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Microbicide, Solution To Female HIV Infection?

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Since the Human Immune Virus and the Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic became known in Nigeria in the mid eighties, no illness has caused more commotion and separated families and friends alike.

From being a rumour initially, it became a cruel reality which raised so much pandemonium that how it is transmitted from person to person became more horrifying and confusing almost by the day.

However, from the mid eighties to now, so much water had passed under the bridge. Form being regarded as the most dreaded diseases, which had no cure, HIV/AIDS is now manageable.

In fact, research has proved that an infected person can live a normal life like every other person. All it requires is awareness in the part of the infected person.

In spite of this encouraging development, however, research has also shown that the virus is still spreading and fastly too, for various reasons, which include the fact that people, mostly out of fear of being discriminated upon, prefer to keep their infection to themselves, or refuse to know their status.

Research has alo showed that majority of those infected are women, thus raising questions regarding why it is so.

It did not take long for researchers to reason that perharps this will not be far from the fact that women seem to be the most vulnerable when it comes to adopting preventive measures during heterosexual intercourse.

This is because the presumed efficacy  of such preventive measures as abstinence, use of condoms and being faithful to a partner could not stop more women from being infected. Hence the decision to come up with a preventive measure strictly to be controlled by women.

In the words of Dr. Orikomaba Korifama Obunge, consultant clinical microbiologist and Head of Medical Microbiology department, University of Port Harcourt Teaching Hospital (UPTH) ‘‘a lot of them (women) are still being infected, not because their partners are a little bit more adventurous, and the ability of them negotiating for the use of preventive measures such as condoms is not working much as it should.

‘‘The issue is that, can we not provide a preventive measure that is controlled by the women, that is capable of forming a barrier during heterosexual intercourse?’’

It is the search for this measure, according to Dr Obunge, that resulted in the emergence of  a concept of a microbiocide by a group of researchers and activities, which also include Dr Obunge.

According to a recent UNAIDS estimates, in 2009 more than 33 million people were living with HIV and approximately 2.5 million people were newly infected.

The estimates also showed that worldwide, nearly half of all individuals living with HIV are now women, who acquired the virus largely by heterosexual exposure.

Further more, many women, because  of limited economic options and gender inequality, cannot reliably negotiate sexual encounters, leaving them vulnerable to unwanted pregnancies and sexually transmitted infections (STIs), including HIV.

Thus, with clinical deployment of safe and effective HIV Vaccine still likely to be years away, topical microbicide formulations that are applied vaginally or rectally are receiving increasing attention as another strategy for HIV prevention.

The microbicide is a product in the form of a gel which could be infected intraveinously with the sole objective of preventing the transmission of the virus during heterosexual intercourse to the woman.

According to the researchers, a review of preclinical and clinical research on the development of microbicides formulated to prevent vaginal HIV transmission yielded 118 studies globally.

Presently, mathematical modeling has shown that if there is such a preventive measure that is workable, then millions of new infections could be prevented and it would be an encouragement for donor agencies to start working on it. Hence the emergence of research on microbicides.

In the words of Dr. Alan Stone of the Medical Research Council in the United Kingdom, ‘‘the development of an effective microbicide is a global priority of the highest order… The question is not whether the microbicide approach will prevent HIV infection but, rather, what proportion of HIV infections it will prevent.’’

Towards coming up with such a microbicide, two research organizations, FHI and Vera Halpen using collaborators in various countries embarked on research for the purpose. In Nigeria the collaborators were Dr. Orikomaba Korifama Obunge and Dr F.S.Ogusola of the university of Lagos.

The research went through the first and second phases, which are smaller studies that look at safety at does and at efficacy before this third phase which entailed randomized clinical/controlled trails on large groups of participants to look at the efficacy of the microbicide.

The products of the investigation were 6% Sodium Cellulose Sulphate (CS), which is a gel that was tested as a possible topical microbicide, but in 2007 was found to be  in effective. Researchers thought that CS could potentially block HIV infection (and possibly others STIs) by creating a barrier between the virus and the woman’s cells in the vagina which the virus targets for infection. This would make it more difficult for the virus to enter the woman’s cell.

