Lassa fever: 2nd death in Lagos

Lassa fever reservoir, the Multimammate rat.

A second death from Lassa fever virus infection has been confirmed by the Lagos State Commissioner for Health, Dr. Jide Idris. He said the deceased, a 27-year-old lady,died few hours after admission at Ijede General Hospital where she presented with fever, vomiting, diarrhoea and body weakness.  

The unnamed lady had earlier travelled to Edo State on 24 December, 2015 and returned to Lagos on 2 January, 2016. 

She took ill on 14 January, 2016 and received care in one private hospital and three churches before she being referred  23 January  The case was confirmed as Lassa Fever on January 26, 2016.

The remains of the patient has been kept in the morgue in leak proof body bag. She is to be buried after due consultation with her family. 

Ninety (90) persons have been line-listed as contacts of the last confirmed case as at January 26, 2016 and contact tracing is on-going.

Meanwhile, Lagos State had recorded 20 suspected cases of Lassa fever as at 26 January since the outbreak of the disease in November, 2015. 

Fourteen  suspected cases tested negative, four cases were confirmed positive of Lassa Fever, while the results of two suspected cases are pending. One case was confirmed on the 15 January 2016, two on 18 January 2016 and one case confirmed on 26 January, 2016.  The Lagos state health ministry has line-listed 537 contacts of the confirmed cases and 534 (99 percent) of the contacts are currently being monitored.

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.

Nigeria's silent rage of malnutrition

A SILENT crisis is raging in Nigeria. Each year, no less than  one million Nigerian children die before their fifth birthday. Malnutrition contributes to nearly half of these deaths.  Malnutrition remains a great challenge, particularly for mothers and children. It contributes to the deaths of about half a million children each year — or about 1 out of every 2 child deaths — and imposes a staggering cost to the nation.

Health experts at a media dialogue on child malnutrition with the theme: “Spend More Money on Nutrition”, organised by UNICEF in collaboration with its partners,  said the first 1,000 days represents a critical window of opportunity.

They said adequate nutrition during this period can avert malnutrition by ensuring that children have the best possible opportunity to grow, learn, and rise out of poverty. Head, Nutrition, Federal Ministry of Health, Dr. Chris Osa Isokpunwu, in a presentation entitled “Nutrition Situation in Nigeria”, described a child’s nutritional status as the reflection of overall health and a cornerstone for survival, health and development.

“Malnutrition among Nigeria’s children is a serious problem throughout the country. Isokpunwu declared,  explaining that an undernourished child has lower resistance to infection and is more likely to die from illness. In addition to increasing mortality risk, poor nutrition in the first two years of life leads to stunted growth, which is irreversible and associated with impaired cognitive ability and reduced school and work performance.

Although the global target is to reduce stunting by 40 percent and reduce and maintain wasting below 5 percent by the year 2025. 

In an investigation of the three key indicators for monitoring the nutritional status of a child under 5 years of age –  underweight, stunting and wasting, data from the Summary of Findings of National Nutrition and Health Survey conducted from 9th February to 5th May, 2014, indicated that the country has a stunting prevalence of 32 percent among children under 5 years of age; while about 21 percent and 9 percent are underweight and wasted respectively.

“Almost 30 percent of Nigerian children are underweight, meaning they don’t weigh enough for their age. This is more than double the proportion of neighbouring Ghanaian children who are underweight.”

Report of a new survey, titled  “Malnutrition: Nigeria’s Silent Crisis,” presents the reasons why proper nutrition for women and children is so important, especially in the first 1,000 days from the start of a woman’s pregnancy until her child’s second birthday. 

The survey notes as a sad  commentary that the rates of stunting in Nigeria have stagnated for more than a decade. About 2 in 5 Nigerian children are stunted, with rates of stunting varying throughout nationwide.

Among factors that contribute to Nigeria’s ongoing struggle with malnutrition include lack of adequate information by parents and caregivers who are not well-informed about appropriate feeding practices and have little understanding about the essential types and varieties of foods that children require to grow up healthy.

The publication prepared by the Nutrition Division, Department of Family Health, Federal Ministry of Health, Abuja, with assistance from the Population Reference Bureau, PRB,  also features the consequences of malnutrition, how investments in nutrition can improve health and economic outcomes, and which interventions are known to be most effective.

In general, the survey found that malnutrition prevalence in the North West and East regions are higher than in the South of the country. 

From the findings, the percentage of children in Nigeria who are wasted, or too thin for their height, has steadily increased over the last decade, rising from 11 percent in 2003 to 18 percent in 2013. At least 1 million Nigerian children under the age of 5 are affected by Severe Acute Malnutrition, SAM, each year.

The children have severely low weight for their height and are at risk of dying unless given urgent attention. About 4 out of 5 Nigerian children do not meet the World Health Organisation’s recommendation for exclusive breastfeeding during the first 6 months of life, while  70 percent of children ages 6 to 23 months are not receiving the minimum acceptable diet.