Meningitis kills 22 in Ghana

AT least 22 persons have been confirmed dead from bacterial meningitis in Ghana, following an outbreak that has lasted three months in the former Gold Coast country.The deaths were recorded in the northern Bole district and central Ghana. The pneumococcal (Meningococcal)  form of meningitis  occurs when bacteria invade the bloodstream and infect the membranes protecting the brain and the spinal cord (the meninges).

Although the outbreak has been contained experts warn that it remains highly contagious. Strict surveillance measures are being enforced. In the Bole district of Ghana’s northern region, health authorities are establishing measures to ensure reported cases are contained.

The dry season, with strong dusty winds and cold nights make people more prone to respiratory problems. The disease mainly affects children and young adults aged 1-30.

Transmission is airborne so infected persons can transmit it to others through droplets of respiratory or throat secretions, especially sneezing and coughing and inhalation. Early diagnosis is an important step of ensuring treatment and preventing the disease from spreading.

Symptoms include stiff neck, high fever, headaches, vomiting and sometimes seizures. Even when the disease is diagnosed early and adequate therapy instituted, 5-10 percent of patients die, typically within 24-48 hours of onset of symptoms, according to WHO. Most victims suffer irreversible neurological consequences.

The largest recorded outbreak of epidemic meningitis was recorded in Africa in 1996, with over 250,000 cases and 25,000 deaths registered. 

The current WHO recommendation for outbreak control is to mass vaccinate every district that is in an epidemic phase, as well as those contiguous districts that are in alert phase. It is estimated that a mass immunization campaign, promptly implemented, can avoid 70 per cent of cases. 

Global leaders urge greater local investments in family planning

 
L-R: Dr. Surya Chandra Surapaty, Chairman, National Population and Family Planning Board of Indonesia (BKKBN); Purnima Mane, President/CEO, Pathfinder; Dr. Ariel Pablo-Mendez, Asst Administrator for Global Health, USAID; Dr. Awa Marie Coll Seck, Minister of Health & Social Action, Senegal, and Benoit Kalasa, Director of the Technical Division of UNFPA, during the official ICFP press conference on "Family Planning and the Sustainable Development Goals" at the opening of the ICFP 2016, in Nusa Dua, Indonesia on Monday, 25 January, 2016.

By Sola Ogundipe, reporting from Nusa Dua, Indonesia

Global leaders have called for greater investment and urgent action towards increasing access to family planning services worldwide, even as an estimated US$9.4 billion is required annually to meet all women’s needs for modern contraception in the developing world.

Making the call for more commitment to family planning initiatives, Monday, while addressing more than 2,500 attendees at the opening of the 4th International Family Planning Conference, ICFP, in Nusa Dua, Indonesia, government, health and development leaders from around the world, unanimously agreed that the way to truly ensure sustenance of family planning programmes is to mobilise funds locally.

Speaking at the event, themed “Global Commitments, Local Actions,” co-hosted by the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health and the National Population and Family Planning Board of Indonesia, President Joko Widodo of Indonesia, expressed a heartfelt commitment to the  global advancement of maternal health and family planning practices built on the principle of informed choice:‎

“I wish that at this ICFP, we can discuss the main foundations necessary to build the planet that we want by 2030. A future that ensures all women and girls are empowered to choose whether and when they want to have children and space their births, so that mothers and their babies have a better opportunities for better lives."

To solve the issues of contraceptive discontinuation that can create major challenges for family planning progress, Jokowi emphasized the importance of investing the “village approach,” increasing access to long acting contraceptives and reducing the cost of family planning by providing free services and peer education programmes.

 “I believe that to achieve the Sustainable Development Goals (SDGs), we have to take local action. In order to sustain economic growth, investments in family planning are absolutely necessary… I want to invite all global leaders to take real action to bring about healthy mothers, healthy children and healthy and prosperous families – because only by doing this, can we make planet earth a better place to live,” Jokowi said.

