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News Article | February 15, 2017
Site: www.eurekalert.org

Thailand has become the first Asian country to eliminate mother-to-child transmission (MTCT) of HIV, thanks to a pragmatic multi-sector response backed by strong political commitment and heavy government investment, a study published in Paediatrics and International Child Health reports. Such an early, concerted response allowed the country to successfully address the four prongs of the recommended World Health Organization (WHO) elimination strategy. As a result, MTCT rates were reduced from 20-40% in the mid-1990s to 1.9% in 2015 (surpassing the WHO elimination target of The WHO strategy focuses on the following four prongs: primary prevention of HIV in women of childbearing age; prevention of unintended pregnancies in women living with HIV; prevention of HIV transmission from an HIV-infected woman to her infant; and provision of appropriate treatment, care and support to women and children living with HIV. In Thailand, initiatives to promote condom use, provide information about the risk of transmission and introduce testing for pregnant and post-partum women were successfully implemented. For example, the 100% Condom Programme, which promotes 100% condom use by male patrons of commercial sex workers, has played a crucial role in preventing HIV infection in women of reproductive age. The success of such initiatives resulted in part from strong political leadership - the national AIDS policy of Thailand was transferred from the Ministry of Public Health to the Office of the Prime Minister in 1991 - and greatly increased investment, with government spending on the HIV/AIDS programme rising from US$684,000 in 1988 to US$82 million by 1997. The high rate of antenatal care provision in Thailand is also key. A voluntary HIV test with same-day results is offered at the first clinic visit, followed by re-testing later in pregnancy for HIV-negative women. For HIV-infected pregnant women, antiretroviral therapy (ART) is provided as soon as possible. Such treatment is now available at much lower cost, thanks to legislative changes which have allowed the non-commercial production of generic ART in Thailand. Counselling services at antenatal clinics also promote the use of dual methods of contraception to prevent unintended pregnancy in women with HIV. The study's author, Professor Usa Thisyakorn of Chulalongkorn University, Bangkok said: "Thailand has achieved WHO elimination of mother-to-child HIV transmission targets with early and concerted efforts of all sectors of Thai society. This provided numerous lessons learned in working together to safeguard children. Since children are the country's future, how the country responds to the problems created for them indicates how highly the country values its future." When referencing the article: Please include Journal title, author, published by Taylor & Francis and the following statement: Please note the article will not be available online until the embargo has been lifted. Taylor & Francis Group partners with researchers, scholarly societies, universities and libraries worldwide to bring knowledge to life. As one of the world's leading publishers of scholarly journals, books, ebooks and reference works our content spans all areas of Humanities, Social Sciences, Behavioural Sciences, Science, and Technology and Medicine. From our network of offices in Oxford, New York, Philadelphia, Boca Raton, Boston, Melbourne, Singapore, Beijing, Tokyo, Stockholm, New Delhi and Johannesburg, Taylor & Francis staff provide local expertise and support to our editors, societies and authors and tailored, efficient customer service to our library colleagues. For more information please contact: Sayjal Mistry, Press & Media Relations Coordinator email: newsroom@taylorandfrancis.com Follow us on Twitter: @tandfnewsroom Introducing Press Pass: journalist access to all Taylor & Francis Journal articles. Contact us for more details.


Grant
Agency: Cordis | Branch: FP7 | Program: CP-IP | Phase: HEALTH-2007-2.3.2-7 | Award Amount: 13.02M | Year: 2009

CHAIN is a large scale integrating project aimed to effectively and durably combat new and existing anti-HIV drug resistance in clinical settings, with a special emphasis on Eastern Europe and in heavily affected resource-poor regions in Africa. This will be achieved through our pan-European network of surveillance and basic research activities, the involvement of all main actors in the field of HIV and anti-HIV drug resistance, monitoring how resistances develop and evolve, improved understanding of mechanisms of resistance development, performing molecular epidemiology studies, providing improved and new strategies to evaluate and limit the emergence and transmission of HIV drug resistance, setting up training and dissemination activities and supporting evidence-based public health policy and action. CHAIN brings together Europes leading internationally recognised scientific expertise in basic science, molecular epidemiology, bioinformatics and surveillance of HIV and HIV resistance including the WHO, strong links to Eastern Europe through the existing FP6 funded cohort network Europe HIVresistance and strategic links to relevant pan-European cohort networks and national cohort networks (PENTA/ECS, CASCADE, EuroSIDA, COHERE, ICoNa, UK-CHIC, SHCS). Our balanced programme of work is informed by optimising the synergistic skills represented by the applicants, and also through harmonising with existing initiatives, that ensures lack of duplication, but rather maximises the impact of European activities. Thus, our African and Eastern European work will be linked to WHO policy, our European surveillance studies will be guided by ECDC (through our advisory board), and our clinical research will generate questions best addressed through the NEAT clinical trial network. Finally, our partnership with the key biotechnology companies in HIV resistance will ensure maximal impact of our basis research activities.


