Bat Borne Nipah Virus Transmitted by Human Secretions

MedicalResearch.com Interview with:

Birgit Nikolay PhDMATHEMATICAL MODELLING OF INFECTIOUS DISEASESInstitut Pasteur

Dr. Nikolay

Birgit Nikolay PhD
MATHEMATICAL MODELLING OF INFECTIOUS DISEASES
Institut Pasteur 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Nipah virus was identified by the World Health Organization as an emerging infectious disease that may cause major epidemics if the pathogen evolves to become more transmissible, leading the organization to prioritize it for research to prevent future health emergencies. In the absence of efficient treatments or vaccines, the only way to control Nipah virus outbreaks is through targeted interventions that limit opportunities of spread. Designing such interventions is challenging in a context where transmission mechanisms remain poorly understood. The study provides important insights to better understand these mechanisms.

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Little Consistency Among Leading Nations Regarding Drug Safety Warnings

MedicalResearch.com Interview with:

Dr Barbara Mintzes PhDAssociate Professor The University of Sydney Charles Perkins Centre and School of PharmacyFaculty of Medicine and HealthThe University of Sydney

Dr. Mintzes

Dr Barbara Mintzes PhD
Associate Professor
The University of Sydney Charles Perkins Centre and School of Pharmacy
Faculty of Medicine and Health
The University of Sydney

MedicalResearch.com: What is the background for this study?  

Response: When medicines are approved for marketing, the information available on rare serious harmful effects, longer-term effects, and outcomes in vulnerable populations is often limited. New serious safety concerns often arise when a medicine is already on the market. In many cases these can be  managed for example through dose reductions or avoiding prescribing to at-risk patients. Drug regulatory agencies such as the US FDA often issue safety warnings to let health professionals and the public know  about new evidence of potential harm and often to provide advice on how to avoid this.

We were interested to know how consistent these warnings are between different countries. This is a research project funded by Australia’s National Health and Medical Research Council and the Canadian Institutes of Health Research. We examined warnings for medicines in Australia, Canada the US and the UK over a 10-year period, from 2007 to 2016 inclusive. We were looking at how often regulators issue the same warning if the drug is approved for marketing at the time.  Continue reading

High Lead Levels in Refugee Children Resettled in US

MedicalResearch.com Interview with:

Madhav P. Bhatta, PhD, MPHAssociate Professor, Epidemiology & Global HealthCollege of Public HealthKent State UniversityKent, OH 44242

Dr. Bhatta

Madhav P. Bhatta, PhD, MPH
Associate Professor, Epidemiology & Global Health
College of Public Health
Kent State University
Kent, OH 44242

MedicalResearch.com: What is the background for this study?

Response: Lead exposure, especially in children, in any amount is harmful. Lead poisoning is a growing global environmental health problem with increasing lead-related diseases, disabilities, and deaths.  While exposure to lead in US children, in general, has significantly declined in the last three to four decades certain sub-groups of US children such as African Americans, immigrants and resettled refugees, and those from lower socioeconomic backgrounds are still vulnerable to environmental lead exposure.

Previous studies among resettled refugee children in the United States had found 4- to 5-times higher prevalence of elevated blood lead level (EBLL) when compared to US-born children. However, most of the studies were conducted when EBLL was defined as blood lead level ≥ 10 µg/dL. In 2012, the US Centers for Disease Control and Prevention changed the reference value for EBLL to ≥ 5 µg/dL. Moreover, because the countries of origin for US resettled refugees change over time, it is important to have epidemiologic studies that provide the current information on EBLL among these vulnerable new US immigrant children.

Using blood lead level data from the post-resettlement medical screening, our study examined the prevalence of elevated blood lead level at the time of resettlement among former refugee children who were settled in the state of Ohio from 2009-2016. We had a large and diverse sample (5,661 children from 46 countries of origin) of children for the study, which allowed us to assess EBLL in children from several countries of origin that had not been previously studied. Continue reading

Travelers Can Bring Home Drug-Resistant Bacteria as Souvenirs from Low and Middle Income Countries

MedicalResearch.com Interview with:

Lynn Meurs, PhDEPIET fellow at Robert Koch InstituteEuropean Centre for Disease Prevention and ControlGermany

Dr. Meurs

Lynn Meurs, PhD
EPIET fellow at Robert Koch Institute
European Centre for Disease Prevention and Control
Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is unknown how Enterobacteriaceae (ESBL) -producing bacteria are spread, but several studies have shown that intercontinental travellers often return home with these drug-resistant bacteria.