Under-Secretary-General of the United Nations and Executive Director of UNFPA, Prof. Babatunde Osotimehin, "Family planning is about women's right and their capacity to take decisions about their health and well-being contributing to the objectives of FP2020.

 “It is a most significant investment to promote human capital development, combat poverty and harness a demographic dividend thus contributing to equitable and sustainable economic development within the context of the Sustainable Development Goals.

Also speaking, President of the Global Development Programme at the Bill & Melinda Gates Foundation, Dr. Christopher Elias, said: “The family planning data and evidence point to concrete steps we can take as a community to get back on track to meet our FP2020 goal.

 “Now we must ask ourselves what more we can do to align our efforts to ensure all women have the information and tools they need to time and space their pregnancies.”

In a telecast, Vice President of the Bill & Melinda Gates Foundation, Melinda Gates reiterated the  Foundation’s commitment to increasing funding for family planning by 2 percent over the next three years. 

In a report by the Guttmacher Institute entitled: “Adding It Up: Investing in Sexual and Reproductive Health” meeting all women’s needs for modern contraception in the developing world would cost $9.4 billion annually, an increase of $5.3 billion.

According to the report, if all need for modern contraception were met, the annual cost of pregnancy related care for women and their newborns would be $28.0 billion, an increase of $13.8 billion.

“The total includes $4.2 billion (a $3.0 billion increase) to provide HIV testing and counseling for all pregnant women, testing for their newborns and antiretroviral therapy for those who need it.

Further, the report notes that fully meeting the need for modern contraception, maternal and newborn health care, and antiretroviral care for pregnant women living with HIV and their newborns, and treatment for four major curable STIs would cost $39.2 billion annually, more than a doubling of current spending in 2014.

But, it also argued that fully satisfying women’s modern contraceptive needs would make health care investments more affordable overall.

“For every additional dollar invested in contraception, the cost of pregnancy-related care (including HIV care for women and newborns) is reduced by $1.47,” the report noted.

A recent global progress report of the Family Planning 2020 (FP2020), a global partnership focused on enabling an additional 120 million women to access voluntary contraception by 2020, in the last three years, 24.4 million more women and girls who want to avoid or delay a pregnancy have begun using modern contraceptives in the world’s poorest countries.

This brings the total of women using a modern method of contraception in FP2020’s 69 target countries to 290.6 million. However annual benchmarks to measure family planning progress, revealed that modern contraceptive use is behind 2015 projections by 10 million.

Ebola Survivors' Clinic opens in Liberia

An Ebola Survivors Clinic has opened in Monrovia, Liberia.
The clinic is located at the Redemption Hospital in the capital. Many patients that are seen are survivors of the Ebola virus disease (EVD) and as a result experience what are called "post-Ebola" symptoms, which include dizziness, blurred vision, headaches, joint pain, among other things.
Treatment at the clinic is not limited to the symptoms, they are also informed of best practices in hygiene and other areas to ensure that spread of the disease does not occur, especially if it is in the environment. 
Moses Soka, leading physician at the clinic, said that many who seek treatment due so because of the difficulty of returning to work as a result of post-infection symptoms. The WHO estimates that there are 5,000 EVD survivors in Liberia. There are currently four survivors facilities operating.
It has been shown that remnants of the Ebola virus can remain after the infection is finished within the eyes and in the semen of male survivors. The clinic also offers screenings for sexually active males so that they can avoid transmitting the Ebola virus to their partners.
WHO representative of Liberia, Alex Gasasira said the clinics not only provide support for the patients, but provide valuable research data to help  determine the cause and best course of treatment.

Trans fats, not saturated fats, increase risk of death

Trans fats, not saturated fats raise the risk of death and coronary disease. Saturated fats come mostly from animal products such as butter, cows' milk, meat, salmon and egg yolks. Trans unsaturated fats, or trans fats, are made from plant oils and are used in margarine and various packaged backed and snack foods.

