Africans Are Introduced To The Blood Pressure Cuff

Some blame witchcraft. Others think it’s a bad batch of moonshine.

But Esther Okaya, who lives in Korogocho, a slum in Nairobi, Kenya, says even teetotalers are falling victim. One minute quarreling with a neighbor; the next minute, dead.

And it’s happened to her.

Okaya’s husband left her. He took the money for her children’s school fees. A few mornings later, her 9-year-old son shuffled home after being turned away by the teacher.

And then she felt it. It was as if her heart seized up. She could not breathe.

At the health clinic the next day, a nurse did something to Okaya that she hadn’t seen before: wrapped a rubber cuff around her arm that squeezed and beeped and spit out a number.

The number was 148.

148 over 90, her blood pressure. Esther Okaya, age 39, had hypertension, which made her more susceptible to heart attack or stroke.

While hypertension is a condition we might more readily associate with a 55-year-old office worker in an American city, it’s actually more prevalent in Sub-Saharan Africa, affecting nearly 1 in 2 residents over the age of 25. Genetic proclivity to salt-retention may play a role. Another factor is economic good news. As Africans earn more and move to cities and spend more on food, their risk factors start to look more Western.

Continue reading.

Photo: Esther Okaya has a health problem that is a growing concern in Sub-Saharan Africa: high blood pressure.

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Let’s talk about our stereotypes about Africa and how ridiculous they are. Also college!

The radically simple Uniject™ injection system

Rethinking the needle to extend the reach of lifesaving vaccines and medications

What if syringes were so easy to use that even untrained health workers could give injections without the risk of error?

What if vaccines for developing countries could be prepackaged in low-cost prefilled syringes, vastly reducing the amount of vaccine wasted?

What if syringes could not be reused—and we knew for certain that gateway to HIV transmission was closed?

The Uniject™ autodisable injection system (Uniject), born in PATH’s Seattle shop, is little more than a small bubble of plastic attached to a needle, but it answers all these needs. It is so simple that health workers can learn to use it after less than two hours of training. It cannot be reused, which eliminates one route of disease transmission. And it is precisely prefilled by the pharmaceutical producers with a single dose, which ensures that the correct amount of drug is delivered and that none is discarded unnecessarily.

PATH developed Uniject with funding from the US Agency for International Development and then licensed the system to BD, the largest syringe manufacturer in the world. As part of the licensing agreement, BD supplies the Uniject system to pharmaceutical producers at preferential prices for use in developing-country programs. Developing Uniject and bringing it to market has been a 20-year endeavor.

Originally developed for use with vaccines, Uniject now promises to extend the reach of other lifesaving drugs as well as contraception.

Uniject is a trademark of BD.

(From PATH)

This interactive map visually plots global outbreaks of measles, mumps, whooping cough, polio, rubella, and other diseases that are easily preventable by inexpensive and effective vaccines. The Global Health Program at the Council on Foreign Relations has been tracking news reports on these outbreaks since the fall of 2008. This project aims to promote awareness of a global health problem that is easily preventable.

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The Unfixed Brain

This video is a bit graphic, but it’s also pretty amazing.

Most of us “think that the brain is sort of the consistency of a rubber ball,” says neurobiologist Suzanne Stensaas of the University of Utah. That’s the consistency the organ becomes when researchers preserve it in chemicals, such as formaldehyde. 

But when alive and firing, the brain is actually really soft and compressible, like a sack of goo. “It’s much softer than most of the meat you see in a market,” Stensaas says. 

In this video, Stensaas explores the anatomy of a 1,400 gram brain freshly removed from an autopsy, before it’s put in any chemicals.

The video gave me a whole new understanding and appreciation for how remarkable — and vulnerable — this amazing organ is. 

Wear your helmets!

Video from University of Utah Brain Institute/

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We’re getting closer to a world without polio.