The aim of our study was to investigate into more detail what causes colonisation with these bacteria in people travelling to low and/or middle-income countries  (LMICs) in the tropics and subtropics. We found that out of the travellers that were ESBL-negative before travelling, 23% of returned with ESBL-producing bacteria. In line with previous studies, we found that travelling to Eastern, Southern, and Western Asia is associated with ESBL colonisation.

Unexpectedly, we furthermore found that staying in a hotel as well as in private accommodation as compared to other types of commercial accommodation such as hostels, camping or guesthouses, was associated with the colonisation with these drug-resistant bacteria. Continue reading

Growth in Rural Emergency Department Visits Outpace Urban Increases

MedicalResearch.com Interview with:

Margaret B. Greenwood-Ericksen MD, MScDepartment of Emergency MedicineUniversity of New MexicoAlbuquerque, NM 87109

Dr. Greenwood-Ericksen

Margaret B. Greenwood-Ericksen MD, MSc
Department of Emergency Medicine
University of New Mexico
Albuquerque, NM 87109

MedicalResearch.com: What is the background for this study?  

Response: I’m an emergency physician, so I see first-hand how emergency department use patterns provide a lens into the status of health care delivery in the communities they serve. Troubling declines in the health of rural Americans coupled with rising rural hospital closures – with little access to alternative sites of care like urgent care – all led me to hypothesize that rural populations may be engaging with the health care system differently than their urban counterparts.

Understanding the health care use of individuals in rural areas may yield insights into addressing rural health disparities. Further, this information may help healthcare systems and policymakers to make data-driven decisions informing new models of healthcare delivery for rural communities.

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Ebola Fight Hampered by Misinformation and Mistrust

MedicalResearch.com Interview with:

Patrick Vinck, PhDResearch Director, Harvard Humanitarian InitiativeAssistant Professor, Global Health and Population T.H. Chan Harvard School of Public Health; Emergency MedicineHarvard Medical SchoolLead Investigator, Brigham & Women's Hospital 

Dr. Vinck

Patrick Vinck, PhD
Research Director, Harvard Humanitarian Initiative
Assistant Professor, Global Health and Population
T.H. Chan Harvard School of Public Health; Emergency Medicine
Harvard Medical School
Lead Investigator, Brigham & Women’s Hospital 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The second worst epidemic of Ebola on record is currently unfolding in the eastern part of the Democratic Republic of the Congo. Whether or not safe practices are implemented to prevent the spread of the epidemic is influenced by the behavior of individuals at-risk of contracting the Ebola Virus Disease (EVD) –

Will they follow the recommendations of health professionals? Will they report suspected cases and deaths? Will they seek treatment from health professionals? Will they accept vaccines and adopt preventive behaviors?

We find that belief in misinformation about Ebola is widespread and trust in authorities is generally low, likely as a result of decades of violence and poor governance and, more recently, the politicization of the Ebola response.

Our analysis shows that trust and (mis-)information influence adherence to risk avoidance behavior and acceptance of vaccination.

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Melanoma Rates Stable in Australia but Rising in US

MedicalResearch.com Interview with:

Melanoma CDC/ Carl Washington, M.D., Emory Univ. School of Medicine; Mona Saraiya, MD, MPH

Example of one type of melanoma

Dr. Catherine M. Olsen
Associate Professor
Cancer Control Group
QIMR Berghofer Medical Research Institute

MedicalResearch.com: What is the background for this study?

Response: Melanoma incidence and mortality rates are increasing globally. Public health campaigns aiming to reduce sun exposure and use of sunbed have been implemented in many parts of the world, but there is significant variability in terms of the history and reach of these campaigns across countries. We examined melanoma incidence rates in eight different countries with different patterns of sun exposure and varying approaches to melanoma control.

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Younger Generations at Much Higher Risk of Obesity Related Cancers

MedicalResearch.com Interview with:

Hyuna Sung, PHD Principal Scientist, Surveillance Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 

Dr. Sung

Hyuna Sung, PHD
Principal Scientist, Surveillance Research
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303 

MedicalResearch.com: What is the background for this study?

Response: This project was motivated by our previous finding on the rise of colorectal cancer among young adults before age 55. Changes in cancer trends among young age group have significant implications because the newly introduced carcinogenic agents are likely to affect trends among young people before they affect those among older people. Owing to this relationship, cancer trends among young people can be often considered as a bellwether for future disease burden. Given the dramatic increase of the obesity prevalence during 3-4 decades in the US, we wanted to expand the colorectal cancer finding to the more comprehensive list of cancers and explain them in the context of obesity epidemic.