For years everyone has been advised to cut out fats. Trans fats have no health benefits and pose a significant risk for heart disease, but the case for saturated fat is less clear. While no one is advocating an increase of the allowance for saturated fats in dietary guidelines, there is no evidence that higher limits would be specifically beneficial to health.

Researchers reviewed 50 observational studies to see the relationship between consumption of both forms of fat and health outcomes in adults. The researchers found that intake of trans fats increase the risk of dying by 34 percent, increase the risk of dying from congenital heart disease by 28 percent, and increase the chance of developing congenital heart disease by 21 percent.

Trans fats were not, however, linked to type 2 diabetes or stroke because of inconsistencies in the data, researchers said. Saturated fats were found by the researchers to generally not be associated with any of the diseases.

The lack of a link between saturated fat did not surprise researchers, as they write in the British Medical Journal, because previous studies have not found it to be linked to colon or breast cancer. Foods high in saturated fats have been found, however, to be associated with processed foods and meats with an increased risk for cancer.

If people are told to eat less saturated or trans fats,  a better choice must be offered. But not much evidence of the best replacement choice was available. These studies suggest replacing foods high in these fats, such as high-fat or processed meats and donuts, with vegetable oils, nuts, and whole grains.

While the study at McMaster University found that saturated fats are not associated with increased risk of death, the Danish Dairy Research Foundation found that moderate amounts of butter could result in increased levels of blood cholesterol.

That study, in the American Journal of Clinical Nutrition, found that olive oil was a better alternative to butter because, unlike butter, it was not seen to cause as great an increase in blood cholesterol.

DNA test frees man of rape charge, after 34 years in prison

A Pennsylvania man who spent more than three decades behind bars for the rape and murder of a 15-year-old girl has been freed after a DNA test.

A judge voided 63-year-old Lewis Fogle's 1982 conviction this week.

Fogle, who had denied shooting Deann Long in the head in 1976, said upon release that he was looking forward to a steak dinner.

His tearful wife, Deb Fogle, who wed him three months before his conviction, was waiting for him outside court and said she always believed he would be cleared.

The Innocence Project, a group that works to exonerate wrongfully convicted people, had led calls for new DNA testing in the case.

It said sperm evidence had "excluded Fogle and pointed to an unidentified male".

"This has been an extremely long journey for Mr Fogle, who has always maintained his innocence of the 1976 crime," said David Loftis, of the Innocence Project.

District Attorney Patrick Dougherty conceded the conviction ought to be thrown out after agreeing to the new DNA test.

But he said he does not believe Fogle is wholly innocent of involvement in Miss Long's death.

The prosecutor said he would decide by next month whether to retry Fogle.

Fogle has been released on a bail bond as he remains charged.

He was among four men arrested in 1981 after a mental health patient identified them under hypnosis as suspects.

Fogle was convicted of second-degree murder based on the testimony of three jailhouse informants.

Charges against his three co-defendants were dropped for lack of evidence.

The district attorney said he would seek DNA from two of the other three men originally charged who are still alive.

Women favor elective C-section over normal delivery

German researchers wrote in a new study that while the reasons women request them are clear, c-sections carry increased risks because of the nature of the procedure. The publication in the German Medical Association's journal - Deutsches Ärzteblatt International, hints that scientific progress, social and cultural changes, and, in particular, legal change have led to a fundamental change in attitudes to CS among patients and doctors.Giving birth via C-section has become common among women, but the World Health Organization (WHO) warns of the unwanted consequences of the procedure.
The UN agency says medically unnecessary c-sections should not be performed because c-section birth can lead to short- and long-term health problems for both the mother and child. In a statement released on Friday, WHO discouraged resorting to C-sections unless deemed necessary due to fetal distress, prolonged labor and the abnormal position of the baby.C-section is considered one of the most common surgeries done globally. 
Goal of this procedure is to safely deliver the baby if delivery through vaginal birth is not possible. the WHO, however, warns that c-section is linked with major complications, which include disability and death, and thus should ideally only be undertaken when medically necessary..In 1991, 15.1 percent of babies in Germany were born by c-section, a number that increased to 30.7 percent in 2012.
This, researchers write, despite the fact that less than 10 percent of the procedures were medically necessary.Rates around the world also have increased as Central American mothers have c-sections 31 percent of the time, 32.2 percent in the United States, and overall European rates are around 25 percent.

