Focus on Mainland Tanzania:(Progress & Impact Series)

Tanzania's National Malaria Control Programme (NMCP) has provided strong, stable leadership in coordinating malaria control activities since 1995. Because of continuity and focus on programme implementation, both the number of partners and resources have been growing, most notably over the last seven years. Between 2003 and 2010, about US$ 450 million in external funding was allocated to scale up the malaria control programme. These increasing contributions have been used to deliver preventive and curative services. 18 562 571 insecticide-treated mosquito nets (ITNs) were distributed between 2007 and 2010 through mass campaigns and the national voucher scheme. Indoor residual spraying (IRS) began in 2007 and had expanded to cover 94% of the targeted structures in 18 districts by March 2011.Rapid diagnostic tests (RDTs) and artemisininbased combination therapies (ACTs) have been deployed to reach half of the population so far, and health workers have been trained in using them. Efforts have also been made to make these new treatments available in the private sector, where up to 40% of the rural population seek care for fever. This deployment of interventions has resulted in improved coverage. 63% of households owned at least one ITN in 2010, compared with 23% in 2004–2005. 64% of all children under five and 56% of all pregnant women nationwide used an ITN the night before the 2010 survey—a more than twofold increase since 2007. In addition, between 2001 and 2006, Tanzania changed its recommended antimalarial drug from chloroquine to sulfadoxine-pyrimethamine (SP) to ACTs, thereby providing access to more effective antimalarials. Because of good coverage results, the Tanzanian government has been able to reduce disease burden and save lives. In the Ifakara surveillance area, the prevalence of parasitaemia in children under five was reduced by more than 5-fold, from 25% in 2004–2005 to less than 5% in 2010. Nationally, severe childhood anaemia was halved, dropping from 11% in 2004–2005 to 5.5% in 2010. All-cause under-five child mortality fell by 45% between 1999 and 2010—from 148 deaths per 1000 live births in 1999 to 81 per 1000 live births in 2010. According to the Lives Saved Tool (LiST estimation model), the lives of 63 000 children under five have been saved by malaria control interventions since 1999. Tanzania's improved malaria and health indicators are all signs that malaria control efforts are working and delivering results. Consideration of other factors that might explain the declines in all-cause under-five mortality leads to the conclusion that the improvement in child health is due in large part to malaria control efforts. The country is also achieving equitable impact on major mortality and malaria coverage indicators. With demonstrated ability to deliver and achieve impact on child survival, Tanzania has articulated even more ambitious malaria control goals: universal ITN coverage, IRS in half of the country, and enhanced diagnosis and ACT treatment of all malaria cases. This will require increased funding and a strengthened health infrastructure. If challenges of resource mobilization, boosting the work force, and strengthening the health system can be met, Tanzania will have paved the way towards unprecedented public health achievements and protection of its population against a major scourge.\u

Clinical Laboratory Parameters Among Adult Males During a Primaquine Chemoprophylaxis Trial in Irian Jaya, Indonesia

Primakuin yang digunakan sebagai profilaksis malaria terbukti efektif dan diterima dengan baik oleh tubuh manusia yang normal terhadap aktivitas enzim 6 glukosa-6 fosfat dehidrogenase (G-6PD). Pemeriksaan laboratoris klinik adalah bagian dari uji coba secara acak dengan kontrol plasebo dalam rangka mengevaluasi penggunaan primakuin sebagai profilaksis pada penduduk transmigran yang tidak kebal di Irian Jaya. Penelitian ini dilakukan terhadap 129 pria Jawa dewasa yang normal G-6PDnya. Pemeriksaan hematologi, fungsi hati dan ginjal, dan pemeriksaan limfosit dilakukan berulang kali selama waktu penelitian profilaksis dilakukan untuk menjamin keamanan dari sukarelawan tersebut dan mengawasi Perubahan yang mungkin terjadi akibat obat profilaksis. Seperti yang diperkirakan, pengguna primakuin tidak menunjukkan gejala peningkatan methemoglobin yang kembali dalam batas normal setelah 7 hari pemberian dosis terakhir. Pada akhir penelitian (12 bulan profilaksis) nilai hematologi, fungsi hati dan ginjal, dan nilai limfosit dari kelompok primakuin sebanding dengan kelompok plasebo, dan berada dalam batas nilai normal untuk orang Indonesia.Hasil penelitian ini memberikan masukan adanya keluhan fisik yang sedikit dari sukarelawan pengguna profilaksis primakuin. Untuk membuktikan hasil penelitian ini dan mempersiapkan penggunaan secara umum primakuin untuk profilaksis malaria, perlu dilakukan uji coba lebih lanjut keamanan primakuin. Di Indonesia, primakuin tidak digunakan sebagai profilaksis dan laporan hasil penelitian ini hendaknya tidak ditafsirkan sebagai laporan keamanan dari primakuin

