Due to the growing threat of antibiotic resistance, the World Health Organization (WHO) has issued new treatment guidelines for three common sexually transmitted infections (STIs) – chlamydia, gonorrhea and syphilis.

These infections can generally be cured by antibiotics but they are becoming more to treat as some antibiotics are now failing due to “misuse and overuse,” the agency said.

WHO estimates that each year, 131 million people are infected with chlamydia, 78 million with gonorrhoea, and 5.6 million with syphilis.

“Resistance to these STIs to the effect of antibiotics has increased rapidly in recent years and has reduced treatment options. Of the three STIs, gonorrhea has developed the strongest resistance to antibiotics,” WHO posted in its website.

Strains of multidrug-resistant gonorrhea that do not respond to any available antibiotics have been detected.

Antibiotic resistance in chlamydia and syphilis, though less common, also exists, making prevention and prompt treatment critical.

WHO said when left undiagnosed and untreated, these STIs can result to serious complications and long-term health problems for women, such as pelvic inflammatory disease, ectopic pregnancy, and miscarriage, and untreated gonorrhea and chlamydia can cause infertility in both men and women.

Infection with chlamydia, gonorrhea and syphilis can also increase a person’s risk of being infected with HIV two- to three fold while an untreated STI in a pregnant woman increases the chances of stillbirth and newborn death, WHO added.

WHO director of reproductive health and research Ian Askew said “chlamydia, gonorrhea and syphilis are major public health problems worldwide, affecting millions of peoples’ quality of life, causing serious illness and sometimes death.

“The new WHO guidelines reinforce the need to treat these STIs with the right antibiotic, at the right dose, and the right time to reduce their spread and improve sexual and reproductive health,” he said.

“To do that, national health services need to monitor the patterns of antibiotic resistance in these infections within their countries,” Askew added.

source: Philippine Star
Health & Medicine

Many people who inject themselves with insulin to control diabetes are improperly performing this vital task, according to a large new study.

Based on the results, experts have crafted recommendations for people who use insulin that touch on everything from what type of needle to use to where the shot should be administered.

“Insulin injection has been assumed to be simple and require little training, but that’s not the case,” senior author Dr. Kenneth Strauss wrote to Reuters Health in an email.

Insulin users “may have been injecting for years and yet have had little or no training in correct technique,” said Strauss, who is medical director in Europe of the medical technology company BD.

In all 42 countries in the current study, many patients were injecting improperly, “leading to worse glucose control, poorer outcomes and higher costs,” he said.

The researchers surveyed 13,289 people at 423 medical centers in 2014 and 2015. Ten percent of respondents said they had never received formal injection instructions, and more than 60 percent said their primary care providers hadn’t reviewed instructions with them recently.

Nearly 200 experts used the survey responses to help develop formal recommendations.

source: Philippine Star
Health & Medicine

More than 300 million people in Asia, Africa and Latin America are at risk of life-threatening diseases like cholera and typhoid due to the increasing pollution of water in rivers and lakes, the United Nations Environment Programme (UNEP) said.

Between 1990 and 2010, pollution caused by viruses, bacteria and other micro-organisms, and long-lasting toxic pollutants like fertiliser or petrol, increased in more than half of rivers across the three continents, while salinity levels rose in nearly a third, UNEP said in a report on Tuesday.

Population growth, expansion of agriculture and an increased amount of raw sewage released into rivers and lakes were among the main reasons behind the increase of surface water pollution, putting some 323 million people at risk of infection, UNEP said.

"The water quality problem at a global scale and the number of people affected by bad water quality are much more severe than we expected," Dietrich Borchardt, lead author of the report, told the Thomson Reuters Foundation.

However, a significant number of rivers remain in good condition and need to be protected, he said by phone from Germany.

About a quarter of rivers in Latin America, 10 percent to 25 percent in Africa and up to 50 percent in Asia were affected by severe pathogen pollution, largely caused by discharging untreated wastewater into rivers and lakes, the report said.

Some 3.4 million people die each year from diseases such as cholera, typhoid, polio or diarrhoea, which are associated with pathogens in water, UNEP said.

