Biomedical Research, A Tool to Address the Health Issues that Affect African Populations.

Traditionally, biomedical research endeavors in low to middle resources countries have focused on communicable diseases. However, data collected over the past 20 years by the World Health Organization (WHO) show a significant increase in the number of people suffering from non-communicable diseases (e.g. heart disease, diabetes, cancer and pulmonary diseases). Within the coming years, WHO predicts significant decreases in communicable diseases while non-communicable diseases are expected to double in low and middle income countries in sub-Saharan Africa. The predicted increase in the non-communicable diseases population could be economically burdensome for the basic healthcare infrastructure of countries that lack resources to address this emerging disease burden. Biomedical research could stimulate development of healthcare and biomedical infrastructure. If this development is sustainable, it provides an opportunity to alleviate the burden of both communicable and non-communicable diseases through diagnosis, prevention and treatment. In this paper, we discuss how research using biomedical technology, especially genomics, has produced data that enhances the understanding and treatment of both communicable and non-communicable diseases in sub-Saharan Africa. We further discuss how scientific development can provide opportunities to pursue research areas responsive to the African populations. We limit our discussion to biomedical research in the areas of genomics due to its substantial impact on the scientific community in recent years however, we also recognize that targeted investments in other scientific disciplines could also foster further development in African countries

The burden of non communicable diseases in developing countries

Background: By the dawn of the third millennium, non communicable diseases are sweeping the entire globe, with an increasing trend in developing countries where, the transition imposes more constraints to deal with the double burden of infective and non-infective diseases in a poor environment characterised by ill-health systems. By 2020, it is predicted that these diseases will be causing seven out of every 10 deaths in developing countries. Many of the non communicable diseases can be prevented by tackling associated risk factors. Methods: Data from national registries and international organisms are collected, compared and analyzed. The focus is made on the growing burden of non communicable diseases in developing countries. Results: Among non communicable diseases, special attention is devoted to cardiovascular diseases, diabetes, cancer and chronic pulmonary diseases. Their burden is affecting countries worldwide but with a growing trend in developing countries. Preventive strategies must take into account the growing trend of risk factors correlated to these diseases. Conclusion: Non communicable diseases are more and more prevalent in developing countries where they double the burden of infective diseases. If the present trend is maintained, the health systems in low-and middle-income countries will be unable to support the burden of disease. Prominent causes for heart disease, diabetes, cancer and pulmonary diseases can be prevented but urgent (preventive) actions are needed and efficient strategies should deal seriously with risk factors like smoking, alcohol, physical inactivity and western diet

Communicable Diseases and the Workplace

[Excerpt] Coming to work when we are sick raises some interesting questions: How contagious are we? Should we stay home? What could be done to prevent disease transmission to others, with its effects on absenteeism, performance, and efficiency, as well as in the interests of public health? Is working from home an option? Shouldn’t the employer provide sick leave or flextime to discourage working when sick? Without sick leave, aren’t people more likely to go to work sick, as well as send sick kids to school? Should an employer sponsor, or even require, vaccinations? When trying to change policy and attitudes on communicable infectious diseases in the workplace, there is a good business case to be made. Workplaces traditionally plan for a variety of crises – especially infrastructure damage and its recovery – but planning and prevention for diseases seems to get overlooked, despite its very significant cost in both human suffering and dollars. Some diseases that have had a costly impact on businesses include mumps, measles, norovirus, SARS, tuberculosis, and whooping cough

Market Structure and Communicable Diseases

Communicable diseases pose a formidable challenge for public policy. Using numerical simulations, we show under which scenarios a monopolist’s price and prevalence paths converge to a nonzero steady-state. In contrast, a planner typically eradicates the disease. If eradication is impossible, the planner subsidizes treatments as long as the prevalence can be controlled. Drug resistance exacerbates the welfare difference between monopoly and first best outcomes. Nevertheless, because the negative externalities from resistance compete with the positive externalities of treatment, a mixed competition/monopoly regime may perform better than competition alone. This result has important implications for the design of many drug patents.communicable disease, resistance, epidemiology, patent

