Public health round-up
Polio-free year in India
Front-line vaccinators, such as the one pictured here, are celebrating India passing a year without polio, for the first time in history. India has not seen a case since a 2-year-old girl in the state of West Bengal developed paralysis on 13 January 2011. A year to that day, WHO said it appeared that transmission of wild poliovirus had been halted in the vast country of 1.1 billion people last year, but that laboratory tests would confirm that this month. WHO said that globally the number of cases had declined from 921 in 2010 to 627 last year. The only other endemic countries – that is, those which have never stopped transmission of the poliovirus – are Afghanistan, Nigeria and Pakistan. Polio eradication was one of several topics on the agenda at WHO’s Executive Board meeting last month.
Malaria deaths down
Annual malaria death rates around the world have fallen by more than one quarter since 2000 thanks to increased prevention and control measures, according to WHO’s World malaria report 2011. Globally, the number of malaria deaths in 2000 were 26.6 per 100 000 people at risk, compared with 2010, when they fell to 19.8 deaths per 100 000. According to the report, which was released on 13 December 2011, annual malaria death rates in WHO’s African region fell by 33%, with an estimated 125 such deaths per 100 000 at risk in 2000 compared with 84 in 2010. Despite this progress, malaria parasites are still causing an estimated 216 million infections and 655 000 deaths in 99 countries and territories with ongoing malaria transmission (2010 figures). Some 86% of the victims are children under 5 years of age and an estimated 91% of all malaria deaths occur in the WHO African region. During the past decade, there has been a significant scaling up of malaria control interventions, including widespread use of insecticide-treated bednets and indoor residual spraying, better diagnostics and wider availability of effective antimalarial medicines. http://who.int/malaria/world_malaria_report_2011
Philippines flood appeal
WHO called on the international community to respond to the United Nation’s appeal for US$ 28.6 million of emergency relief for the flood-ravaged southern Philippines on 22 December, a few days after the country was hit by a tropical storm. More than 641 000 people were affected by flooding and about 1000 are believed to have been killed in the disaster. In response to a request from the government, WHO sent emergency supplies to the affected area, including 416 000 bottles of water purification tablets; 20 000 doses of oral rehydration salts and 4000 containers of zinc sulfate for treatment of diarrhoea; 612 litres of hand sterilizer and 498 cadaver bags. WHO's Regional Office for the Western Pacific contributed US$ 100 000 for relief efforts.
For a cholera-free Hispaniola
The Dominican Republic and Haiti issued a call for action for a “cholera-free Hispaniola” by investing in water, sanitation and hygiene infrastructure on the island (where the two countries are situated). They were joined by WHO’s Regional Office for the Americas, the US Centers for Disease Control and Prevention, the United Nations Children’s Fund and other partners. Haiti is experiencing one of the largest cholera epidemics in modern history. It began in October 2010, 10 months after the devastating earthquake of the same year. While the international community has supported both governments in implementing cholera prevention and control interventions, major investments in infrastructure are needed to stop cholera from becoming endemic in Haiti.
Brazil smoking ban
Brazil passed a law banning smoking in enclosed public and private collective-use spaces on 15 December. In addition, the law prohibits tobacco advertising at the point of sale, raises taxes on tobacco products and increases the required size of health warnings that must be included on both sides of cigarette packages. The measures are in line with the WHO’s Framework Convention on Tobacco Control. Brazil, with its population of 195 million, is the largest country in the world to declare all workplaces and indoor public spaces 100% smoke-free. More than 17% of adults in Brazil smoke, and an estimated 200 000 Brazilians die each year as a result of tobacco use.
Anti-tobacco centre opens
WHO opened the Centre for Tobacco Control in Africa in November last year to boost tobacco control in WHO’s African region. The centre is hosted by a consortium led by Makerere University’s School of Public Health and is based in Kampala, Uganda. It is funded by a grant to WHO from the Bill & Melinda Gates Foundation. Its work will initially focus on five countries: the host, Uganda, as well as Angola, Kenya, Mauritania and South Africa. WHO recently stepped up its tobacco control work in Africa to prevent tobacco use from becoming as prevalent there as it is in other parts of the world.