Researchers wrote that no difference in neonatal outcome was found between elective c-section and vaginal delivery, leading them to conclude that many are based on societal factors which may increase the risks of the procedure.Scientific advances, social and cultural changes, and medicolegal considerations seem to be the main reasons for the increased acceptibility of cesarean sections. Cesarean section is, however, associated with increased risks to both mother and child. It should only be performed when it is clearly advantageous.The international healthcare community has long considered 10-15 percent as the ideal number of c-section births per country, but while the surgery can prevent maternal and child death and morbidity, no evidence can show the benefits of the procedure for women and their babies who do not need c-section.

Women would rather have an elective Cesarean Section than a vaginal delivery, according to  research. A review of worldwide Cesarean Section data that shows the occurrence of the procedure has significantly increased because women favor them over vaginal delivery.

Apes may soon begin to speak

Humans are not the only primates with the capacity for speech. Koko the gorilla understands a silent form of communication, American Sign Language.

At The Gorilla Foundation, where Koko has spent more than 40 years living immersed with humans -- interacting for many hours each day with psychologist Penny Patterson and biologist Ron Cohn, she is performing amazing vocal behaviours.The vocal and breathing behaviors Koko had developed were not necessarily supposed to be possible.

And the particular vocal repertoire of each ape species was thought to be fixed. They didn't really have the ability to learn new vocal and breathing-related behaviours.
These limits fit a theory on the evolution of language, that the human ability to speak is entirely unique among the nonhuman primate species still around today.
In a study published online in July in the journal Animal Cognition, Perlman and collaborator Nathaniel Clark of the University of California, Santa Cruz, sifted 71 hours of video of Koko interacting with Patterson and Cohn and others, and found repeated examples of Koko performing nine different, voluntary behaviors that required control over her vocalization and breathing. These were learned behaviors, not part of the typical gorilla repertoire.
Among other things, Perlman and Clark watched Koko blow a raspberry (or blow into her hand) when she wanted a treat, blow her nose into a tissue, play wind instruments, huff moisture onto a pair of glasses before wiping them with a cloth and mimic phone conversations by chattering wordlessly into a telephone cradled between her ear and the crook of an elbow.
"She doesn't produce a pretty, periodic sound when she performs these behaviours, like we do when we speak," Perlman says. "But she can control her larynx enough to produce a controlled grunting sound."
Koko can also cough on command -- not particularly groundbreaking human behavior, but impressive for a gorilla because it requires her to close off her larynx.
"The motivation for the behaviors varies," Perlman says. "She often looks like she plays her wind instruments for her own amusement, but she tends to do the cough at the request of Penny and Ron."
These behaviors are all learned, Perlman figures, and the result of living with humans since Koko was just six months old.
"Presumably, she is no more gifted than other gorillas," he says. "The difference is just her environmental circumstances. You obviously don't see things like this in wild populations."
This suggests that some of the evolutionary groundwork for the human ability to speak was in place at least by the time of our last common ancestor with gorillas, estimated to be around 10 million years ago.
"Koko bridges a gap," Perlman says. "She shows the potential under the right environmental conditions for apes to develop quite a bit of flexible control over their vocal tract. It's not as fine as human control, but it is certainly control."
Orangutans have also demonstrated some impressive vocal and breathing-related behavior, according to Perlman, indicating the whole great ape family may share the abilities Koko has learned to tap.