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Venezuela: Rapid Rise in Infant Mortality Linked to Health Care System Collapse

MedicalResearch.com Interview with:
"By @plumavioleta "Atardecer en #caracas... #avebolivar # ccs #venezuela." via @PhotoRepost_app" by Pedro Fanega is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Ms Jenny García, PhD candidate
Institut National d’Études Démographiques INED
Institut de Démographie de l’université Paris 1 Panthéon Sorbonne IDUP
Paris, France

Prof Gerardo Correa, MSc
Instituto de Investigaciones Económicas y Sociales IIES
Universidad Católica Andrés Bello UCAB
Caracas, Venezuela

Prof Brenda Rousset, PhD
Departamento de Estadística, Escuela de Sociología (FaCES)
Universidad Central de Venezuela UCV
Caracas, Venezuela

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Venezuela, as many countries in Latin America, showed substantial improvements in infant mortality rates during the last 60 years. However, the decreasing pattern might be reversing. Recent socioeconomic and political events have led to a collapse in living standards, along with a breakdown of the health system. At the same time, a strict secrecy policy has ruled public institutions, and since 2013 the Venezuelan government stopped publishing mortality statistics.

This study attempts to fill this gap and estimate infant mortality using hospital and census data after 2013.

The main finding is that infant mortality rates in Venezuela may have stopped decreasing and started increasing in 2009 – around the time funding for the Venezuelan health system started to be substantially reduced. By 2016, the infant mortality rate was 21.1 deaths per 1000 live births, which is 1.4 times the rate in 2008 (15.0 deaths per 1000 live births), and equivalent to the rate recorded in the late 1990s, meaning 18 years of progress may have been lost.  Continue reading

Zika: Simple General Movement Assessment Tool Can Predict Babies at Risk of Developmental Problems

MedicalResearch.com Interview with:

Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases  David Geffen School of Medicine at UCLA

Dr. Nielsen

Karin Nielsen-Saines, MD, MPH
Professor of Clinical Pediatrics
Division of Pediatric Infectious Diseases
David Geffen School of Medicine at UCLA

MedicalResearch.com: What is the background for this study?

Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age.

We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months  and then tested them through standard neurodevelopmental tests at the age of 12 months.

We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies.  This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to  stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better  to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early.

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Obesity in Childhood Adversely Impacts Lung Development

MedicalResearch.com Interview with:

Judith Garcia Aymerich Head of the Non-Communicable Diseases and Environment Programme ISGlobal 

Dr. Garcia-Aymerich

Judith Garcia Aymerich
Head of the Non-Communicable Diseases and Environment Programme
ISGlobal 

MedicalResearch.com: What is the background for this study?

Response: Several studies have assessed the associations of overweight and obesity with lung function in children and adolescents, but they have found contradictory results. An important limitation of these studies is that most of them considered only overall body weight and did not take into account for the different contribution of lean body mass and fat mass, and their relative proportions that vary by age and sex. Continue reading

All Travelers to Pakistan At Risk of Getting Drug Resistant Typhoid Fever

MedicalResearch.com Interview with:

Kevin Chatham-Stephens, MD, MPH, FAAP CDR U.S. Public Health Service

Dr. Chatham-Stephens

Kevin Chatham-Stephens, MD, MPH, FAAP
CDR U.S. Public Health Service

MedicalResearch.com: What is the background for this study?

Response: Typhoid fever is a life-threatening disease caused by Salmonella Typhi bacteria. It spreads when someone consumes food or water that has been contaminated with feces (poop) from someone carrying the bacteria. About 12–27 million cases of typhoid fever occur worldwide every year.

About 350 culture-confirmed cases of typhoid fever in the United States are reported to CDC each year. Most of these cases occur among international travelers.

Symptoms of typhoid fever often include high fever, weakness, stomach pain, cough, and loss of appetite. Some people have diarrhea or constipation. Typhoid fever can be prevented through vaccination and safe food and water practices. Typhoid fever is treated with antibiotics, although most infections diagnosed in the United States cannot be successfully treated with the class of antibiotics called fluoroquinolones.

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Scabies: For Community Control, Exam of Just Arms and Legs May Be Sufficient

MedicalResearch.com Interview with:
Michael Marks MRCP DTM&H PhD
Clinical Research Department, Faculty of Infectious & Tropical Diseases
London School of Hygiene and Tropical Medicine
Hospital for Tropical Diseases
London, United Kingdom
Twitter @dr_michaelmarks
Daniel Engelman MBBS; BMedSci; MPHTM; FRACP; PhD
Centre for International Child Health, University of Melbourne,
Tropical Diseases Research Group
Murdoch Children’s Research Institute
Melbourne, Australia
Twitter @Dan_Engelman

The lateral aspect of the left hand depicted here, reveals the presence of papules due to an infestation of the human itch mite, Sarcoptes scabiei var. hominis, in a case of what is commonly referred to as scabies.

