Health
Microbicide, Solution To Female HIV Infection?
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
Health
Taraba Confirms Lassa Fever Outbreak
The authorities in Taraba State Ministry of Health yesterday confirmed the outbreak of Lassa Fever in the State.
Making the confirmation in an interview, State Commissioner for Health, Dr. Gbangsheya Buma disclosed that out of the nine suspected cases that were recorded last Friday, eight turned out positive for the viral haemorrhagic fever.
Buma stated that the state Ministry of Health is closely monitoring the situation in collaboration with the Nigeria Center for Disease Control, NCDC, and the Federal Medical Center, Jalingo, FMC, authorities to contain the spread of the disease.
“It is not a surprising thing, this is the season, and we have made preparations, though the outbreak may be overwhelming.
“I just received support from NCDC; they have sent some people here to provide technical support with the aim of stopping the progress of the disease.
“We are actually on top of it. We have provided support as a state to the FMC to provide free treatment to patients of Lassa fever,” he said.
Acting Head of Clinical Services at FMC Jalingo, Joseph Kuni, provided further insight on the outbreak, revealing that the center currently has ten patients in its isolation ward, with some awaiting test results.
Kuni said, “From January to February, the center had recorded 19 deaths from the isolation center.
“From January to February, we sent 105 samples, and 60 of them came out positive for Lassa Fever while 39 came out negative. The remaining ones are still being awaited.”
He explained that due to a fire outbreak that affected the modular laboratory last year, the center cannot perform tests locally, so they send samples to Bauchi or Abuja for testing.
Additionally, Kuni confirmed that one medical doctor from the hospital was affected but has since been treated and discharged.
Kuni emphasised the need for more assistance considering the alarming number of cases, particularly from the central part of the state.
Warning that Lassa Fever is endemic in Nigeria, Kuni said with sporadic outbreaks occurring primarily during the dry season, and it is transmitted to humans through contact with contaminated food or household items.
Health
Experts Warn On Excess Consumption Of Sweetened Beverages
Drinking two litres or more per week of artificially sweetened beverages — the equivalent of a medium-sized fast-food diet soda a day — raises the risk of an irregular heartbeat called atrial fibrillation by 20 percent when compared to people who drank none, a new study found.
Known as A-fib, atrial fibrillation is an irregular heartbeat often described by many people who have it as a “quiver,” “flutter” or “flip-flop” of the heart in the chest.
Drinking a similar number of added-sugar beverages raised the risk of the condition by 10 percent, while drinking about four ounces of pure, unsweetened juices, such as orange or vegetable juice, was associated with an 8 percent lower risk of atrial fibrillation, the study found.
“This is the first study to report an association between no- and low-calorie sweeteners and also sugar-sweetened beverages and increased risk of atrial fibrillation,” said Penny Kris-Etherton, a professor emeritus of nutritional sciences at the Pennsylvania State University, in a statement. She was not involved in the new study.
While the study could only show an association between sweetened drinks and A-fib, the relationship remained after accounting for any genetic susceptibility to the condition. A 2017 study found people with European ancestry had about a 22 percent risk of inheriting the condition.
This heart condition may affect one in four women after menopause, the study further reveals”We still need more research on these beverages to confirm these findings and to fully understand all the health consequences on heart disease and other health conditions,” Kris-Etherton said.
“In the meantime, water is the best choice, and, based on this study, no- and low-calorie sweetened beverages should be limited or avoided,” she added.
Atrial fibrillation is dangerous and on the rise and is the leading cause of stroke in the United States. In addition, strokes connected to A-fib tend to be “more severe than strokes with other underlying causes,” according to the united states centre for Disease Control and Prevention.
Atrial fibrillation can also lead to blood clots, heart failure and “can increase the risk for heart attack, for dementia, for kidney disease. All of those things are likely long term risks,” Dr. Gregory Marcus, Professor of Medicine at University of California, San Francisco School of Medicine and associate chief of cardiology for research at UCSF Health, told The Tide’s in an interview.
Health
Ogun Seals College’s Nursing Department Over Illegal Operations
The Nursing Department of the Harvarde College of Science Business and Management Studies in Abeokuta has been shut.
The department was sealed yesterday for operating without accreditation from the Nursing and Midwifery Council of Nigeria (NMCN).
The enforcement team comprised officials of enforcement team of the Ogun Ministry of Health and members of the State Nursing and Midwifery Committee (SNMC).
Speaking during the enforcement exercise, the Permanent Secretary, Ogun Ministry of Health, Dr Kayode Oladehinde, said that the private institution had been offering a degree programme in Nursing Sciences.
He added that this had been going on for about six years without accreditation from the regulatory body.
Oladehinde, represented by the Acting Director of Nursing Services, Mrs Serifat Aminu, said that such unauthorised programme contributed to quackery in nursing and posed a threat to public health.
According to him, the nursing department of the institution will remain sealed until fully accredited.
He described a degree in Nursing obtained from Harvarde College and similar institutions without NMCN accreditation as worthless, stating that graduates would be unable to obtain a valid license to practice in Nigeria and other parts of the world.
“We have discovered that many institutions, including Harvarde College, offer nursing degrees to unsuspecting students.
“Our mission is to clamp down on such institutions because they end up producing quacks in the nursing profession.
“This is dangerous for society. Unfortunately, most students are unaware that their time is being wasted,” he said.
The permanent secretary advised parents and candidates desiring to pursue nursing or related programmes to conduct due diligence by checking the NMCN website for a list of accredited institutions, saying the regulatory body updated the list yearly.
He warned parents to be cautious of institutions making false claims, assuring that the Ogun government would continue to work diligently against quackery in both the education and practice of the nursing profession in the state.
Responding, a 300-level student, who wished to remain anonymous, expressed shock at the institution’s lack of accreditation, regretting the amount of money her parents had spent on the
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