Universal test for oral, genital herpes coming

Differences in strains of the herpes simplex viruses, HSV, may lead to the development of more accurate diagnostic tests and possibly a vaccine for oral and genital herpes.
After existing tests for HSV proved to be significantly inaccurate while testing patients in East Africa, researchers sought to understand the different strains of HSV1, which causes cold sores, and HSV2, which causes genital herpes, in order to create a better test.
HSV2 is more rare than HSV1, however it also has been shown in studies to make people more susceptible to getting the human immunodeficiency virus, or HIV.
The current test was made based on the genomic sequencing of European strains of HSV. It tests for a glycoprotein present in both strains of the virus, however researchers thought the specific glycoproteins in African strains are different from those in the U.S. and Europe.
A professor of medicine at the Johns Hopkins University School of Medicine, Dr. Thomas Quinn, remarked that the test was just not as specific as it should be
"Because HSV2 enhances HIV transmission, we have been testing people across East Africa for genital herpes, but everybody was coming up positive."
The first study published in the Journal of Virology, researchers gathered 34 strains of HSV2, finding 14 in Uganda, 8 in Japan, 1 in South Africa, and 11 in the United States, and included 2 previously gathered strains from South Africa. They mapped the strains' genomes, comparing them to one another and to HSV1. HSV2, they found, has far less genetic diversity regardless of where the strain of the virus came from.
In the second study, researchers looked specifically at the glycoproteins in HSV2 from each of the regions because of the results of Quinn's tests on patients in East Africa. The researchers compared glycoprotein G in the 36 newly mapped strains, as well as 26 previously gathered ones. They found that glycoprotein G, as well as glycoproteins I and E, showed variation from the North American and European versions diagnostic tests already target.
Finding the differences explains why the tests in Africa appeared so unreliable. He expects the discoveries of both studies will help lead to the development of more accurate diagnostic tests.
The fully mapped genomes of HSV2 strains also may lead to the development of a vaccine for the virus because researchers now have an understanding that the strains are not all that different, which may mean fewer antigens will be needed for innoculation.

An effective Ebola vaccine is at hand, says WHO

An effective Ebola vaccine is in the making, the World Health Organisation, WHO, has announced. This development followed results of an interim analysis of the high effectiveness of an experimental vaccine, called the VSV-EBOV, manufactured by Merck, Sharp & Dohme.

The global health body says hopes of a line of defence against the terrible disease are high, in view of preliminary results of the analyses of the Guinea Phase III efficacy vaccine trial on the VSV-EBOV vaccine. 

Tests conducted by an independent body of international experts - the Data and Safety Monitoring Board are promising.

"This is an extremely promising development. The credit goes to the Guinean Government, the people living in the communities and our partners in this project. An effective vaccine will be another very important tool for both current and future Ebola outbreaks," said WHO Director-General of the  Dr Margaret Chan.

Although the vaccine shows 100 percent efficacy in individuals, more conclusive evidence is needed on its capacity to protect populations through what is called “herd immunity”. To that end, the Guinean national regulatory authority and ethics review committee have approved continuation of the trial.

Guinea's national coordinator for the Ebola response. Dr Sakoba Keita, described the feat as "Guinea’s gift to West Africa and the world.”  

Director of the Division of Infectious Disease Control at the Norwegian Institute of Public Health and Chair of the Study Steering Group, John-Arne Røttingen explained that “The 'ring' vaccination method adopted for the vaccine trial is based on the smallpox eradication strategy.

By vaccinating all people who have come into contact with an infected person, a protective 'ring' is created to stop the virus from spreading further. This strategy has helped scientists to follow the dispersed epidemic in Guinea, and will provide a way to continue this as a public health intervention in trial mode.

The Guinea vaccination trial began in affected communities on 23 March 2015 to evaluate the efficacy, effectiveness and safety of a single dose of the vaccine VSV-EBOV by using a ring vaccination strategy.

To date, over 4 000 close contacts of almost 100 Ebola patients, including family members, neighbours, and co-workers, have voluntarily participated in the trial.

There are plans to include 13 to 17-year-old and possibly 6 to 12-year-old children on the basis of new evidence of the vaccine’s safety.