USAID - the US government’s overseas development assistance agency - has a new chief. Dr Rajiv Shah was sworn in on 7th January - see USAID press release.

Dr Shah is sure to be hearing from many people who would like to see changes in USAID policy, particularly as regards health. Amongst them will be Dr Orin Levine Executive Director of the International Vaccine Access Center at Johns Hopkins University. Writing in the Huffington Post, Dr Levine says USAID’s health policies should be more “child friendly”. He refers in particular to the two biggest killers of children, both of them the result of infections - pneumonia and diarrhoea. He notes that USAID funding has tended to focus more on diseases that kill adults, particularly AIDS. Interventions are available, proven by research to be effective, that USAID should fund in order to save children’s lives.

Recently published new guidelines for the diagnosis, treatment, prevention and control of dengue (see TropIKA.net report) have been hailed by the Wellcome Trust as an example of how research can shape policy - see Trust press release.

The Wellcome Trust funded some of the research on which the new guidelines are based, particularly research conducted in Viet Nam. The press release also describes how malaria policy in Kenya has been influenced by Trust-funded work.

For patients with chronic infectious disease, quality of life (QoL) is arguably the most important issue, but it is often not considered in research. An Ethiopian study (1) has looked at the QoL of patients coinfected with TB and HIV.

The research team interviewed 591 HIV-positive patients, of whom 124 (21%) were TB/HIV co-infected. Use was made of a short version of WHO’s QoL scoring system. Depression was also assessed.

TB/HIV co-infected patients had lower scores on all aspects of QoL, compared with HIV-infected patients without active TB. Depression, having a source of income and family support emerged as particular problems. In co-infected patients, individuals who had depression were 8.8 times more likely to have poor physical health as compared with individuals who had no depression. Self-stigma was also associated with poor QoL.

The authors of the study recommend that TB programmes should design strategies to improve the QoL of TB/HIV co-infected patients. Depression and self-stigma should be given particular consideration and families of the patients should be counselled and educated.

Reference

1. Deribew A, Tesfay M, Hailemichael Y, Negussu N, Daba S, Woji A, Belachew T, Apers L, Robert C (2009). Health Qual Life Outcomes; 7(1):105.

A report in the Hindu newspaper says that the Indian Council of Medical Research (ICMR) will be setting up an expert group to examine the increasing number of cases of the infectious disease Chikungunya.

ICMR also intends to create a National Virology Network to monitor the outbreak of all viral diseases throughout India.

Chikungunya - viral disease, carried by Aedes aegypti mosquitoes - was first reported in the 1950s and in recent years has steadily become more common in Africa, Asia and the Pacific islands, with the first European cases seen in 2007. It has similar symptoms to dengue, making diagnosis difficult. The fever lasts only a few days but severe joint pains and fatigue can persist for many months. The disease has also recently been shown to cause severe blistering of the skin of infected children (1). No vaccine or specific treatment exists for Chikungunya. There are concerns that the increasing frequency of the infection will cause problems for blood transfusion services in many parts of the world (2), although improved blood tests are under development (3).

References

1. Robin S, Ramful D, Zettor J, Benhamou L, Jaffar-Bandjee MC, Rivière JP, Marichy J, Ezzedine K, Alessandri JL (2010). Severe bullous skin lesions associated with Chikungunya virus infection in small infants. Eur J Pediatr; 169(1):67-72.
2. Petersen LR, Stramer SL, Powers AM (2010). Chikungunya virus: possible impact on transfusion medicine. Transfus Med Rev. 2010 Jan;24(1):15-21.
3. Sharma S, Dash PK, Santhosh SR, Shukla J, Parida M, Lakshmana Rao PV (2010). Development of a Quantitative Competitive Reverse Transcription Polymerase Chain Reaction (QC-RT-PCR) for Detection and Quantitation of Chikungunya Virus.