Tag: HIV/AIDS

Global HIV Prevention—Check!

by ihsection, posted in Guest Blog, HIV/AIDS

by Kate McQuestion E-mail
In 2006, an article in the New England Journal of Medicine cited the substantial success of the implementation of a routine checklist on reducing catheter-related infections in the Intensive Care Unit of a Michigan Hospital. This story was shortly followed by media uptake the WHO Patient Safety Checklist, which, when utilized, reduced surgery-related mortality by almost 50%. The clinical use of checklists has become a hot topic for clinical quality improvement advocates, and as such, they been generally embraced in some areas of clinical practice.

Could this kind of tool be effective in public health?

The concept of a checklist is, intentionally, simple. The checklist serves as a mechanism to combat human failures of attention or memory—particularly in high stress or repetitive environments. The overall goal of a checklist is not only to ensure that each item is checked-off as prescribed, but to ensure an environment that promotes teamwork and professional discipline. Due to the ability of checklists to make complex systems approachable, they have already been widely used in industries such as aviation and construction, and now are advancing in medicine as well.

HIV prevention efforts, too, involve complex systems consisting of dynamic target populations, multiple programmatic efforts, and a lack of measurable quality indicators—all in all, making sustainable quality improvement challenging.

Checklists might provide a standardized method to ensure basic quality improvement and program management practices in an environment where pressing need may often lead to deficits in consistent and quality programming. Furthermore, they can be used as a tool to increase quality by improving communication, both internally within an organization, but also with the members of the target population being served.

It is a common complaint that too little emphasis falls of clinical delivery sciences, but it is fair to say that even less falls of preventative services delivery. NGOs working in HIV prevention need to keep better track of both the outcomes and impact of their programs. With out measuring results, it is hard to identify best practices and improve quality standards. HIV Quality Improvement Checklist tools could serve as a constant reminder for NGOs to monitor and evaluate results, thus improving health of communities world-wide.

Sources:

  • Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Eng J Med 2006; 355: 2725–32.
  • Gawande A. The Checklist Manifesto: How to Get Things Right. Henry Holt and Co: New York, 2009.
  • Haynes AB, Weiser TG, Berry WR, et al; Safe Surgery Saves Lives Study Group. A surgical safety checklist to reduce morbidity and mortality in a global population [published online ahead of print January 14, 2009]. N Engl J Med. 2009; 360(5):491-499.

Kate McQueston is a Master of Public Health Student at The Dartmouth Institute for Health Policy and Clinical Practice and Intern at the WHO Regional Office for Europe Division for Communicable Diseases.

Global Health News Last Week

by ihsection, posted in News

From March 28 to April 1, panelists working in Canada, Uganda, the United States, and Zambia will lead a discussion in GHDonline.org on ways to build sustainable partnerships to strengthen surgical and anesthesia capacity in resource-poor settings. More information can be found here.

March 22 was World Water Day. Blogger Tom Murphy has collected some interesting videos on PSI’s blog here.
Elizabeth Taylor, Hollywood icon and longtime advocate for the fight against HIV/AIDS, passed away on March 23 at age 78.
March 24 was World TB Day.

POLICY

  • China, the world’s largest tobacco producer and home to a third of all smokers, has issued a national ban on smoking in hotels, restaurants and other indoor public spaces.
  • Fears are growing among HIV/AIDS sufferers in the Ukraine amid claims from some patients that they have been denied life-saving medicines by authorities during a crackdown on drug substitution therapy.
  • The WHO has announced a list of 30 essential medicines for treating common diseases of mothers and children that can be used as the basis for procurement and supply of medicines and guide local medicine production.

RESEARCH

  • Scientists from the University of California, Berkeley (UCB), Dublin City University and Universidad de Valparaiso (Chile) have developed a self-powered, low-cost chip that can test blood samples and diagnose diseases like tuberculosis and HIV within minutes.
  • Researchers have discovered that capsaicin, the compound that makes jalapeños, red chilies, and the famous habanero pepper spicy, inhibit the production of cholera toxins.
  • Results from a recent study show that people with HIV who change antiretroviral treatment regimens due to side effects are at higher risk for developing drug resistance.
  • The Pakistan Medical Association’s 2011 annual report found that 400,000 infants die in the first year of their life each year and 1 out of 10 children die by the age of five.
  • A study by researchers from Johns Hopkins University found that child diarrhea deaths could be almost halved if currently available interventions such as breastfeeding, hand washing with soap, and improved household water treatment were widely implemented.
  • Global health and development blogger Amanda Makulec shares seven key ideas that she took home from the Global Health Metrics and Evaluation Conference in Seattle.

