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| HEALTH & FITNESS |
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Malaria control must be priority Gout may bring more misery in menopausal zone nAdditional BP screening may cut incidence of CVD events and death nNeem tree may hold clues for HIV treatment
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Malaria control must be priority According to the WHO also, about half the world’s population is at risk from malaria. Despite the fact of its being a preventable and treatable disease, it still claims the life of one child every minute, with more than 90 per cent of all malaria deaths occurring in the African continent. India’s share in South Asia is 83 per cent of the total cases reported in this region. At present it is one of the major killers. In India, deaths due to malaria could be more than 40 times higher than what is presently estimated. Recent research published in the Lancet shows that malaria kills 1.2 million people worldwide each year - twice as high as the figure in the World Malaria Report, 2011. An Indian study estimates that “4800 malaria deaths in children younger than five years and 42,000 malaria deaths in those aged five years or older” for the year 2010 as against “19,000 malaria deaths in children younger than five years and 87,000 malaria deaths in those aged five years or older in 2002.” This means that malaria killed an estimated 46,800 Indians in 2010. However, the National Vector-Borne Disease Control Programme estimates that 1,023 people died of malaria infection in 2010. Therefore, due to the discrepancy in the figures at the national and international levels, it became a very debatable issue. A large number of cases of malaria were treated in Chandigarh in 2010 and 2011, and these patients came from the surrounding districts of Haryana and Punjab. Sometimes malaria may be confused with viral fever and typhoid, but the latest outbreaks of the fatal disease shows that the patients died due to multi-organ failure, an unusual feature of this disease. Some of them were advancing towards renal failure and had to be put on dialysis as well. A substantial number of these cases were caused by Plasmodium falciparum. In such circumstances, an early diagnosis can lead to timely therapeutic intervention, which can prevent mortality in complicated malaria cases. The Roll Back Malaria is basically a global partnership initiated by the WHO, UNDP, UNICEF and the World Bank in 1998. It seeks to work with governments, other development agencies, NGOs and private sector companies to reduce the human and socio-economic costs of malaria. It was promoting four main strategies to pursue its goal of halving the world’s burden of malaria by 2010. The strategies are evidence-based, outcome-focused and cost-effective: (a) Prompt access to treatment; (b) Insecticide-treated mosquito nets (ITNs); (c) Prevention and control of malaria in pregnant women (d) Malaria epidemic and emergency response. Globally, Africa has about 90 per cent burden of the fatal cases of malaria. Therefore, realising the gravity of the situation in April 2000, delegations from 44 African nations met in the largest ever summit of Heads of State focused on a single health issue in Abuja (Nigeria) and committed their countries to cutting malaria-related deaths to half during the next decade - by 2010. These African leaders, endorsing this Roll Back Malaria (RBM) goal for 2010 in the Abuja Declaration, also set interim targets and drew up a plan of action for expanding access to and use of effective interventions. One year later, in 2001, the first Africa Malaria Day re-affirmed their commitment across the continent with public events and health educational programs. Therefore, keeping in view the progress made by these programmes, April 25 was designated as World Malaria Day in 2007 by the 60th session of the World Health Assembly, the decision-making body of the WHO, reiterating the Abuja Declaration. The day was essentially established to globally provide education and understanding of malaria and disseminate information on malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas. The theme for World Malaria Day-2012 is “Sustain Gains, Save Lives: Invest in Malaria” - this marks a decisive juncture in the history of malaria control. Whether the malaria map will keep shrinking, as it has in the past decade, or be reclaimed by the malaria parasites, depends, to a great extent, on the resources that will be invested in control efforts in the coming years. In addition, the CDC conducts multidisciplinary strategic and applied research globally to increase knowledge about malaria and develop safe and effective interventions that can lead to the elimination and eventual eradication of malaria. As a WHO Collaborating Center for Prevention and Control of Malaria, CDC works closely with the WHO, which has just released new malaria surveillance manuals and launched the T3 (Test, Treat, and Track) Initiative, urging increased investment in national capacity for diagnostic testing, diagnosis-based treatment and the surveillance of malaria. Investments in malaria control have created unprecedented momentum and led to remarkable results in the past. In Africa, malaria deaths have been cut by one-third within the last decade; outside Africa, 35 out of the 53 countries, affected by malaria, have reduced cases by 50 per cent in the same time period. In countries where access to malaria control interventions has improved most significantly, overall child mortality rates have fallen by approximately 20 per cent. Therefore, sustaining malaria control efforts is an investment in development. This continued investment in malaria control now would propel malaria-endemic countries towards near-zero deaths by 2015 and achieving the Millennium Development Goals, especially those relating to improving child survival and maternal health, eradicating extreme poverty and expanding access to education. However, these gains may be reversed unless malaria control becomes a priority for global, regional and national decision-makers. Despite the current economic scenario, development aid needs to continue flowing to national malaria control programmes to ensure widespread population access to life-saving and cost-effective interventions.
The writer is Professor & Head, Department of Microbiology, Government Medical College Hospital, Chandigarh.
