tuberculosis

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American teenager is the face of global TB | 

Washington, DC Jake paused when he entered the room. He pulled out his phone to take a picture of the empty seats facing the empty table where he and his mom, Caryn, will soon sit.

The Irvine, California high school Freshman is dressed in a sharp suit and polka-dot bowtie. A young embodiment of California cool, Jake jokes with his mother as he decides what Instagram filter to apply before sharing the photo.

He is every bit the normal American kid, except for one unapparent difference. Jake has tuberculosis (TB).

(l to r) Dr Felice Adler, Jake Kaufman and Caryn Kaufman
(l to r) Dr Felice Adler, Jake Kaufman and Caryn Kaufman
Courtney Miller

He shows no evidence of active TB, the kind that can spread from person to person, but cannot know for sure if the preventative therapy worked. Jake is a perfectly healthy teen who lives with the possibility that he is still infected by TB.

Nearly 1 million children around the world developed TB in 2010, says a new study. The researchers also estimated, for the first time, that more than 30,000 children were infected by a multidrug-resistant form of TB.

Jake and Caryn are in Washington to put a face on the problem of TB and encourage lawmakers to provide support for the research and development of treatments, diagnostic tools and preventative steps against TB. They lobbied with the advocacy organization RESULTS and participated in a briefing at the Senate Visitors Center on Wednesday.

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If only TB was as sexy as Ebola | 

All geared up for dealing with Ebola
All geared up for dealing with Ebola
Boston University

The world was briefly alarmed, or, well, the media has tried to sound the alarm, when it was reported that the usually deadly Ebola virus had spread from its confines in tropical sub-Saharan Africa to Canada when a man who had been in Liberia returned very ill to Saskatoon, Saskatchewan.

Holy Hot Zone Batman!

Wait, never mind. Canadian health officials have since said that the man who fell ill with the symptoms of severe hemorrhagic fever – massive internal bleeding caused by the infection basically melting down your insides – doesn’t appear to have Ebola. I doubt the man, who remains surrounded by health workers in masks and protective clothing given he still has one of the other kinds of horrible hemorrhagic viruses, will be much relieved.

Nor will many of those living in Guinea or anywhere else near the latest outbreak of this made-for-Hollywood infectious bug be relieved. Nearly 60 people have been reported killed from the infection in this West African outbreak, out of about 80 diagnosed. Continue reading

Seattle Biomed pioneering ‘rational’ approach to vaccines | 

Early anti-vaccine hysteria. Cartoon of Edward Jenner administering cowpox vaccine to frightened young women, and cows emerging from different parts of people's bodies.
Early anti-vaccine hysteria. Cartoon of Edward Jenner administering cowpox vaccine to frightened young women, and cows emerging from different parts of people’s bodies.
Wikipedia, James Gilray

Vaccines are widely, legitimately, hailed as one of medicine’s most powerful weapons in the fight against infectious disease. Millions of lives are saved, deaths prevented, every year using this simple tool that can cost as little as a handful of pennies.

Holy bang for the buck, batman!

So it’s unfortunate we know so little about how vaccines actually work. Not knowing has spawned a persistent anti-vaccine movement by those who fear, based on little hard evidence, the potential for harm caused by tweaking our immune system.

But not knowing is also causing some problems for the biomedical community.

“I don’t see how we’re going to ever develop effective vaccines against AIDS, TB or malaria without first gaining a lot more insight into how the immune system works – and how vaccines promote immunity,” said Alan Aderem, president of Seattle Biomed, a research organization that has been working on matters of global health since Bill Gates was a teenager. Continue reading

South African hospital sending patients with drug-resistant TB home | 

62178-south-africa
MSF

Drug resistant tuberculosis is a serious global problem, especially those forms of drug-resistant TB that can fend off multiple types of drugs. Patients with resistant forms of TB are supposed to be treated and monitored to reduce the spread of the disease.

That is not happening in South Africa.

A new study published in the British medical journal The Lancet today shows that South African hospitals are releasing a “ substantial” number of patients with extremely drug resistant forms of TB to their homes.

Given the already poor status of people living with TB in South Africa, the lack of proper care poses a threat to the millions who live in the country. The first case of totally drug resistant TB in South Africa was recorded last year as more and more people with TB are not being cured. It is made worse by the fact that people living with HIV are at a greater risk of catching TB. Continue reading

Visualizing progress against AIDS, tuberculosis and malaria | 

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) announced this week that donors pledged a total of US $12 billion to save lives through prevention and treatment of these three diseases.

The $12 billion represents the largest amount pledged to the Global Fund to date, as shown in the figure below. Many celebrated this milestone while others, as Humanosphere reported earlier this week, emphasized that it fell short of the goal of $15 billion, an amount advocates said was needed to continue to make progress against these killers.