The other products of investigation are vaginal gel, single use applicator, and 3.5ml of gel.

According to the researchers, the study design at this phase III entailed randomized placebo controlled trail, in which a total of 2160 women at high risk of HIV/STI were in Lagos while the other half were in Port Harcourt.

The placebo is not the treatment being tested, but looks exactly like the treatment. For topical microbicides trails, the control group received a gel that looked and was used the same day as the gel given to the intervention group, except that it did not contain the microbicide.

Placebos are used in blinded clinical trails so that participants for twelve months, while tests were carried out for HIV, gonnorhoea and Chlamydia at baseline and at each monthly follow up visits.

A summary of the research showed that the duration of the study was 12 months of participants recruitment, 12 months of product used for each participants and 26 total months in the fields including screening and close-down, while the primary objective of the study was to determine the effectiveness of CS gel in preventing male-female vaginal transmission of HIV infection among women of high risk.

The primary endpoint is the incidence of HIV-1 and HIV-2 infection as determined by detection of HIV antibodies from all Mucosal Transudate (OMT) specimens, while the secondary objective is to determine the effectiveness of CS gel in preventing malae-female  transmission of gonnorrhoea and chlamydial infection among women at high risk.

The secondary end point is the incidence of the genital gonorrhea or chlamydial infections as determined by DNA probe technology from self-administered vaginal swabs .

At the end of the study, it was found that the CS gel (this microbicide) did not protect against HIV and canot be used, “there were more infection in CS group compared to the placebo group from other studies outside Nigeria resulting in the stoppage of the study on CS3, and the preventive measure (HIV risk reduction messages works)”

It was thus agreed that community/scientist rapport must recognize that community involvement is an essential component in microbicide trail; that the approach to such involvement must consider the local setting (community politics and environment) that the relationship is a dynamic one.

Others are that it is clear the development of a topical microbicide to prevent the sexual transmission of HIV is scientifically, ethically and culturally complicated; and that in spite of these the benefit in lives protected may far exceed those risks seen and, as yet, unforeseen.

The implication of the foregoing is as encouraging as it is dreadful. Encouraging  because by this and other researches carried out, all in pursuit of a solution to the HIV/AIDS pandemic show that there is a relentless quest to get a solution .

However, the situation looks dreadful considering that such solution seem to have remained evasive and hence almost impossible to come by.

This, therefore, is an indicator that a lot of work still needs to be done to thoroughly put the transmission of HIV under check, particularly as it concerns the most vulnerable groups.

Such areas that require more job to be done include community sensitization/involvement, capacity building programmes for various stakeholders, including families.

The question that should thus be on every bodies mind is “which way forward in HIV prevention.”

 

Sogbeba Dokubo

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World Bank Forecasts Slow Global Growth, Cites New COVID-19 Variants

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The World Bank says despite a strong rebound in 2021, the global economy is entering a “pronounced slowdown” due to fresh threats from COVID-19.
Other factors are the rise in inflation, debt and income inequality, capable of endangering the recovery in emerging and developing economies.
The World Bank, led by David Malpass, released its Global Economic Prospects report yesterday.
The report says global growth is expected to decelerate markedly from 5.5 percent in 2021 to 4.1 percent in 2022.
For 2023, the year will dally by 3.2 percent as pent-up demand dissipates, and as fiscal and monetary support is unwound across the world.
The institution found that the rapid spread of omicron indicates that the pandemic will likely continue to disrupt economic activity.
“In addition, a notable deceleration in major economies—including the United States and China—will weigh on external demand in emerging and developing economies”, the report noted.
The World Bank warns that with developing economies lacking the policy space to support activity, new COVID-19 outbreaks, supply-chain bottlenecks, inflationary pressures and financial vulnerabilities may increase the risk of a hard landing.
“The world economy is simultaneously facing COVID-19, inflation, and policy uncertainty, with government spending and monetary policies in uncharted territory.
“Rising inequality and security challenges are particularly harmful for developing countries.
“Putting more countries on a favourable growth path requires concerted international action and a comprehensive set of national policy responses”, said President David Malpass.
The World Bank forecast came days after the discovery of Deltacron in Cyprus by a researcher and his team.
Professor of Biological Sciences at the University of Cyprus, Leondios Kostrikis, said the new strain is a combination of delta and omicron.
Weeks earlier, IHU, also a new variant, was detected in France. Dozens of cases were reported near the South of Marseille.
The index case was a fully-vaccinated man who returned from a visit to Cameroon in November 2021. The country shares border with Nigeria.