DISEASES AND DISASTERS

  • Despite setbacks, work continues at Japan’s Fukushima Dai-Ichi nuclear power plant. Meanwhile, in addition to radiation-contaminated vegetables, officials are now warning families to not give Tokyo tap water to infants due to elevated levels of radiation found in the water supply. The World Bank estimates that the earthquake and tsunami have caused as much as $235 billion in damage to Japan and that it will take five years for the nation to recover.
  • The crisis in CĂ´te d’Ivoire continues as well, as the country’s healthcare system is strained by the violence.
  • Leprosy, which has been officially “eliminated” in India, still affects hundreds of thousands of people who are shunned by society. There are 130,000 new cases diagnosed in the country each year.
  • Leaders at the 26th Annual Conference of Alzheimer’s Disease International challenged the World Health Organization and countries around the world to take action on the dramatic surge in the global incidence of Alzheimer’s disease and dementia.

Global Health News Last Week

by ihsection, posted in News

POLICY

  • Assistant Senate Majority Leader Richard Durbin (D-IL) and Senator Bob Corker (R-TN) introduced the Water for the World Act of 2011, a bill in the Senate which will make providing safe and clean drinking water around the world a priority for US foreign aid.
  • More than 60 world nutrition experts met at WHO headquarters last week to revise guidelines and to identify solutions to tackle the growing problems of both malnutrition and obesity around the world.
  • Ministers of health and other high-level health officials from throughout the Americas called for a series of actions to reduce the toll of chronic noncommunicable diseases, in a declaration issued last week in Mexico City.
  • The Global Fund announced that former President of Botswana Festus Mogae and former U.S. Health and Human Services Secretary Michael O. Leavitt have agreed to lead a high-level panel of experts that will conduct an independent and thorough review of the Global Fund’s financial safeguards.
  • UN agencies are concerned that reduced donor funding due to the recession, combined with free trade agreements, will reduce the availability of low-cost HIV medications in developing countries.
  • The United Nations General Assembly will convene a high-level meeting in September this year to discuss the financial burden caused by non-communicable diseases (NCD) on countries.

RESEARCH

  • A study done is Malawi by the World Bank attracted attention (and criticism) from Businessweek. Young women were given to stay in school and deter them from accepting money and gifts from “sugar daddies” in exchange for sex. The study found that HIV infection rates were 60% among schoolgirls who received cash compared to those who received nothing.
  • A recent review of malaria treatment clinical trial results, published in the Chochrane Library, shows that artesunate was more effective that quinine at treating severe malaria.
  • A personalized text messaging reminder service significantly boosted antiretroviral (ARV) adherence over a six-week period compared with a standard beeper reminder system, according to a study published in the March issue of AIDS Patient Care and STDs.
  • About 600 people gathered at the Global Health Metrics and Evaluation conference in Seattle to discuss issues surrounding the evaluation of effectiveness of health programs.

PROGRAMS

  • Global health blogger Alanna Shaikh discusses how micro-credit and the Green Revolution, two of international development’s biggest successes, are being re-evaluated.
  • The Nepalese government is planning launch a large vaccination campaign against elephantiasis in 40 high-risk districts.
  • Dubai’s Ministry of Health introduced Pneumococcal Conjugate Vaccine PCV13, a vaccine that protects young children from the worst effects of illnesses including pneumonia, blood infections and meningitis.
  • The National Influenza Center of the Chinese Center for Disease Control and Prevention has been designated as a World Health Organization Collaborating Centre for Reference and Research on Influenza, making China the first developing country to house such an institution.