Grant
Agency: Cordis | Branch: FP7 | Program: CP-SICA | Phase: HEALTH-2007-3.5-2 | Award Amount: 3.76M | Year: 2009

Inadequate access to and use of research evidence to inform health policy limits the achievement of universal and equitable access to healthcare, hinders quality improvement and makes it difficult to use healthcare resources wisely. Poorly informed decision-making about health policies and systems is one of the reasons why services fail to reach those most in need, health indicators are off track, and it appears unlikely that many countries in Africa will meet the health MDGs. SURE will support improvements in health policies and systems in low and middle-income countries (LMIC) by improving access to and use of policy-relevant syntheses of research evidence that are contextualized and tailored to meet the needs of decision makers. SURE will develop, pilot and evaluate five strategies designed to strengthen access to and use of reliable and timely research syntheses in policymaking: user friendly formats for research syntheses, clearing houses for syntheses and policy relevant research, mechanisms for responding rapidly to policymakers needs for research evidence, methods for organizing and managing deliberative forums involving policymakers, researchers and others, and methods for involving civil society and the public in policy development. SURE will develop capacity for evidence-informed healthcare policy and undertake a comparative evaluation of initiatives between policymakers and researchers using these and other strategies. SURE will collaborate with the Evidence-Informed Health Policy Network (EVIPNet) and the Regional East African Community Health (REACH) Policy Initiativetwo international efforts to improve the use of research evidence in policy and health systems decisions via partnerships between policymakers, researchers and civil society. SURE will use a range of dissemination strategies. Global dissemination will be coordinated by and capitalise on WHO, with the aim of maximising the projects impact on health policy in Africa and othe


News Article | February 5, 2016
Site: news.yahoo.com

A female Aedes aegypti mosquito is seen on the forearm of a health technician in a laboratory conducting research on preventing the spread of the Zika virus and other mosquito-borne diseases, at the entomology department of the Ministry of Public Health in Guatemala City, February 4, 2016. REUTERS/Josue Decavele More RIO DE JANEIRO (Reuters) - Scientists identified the Zika virus in the saliva and urine of two infected patients, a top Brazilian biomedical research institution said on Friday, prompting its president to urge pregnant women not to kiss strangers just as local carnival celebrations begin. The discovery added to the rising concern over Zika, which is spreading rapidly in the Americans and has been linked to thousands of severe birth defects in Brazil. They said they used genetic testing to identify the virus in saliva and urine samples from two patients who had symptoms caused by Zika infection, and determined that the virus was active, meaning it had the potential to cause infection, scientists at the public Oswaldo Cruz Foundation said. They said more research was needed to determine whether Zika could be transmitted by either fluid. This marked the first time the mosquito-borne infection that has prompted a global health scare has been detected in saliva and urine, the scientists told reporters in Rio de Janeiro, host of the 2016 summer Olympic Games in August. The vast majority of Zika infections have been caused by mosquito bites, but word surfaced this week of infections caused by sexual transmission and blood transfusions. These developments come just as Rio kicks off its annual carnival celebrations, a raucous five-day bacchanalia known for street parties and lots of alcohol and kissing. Some revelers even keep track of the number of complete strangers they kiss. Because Zika has been linked to the birth defect microcephaly, a condition in which infants are born with abnormally small heads and can suffer developmental problems, the Oswaldo Cruz Foundation scientists recommended that pregnant women take special precautions and avoid crowds during carnival. "In light of the possibility of being in contact with someone who is infected, do not kiss, obviously," Dr. Paulo Gadelha, the foundation's president, told reporters. "We cannot say today that there is no possibility of transmission," Gadelha added. Fiocruz, as the foundation is informally known, said it made the discovery after carrying out a partial genome sequencing of the virus found in the samples from the two patients. "Imagine the social and economic impact of having a mega sporting event with millions of attendees with a brutal infection in the country ... especially at a time we are going through an economic crisis," said Dr. Leonardo Vedolin, a neuroradiologist in Porto Alegre. There is no treatment or vaccine for Zika. Most infections cause either no symptoms or symptoms including a mild fever, skin rash and conjunctivitis that normally last for two to seven days, according to the World Health Organization. Its association with microcephaly and Guillain-Barré syndrome, a condition in which the body's immune system attacks part of the nervous system, has increased alarm over Zika. Researchers are working to confirm that the virus causes those conditions. Brazil's government may decide to revise a law next week that restricts the country's ability to send medical samples abroad, and does not clearly define protocol when a public health emergency, like Zika, is involved. Two government sources said the decision would be made at a meeting next Wednesday between the health, science and technology ministries as well as President Dilma Rousseff's chief of staff. Brazil's health ministry said it had been collaborating with the U.S. Centers for Disease Control and Prevention to try to nail down whether Zika causes Guillain-Barré. Of medical samples collected in Salvador, in northeast Brazil, one third will remain in Brazil and the rest will go to the United States for research, the ministry said.