(via The Gates Foundation)


Mapping The Diseases That Will Most Likely Kill You

Depending on where you live, these are the diseases that will most likely kill you. Using data from the World Health Organization, Simran Khosla at the GlobalPost labeled each nation with the disease that caused the most death in that country.

And it seems like much of the world will succumb to heart disease. Most prevalent in Africa is HIV/AIDS and tuberculosis. You can zoom in on the other regions at GlobalPost.

First Vaccine for Dengue Fever Shows Promise in 2nd Big Trial

By Andrew Pollack

An experimental vaccine against dengue fever being developed by Sanofi proved about 60 percent effective in its second large clinical trial. The results could clear the way for the introduction of the world’s first inoculation against the disease, which is mosquito-borne and becoming an increasing threat.

Sanofi, a French drug company, said on Wednesday that use of the vaccine cut the risk of getting dengue by 60.8 percent in the trial, which involved 20,875 children ages 9 to 16 from several countries in Latin America and the Caribbean.

Those who received the vaccine also had an 80.3 percent lower risk of being hospitalized for dengue compared with children who received injections of a placebo.

The results are roughly similar to those from the first large clinical trial, in which the vaccine reduced the incidence of dengue fever by 56.5 percent. That trial involved about 10,000 children in Southeast Asia.

“For the first time ever, after 20 years of research and industrial commitment, dengue is set to become a vaccine-preventable disease,” Olivier Charmeil, chief executive of Sanofi Pasteur, the vaccine division of Sanofi, said in a statement.

(More from The New York Times)

The worm has turned

Schistosomes belong to the class Trematoda. They are parasitic flatworms with complex life cycles that involve infecting at least two hosts. The primary host, where the flatworms or flukes sexually reproduce, are vertebrates, including humans. The intermediate host, which is employed to disperse the parasite, is usually a snail.

In the image above by Bo Wang and Phillip A. Newmark of the University of Illinois at Urbana-Champaign (which won a 2013 BioArt award from the Federation of American Societies for Experimental Biology), developing Schistosoma mansoni larvae (center) are shown developing inside the muscular, fibrous tentacle of a snail host.

Eventually these larvae are released into water. If the contaminated water comes into contact with human skin, the larvae penetrate and ultimately develop into adult worms residing in veins of the urinary tract and intestines, causing a condition known as schistosomiasis, which affects almost 240 million people worldwide.

The infection is prevalent in tropical and sub-tropical regions, in poor communities without potable water and adequate sanitation. There are many potential complications of schistosomiasis, including gastrointestinal bleeding, renal failure, infertility, pulmonary hypertension and sepsis. Typical treatment involves the drug Praziquantel, an anthelmintic that causes the flukes to be expelled from the body. The disease can become chronic, and in some regions, acute schistosomiasis is associated with a mortality rate of up to 25 percent.

A Simple, Elegant Invention That Draws Water From Air

When Italian designer Arturo Vittori and Swiss architect Andreas Vogler first visited Ethiopia in 2012, they were shocked to see women and children forced to walk miles for water.

Only 34 percent of Ethiopians have access to a reliable water supply. Some travel up to six hours a day to fetch some or, worse, resorts to using stagnant ponds contaminated by human waste, resulting in the spread of disease.

Worldwide, a whopping 768 million people — two and a half times the U.S. population — don’t have access to safe drinking water. So just imagine if we could just pull water out of thin air?

That’s what Vittori and Vogler asked once they saw the magnitude of problem and vowed to take action. Their firm, Architecture and Vision, has since come up with WarkaWater, a majestic palm-like structure that may look like something you’d see in a modern art museum but it’s been designed to harvest water from the air.

WarkaWater, which is named after an Ethiopian fig tree, is composed of a 30-foot bamboo frame containing a fog-harvesting nylon net that can be easily lowered for repairs and to allow communities to measure the water level.

Collecting water through condensation is hardly a new technique, but the creators of WarkaWater say their tree-inspired design is more effective, maximizing surface and optimizing every angle to produce up to 26 gallons of drinkable water a day — enough for a family of seven.

