Trained Rats Detect TB Better Than Microscopy

MedicalResearch.com Interview with:

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

MedicalResearch.com Interview with:

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

MedicalResearch.com Interview with:

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

Air Pollution Linked To Increased Mortality, Especially In Developing Cities

MedicalResearch.com Interview with:
“air pollution, beijing” by 大杨 is licensed under CC BY 2.0Longjian Liu, M.D., Ph.D. MSc (LSHTM), FAHA

Associate Professor
Department of Epidemiology and Biostatistics
Dornsife School of Public Health, and
Adjunct Associate Professor,
College of Medicine
Drexel University
Nesbitt Hall-RM515, 3215 Market ST
Philadelphia PA, 19104 

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

Response: This is an international collaborative project, supported by Drexel Office of International Programs, and Chinese Academy of Sciences.

The main findings are air pollution has posted a serious public health issue in China, specifically in urban cities.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: Air pollution is an international issue, we must take action, specifically in developing counties with rapid urbanization, like China.  

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Air Pollution Related Deaths Concentrated Among Minorities and the Poor

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“air pollution, beijing” by 大杨 is licensed under CC BY 2.0

Air Pollution, Beijing

Philip J. Landrigan, MD, MSc, FAAP
Dean for Global Health
Professor of Preventive Medicine and Pediatrics
Arnhold Institute for Global Health
Icahn School of Medicine at Mount Sinai 

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

  1.  Pollution is the largest environmental cause of disease and premature death in the world today.  It is responsible for 9 million deaths per year – 16% of all deaths worldwide – three times more deaths than AIDS, malaria and TB combined.  These numbers are growing from year to year as pollution in many parts of the world increase.
  2. Pollution is highly unjust. 92% of all pollution-related deaths occur in low-and middle- income countries, and in the United States and other high-income countries pollution-related disease and death are concentrated among minorities and the poor.  Think Flint.
  3. Pollution is very costly.  Pollution-related diseases cause productivity losses that reduce GDP in low- and middle-income countries by up to 2% per year. Pollution-related disease also results in health-care costs that are responsible for 1.7% of annual health spending in high-income countries like the US and for up to 7% of health spending in heavily polluted and rapidly developing low- and middle-income countries.
  4. Pollution is neglected and its control is seriously underfunded.
  5. The good news is that despite its great magnitude and long-standing neglect, pollution can be controlled, and pollution prevention is highly cost-effective. Pollution is not the inevitable consequence of economic development. High-income and some middle-income countries have enacted legislation and issued regulations mandating clean air and clean water, established chemical safety policies, and curbed their most flagrant forms of pollution. As a result, our air and water are now cleaner, the blood lead concentrations of our children have decreased by more than 90%, our rivers no longer catch fire, our worst hazardous waste sites have been remediated, and many of our cities are less polluted and more livable. Health has improved and people are living longer. High-income countries have achieved this progress while increasing GDP by nearly 250%. The claim that pollution control stifles economic growth, kills jobs and drags down the economy is false and has repeatedly been proven to be untrue. Pollution control is a winnable battle, and the control of pollution will return billions of dollars to the economies of countries around the world as it has already in the United States.

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With Increasing Westernization, Inflammatory Bowel Disease Becoming a Global Health Issue

MedicalResearch.com Interview with:

Gilaad Kaplan, MD, MPH, FRCPC Associate Professor  CIHR New Investigator & AI-HS Population Health Investigator Co-Director, Environmental Health Research Group Snyder Institute for Chronic Diseases & Institute of Public Health Departments of Medicine & Community Health Sciences University of Calgary

Dr. Kaplan

Gilaad Kaplan, MD, MPH, FRCPC
Associate Professor
CIHR New Investigator & AI-HS Population Health Investigator
Co-Director, Environmental Health Research Group
Snyder Institute for Chronic Diseases & Institute of Public Health
Departments of Medicine & Community Health Sciences
University of Calgary

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

Response: The aim of the study was to provide a global perspective on the epidemiology of the inflammatory bowel diseases in the 21st century.

During the 20th century IBD was considered a disease of the Western world. At the turn of the 21st century, IBD has become a global disease with accelerating number of cases in the developing world as it transition towards a westernized society.

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The President’s Malaria Initiative Reduced All-Cause Childhood Mortality

MedicalResearch.com Interview with:

Alexsandra Jakubowski

Aleksandra Jakubowski MPH

Aleksandra Jakubowski, MPH PhD candidate
Department of Health Policy and Management
Gillings School of Global Public Health
University of North Carolina at Chapel Hill

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

Response: The US President’s Malaria Initiative (PMI) provides approximately $600 million annually to fund implementation of key evidence-based malaria prevention and treatment interventions, including insecticide treated nets (ITNs), artemisinin-based combination therapy (ACT), and indoor residual spraying (IRS) to populations in 19 recipient countries in sub-Saharan Africa (SSA). Despite this considerable investment, no study to date has evaluated the impact of PMI on population health outcomes. Previous evaluations have noted improved health outcomes in PMI countries, but comparison groups are needed to establish whether these changes were beyond the declining trends in mortality observed in the rest of the region. Our study sought to generate objective evidence for policy makers about the role this US-funded malaria aid program may have played in curbing child mortality in SSA.

We used a quasi-experimental design known as difference-in-differences to compare trends in health outcomes in PMI-recipient vs. PMI non-recipient countries. We analyzed publicly-available data from 32 countries in SSA spanning a period that included about ten years before and after the introduction of the program.

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Heart Failure Deadly At Earlier Age in Poorer Countries

MedicalResearch.com Interview with:

Hisham Dokainish, M.D., FRCPC, FASE, FACC Associate Professor of Medicine, McMaster University Principal Investigator, Population Health Research Insitute Director of Heart Failure Services, Director of Medical Diagnostic Units & Echocardiography, Hamilton Health Sciences Hamilton, ON, Canada

Dr. Dokainish

Hisham Dokainish, M.D., FRCPC, FASE, FACC
Associate Professor of Medicine, McMaster University
Principal Investigator, Population Health Research Insitute
Director of Heart Failure Services,
Director of Medical Diagnostic Units & Echocardiography, Hamilton Health Sciences
Hamilton, ON, Canada

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

Response: Most data on mortality and prognostic factors in patients with heart failure come from North America and Europe, with little information from other regions of the world, particularly from low and middle income countries.

MedicalResearch.com: What are the main findings?

Response: We enrolled 5823 patients within 1 year (with 98% follow-up). Overall mortality was 16·5%: highest in Africa (34%) and India (23%), intermediate in southeast Asia (15%), and lowest in China (7%), South America (9%), and the Middle East (9%). These large regional differences in mortality persisted after multivariable adjustment for demographic, clinical, medication and socioeconomic variables. About half of the mortality risk was explained by multivariable modeling with these variables; however, the remainder was unexplained.

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