Prostate cancer in renal transplant recipients.

International audienceBACKGROUND: We conducted a retrospective multi-centre study to determine the characteristics of prostate cancer in renal transplant recipients (RTR) and to analyse the relation with immunosuppressive maintenance therapies. METHODS: Patients from 19 French transplant centres diagnosed with prostate cancer at least 1 year after kidney transplantation were included in this study. Data regarding demographics, kidney transplantation, prostate cancer and immunosuppressive treatment were analysed. RESULTS: Sixty-two patients met the eligibility criteria for this study. Thirty-eight patients (61.3%) received calcineurin inhibitors (CNI) and azathioprine (AZA) with or without steroids, twenty received CNI with or without steroids (32.2%) and four received CNI and mycophenolate mofetil (6.5%). Patients with CNI and AZA immunosuppressive therapy presented more high-stage cancer (T3 and T4) when compared to patients receiving CNI alone (47.5% versus 15%, respectively, P = 0.03). A non-significant increase in lymph node invasion was found in patients receiving CNI and AZA compared to patients receiving CNI alone (21% versus 5%, P = 0.16). In the multivariate analysis, the immunosuppressive regimen with CNI and AZA was the only independent risk factor for locally advanced disease (P = 0.007). CONCLUSION: Our results showed that RTR are at risk for early occurrence and for locally advanced prostate cancer, especially when they received a CNI and AZA maintenance immunosuppressive therapy

CLINICAL LABORATORY PARAMETERS AMONG ADULT MALES DURING A PRIMAQUINE CHEMOPROPHYLAXIS TRIAL IN IRIAN JAYA, INDONESIA

<p class="Style13">Primakuin yang digunakan sebagai profilaksis malaria terbukti efektif dan diterima dengan baik oleh tubuh manusia yang normal terhadap aktivitas enzim 6 glukosa-6 fosfat dehidrogenase (G-6PD). Pemeriksaan laboratoris klinik adalah bagian dari uji coba secara acak dengan kontrol plasebo dalam rangka mengevaluasi penggunaan primakuin sebagai profilaksis pada penduduk transmigran yang tidak kebal di Irian Jaya.</p> <p class="Style13">Penelitian ini dilakukan terhadap 129 pria Jawa dewasa yang normal G-6PDnya. Pemeriksaan hematologi, fungsi hati dan ginjal, dan pemeriksaan limfosit dilakukan berulang kali selama waktu penelitian profilaksis dilakukan untuk menjamin keamanan dari sukarelawan tersebut dan mengawasi perubahan yang mungkin terjadi akibat obat profilaksis.</p> <p class="Style13">Seperti yang diperkirakan, pengguna primakuin tidak menunjukkan gejala peningkatan methemoglobin yang kembali dalam batas normal setelah 7 hari pemberian dosis terakhir. Pada akhir penelitian (12 bulan profilaksis) nilai hematologi, fungsi hati dan ginjal, dan nilai limfosit dari kelompok primakuin sebanding dengan kelompok plasebo, dan berada dalam batas nilai normal untuk orang Indonesia.</p><p class="Style13">Hasil penelitian ini memberikan masukan adanya keluhan fisik yang sedikit dari sukarelawan pengguna profilaksis primakuin. Untuk membuktikan hasil penelitian ini dan mempersiapkan penggunaan secara umum primakuin untuk profilaksis malaria, perlu dilakukan uji coba lebih lanjut keamanan primakuin. Di Indonesia, primakuin tidak digunakan sebagai profilaksis dan laporan hasil penelitian ini hendaknya tidak ditafsirkan sebagai laporan keamanan dari primakuin.</p