The lateral aspect of the left hand depicted here, reveals the presence of papules due to an infestation of the human itch mite, Sarcoptes scabiei var. hominis, in a case of what is commonly referred to as scabies.CDC image

 

 

 

 

 

 

 

 

 

MedicalResearch.com: What is the background for this study?

MM: Scabies is extremely common. Globally in the region of 100-200 million people are believed to be affected by scabies annually.

Recently the WHO has recognised Scabies as a ‘Neglected Tropical Disease’ in response to this burden of disease. There has been increasing interest in using Mass Drug Administration (treating whole communities) as a strategy to control scabies in communities. In order to make this practical countries need an easy mechanism for establishing if scabies is a significant problem in their communities. In general when treating an individual, clinicians would conduct a full body examination to diagnose scabies – however this may not be practical or necessary when making decisions about whether to treat whole communities.

DE: Despite the fact that Scabies is a very common condition that causes a great deal of health problems, it has been largely neglected by health, research and funding agencies – but pleasingly, the WHO has now started to take action on scabies control, starting with the recognition of scabies as a “Neglected Tropical Disease”

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Stroke Prevention Should Begin in Young Adults

MedicalResearch.com Interview with:

Gregory A. Roth MD MPH Assistant Professor, Medicine - Cardiology Adjunct Assistant Professor, Global Health Adjunct Assistant Professor, Health Metrics Sciences School of Public Health University of Washington Seattle, WA

Dr. Roth

Gregory A. Roth MD MPH
Assistant Professor, Medicine – Cardiology
Adjunct Assistant Professor, Global Health
Adjunct Assistant Professor, Health Metrics Sciences
School of Public Health
University of Washington
Seattle, WA

MedicalResearch.com: What is the background for this study? What are the main findings?

 

Response:  We found that globally, one in four people over age 25 is at risk for stroke during their lifetime. But we also found large geographic variation, including a nearly five-fold difference in lifetime stroke risk worldwide, with the highest risk in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk in eastern sub-Saharan Africa (11.8%). Chinese men and Latvian women had the world’s highest estimated lifetime stroke risk in 2016. The lifetime stroke risk on average for 25-year-olds in 2016 ranges from 8% to 39%, depending on the country in which they live.

This is the first time a study has produced estimates of lifetime stroke risk starting at age 25, whereas previous studies begin at age 45. These findings suggest that adults need to think about their long-term health risks, including stroke, at a much younger age. Additionally, one’s risk of stroke over the course of your lifetime depends on where you live. Given the burden of stroke among adults is dependent on modifiable risk factors and the characteristics of health systems, our findings may be useful for long-term planning, especially in terms of prevention and public education.  Continue reading

Cost-effectiveness of Humanitarian Pediatric Cardiac Surgery

MedicalResearch.com Interview with:

Marcelo G. Cardarelli, MD A member of Inova Medical Group

Dr. Cardarelli

Marcelo G. Cardarelli, MD
Inova Children’s Hospita
Fairfax, Falls Church, Virginia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Global Humanitarian Medical efforts consume a large amount of resources (nearly $38B in 2016) and donors (Countries, International organizations, WHO, Individuals) make the decisions as to where their funds should be allocated based on cost-effectiveness studies. Most resources go to prevent/treat infectious diseases, sanitation efforts and maternal/child care issues. An insignificant amount of resources is directed to satisfy the surgical needs of the populations in low and middle income countries (LMICs).

The idea behind our project was to find out if it was cost-effective to perform a tertiary surgical specialty (pediatric cardiac surgery) in this context and the answer (at $171 per DALY averted) was an overwhelming yes!

But most importantly, we believe, as many others do, that judging the cost/effectiveness of an intervention in order to decide resources allocation is valid for diseases that can be prevented, but not relevant when it comes to surgical problems that are not preventable.

Instead, we propose the use of another measure of effectiveness, what we call “The Humanitarian Footprint”.

The Humanitarian Footprint represents the long term benefits, as measured by changes in the life expectancy, extra years of schooling and potential lifetime earnings of patients treated surgically during humanitarian interventions.

To our surprise and based on the results, the effects on society of at least this particular surgical intervention were greater than we expected. We suspect this measure can be used in many other surgical humanitarian interventions as well.  Continue reading

Female Genital Mutilation of Young Girls Declines in Africa, Not in Western Asia

MedicalResearch.com Interview with:
Professor Ngianga-Bakwin Kandala Professor of Biostatistics Department: Mathematics, Physics and Electrical Engineering Northumbria University, UKProfessor Ngianga-Bakwin Kandala

Professor of Biostatistics
Department: Mathematics, Physics and Electrical Engineering
Northumbria University, UK

 MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The background “UNICEF (2014) estimates that worldwide more than two hundred million women have undergone some form of FGM/C, and approximately 3.3 million girls are cut each year. Recent estimates show that if FGM/C practices continue at current, 68 million girls will be cut between 2015 and 2030 in 25 countries where FGM is routinely practiced and more recent data are available (UNJP, 2018).”