It estimated that up to 164 million people in Africa, 134 million in Asia and 25 million in Latin America were at risk of infection from the diseases.

It said building more sewers was not enough to prevent infections and deaths, adding that the solution was to treat wastewater.

Organic pollution, which can cause water to be completely starved of oxygen, affects one kilometre (0.6 mile) out of seven kilometres (4.4 miles) of rivers in Latin America, Africa and Asia, threatening freshwater fisheries, UNEP said.

Severe and moderate salinity levels, caused by the disposal of salty water from mines, irrigation systems and homes, affect one in 10 rivers on the three continents, making it harder for poor farmers to irrigate their crops, it said.

The trend of worsening water pollution was "critical", Borchardt said.

"It is much more expensive to clean up surface water from severe pollution than to implement proper management which includes prevention of pollution," he said. "Tools are available but the challenge is to implement them."

source: Philippine Star
Health & Medicine

Medical science has advanced tremendously over the years and children can be protected against more diseases than before. One of the most successful advancements of medical science has been in immunizing children through vaccinations.

However, if not treated, vaccine-preventable diseases can result in protracted disabilities, high medical bills or long-term disability care, exponentially increasing financial burden on a family.

In 2012, the Philippines became the first country in Southeast Asia to introduce a vaccine against rotavirus, a great achievement in the country’s effort to combat diarrheal diseases.

We focused initially on immunizing children living in the poorest communities, where there exists the highest child morbidity and mortality rates from diarrheal disease. The Philippines’ actions have encouraged our neighbors Indonesia to consider introducing the rotavirus vaccine too.

Rotavirus is a leading killer of Filipino children under age five, taking lives of thousands each year. It can weaken their immune system and slow their growth, affecting their ability to attend school and lead normal, productive lives. Along with this, rotavirus is known to cause repeated episodes of diarrhea. The consequence: increased susceptibility to pneumonia, an acute respiratory infection that can be fatal.

Immunizations, in such cases, can save your family time and money and strengthen the overall health of a nation. Thus it is imperative that every child and infant in the Philippines has access to it.

The vaccine was introduce here in 2012, but is currently only available to infants who qualify under the National Housing Targeting System for Poverty Reduction and further excludes those who cannot get access to private facilities.

The good news is that effective rotavirus vaccines are available. Global health experts, including the World Health Organization (WHO), have recommended that all countries include rotavirus vaccines in their national immunization programs. While more than 80 countries have done so, a few – including the Philippines – have only introduced the vaccine at a sub-national level. In these countries, the vaccine is only available to some children.

To lower the cost of providing the vaccine through the National Immunization Program, allowing for it to be expanded to all children, government should explore different models for purchasing the current vaccine and continue to support the research and development of new, more affordable products.

This year, it’s unconscionable that children are still suffering from diseases we have the knowledge and tools to prevent. Through a collaborative initiative with the government, we can take the health of our children back to our own hands.

ROTA Council recommendations

The ROTA Council, a global body of scientific experts on rotavirus, strongly agrees with the WHO recommendation. It recommends that the key stakeholders in countries where these vaccines have not yet been introduced – or have only been introduce in some states or populations – take action in the following areas:

• Countries collaborate with non-governmental agencies (WHO, UNICEF) to develop a set of comprehensive initiatives to reduce diarrhea related illness and death, compliant with the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea.
• National governments and funding agencies should continue to support the researchand development of new, low-cost rotavirus vaccines that are also safe and efficacious.
• Global health entities and non-governmental organizations influential in vaccine programs should focus on regulating prices and ensuring affordability towards the individual country’s ability to pay.
• National government, global health entities, funding agencies, manufacturers, and other stakeholders should address supply shortages, volume of administration and storage, delivery and storage systems, safety concerns, and cultural sensitivity in low- and middle-income countries. Additional mechanisms may be needed to provide innovative funding options for low-middle income, non-Gavi eligible countries

The Philippines has already made history in Southeast Asia by being the forst to introduce the rotavirus vaccine. We hope that the new government under the leadership of President Duterte takes imminent steps to expedite the immunization program and ensure that health care reaches all children, adequately and effectively.

source: Philippine Star
Health & Medicine