Tuberculosis and pregnancy

Tuberculosis and pregnancyTuberculosis is a disease of antiquities and it has been there since medieval times though according to literature, It is no older than the first conception of Adam's wife. Despite the extensive studies on tuberculosis and it being declared a global emergency, very little literature from the developing world is available on the interaction of this disease and pregnancy. There is a serious lack of information form those countries that bear the greatest burden of the disease particularly southern Africa where the duo epidemic of tuberculoses and HiV threaten the post independence gains in education, health, economic and other sectors of the economy, The scanty information on the impact of tuberculosis- a disease with effective chemotherapy- on pregnancy raises serious ethical and moral issues, which this paper will attempt to address.Office of Global AIDS/US Department of State

Ebola respons-ibility: moving from shared to multiple responsibilities

Combating threats of infectious diseases has been increasingly framed as a global shared responsibility for a multi-actor framework, of states, international organisations and non-governmental actors. However, the outbreak of Ebola Virus Disease (EVD) has shown that this governance framework has not been able to limit the spread of this virus, despite the normative and legislative changes to global disease control. By unbundling the concept of responsibility, this article will assess how global shared responsibility may have failed due to the fact that accountability does not fall on any one state or stakeholder, highlighting an inherent weakness with the global disease governance regime. As such, this paper concludes that a move towards multiple responsibilities may prove a more effective mechanism for ensuring global health security

Global Mortality Estimates for the 2009 Influenza Pandemic from the GLaMOR Project: A Modeling Study

Background: Assessing the mortality impact of the 2009 influenza A H1N1 virus (H1N1pdm09) is essential for optimizing public health responses to future pandemics. The World Health Organization reported 18,631 laboratory-confirmed pandemic deaths, but the total pandemic mortality burden was substantially higher. We estimated the 2009 pandemic mortality burden through statistical modeling of mortality data from multiple countries. Methods and Findings: We obtained weekly virology and underlying cause-of-death mortality time series for 2005–2009 for 20 countries covering ~35% of the world population. We applied a multivariate linear regression model to estimate pandemic respiratory mortality in each collaborating country. We then used these results plus ten country indicators in a multiple imputation model to project the mortality burden in all world countries. Between 123,000 and 203,000 pandemic respiratory deaths were estimated globally for the last 9 mo of 2009. The majority (62%–85%) were attributed to persons under 65 y of age. We observed a striking regional heterogeneity, with almost 20-fold higher mortality in some countries in the Americas than in Europe. The model attributed 148,000–249,000 respiratory deaths to influenza in an average pre-pandemic season, with only 19% in person

A prospective study of agaricus blazei mycelia compound administration in asymptomatic HIV-1 infected patients in Lusaka, Zambia

Agaricus mycelia compound (ABPC) has been used as a food supplement in Japan for several yearsAgaricus mycelia compound (ABPC) has been used as a food supplement in Japan for several years. It has been shown to have immune enhancing activities both z.77 vz.fro and z.77 1;z.1;o, leading us to speculate a potential role in the treatment of HIV infection. To determine the value of ABPC as an immune enhancing supplement for HIV-infected individuals, we carried out a prospective randomised clinical study. We recruited 54 HIV-1 infected asymptomatic patients attending a general clinic in Lusaka, Zambia. Informed consent was obtained from all participants after explaining the purpose and details of the study. At recruitment, all patients had blood CD4 counts >200 cells/m61. The study participants were divided into the ABPC group (28 subjects) and placebo group (26 subjects). ABPC or placebo was administered by directly observed therapy methodology. During the 12-month period, 3 and 5 patients died in the ABPC and placebo groups, respectively. During that time, 9 and 5 patients in the ABPC and the placebo groups, respectively, left the study and returned to their villages. After 12 months, the average CD4 counts in the placebo group had significantly decreased (P=0.018), while the numbers were maintained in the ABPC group. This finding suggests that ABPC administration is beneficial for maintaining CD4 counts in patients with HIV infection, thereby delaying the onset of AIDS.Office of Global AIDS/US Department of State

Echoviruses diagnosed in two Children presenting with Acute Flaccid Paralysis (AFP): An Illustration of the Evolving role of the Zambian AFP Surveillance Programme in the Absence of Polio

Background: The Enteric Cytopathic Human Orphan virus commonly referred to by  the acronym ECHO virus has been known to cause acute flaccid paralysis (AFP). Zambia has since 1993 run a national AFP surveillance program to primarily detect and confirm poliomyelitis cases. Through this program other enteroviruses have  been confirmed to be associated to the non-polio cases. We describe two patients with acute flaccid paralysis presenting like poliomyelitis and yet are non-polio cases associated with ECHO virus.Case reports: In March 1995, a 2 year old male from Misisi compound, presented at the UTH with muscle weakness and paralysis of sudden onset. Aside from the acute flaccid paralysis presenting in both legs and arms, the child had no other signs of  symptoms of significance. Laboratory investigations using the WHO polio laboratory network standard protocols revealed the  presence of ECHO 7 virus. In April 1995, a 4 year old girl from Kamwala South in Lusaka presented at the UTH with symptoms and signs of AFP of asymmetrical presentation affecting the Left upper and lower limbs, fever and sore throat. Two stool  specimens collected for laboratory analysis revealed the presence of Echovirus untyped.Discussion: AFP is a neurological condition primarily suspected as a poliomyelitis commonly seen in children below 15 years defined by sudden onset of weakness and floppiness affecting usually one or more limbs. Laboratory analysis has revealedother viruses including the Echovirus being associated with acute flaccid paralysis. This case series reveals Echovirus 7 and Echovirus untyped as being associated with AFP cases that presented to the UTH initially suspected to be poliomyelitis.Conclusion: The clinical manifestations and laboratory results provide evidence of ECHO virus causing acute flaccid paralysis similar to that caused by polio virus. The last wild polio cases circulating in Zambia were in 2001. It is important that Zambia continues to investigate other causes of AFP for clinical decision making, scientific documentation and policy guidance