Main findings: The prevalence of FGM/C among children varied greatly between countries and regions and also within countries over the survey periods. We found evidence of significant decline in the prevalence of FGM/C in the last three decades among children aged 0–14 years in most of the countries and regions, particularly in East, North and West Africa. We show that the picture looks different in Western Asia, where the practice remains and affects the same age group.

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Tens of Thousands Worldwide Die of Antibiotic-Resistant Bacteria

MedicalResearch.com Interview with:
"Antibiotics" by Michael Mortensen is licensed under CC BY-SA 2.0Dr Alessandro Cassini MD

Epidemiologist, European Centre for Disease Prevention and Control
Solna, Sweden

MedicalResearch.com: What is the background for this study?

Response: We published an ECDC study estimating attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the European Union and the European Economic Area (EU/EEA). This study is based on 2015 data from the European Antimicrobial Resistance Surveillance Network (EARS-Net).

The study was developed by experts at ECDC and the Burden of AMR Collaborative Group, and published in The Lancet Infectious Diseases.

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Canadians Enjoy High Level of Health and Longevity

MedicalResearch.com Interview with:
"Drapeau au Parlement du Canada" by abdallahh is licensed under CC BY 2.0Dr. Justin Lang, PhD

Research Analyst, Public Health Agency of Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is based on the Global Burden of Disease Study, which is led by the Institute of Health Metrics at the University of Washington. In this study, we present estimates from the Global Burden of Disease Study to describe the major causes of health loss among Canadians, and how these have changed from 1990 to 2016.

In 2016, cancers, cardiovascular diseases, musculoskeletal disorders, and mental and substance use disorders, combined, resulted in over half of the total health loss among Canadians as measured by disability adjusted life years. Disability-adjusted life years is a measure that combines both mortality, through years of life lost, and morbidity, through years lived with disability, into a single measure that allows us to compare health loss from different causes using the same metric.

The all-cause age-standardized years of life lost rate declined 12% between 2006 and 2016, while the all-cause age-standardized years lived with disability rate remained stable (+1%) and the all-cause age-standardized disability-adjusted life year rate declined by 5%.

Finally, between 1990 and 2016, there has been a shift in what contributes to health loss in Canada from premature mortality to disability. In 1990, 45% of total all-cause disability-adjusted life years were due to years lived with disability. By 2016, this proportion grew to 52%.  Continue reading

Increase In Measles in Italy Linked to Austerity Measures

MedicalResearch.com Interview with:

Measles

Veronica Toffolutti PhD
Research Fellow in Health Economics
Bocconi University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Austerity has been linked to several health damaging effects such as suicides, increase in unmet needs, disease outbreaks that affect vulnerable peoples such as malaria in Greece, HIV in Greece and Romania during the current economic crises or in the earlier economic crisis cuts in public health expenditure have been linked with diphtheria and TB.

Europe is experiencing declining vaccination rates and resurgences in measles incidence rates. Italy appears to be particularly affected reporting the second largest number, second to Romania, of infection in Europe in 2017. Starting from the point that the primary reason for the outbreak in the decline in the measles vaccination we test the hypothesis that large budget reductions in public health spending were also a contributing factor.

Using data on 20 Italian regions for the period 2000-2014 we found that each 1% reduction in the real per capita public health expenditure was associated with a decrease of 0.5 percentage points (95% CI: 0.36-0.65 percentage points) in MMR coverage, after adjusting for time and regional-specific time-trends.  Continue reading

Little Global Investment in Adolescent Health

MedicalResearch.com Interview with:

Chunling Lu, PhD Director, Program in Global Health Economics and Social Change Assistant Professor in Global Health and Social Medicine Division of Global Health Equity, Brigham and Women's Hospital Department of Global Health and Social Medicine, Harvard Medical School Harvard Center for Population and Development Studies Institute for Quantitative Social Science, Harvard University Boston, MA 02115

Dr. Chunling Lu

Chunling Lu, PhD
Director, Program in Global Health Economics and Social Change
Assistant Professor in Global Health and Social Medicine
Division of Global Health Equity, Brigham and Women’s Hospital
Department of Global Health and Social Medicine, Harvard Medical School
Harvard Center for Population and Development Studies
Institute for Quantitative Social Science, Harvard University
Boston, MA 02115

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Today, we have the largest generation of youth (10-24 years) in human history (1·8 billion) and about 90% of them live in low- and middle-income countries.  Healthy growth and learning during the adolescent years underpins future population health and productivity. The importance of adolescent health has now been recognized with the inclusion of adolescents in the 2015 Every Woman, Every Child agenda through the Global Strategy for Women’s Children’s and Adolescents’ Health. A capacity to finance health care has underpinned progress in most areas of health. In poorer countries much of that financing comes from global donors. As little is known about donors’ contribution to adolescent health, our study fills in that knowledge gap by assessing how much development assistance has been disbursed to projects for adolescent health in 132 developing countries between 2003 and 2015.