Global Fund ATM

Significant progress has been made in reducing deaths from AIDS, tuberculosis, and malaria worldwide. The video below charts the decline in deaths from HIV/AIDS worldwide from 1990 to 2010 using the Institute for Health Metrics and Evaluation’s (IHME) data visualization tools:

The video shows how deaths from HIV/AIDS increased in most age groups through 2005 but started to drop by 2010. Continue reading

What global health needs is more (value for) money | 

There’s been a lot of hoo-hah this week in and around the UN General Assembly meeting in New York City focused on maintaining the world’s progress against poverty, especially diseases of poverty – aka global health.

GlobalFundLogoNothing perhaps inspires more hoo-hah in the global health arena than the Global Fund to Fight AIDS, Tuberculosis and Malaria – and for good reason. The Global Fund has saved millions of lives by getting life-saving drugs to people with HIV, TB and malaria, by getting tens of millions of bed nets out to prevent malaria and by literally bringing back to life many of the poorest, most ravaged communities on Earth. It now pays for most TB and malaria care worldwide, and one-fifth of the world’s response to HIV-AIDS.

It’s easy to forget how hopeless we all felt little more than a decade ago regarding the deadly threat of these major killers. It’s easy to forget how crazy ambitious it was to launch the Global Fund. AIDS was burning a wide swath through Africa, which the Economist magazine notoriously dubbed “The Hopeless Continent.” Hardly anyone even thought much about the millions dying from TB and malaria.

The Global Fund was, and is, one of the most hopeful, compassionate and impressive things the international community has done in a long time. That’s why it’s being celebrated in and around the grand UN confab this week. That’s why everyone cheered at the stunning statistics of lives saved, as well as when Britain announced this week it would give another $1.6 billion to the Global Fund, and it’s also why some are clamoring for even more funds – since many millions more are still not reached.

But like most things we humans do when we rush in to fix something, the Global Fund was also seriously flawed.

And it’s high time we deal with the flaws. Or so says Amanda Glassman, a global health expert and author of a new report called More Health for the Money. Here’s the video version:

What? There are 200 different kind of bed nets to prevent malaria? How can that be? Continue reading

North Korea facing hidden Tuberculosis crisis | 

Dr. KJ Seung in North Korea.
Dr. KJ Seung in North Korea.
The Eugene Bell Foundation

Multidrug-resistant tuberculosis (MDR-TB) is a global problem, but one that is particularly worrisome in Asia. An estimated 60% of the 500,00 MDR-TB cases in 2011 occurred in Brazil, China, India, Russia and South Africa. The problem is made worse by the low number of people with MDR-TB enrolled in treatment in countries like China, Myanmar and India.

Information on MDR-TB in the reclusive North Korea has been hard to come by, until now. Dr. KJ Seung has been working in North Korea on TB for years and heard from his colleagues that first-line TB drugs were not working for patients.

“I’ve treated MDR-TB in a lot of different countries, but the situation in North Korea is the worst I’ve ever seen,” he said in a recent interview with PIH. “There are simply too many patients. At every sanatorium we visit, there are lines of patients who have failed multiple courses of treatment with regular TB drugs and are hoping to get into our treatment program.”

Dr Seung decided to analyzed sputum samples from 245 of TB patients to get to the bottom of it. His results were stunning. Eighty-seven percent of the patients analyzed have MDR-TB. The results of the study were published this week in the open-access medical journal PLOS Medicine. Continue reading

From Zambia to America, a plea to continue the global fight against AIDS, TB and malaria | 

Luwiza Makukula
Luwiza Makukula

It’s hard to imagine Luwiza Makukula of a dozen or so years ago.

“Things were very difficult in Zambia then,” said Makukula, a soft-spoken and elegantly dressed grandmother of two I met briefly during a visit to Seattle this week. Her visit was sponsored by the anti-poverty organization RESULTS, a group which the Seattle Times’ columnist Danny Westneat once described as “the most influential anti-poverty group you’ve never heard of.” One of the reasons for this is the way RESULTS has operated for some 30 years – quietly, persistently and face-to-face.

That’s why Makukula came here from Zambia to tell her story.

“I lost my husband to HIV in 2001,” she said. “We didn’t know but after he died I started getting sick with fevers, in and out of the hospital.”

Makukula was eventually diagnosed with TB, and then found to also be HIV-positive. By then, she was in a wheelchair, suffering from exhaustion and cognitive lapses. They put her in an isolation ward that she said “felt like jail.” The drugs she needed to stay alive cost about $200 a month, in a country which at the time had an annual per capita income of about $1000.

She wasn’t alone in her deadly predicament. At the time, HIV and TB were burning a wide swath across much of southern Africa. Continue reading