Controlling malaria in Africa: progress and priorities

"This work was supported ... by the Africa Bureau, Office of Operation and New Initiatives (ONI) and the Office of Analysis, Research and Technical Support (ARTS), United States Agency for International Development (A.I.D.) through the Africa Child Survival Initiative - Combatting Childhood Communicable Diseases (ACSI-CCCD) Project, Africa Regional Project (698-0421) Washington, D.C."--P. 2 of cover.Includes reports from Burundi, Central African Republic, Congo, Co?te d'Ivoire, Guinea, Liberia, Malawi, Nigeria, Rwanda, Swaziland, Togo, and Zaire."Malaria"--cover.Includes bibliographical references

Direction & Dilemma of Tropical Oral Health: a position paper

A number of tropical and communicable diseases are evident as oral manifestations. The tropical and communicable disease of oral health concern is an issue because, not only it is restricted to tropical countries, it is also affecting an underserved population of developed countries. Cross-border transmission of communicable diseases of tropical countries is an agenda where the number of tropical diseases, manifested with oral lesions, has not been taken into consideration by oral health care providers for timely identification and setting a goal for prevention and control of transmission at home and abroad. Moreover, every developed country has underserved populations that are prone to develop communicable oral diseases/TODs like tropical countries. The underserved population in developed countries are also experiencing higher incidence rate of communicable diseases which are not necessarily due to cross-border transmission, but related to their poor life-style and other prevailing factors of inequalities. However, the type of communicable diseases is dependent on the mode of transmission and progression; it may be contagious, vector borne or environmentally transmitted. Using TRIP (copy available at ICTOH*), I have searched and collated information anecdotally to understand the situation of the tropical oral diseases. First, we need to define what are tropical oral diseases? On this issue we had several discussions and interactions and reviewing of reports. We concluded that the tropical oral diseases largely cover communicable diseases which are mostly prevalent in the tropical countries. Also non-communicable diseases of life-threatening nature, those that are widely prevalent in the tropical countries, such as oral cancer and pre-cancer (in SE Asia), Noma (in Africa) could be taken into consideration to be identified as a category of tropical oral diseases (TODs). Moreover, till date, we are not able to rule out precisely, any possibility of mutational transmission of communicable disease(s) of oral health concern. Therefore, although all the communicable diseases have an infective nature, we cannot ignore the potential of inheritance factor which may exist irrespective of tropical and non-tropical locations, globally. To reduce the inequalities and improve prevention, including consistent clinical management (tertiary care), our oral health care providers may need to be adequately equipped to combat TODs. There are various oral diseases and conditions which fall into the category of ‘TODs,’ that need to be detected and managed by the general dental practitioners. They need to be able to ascertain when they should refer the critical TODs/cases to a specialist in oral medicine and/or surgery or a physician. Many of these disease (TODs) conditions are manifested with similar features and therefore it becomes almost impossible to identify these diseases clinically for definite diagnosis. In order to ensure that dental practitioners are able to tackle TODs appropriately and efficiently, development of appropriate measures to tackle TODs, in both clinical and community settings is necessary. The development of clinical databases and diagnostic test reports, carried out in the tropical countries is therefore highly recommended. The pooling of resources and clinical knowledge for early detection (required for early prevention and appropriate management of TODs) should therefore be an important point of consideration. I also strongly suggest developing a framework convention to recognize the TODs globally through a realistic strategic approach. Another very important component is development of research specifically in the areas of TODs. In the 1st International working group meeting we had discussed and taken resolution which had been published as a declaration from Poole, England. We have already started to develop a database in part of India, Bangladesh, Sudan, and Jordan. Therefore, it is our responsibility and commitment to put our efforts to pursuing need-based researches on the priority areas of TODs. The identification of the TOD priority research and the establishment of a research team with a lead will be a significant shot in the arm in the process of developing TOH and may generate the momentum which will ultimately lead to the further development of this area. Therefore, in this meeting I suggest the development of a research team(s) by a lead, and to work for securing grants-in –aids, nationally and internationally. We have started few projects with local support which will probably help act as pilot projects for the larger collaborative projects(s) to submitting for grants-in-aids in the near future. We would need to work on TODs, focusing on the aim of developing a few specific objectives, keeping in mind how beneficial it will be for the WHO International Clinical Trial Registry Platform. We may eventually propose a broad classification of TDOs as (i) Communicable and transmissible tropical oral diseases (TODs) includes Category 1 (Highly prevalent): AIDS/HIV infection, Malaria, TB, Kala-Azar, and Category 2 (Moderately prevalent): Mucocutaneous Leishmaniasis (MCL), Onchocerciasis, and Leprosy. (ii) Non-communicable diseases causing death and disability in the tropical countries. Oral Cancer, Noma (Cancrum Oris), PCM i.e. Marasmus (M), Kwashiorkor (K) including M&K and Diabetes. We do not have sufficient information on oral manifestation of WHO listed other tropical and communicable diseases which are mostly prevalent in African and Asian tropical countries, needs to be data-based. Moreover, we also need to identify the other systemic diseases of oral health concern in the tropical countries, (Proposed checklist draft protocol is available at ICTOH*).Some of those diseases is preceded with oral signs and/or coincided should be an important concern for oral health practitioners. However, I have identified the following constrains could be tackled through effective approaches for a realistic development of TODs, and that may help in a direction. Inadequate clinical data: Needs to be developed with an authentic database Inadequate training facilities for clinical diagnosis and management of TODs and conditions: A structured training programme for clinical diagnosis and management needs to be developed Lack of initiative for community education for the prevention and control: Oral health professionals of the tropical countries may need to participate, individually, and/or in a team (through an integrated approach) for the prevention and control of communicable diseases of oral health concern including TODs and general systemic diseases with oral manifestations (Preceded and/or coincided oral signs) Non-existence of categorization of Tropical Disease Research (TDR) [cf. WHO TDR value for tropical disease]: A specific TDR for TODs would be a good initiative Inadequate research: Priority-based systematic lab-based and epidemiological researches need to be developed, within the existing facilities Non existence of specific course contents: The syllabus and curriculums of the undergraduate and postgraduate courses need to be incorporated with the specific modules of TODs (especially in the tropical countries)