We found that donors’ contribution to the projects targeting adolescent health cumulatively accounted for only 1.6% of development assistance for health.

Among the top 10 leading causes of disability adjusted life years (DALYs) in adolescents, sexual, reproductive health and HIV/AIDS received the largest donors’ contribution (approximately 68% during the study period), followed by interpersonal violence, tuberculosis, and diarrheal diseases.

Other major causes of disease burden, including anemia, road injuries, and depressive disorders, have been largely overlooked by donors.  Continue reading

Did Billions in US AIDS Prevention Money Save Babies’ Lives in Kenya?

MedicalResearch.com Interview with:

Professor Donna Spiegelman ScD Susan Dwight Bliss Professor of Biostatistics Director, Center for Methods in Implementation and Prevention Science (CMIPS)­­­­­­, Yale School of Public Health Professor, Department of Statistics and Data Science, Yale University Director, Interdisciplinary Methods Core, Center for Interdisciplinary Research on AIDS Yale School of Medicine

Dr. Spiegelman

Professor Donna Spiegelman ScD
Susan Dwight Bliss Professor of Biostatistics
Director, Center for Methods in Implementation and Prevention Science (CMIPS)­­­­­­,
Yale School of Public Health
Professor, Department of Statistics and Data Science, Yale University
Director, Interdisciplinary Methods Core, Center for Interdisciplinary Research on AIDS
Yale School of Medicine

MedicalResearch.com: What is the background for this study?

Response: HIV infections can be transmitted from mothers to their infants during pregnancy, childbirth, and  breastfeeding.  Without access to a package of health services that includes antiretroviral medicines and counseling on best breastfeeding practices, it is estimated that 25% of children born to HIV-positive mothers become infected with HIV.In low-resource settings, 50% of these children die before their second birthday.

A 32% increase in under-five mortality between 1988 and 2003 prompted the Kenyan government to establish Prevention of Mother to Child Transmission of HIV (PMTCT) programs
in over 10,000 health facilities.
This achievement was supported by U.S.President’s Emergency Fund for AIDS Relief
(PEPFAR), the which contributed over $248 million to PMTCT programs in Kenya between 2004 and 2014.

Although this investments in PMTCT coincided with a remarkable halving of Kenya’s under-five mortality rate, it is unknown whether this improvement can be causally attributed to PEPFAR funding for PMTCT. During the 2000s, child mortality decreased across most of sub-Saharan African countries.  These regional trends, rather than PEPFAR funding, may explain all or part of Kenya’s reduction in over 10,000 in child mortality. To help identify whether PEPFAR’s investments in PMTCT made a causal contribution to this reduction in child mortality, we used statistical methods to assess whether the amount or “dose” of PEPFAR funding provided to different provinces in Kenya was associated with increased HIV testing among pregnant women, which is a critical first step in identifying which women need PMTCT, and reduced infant mortality in Kenya.

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Mathematical Model Investigates Spread of Cholera In Limited Resource Setting

MedicalResearch.com Interview with:
“Cholera Hospital 3” by Mark Knobil is licensed under CC BY 2.0Dr. Daihai He
Assistant Professor
Department of Applied Mathematics
Hong Kong Polytechnic University  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A large-scale cholera outbreak hit Yemen in 2017-2018 and caused an estimated 1,100,720 suspected cases and 2291 associated deaths between 27 April 2017 and 20 May 2018, thus a case fatality ratio 0.21%.

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Multiple Myeloma Cases and Deaths Increase Worldwide

MedicalResearch.com Interview with:

Andrew J. Cowan, MD Seattle Cancer Care Alliance Division of Medical Oncology University of Washington, Seattle

Dr. Cowan

Andrew J. Cowan, MD
Seattle Cancer Care Alliance
Division of Medical Oncology
University of Washington, Seattle

MedicalResearch.com: What is the background for this study? What are the main findings?

 

Response: Multiple myeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden of multiple myeloma is needed to help direct health policy, resource allocation, research, and patient care.

Myeloma cases and deaths increased from 1990 to 2016, with middle-income countries contributing the most to this increase. Treatment availability is very limited in countries with low socioeconomic development.