News Article | February 15, 2017
Site: news.yahoo.com

A Ministry of Public Health official holds blood test slides taken from children, who live in the Thai-Myanmar border, at a malaria clinic in the Sai Yoke district, Kanchanaburi Province October 26, 2012. REUTERS/Sukree Sukplang LONDON (Reuters) - Multidrug-resistant malaria superbugs have taken hold in parts of Thailand, Laos and Cambodia, threatening to undermine progress against the disease, scientists said. The superbugs - malaria parasites that can beat off the best current treatments, artemisinin and piperaquine - have spread throughout Cambodia, with even fitter multidrug resistant parasites spreading in southern Laos and northeastern Thailand. "We are losing a dangerous race to eliminate artemisinin resistant...malaria before widespread resistance to the partner antimalarials makes that impossible," said Nicholas White, a professor at Oxford University in Britain and Mahidol University in Thailand who co-led the research. "The consequences of resistance spreading further into India and Africa could be grave if drug resistance is not tackled from a global public health emergency perspective." More than half the world's people are at risk of malaria infection. Most victims are children under five living in the poorest parts of sub-Saharan Africa. Recent progress against the mosquito-borne disease has been dramatic and numbers falling ill have been significantly reduced, but it still kills more than 420,000 people each year, the World Health Organization says. Malaria specialists worldwide say emerging drug resistance in Asia is now one of the most serious threats to that progress. From the late 1950s to the 1970s, chloroquine-resistant malaria parasites spread across Asia and then into Africa, leading to a resurgence of malaria cases and millions of deaths. Chloroquine was replaced by sulphadoxine-pyrimethamine (SP), but resistance to SP subsequently emerged in western Cambodia and again spread to Africa. The fear now is that the same pattern of resistance spread and the resurgence will repeat itself. "We now see this very successful resistant parasite lineage emerging, outcompeting its peers, and spreading over a wide area," said Arjen Dondorp, of the Mahidol Oxford Tropical Medicine Research Unit in Thailand, who co-led the work. Efforts to control malaria in Asia must be stepped up urgently "before it becomes close to untreatable". In their study in the Lancet Infectious Diseases journal, the scientists said that after examining blood samples from malaria patients in Cambodia, Laos, Thailand and Myanmar, they found that a single mutant parasite lineage, known as PfKelch13 C580Y, has spread across three countries, replacing parasites containing other, less artemisinin-resistant mutations. They explained that while the C580Y mutation does not necessarily make the parasite more drug-resistant, it does have other qualities that make it more risky - notably it appears to be fitter, more transmissible and able to spreading more widely.


Patent
Sanofi S.A., U.S. Army, Global Solutions For Infectious Diseases and Ministry Of Public Health | Date: 2016-02-24

The disclosure relates to immunological compositions for vaccinating human beings against infection by the Human Immunodeficiency Virus (HIV).


Nimpagaritse M.,Ministry of Public Health | Bertone M.P.,Institute of Tropical Medicine
Health Policy and Planning | Year: 2011

In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent drugs stock-outs; the reduced quality of the services and the disruption of the referral system; the motivation of the health staff who saw the administrative workload increase (not necessarily because of increased utilization) and faced 'ethical dilemmas' caused by the imprecise targeting of the reform. Undoubtedly, the removal of user fees for certain groups was an equitable and necessary measure in an extremely poor country such as Burundi. However, the suddenness of the decision and the lack of preparation had critical and long-lasting consequences for the entire health system. This analysis, performed from the frontline perspective, clarifies the importance of a rigorous planning of any reform, as well as of involving peripheral actors and understanding the complex challenges that they face. © The Author 2011; all rights reserved.