Experts will gather in Geneva from 5 to 7 March to revisit the topic of whether yaws can be wiped out. WHO convened the meeting following findings that taking a single pill is as effective as the currently recommended penicillin injection to cure yaws. “We may be closer now than we have been in decades,” Kingsley Asiedu, a yaws expert with WHO's Department of Neglected Tropical Disease Control, said, calling the study on the bacterial skin disease, which leads to chronic disfiguration and disability in 10% of untreated cases, the most important in half a century. In 2010, the Lihir Medical Centre in Papua New Guinea, where the disease is still endemic, gave the one-time oral dose of the antibiotic azithromycin to about half of 250 infants and children aged from six months to 15 years who had yaws. Follow-up examinations in 2011 showed that the oral treatment was as effective as penicillin injections, which – unlike oral antibiotics – require trained health staff and equipment that is often scarce in areas most in need of treatment.
Healthy lifestyle pays
It is well known that healthier eating habits and lifestyles are important for preventing diabetes, but quantifying their benefits is difficult. A study published in BMC Public Health in January this year found that pre-diabetic Australians aged 45–64 years could work longer and earn more money by adopting a lifestyle change or by taking metformin, an oral anti-diabetic. However, when researchers compared lifestyle changes – diet or exercise – with the use of metformin, they found that lifestyle changes delivered more benefits than the drug. Their results showed that if the lifestyle intervention had been introduced in 1983, an additional 753 person-years in the labour force could have been achieved between 1993 to 2003 for the male cohort aged 60–64 years in 2003, and 890 person-years for the equivalent female group. During that period, the lifestyle intervention applied to the same male and female cohorts could have resulted in additional income of 34 million Australian dollars (AUD) and AUD 28 million, respectively. The impact on labour force participation was lower for the metformin intervention, but increased with age for both interventions. http://www.biomedcentral.com/1471-2458/12/16/abstract
Speedy social media
Social media and internet-based news (including blogs and news feeds) were quicker in tracking the cholera epidemic in Haiti than more traditional ways of monitoring disease outbreaks, such as hospital and health clinic surveys, and could be of great help to doctors and epidemiologists, according to a study published in the American Journal of Tropical Medicine and Hygiene in January. The study authors, scientists from the Children’s Hospital Boston and Harvard Medical School, analysed news and Twitter feeds from the early days of the Haiti cholera epidemic in 2010 and found them to be a rich source of valuable information that was available as much as two weeks ahead of surveillance reports issued by the government health ministry.
Women in the United Republic of Tanzania are more likely to go for cervical cancer screening if they have knowledge of the disease and understand how it is prevented and, also, if the screening facilities are not far away from their homes, according to a study published in BMC Public Health in October last year. The estimated incidence of cervical cancer is 30 to 40 per 100 000 women in the country. The study looked at the key factors relating to the uptake of such screening. Women surveyed in a rural district, where less than one quarter (22.6%) of the participants were screened, mentioned a variety of factors. The study found that only knowledge of cervical cancer and how to prevent it, and distance from the screening facility were significant factors. http://www.biomedcentral.com/1471-2458/12/22/abstract
- 4 February: World Cancer Day http://www.worldcancerday.org
- 20–21 February: Eighth Meeting of the Global Collaboration for the Development of Pesticides for Public Health
- 8 March: International Women’s Day http://www.womenforwomen.org
- 21 March: International Day for the Elimination of Racial Discrimination
- 22 March: World Water Day http://www.unwater.org/worldwaterday
- 24 March: World Tuberculosis Day http://www.worldtbday.org
- 7 April: World Health Day. This year’s theme is healthy ageing http://www.who.int/world-health-day