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Solar Powered Oxygen Could Fill Critical Gap in Underserved Areas

MedicalResearch.com Interview with:

Michael Hawkes MD PhD Adjunct Professor Assistant Professor  Pediatrics, Faculty of Medicine School of Public Health University of Alberta

Dr. Hawkes

Michael Hawkes MD PhD
Adjunct Professor
Assistant Professor
Pediatrics, Faculty of Medicine
School of Public Health
University of Alberta

MedicalResearch.com: What is the background for this study? What are the main findings?

  • Pneumonia is the leading cause of mortality in children globally.
  • Oxygen is an essential therapy for children with hypoxemic pneumonia, but is not available in many resource-limited and rural areas.
  • Our innovation, solar powered oxygen delivery, harnesses freely available sun and air to delivery oxygen to patients independent of grid electricity.
  • We performed a randomized controlled trial of solar powered oxygen delivery, compared to standard oxygen delivery using compressed oxygen cylinders in children with hypoxemia hospitalized at two centres in Uganda.
  • Solar powered oxygen was non-inferior to cylinder oxygen with respect to clinical outcomes, and offers advantages in terms of reliability, simplicity, and cost.

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Severely Malnourished Children May Benefit From Vitamin D Supplement

MedicalResearch.com Interview with:
Dr Javeria Saleem PhD

Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry
Queen Mary University of London
London, United Kingdom

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Severe acute malnutrition is the most extreme and visible form of undernutrition. Affected children have very low weight for their height and severe muscle wasting; they may also have swollen feet, face and limbs. Around 20 million children suffer from severe acute malnutrition worldwide of whom an estimated 1.4 million live in Pakistan. The condition is a major cause of death in children under 5 in Asia and Africa. The standard treatment is to give a high-energy, micronutrient enhanced paste called ready-to-use therapeutic food (RUTF).

Vitamin D deficiency has been reported to be a risk factor for severe wasting in children with severe acute malnutrition Ready-to-use therapeutic food contains relatively modest amounts of vitamin D. However, the effects of adding high-dose vitamin D to this standard treatment have not previously been evaluated.

We therefore did a clinical trial to assess whether high-dose vitamin D hastened recovery in 185 children aged 6-58 months who were receiving standard treatment for severe acute malnutrition in Southern Punjab, Pakistan. The 93 children in the active arm of the study received two doses of 5 mg vitamin D by mouth, while the 92 children in the control arm received placebo (a dummy medicine containing no vitamin D).

Our findings were very striking: after 2 months of treatment, the children who received high-dose vitamin D in addition to standard therapy had significantly better weight gain, and significantly better motor and language development, than those who received standard treatment alone.

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Trained Rats Detect TB Better Than Microscopy

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Howard Burditt / Reuters The rats have been used to to detect land mines in Africa.

Howard Burditt / Reuters
The rats have been used to to detect land mines in Africa.

Georgies Mgode PhD
Sokoine University of Agriculture
Pest Management Centre
African Centre of Excellence for Innovative Rodent Pest Management and Biosensor Technology Development
Morogoro, Tanzania

MedicalResearch.com: What is the background for this study?

Response: The background of this study is the APOPO and Sokoine University of Agriculture together with NIMR and NTLP interest to explore a cheap, reliable and sustainable means of addressing TB problem in high-burden countries with limited access to advanced sensitive tests. This refers to countries where to-date TB diagnosis is mainly by microscopy that is less sensitive leaving majority of patients undetected. We were driven to explore how these rats can contribute to diagnosis of TB in children that is known to be difficult and rats are known to have a better and advanced sense of smell. According to WHO ” an estimated 1 million children became ill with TB and 250 000 children died of TB in 2016 and the actual burden of TB in children is likely higher given the challenge in diagnosing childhood TB.  Continue reading

US Free Trade Agreements Can Contribute to “Globesity”

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These are trends in calorie availability in Canada and synthetic controls, 1978-2006. Data from the United Nations Food and Agricultural Office (2016). 'Synthetic controls' are constructed from a weighted combination of OECD countries, where weights correspond to the similarity of each country with Canada before CUSFTA.  CREDIT American Journal of Preventive Medicine

Trends in calorie availability in Canada and synthetic controls, 1978-2006. Data from the United Nations Food and Agricultural Office (2016). ‘Synthetic controls’ are constructed from a weighted combination of OECD countries, where weights correspond to the similarity of each country with Canada before CUSFTA.
Credit:
American Journal of Preventive Medicine

Pepita Barlow, MSc, Department of Sociology
University of Oxford, Manor Road Building, Manor Road,
Oxford, United Kingdom
 

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: The escalating global prevalence of overweight and obesity, or “globesity,” is often described as a pandemic. Globalization via free trade agreements (FTAs) with the US has been implicated in this pandemic because of its role in spreading high-calorie diets rich in salt, sugar, and fat through the reduction of trade barriers like tariffs in the food and beverage sector.  