Wangroongsarb P.,Ministry of Public Health
The Southeast Asian journal of tropical medicine and public health | Year: 2012

The rise of artemisinin resistant Plasmodium falciparum along the Thai-Cambodian border is an urgent public health threat. We conducted an employer-based survey of migrant workers in two provinces in Thailand along the Thai-Cambodian border to explore socio-economic conditions, bednet ownership, and parasite prevalence among migrant workers. Five thousand three hundred seventy-one migrant workers were enrolled in this study; 56.9% were male. Cambodians comprised 69.0%, migrants from Myanmar comprised 20.7% and Mon and Laotian comprised 10.3%. Short term (< 6 months) Cambodian migrants, primarily located in Chanthaburi Province, typically work in orchards or on cassava farms. The majority did not speak Thai and bednet ownership was low. The only cases of malaria, all P. vivax, were found in Chanthaburi. Migrants in Trat Province were primarily long-term residents (> 6 months) from Cambodia and Myanmar and were engaged in rubber tapping, fisheries and domestic work. Bednet ownership and oral Thai fluency were higher, though Thai literacy remained low. Migrants from Myanmar had higher mother tongue literacy than migrants from Cambodia. The low oral Thai fluency and literacy rates suggest a Behavior Change Communication (BCC) package for Cambodian migrants should be developed in the Cambodian language. The low parasite prevalence and absence of P. falciparum in this study are encouraging signs in the fight against artemisinin resistance in eastern Thailand.


The previous nationwide mapping of schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon was conducted 25 years ago. Based on its results, mass drug administration (MDA) of praziquantel was limited to the three northern regions and few health districts in the southern part of Cameroon. In 2010, we started the process of updating the disease distribution in order to improve the control strategies. Three of the ten regions of Cameroon were mapped in 2010 and the data were published. In 2011, surveys were conducted in four additional regions, i.e. Littoral, North-West, South and South-West. Parasitological surveys were conducted in March 2011 in selected schools in all 65 health districts of the four targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma haematobium was the most prevalent schistosome species, with an overall prevalence of 3.2%, followed by S. mansoni (3%) and S. guineensis (1.2%). The overall prevalence of schistosomiasis across the four regions was 7.4% (95% CI: 6.7-8.3%). The prevalence for Ascaris lumbricoides was 19.5% (95% CI: 18.3-20.7%), Trichuris trichiura 18.9% (95% CI: 17.7-20.1%) and hookworms 7.6% (95% CI: 6.8-8.4%), with an overall STH prevalence of 32.5% (95% CI: 31.1-34.0%) across the four regions. STH was more prevalent in the South region (52.8%; 95% CI: 48.0-57.3%), followed by the South-West (46.2%; 95% CI: 43.2-49.3%), the North-West (35.9%; 95% CI: 33.1-38.7%) and the Littoral (13.0%; 95% CI: 11.3-14.9%) regions. In comparison to previous data in 1985-87, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis.


Tchuem Tchuente L.A.,Ministry of Public Health
PLoS neglected tropical diseases | Year: 2012

Schistosomiasis and soil-transmitted helminthiasis (STH) are widely distributed in Cameroon. Although mass drug administration (MDA) of mebendazole is implemented nationwide, treatment with praziquantel was so far limited to the three northern regions and few health districts in the southern part of Cameroon, based on previous mapping conducted 25 years ago. To update the disease distribution map and determine where treatment with praziquantel should be extended, mapping surveys were conducted in three of the seven southern regions of Cameroon, i.e. Centre, East and West. Parasitological surveys were conducted in April-May 2010 in selected schools in all 63 health districts of the three targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma mansoni was the most prevalent schistosome species, with an overall prevalence of 5.53%, followed by S. haematobium (1.72%) and S. guineensis (0.14%). The overall prevalence of schistosomiasis across the three regions was 7.31% (95% CI: 6.86-7.77%). The prevalence for Ascaris lumbricoides was 11.48 (95% CI: 10.93-12.04%), Trichuris trichiura 18.22% (95% CI: 17.56-18.90%) and hookworms 1.55% (95% CI: 1.35-1.78%), with an overall STH prevalence of 24.10% (95% CI: 23.36-24.85%) across the three regions. STH was more prevalent in the East region (46.57%; 95% CI: 44.41-48.75%) in comparison to the Centre (25.12; 95% CI: 24.10-26.17%) and West (10.49%; 95% CI: 9.57-11.51%) regions. In comparison to previous data, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis.

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