Continue reading.

Photo: The WarkaWater gathers water from fog and condensation. Named after an Ethiopian fig tree, it consists of a 30-foot bamboo frame and a nylon net. It was invented by an Italian firm and three of them are shown here in an Ethiopian village. (Courtesy of Architecture and Vision)

The Peace Corps is excited to be a partner of Saving Mothers, Giving Life. We are particularly proud of the contributions Peace Corps Volunteers have made at the community level to promote the importance of essential maternal health services, and we are thrilled to continue our collaboration to aggressively reduce maternal mortality. - Acting Director Carrie Hessler-Radelet

Saving Mothers’ first Annual Report, Making Pregnancy and Childbirth Safe in Uganda and Zambia, demonstrates rapid progress towards reducing maternal mortality ratios in eight pilot districts.

In Uganda districts, the maternal mortality ratio has declined by 30%, while in facilities in Zambia, the maternal mortality ratio has decreased by 35%. The Report showcases the activities that have helped contribute to these gains, including:

  • Increasing the number of women delivering in health facilities by 62% and 35% in Uganda and Zambia, respectively
  • Enhancing women’s access to Emergency Obstetric and Newborn Care, by hiring and training skilled birth attendants;
  • Strengthening transportation and communications networks among communities and facilities, in addition to strengthening the supply chain for life-saving medicines and commodities; and
  • Expanding testing and treatment for HIV/AIDS for women and their newborns.

Download the full report

Measles outbreaks (purple) worldwide and whooping cough (green) in the U.S., thanks in part to the anti-vaccination movement. (Council on Foreign Relations)

The toll of the anti-vaccination movement, in one devastating graphic

By Michael Hiltzik

Aaron Carroll today (1/20/14) offers a graphic depiction of the toll of the anti-vaccination movement. (H/t: Kevin Drum.) It comes from a Council on Foreign Relations interactive map of “vaccine-preventable outbreaks” worldwide 2008-2014.

A couple of manifestations stand out. One is the prevalence of measles in Europe — especially Britain — and the U.S. Measles is endemic in the underdeveloped world because of the unavailability of the MMR (measles, mumps and rubella) vaccine.

But in the developed world it’s an artifact of the anti-vaccination movement, which has associated the vaccine with autism. That connection, promoted by the discredited British physician Andrew Wakefield and the starlet Jenny McCarthy, has been thoroughly debunked. But its effects live on, as the map shows.

Vaccine panic also plays a role in the shocking incidence in the U.S. of whooping cough, also beatable by a common vaccine. Researchers have pointed to the effect of “non-medical exemptions” from legally required whooping cough immunizations — those premised on personal beliefs rather than medical reasons — as a factor in a 2010 outbreak of whooping cough in California.

These manifestations underscore the folly and irresponsibility of giving credence to anti-vaccination  fanatics, as Katie Couric did on her network daytime TV show in December. We examined the ethics of that ratings stunt here and here.

Among other worthwhile examinations of the impact of the anti-vaxxers, see this piece about growing up unvaccinated in Great Britain in the 1970s, and this disturbing piece by Julia Ioffe about her battle with whooping cough, a disease no American should have.

The lesson of all this is that vaccination is not an individual choice to be made by a parent for his or her own offspring. It’s a public health issue, because the diseases contracted by unvaccinated children are a threat to the community. That’s what public health is all about, and an overly tolerant approach to non-medical exemptions — and publicity given to anti-vaccination charlatans like Wakefield and McCarthy by heedless promoters like, sadly, Katie Couric, affect us all.

Carroll, who assembles the relevant papers and documents on the MMR/Autism sophistry here, deserves the last word. “Vaccinate your kids,” he writes. “Please.”

