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Archive for January 26th, 2010

Jan 26 2010

Fake antimalarials seized in Nigeria

Posted by: Paul Chinnock - Editorial Team

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One reason why research is needed to develop new antimalaria drugs is the the appearance of resistance to drugs currently in use. The mainstay of malaria treatment is now artemisinin combination therapy (ACT) but many ACTs in circulation are faked or substandard versions. These products tend to contain low doses of active drugs, and when the malaria parasite is exposed to such doses the development of resistant strains is more likely to occur.

Action against fakes has generally been inadequate. News that fakes have been intercepted and seized by the authorities is always welcome therefore. AllAfrica.com reports that Nigeria’s National Agency of Food and Drugs Administration and Control (NAFDAC) has impounded a consignment of nine packages of the antimalarial Lonart (artemether plus lumafantrine) valued at Naira 10 million ($67 million). NAFDAC made the discovery during routine checks at Lagos airport and employed their recently acquired drug testing equipment to establish that the drugs were faked.

While the story is encouraging, one can only speculate as to how many fake antimalarials (and other drugs) are still entering countries like Nigeria undetected.

Jan 26 2010

China reports massive progress against TB

Posted by: Paul Chinnock - Editorial Team

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Tuberculosis control efforts in China are claimed to have saved over three-quarters of a million deaths and prevented 20 million new cases of the disease over the last eight years.

According to the Xinhua.net news service, the figures were given at a joint meeting of China’s health ministry with the World Bank and the UK Department for International Development, which supported the TB control programme based on DOTS (directly observed treatment, short course).

China’s population of TB patients was estimated as 4.5 million in 2009, the world’s second largest after India.

Jan 26 2010

Tropical diseases exist in the Arctic - poverty is responsible

Posted by: Paul Chinnock - Editorial Team

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Arguing that the burden of neglected tropical diseases (NTDs) is not just dependent on climate, but mainly related to incidence of poverty, an editorial [1] in PLoS Neglected Tropical Diseases details the large number of neglected infections of poverty in the Arctic region and calls for greater research into these devastating, debilitating and sometimes deadly diseases.

“One of the most dramatic illustrations of poverty as the single most important determinant of neglected infections among human populations is the observation that these conditions occur among the poorest people in the Arctic region,” states the paper’s author, Dr Peter Hotez, President of the Sabin Vaccine Institute and Distinguished Research Professor at George Washington University. He says there are a dozen neglected infections of poverty in the region, most of which are food-borne.

There are seven countries with significant territory in the Arctic, including Canada, Finland, Greenland, Norway, Russia, Sweden and the United States (Alaska). Iceland is also sometimes included in the definition of the Arctic. Approximately two million people live north of the Arctic Circle, with 60% living in Arctic Russia. A high percentage of these populations represent aboriginal or indigenous peoples. In Canada, the most indigenous people of the Arctic are the roughly 50,000-60,000 Inuit.

Dr Hotez notes that it is not surprising that neglected infections of poverty are found in the Arctic given the region’s socioeconomic deprivation, stress, and environmental degradation. Indigenous people living in the Arctic region suffer disproportionately from high rates of chronic conditions such as smoking, drinking and obesity and have a life expectancy 8-12 years shorter than the non-indigenous population. “Indeed, overall the world’s indigenous people in general suffer from high rates of infections such as ectoparasitic skin infestations, upper and lower respiratory track infections, and central nervous system infections from bacterial invasive organisms and tuberculosis, childhood illnesses, diarrheal and intestinal helminth infections, urinary tract infections, bone and musculoskeletal infection and in some cases, HIV/AIDS and malaria,” Hotez writes.

Many of the parasitic infections are food-borne and transmitted through uncooked or inadequately prepared meats from polar bear and sea mammals such as walrus or seal. Other infections are zoonoses (diseases that can be transmitted from animals to humans) transmitted from livestock unique to the Arctic region such as reindeer and elk.

Toxoplasmosis is one of the neglected infections of poverty endemic to the Arctic region. In terms of prevalence and diseases burden, toxoplasmosis is probably the most important parasitic infection in the North American Arctic. Toxoplasmosis can seriously impact people with a weakened immune system. The parasite can also cause encephalitis, neurologic diseases and can also affect the heart, liver and eyes. “Given the high rates of toxoplasmosis, a program of newborn screening for these populations would identify at-risk infants eligible for antiprotozoan chemotherapy,” Hotez concludes.

Dr Hotez also calls for further study of neglected infections of poverty throughout the Arctic region, including among the indigenous populations living in Russia and Siberia. “Ultimately, programs for prevention of neglected infections may need implementation for all of the indigenous people living in the Arctic region,” Hotez states.

Reference
1. Hotez PJ (2010) Neglected Infections of Poverty among the Indigenous Peoples of the Arctic. PLoS Negl Trop Dis 4(1): e606.