We used a “natural experiment” design (that mimics a randomized controlled trial as closely as possible) and data from the United Nations Food and Agricultural Office to evaluate the impact of the 1989 Canada-US Free Trade Agreement on caloric availability in Canada (CUSFTA).  

We found that CUSFTA was associated with an increase in caloric availability and likely intake of approximately 170 kilocalories per person per day in Canada. Additional models showed that this rise in caloric intake can contribute to weight gain of between 1.8-9.3 kg for men and 2.0-12.2 kg for women aged 40, depending on their physical activity levels and the extent to which availability affects caloric intake.  Continue reading

Study Finds Opportunities for Improvement to Pediatric Healthcare in Australia

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Professor Jeffrey Braithwaite, PhD Dr. Braithwaite is founding director of the Australian Institute of Health Innovation at Macquarie University and Chief Investigator of the just-published CareTrack Kids Study the largest study of the quality of care to children ever undertaken.

Prof. Braithwaite

Professor Jeffrey Braithwaite, PhD
Dr. Braithwaite is founding director of the Australian Institute of Health Innovation at Macquarie University and Chief Investigator of the just-published CareTrack Kids Study the largest study of the quality of care to children ever undertaken.

MedicalResearch.com: What is the background for this study?  

Response: While seeking to improve health outcomes for patients, there has been substantial investment in developing clinical practice guidelines, to support the delivery of evidence-based healthcare. Prior to the CareTrack Kids study, little was known about the level of adherence to clinical practice guidelines for the care of Australian children.

Our study examined care provided to children under 16 years of age treated for 17 important clinical conditions, such as asthma or fever, to assess adherence to these guidelines. We surveyed over 6500 medical records in four clinical settings (general practices; paediatricians offices; hospital emergency departments; and hospital inpatient wards) in South Australia, New South Wales and Queensland, and assessed visits during 2012 and 2013.  Continue reading

Zika Birth Defects More Severe When Mothers Infected During First Trimester

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This image depicts a posterior view of a patient’s back, captured in a clinical setting, upon presenting with this blotchy rash. After a diagnostic work-up, it was determined that the rash had been caused by the Zika virus. Note: Not all patients with Zika get a rash CDC image

This image depicts a posterior view of a patient’s back, captured in a clinical setting, upon presenting with this blotchy rash. After a diagnostic work-up, it was determined that the rash had been caused by the Zika virus.
Note: Not all patients with Zika get a rash
CDC image

Professor Bruno Hoen, M.D., Ph.D
Dept of Infectious Diseases, Dermatology, and Internal Medicine
University Medical Center of Guadeloupe 

MedicalResearch.com: What is the background for this study?

Response: Zika virus (ZIKV) infection during pregnancy has been identified only recently to cause severe birth defects, including microcephaly, other brain defects, and the congenital Zika syndrome. However, the magnitude of this risk was not clearly defined, with discrepancies between observational data from Brazil and the U.S. Zika Pregnancy Registry. We implemented a cohort study of pregnant women who have been exposed to ZIKV throughout the outbreak that hit the Caribbean in 2016.
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Patients With Multiple Chronic Diseases Incur High Out-of-Pocket Expenses

MedicalResearch.com Interview with:

Dr Grace Sum Chi-En National University of Singapore

Dr Grace Sum    Chi-En

Dr Grace Sum Chi-En
National University of Singapore

MedicalResearch.com: What is the background for this study?

Response: Chronic diseases are conditions that are not infectious and are usually long-term, such as diabetes, hypertension, cancer, chronic lung disease, asthma, arthritis, stroke, obesity, and depression. They are also known as non-communicable diseases (NCDs). Multimorbidity, is a term we use in our field, to mean the presence of two or more NCDs. Multimorbidity is a costly and complex challenge for health systems globally. With the ageing population, more people in the world will suffer from multiple chronic diseases.

Patients with multimorbidity tend to need many medicines, and this incurs high levels of out-of-pocket expenditures, simply known as cost not covered by insurance. Even the United Nations and World Health organisation are recognising NCDs as being an important issue.

Governments will meet in New York for the United Nations 3rd high-level meeting on chronic diseases in 2018. Global leaders need to work towards reducing the burden of having multiple chronic conditions and providing financial protection to those suffering multimorbidity.

Our research aimed to conduct a high-quality systematic review on multimorbidity and out-of-pocket expenditure on medicines.  Continue reading