(From Los Angeles Times)

Depression top cause of illness in world’s teens

Depression is the top global cause of illness and disability for adolescents, with suicide the third-biggest cause of death, the World Health Organization said on May 14th, 2014.

The finding is in a new report by the UN agency, which has pulled together a wealth of published evidence with direct consultations with 10 to 19-year-olds around the world to assess the health issues that affect them.

"The world has not paid enough attention to the health of adolescents," says Flavia Bustreo, head of the WHO’s family, women and children’s health division.

Some studies show that half of all people who develop mental disorders have their first symptoms by the age of 14, said the report.

"If adolescents with mental health problems get the care they need, this can prevent deaths and avoid suffering throughout life," it said.

The study looked at a broad range of issues, including tobacco, alcohol and drug use, HIV, injuries, mental health, nutrition, sexual and reproductive health, and violence.

Traffic injuries were the number two cause of illness and disability, behind depression, with boys three times more likely to die than girls.

WHO said it was crucial for countries to reduce the risk by increasing access to reliable and safe public transport, improve road safety regulations such as alcohol and speed limits, establish safe pedestrian areas around schools and graduated licensing schemes where drivers’ privileges are phased in over time.

Worldwide, an estimated 1.3 million adolescents died in 2012, it said. The top three causes of death globally were road traffic injuries, HIV/AIDS, and suicide.

HIV was the second cause of deaths in adolescents globally, WHO said, with estimates suggesting the number of HIV-related deaths among adolescents was rising.

This was predominantly in Africa, at a time when HIV-related deaths were decreasing in all other population groups.

"We must not let up on efforts to promote and safeguard the sexual and reproductive health of adolescents, including HIV," said WHO scientist Jane Ferguson, lead author of the report.

For adolescent girls alone, the second-biggest killer after suicide was complications during childbirth.

That was despite major progress on that front, WHO said, with death-rates plummeting since 2000—by 57 percent in Asia, 50 percent in the Middle East and 37 percent in Africa.

Other infectious disease also remained major killers, despite marked successes such as a 90-percent decline in death and disability from measles in Africa over the past decade, thanks to childhood vaccination.

Common infectious diseases that have been a focus for action in young children were among the hardest-hitting.

For example, diarrhoea and lower respiratory tract infections ranked second and fourth among causes of death in 10 to 14-year-olds.

Combined with meningitis, these conditions accounted for 18 percent of all deaths in this age group, little changed from 2000, WHO said.

A Few Ebola Cases Likely In U.S., Air Traffic Analysis Predicts

It’s only a matter of time, some researchers are warning, before isolated cases of Ebola start turning up in developed nations, as well as hitherto-unaffected African countries.

The current Ebola outbreak in West Africa has killed more people than all previous outbreaks combined, the World Health Organization said Wednesday. The official count ;includes about 3,600 cases and 1,800 deaths across four countries.

Meanwhile, the authors of a new analysis say many countries — including the U.S. — should gear up to recognize, isolate and treat imported cases of Ebola.

The probability of seeing at least one imported case of Ebola in the U.S. is as high as 18 percent by late September, researchers reported Tuesday in the journal PLOS Currents: Outbreaks. That’s compared with less than 5 percent right now.

These predictions are based on the flow of airline passengers from West Africa and the difficulty of preventing an infected passenger from boarding a flight.

As with any such analysis, there’s some uncertainty. The range of a probable U.S. importation of Ebola by Sept. 22 runs from 1 percent to 18 percent. But with time — and a continuing intense outbreak in West Africa — importation is almost inevitable, the researchers told NPR.

"What is happening in West Africa is going to get here. We can’t escape that at this point," says physicist Alessandro Vespignani, the senior author on the study, who analyzes the spread of infectious diseases at Northeastern University.

Continue reading.

Image: Air traffic connections from West Africa to the rest of the world: While Guinea, Liberia and Sierra Leone don’t have many flights outside the region, Nigeria is well-connected to Europe and the U.S. (PLOS Currents: Outbreaks)