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Gout may bring more misery in menopausal zone Rita, 55, complained to her gynaecologist, “I had hysterectomy done six weeks after surgery. Now I have developed pain and swelling in the big toe of my left foot. I have also developed water retention in my fingers causing stinging, and my joints swell in my hands. I am unable to wear any rings, and my physician feels it is lack of estrogen. But I do not want to take hormones due to the alleged side-effects. I am currently taking the following supplements daily: cod liver oil, vitamin B complex, starflower oil, garlic, omega 3 and 6 complex. Can it give me relief from pains in the toe and fingers?” You may require investigations and treatment for gout, which is fairly common among post-menopausal women, the doctor replied. Also, high B.P, heart disease, and renal failure are commonly found in women with gout, she added. You require a good check-up. You may require the support of estrogen also, the gynaecologist opined. What is gout?
Once called the “disease of kings”, gout is a form of arthritis in which uric acid crystals build up in the joints, causing intense pain, swelling and inflammation. Uric acid is a byproduct of the biological process by which the body breaks down purines. Purines are found in many foods and also naturally produced in the body. In most people, the kidneys can filter out extra uric acid and excrete it with the urine. For individuals with gout, however, this process is flawed. The kidneys are either overwhelmed by an overproduction of uric acid or are not equal to the task of filtering it out. As uric acid concentrations in the blood increase, deposits form in the joints. The joints of the big toe are usually the first and most severely affected. It is well known that the kidneys become less efficient at ridding the body of excess uric acid, in the menopausal zone. The number of gout cases is increasing steadily and the vast majority of new gout sufferers are women. Several factors can alter a woman’s likelihood of developing gout after menopause — being obese, hypertensive, or taking diuretics. For most menopausal women, pain and stiffness usually begin in the big toe and then affect the ankles, knees and wrists. With this onset of pain comes swelling and often redness, which may lead to kidney stones or kidney disease. For menopausal women, the onset of gout may occur at any point in the menopausal process as the kidneys continue to lose the support of the estrogen hormone. Prevention and treatment
The following can aggravate gout, so be careful with alcohol, meat and fish, infections, surgery, trauma, and drugs, including cyclosporine, furosemide, ethambutol, aspirin, pyrazinamide, thiazides and nicotinic acids. Treating gout includes the use of prescription medications, depending on the degree to which uric acid affects the body. Women who are overproducers can take allopurinol (Lopurin, Zyloprim) to decrease their body’s uric acid production. Under-excreters can take probenecid (Benemid, Probalan) to help their body eliminate uric acid. Besides avoiding non-vegetarian foods, go light on moderate-purine foods such as asparagus and mushrooms. In addition to prescription medications, many menopausal women may also use anti-inflammatory drugs such as ibuprofen to relieve swelling and pain. Prednisone or other steroid-affiliated drugs may prove beneficial in improving inflammation when over-the-counter medications are ineffective. Staying active will help alleviate many of the symptoms of menopause as well as decreasing your chances of gout.
The writer is a Chandigarh-based senior
gynaecologist.
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Additional BP screening may cut incidence of CVD events and death Moreover, only 100 million of these people receive treatment, while only 5 per cent of the total are controlled. Against this backdrop, this study was designed to assess the cost-effectiveness of an intervention to increase screening by 25 per cent in developing countries using a non-lab screening tool to treat those with a systolic blood pressure of greater than 140 mmHg and CVD risk of greater than 20 per cent. — ANI Just 15 minutes of exercise a day can help smokers kick the butt They also found that active smokers were 43 per cent less likely to relapse when they did quit. Life expectancy was found to increase by 5.6 years on average, and the risk of death was reduced by 43 per cent, putting them at the same level as sedentary non-smokers. — ANI Several rheumatic heart disease patients `under-treated` Across the African and Indian regions included in the study it was revealed that patients are not receiving the surgery they need, secondary prevention with penicillin - to prevent further attacks of rheumatic fever — is being under-utilized and many patients are unaware of their target anti-coagulation levels. Specifically, only 41 per cent of patients enrolled in the study had received surgery. As the pilot results included a large tertiary academic centre, this does not reflect the dire lack of surgery available at the majority of enrolling centres. In fact, more than 85 per cent of the enrolling centres do not have surgery available on a regular basis for RHD patients. — ANI Neem tree may hold clues for HIV treatment Sonia Arora, an assistant professor at Kean University in New Jersey, is delving into understanding the curative properties of the neem tree in fighting the virus that causes AIDS. Her preliminary results seem to indicate that there are compounds in neem extracts that target a protein essential for HIV to replicate. If further studies support her findings, Arora’s work may give clinicians and drug developers a new HIV-AIDS therapy to pursue. Extracts from neem leaves, bark and flowers are used throughout the Indian subcontinent to fight against pathogenic bacteria and fungi. “The farther you go into the villages of India, the more uses of neem you see,” said Arora. — ANI Anorexia may be caused by brain abnormality The pioneering research, carried out on anorexics as young as eight and using powerful new brain-imaging techniques, could lead to different treatments. Anorexia is defined as a body weight at least 15 per cent below that expected, the Daily Express reported. “We believe subtle problems in early brain development make patients susceptible to anorexia. We need to re-examine other mental health problems,” said Psychologist Dr Ian Frampton of Exeter University, one of two researchers leading the study. — ANI
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Malaria and tuberculosis are the diseases of antiquity, commonly found in developing tropical and subtropical countries, with very high morbidity and mortality. Preventive and therapeutic measures have been taken according to the prevailing knowledge about these maladies century after century. As per an estimate, 216 million cases of malaria and 655,000 deaths were reported worldwide in 2010, a decrease of 17 per cent in malaria incidence and 25 per cent reduction in global malaria mortality since 2000.