DISEASES AND DISASTERS

  • Europe is concerned by the growing incidence of drug-resistant TB, particularly in children.
  • The world continues to follow the aftermath of the earthquake and tsunami in Japan, including the unfolding situation at the Fukushima Dai-ichi nuclear power plant. The WHO has assured that there is no danger to individuals being exposed to radiation in nearby nations (e.g. China).
  • As if Haiti needed any more bad news, a study published in the Lancet says that the UN estimate of 400,000 cholera cases in Haiti this year is nearly half of what the real projection should be for the recovering nation. Meanwhile, health officials in Lagos have called on residents to observe high standards of personal and environmental hygiene and have designated emergency numbers to call in case of suspected cases; the Ghana Health Service has set up cholera centers in Accra to deal with the outbreak there; and the interim federal government of Somalia on Tuesday denied reports of an outbreak of cholera in the country, responding to an Associated Press story over the weekend that Somali doctors had reported that more than 20 people had died from the disease.
  • In the February 2011 issue of PLoS Neglected Tropical Disease Journal, contributing editor Serap Aksoy discussed the triumphs behind the control of human African trypanosomiasis, or African Sleeping Sickness.
  • Although women get diagnosed for tuberculosis (TB) later than men, treatment outcomes among women are better than men with higher TB treatment success rate and lower default (drop-out) rate in the female patients. The finding was announced at a meeting on TB and women in New Delhi, India.
  • While the total number of newly reported HIV positive people and AIDS patients are still low in Japan compared with other countries, the number of newly HIV-infected people in Japan has doubled in the past decade due to public complacency and lower awareness.

Global Health News Last Week

by ihsection, posted in Information and Social Media, News

The 13th Triennial World Congress on Public Health, to be hosted by the Ethiopian Public Health Association and held from April 21-29, 2012 in Addis Ababa, will bring together leaders in health from across the globe. The conference, “Towards Global Health Equity: Opportunities and Threats,” is currently accepting abstracts; the deadline is Friday, October 21, at 12 a.m. PT (3 a.m. ET). More information can be found here.

International Women’s Day was March 8.

On March 11, a 9.0 earthquake rocked Japan’s Chiba prefecture, followed by a colossal tsunami that washed entire villages away.


The world, of course, stands ready to help, but it is unlikely that most of the assistance will be needed, as Japan is one of the most disaster-ready countries in the world. Unfortunately, the explosions in several of the country’s nuclear plants means that the threat of radiation poisoning looms heavily.

POLICY

  • A panel of independent experts has released a report harshly criticizing the World Health Organization’s handling of the 2009 epidemic of H1N1 swine flu.
  • UN officials expressed concern that rising food and energy prices could compromise or even reverse progress toward the MDGs in developing nations.
  • UN Secretary-General Ban Ki-moon has instructed senior managers to cut 3%, or US$5.4 billion, from budgets.
  • The Kenyan government has moved to strip HIV/AIDS of its special status and begin treating it as a chronic medical condition. It has begun implementing a disease integration model that will do away with emergency response measures and dismantle parallel administrative structures set up to manage the disease.

RESEARCH

  • HealthMap, a project that aggregates health and surveillance data from sounces such as the WHO, Google News, and Eurosurveillance, was launched recently to “[bring] together disparate data sources to achieve a unified and comprehensive view of the current global state of infectious diseases and their effect on human and animal health.”
  • According to a study done by Tuberculosis Research Centre in India, alarming numbers of women with TB become homeless after they are diagnosed. Approximately 100,000 women are abandoned by their husbands due to TB every year in India.
  • A group of researchers from EPFL’s Global Health Institute and Inserm (Institut National de la SantĂ© et de la Recherche MĂ©dicale, the French government agency for biomedical research) has discovered that a class of chemotherapy drugs also kills the parasite that causes malaria.

PROGRAMS

  • Oxfam recently released a report criticizing the World Bank for its praise of Ghana’s healthcare system. Amanda Glassman of CGDev disagrees, arguing that Oxfam ignored surveys indicating the system’s success in improving health indicators and beneficiaries’ satisfaction with the quality of service.
  • On March 9, Saving Lives At Birth, a global partnership between USAID, the Government of Norway, The Bill and Melinda Gates Foundation, Grand Challenges Canada, and the World Bank, was launched. The partnership “will seek innovative solutions to reduce maternal and newborn mortality in developing countries.”

DISEASES

  • Rwanda is on track to completely eliminate malaria, the first country in its region.