies of malaria every 30 seconds.

NEWS: Army to build dormitory for blind, deaf in Jinja

Army to build dormitory for blind, deaf in Jinja
Wednesday, 3rd February, 2010 (from NEW VISION ONLINE)

By Donald Kiirya

THE army will construct a sh30m dormitory block at Spire Road School for the blind and deaf in Jinja district. The project will start this month. The dormitory that will house 30 pupils is one of the army’s projects to mark the Terehe Sita day. Speaking at the ground-breaking ceremony on Tuesday, the defence minister, Dr. Crispus Kiyonga, said: “Celebrations of the 29th army day will take place on February 6. During the week before the celebrations, soldiers engage in development activities and projects for the communities.” He said the army was in Busoga to explain its achievements in the course of the year, find out whether the people were happy with it and make sure that the people develop. Engineer Lt. Col. Besigye Bekunda said the dormitory, which will be constructed by the army’s engineering brigade, will include a rain water harvest system, which will be completed within one month. Brig. Samuel Lwanga, the deputy chief of medical services, said 15 pupils from the school with simple eye disabilities will also be treated at the eye clinic in Iganga. The army is carrying out similar community activities in the districts of Jinja, Iganga, Bugiri, Namutumba, Kaliro, Kamuli and Mayuge.

NEWS: VP commissions modern virus labs

VP commissions modern virus labs

Wednesday, 3rd February, 2010 (NEW VISION ONLINE)

Bukenya commissioning the laboratories at Entebbe yesterday

By Andante Okanya
THE Vice-President, Dr. Gilbert Bukenya, on Tuesday commissioned modern laboratories at the Uganda Virus Research Institute in Entebbe. The laboratories will be used to carry out scientific research and clinical studies. They will also be used for trials on vaccines for HIV/AIDS and other communicable diseases. The institute has previously made great breakthroughs in scientific research. It was the first to isolate more than 20 new airborne viruses, including the West Nile Virus, Bwamba Fever, Semliki Forest Virus, Orungo and Kadam. The fully-equipped laboratories were set up with funding from the British government. Speaking at the ceremony, Bukenya urged Ugandans to stick to the ABC strategy in the fight against HIV/AIDS. He said those agitating for the removal of the C (condom) are enemies in the fight against the deadly virus. “ABC strategy is to save lives. It is not religious. Those who say remove the C are not serious,” Bukenya said. James Kakooza, the state minister for primary health care, reassured health workers that the Government will ensure that they are paid according to international standards starting this year. The British High Commisioner to Uganda, Martin Shearman, revealed that his Government would support the Medical Research Council until 2019. An estimated 1.4 million people are currently living with AIDS in Uganda, with an annual infection rate of 130,000 people.