Laboratory surveillance of communicable diseases : enteric pathogens

Laboratories represent a crucial link in the surveillance chain. Since only a small proportion of cases of enteric infections are asked to submit a stool sample, one needs to assess the practices for testing for enteric pathogens and their notification practices. Five local laboratories participated in this study. This included a description of the laboratory practices; capacity for stool sample analysis; awareness of the notification system and the factors which could improve the system at laboratory level.peer-reviewe

Morbidity Pattern Among Out-Patients Attending Urban Health Training Centre in Srinagar

The current study was designed to identify the morbidity pattern of out-patients attending Urban Health Training Centre in an urban area of a medical college in Srinagar, Pauri Garhwal district, Uttarakhand, North India. The present study record-based retrospective study was conducted among the out-patients attending the regular clinic at the Urban Health Training Centre, of a medical college in Srinagar city of Uttarakhand State of North India during the study period of one year in 2014. Data was retrieved from the OPD registers maintained at the clinic. Data was collected pertaining to socio-demographic profile, morbidity details and treatment pattern. Diseases were identified using the International Classification of Diseases (ICD-10) code. Descriptive analysis was done. During the study period, a total of 9343 subjects attended the OPD. Among them, majority of them (60%) were females. More than half (56 %) belonged to the age group of 35-65 year age-group. The association of disease classification was found to be statistically significant with respect to gender. The leading morbidity of communicable disease was found to be certain infectious and parasitic diseases especially Typhoid whereas musculoskeletal system and connective tissue disorders were the most common cause among morbidity due to NCDs. Out of all, typhoid was found to cause maximum of morbidity among the subjects. The present study highlights the morbidity pattern of communicable and NCDs among the population of hilly areas of Garhwal, Uttarakhand India. Priority should be preferred for the regular tracking of diseases in terms of preventive and promotive aspects. Morbidity in the out- door clinics reflects the emerging trend of mixed disease spectrum burden comprising communicable and non-communicable diseases

Communicable behavior of non-communicable diseases

Communicability of non- communicable diseases can be explained using the prototype of non- communicable diseases. The concept can be further extended to other non- communicable diseases. Diabetes mellitus (DM) is regarded as the prototype of non-communicable diseases. Its subtype, type 2 DM is usually associated with obesity. Obesity, in turn, can be attributed to deranged eating habits and lack of physical activity. Eating habits of a person bears a close resemblance to the parental eating habits. Other factors contributing to obesity like alcoholism can also be transmitted from parents to child. Smoking, another factor implicated in DM, can be picked as a habit from peer group as well as family. All these factors implicated directly or indirectly in the pathogenesis of DM are actually components of lifestyle. These lifestyle components can be transmitted both in an inter-generation and intra-generation fashion. And so the chances of transmission of DM (a lifestyle disease) in the same fashion cannot be ruled out