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HIV/AIDS: ‘Wike’s Waiver Intended To Control Prevalence’

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Following concerns over HIV/AIDS prevalence in Rivers State, indicators are  rife that the new user fee waiver instituted by the state government will enhance the control of HIV prevalence if there is effective monitoring mechanism in the state.
Stating this in an exclusive interview recently, the  National Secretary of Network of People Living with HIV/AIDs in Nigeria(NEPWHN), Mr Clifford Emmanuel, said the waiver is the best thing that has happened to HIV prevalence in the state.
The national secretary explained that the implication of the waiver is that all fees that were paid by people who tested positive to HIV in other to secure treatment, are now being paid by the State Government.
Emphasizing on the effectiveness of the execution on the governor directives, the national secretary said this is where there could be a snag to “the governor’s good intention”
According to him, ensuring effective execution of the governor’s directive in government – owned facilities will be difficult without a functional monitoring and evaluation mechanism being put in place.”
”It will even be more difficult, to check the execution of the governor’s directive in the private health sector because some key stakeholders are likely to see it as an opportunity to extort both the government and those who require the services.
”One way to ensure that the governor’s real intention of instituting the user free waiver is achieved is for there to be an effective monitoring and evaluation mechanism, on the one hand, and the defaulters are made to face punishment.

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Natural Health Tips For 2022

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The year is just beginning and as usual many people will start with new year resolutions. Unfortunately, most of these resolutions will sweep health to a corner, and put money and income at the top.
There is nothing wrong in making money, but the setback is when we make resolutions without thinking about our health.
Remember health is wealth, and without good health all our new year resolutions may not be achieved. It is good health that drives every aspect of our lives from family, recreation, career, and education.
If we abandon our health and live carelessly without taking deliberate action on how to better our health then we will face many challenges towards our resolutions.
Therefore, before anything else, one is advised to take actions that will better his or her health such that it will be easy to sail through 2022 strong and resilient.
To achieve that, the following natural health tips have been recommended.
1. Eat good food. Now many people think or reason that good food is expensive, but that is a big misconception. Good food is beyond eating three square meals. Every meal should be well thought out and planned. Remember food is key in sustaining life. Make sure you eat natural food more than processed ones.
A lot of people on the” go” mostly workers that have right schedules like bankers, journalists, lawyers eat junks or sold food from shops and restaurants. Even at that make sure you combine food rightly.
Poor nutrition has been blamed for 60 percent of our ailments. It is therefore advisable to ensure you eat deliberately and not out of compulsion.
It is also  advised that you cut down on red meat consumption, fats and fries.
2. Be active. Do Exercise.
Most works these days make a lot of people immobile or sedentary. This worsens heart attacks, arthritis, back related problems, including many other ailments.
To prevent this, ensure you do some exercise by simply walking around your neighbourhood or engage in some activity or hobby that make you sweat at least twice a week.
3. Make Friends
Relationships are key to sound mind health. One’s network determines how one can tackle his or her challenges. Remember a problem shared is a problem solved. In the light of this, you are advised to strike friendship with neighbours, colleagues, even strangers.
Friends can help you solve challenges, assist you financially and morally.
Try and be more convivial by talking to people, sharing ideas and experiences. These will help you ease life and prolong one’s age.
4. Be more Adventurous.
A little bit of a pounding heart, a racy breathing is good for health according to experts. Though it fires adrenaline in the body, but the end is the feel good hormones oxytocin circulates in the body and strengthens the serotonin that is boosting our immunity.
Besides, life can be boring sometimes and this may worsen mental health. Adventure helps one to see life as a challenge rather than a planned systematic way of living.
Try and add something  new learn new skills, learn new language, learn new trade. All these help to boost happiness, open new opportunities and make life more endearing.
To be cont’d

By: Kevin Nengia

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