WHO says ageing policies needed globally - How is the 2002 WHO active ageing framework applicable to Zambia? - African Population Studies Vol.28 No.3

A recent news release from the World Health Organization that came out on Nov.6 says that there is a need for effective strategies to combat chronic illnesses associated with aging, as there is an "ageing world population."

According to WHO, policies are needed globally, not just for developing countries. One of the recent issues from African Population Studies looks at a policy framework on aging published by WHO in April 2002. This is discussed in the article "Determinants of active ageing in Zambia" by Christopher Chabila Mapoma in vol.28 no.3. The study addresses the need to see if this type of policy framework works in developing countries, specifically Zambia. Its aim is to find out which determinants of the active ageing framework apply not only to Zambia, but the continent of Africa as a whole. The study also examines how HIV/AIDS affects active aging. Active aging is defined by WHO as "the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age." Mapoma mentions that little research has been done on the importance and contribution of the "active ageing" concept in Africa.

For this study, researchers surveyed participants ages 60 years and older in four seniors homes in the Matero, Kandiana, Maramba, Mitanda and Chibolya neighbourhoods of the Lusaka, Sesheke, Livinstone, Ndola and Mufulira districts. 41.2 per cent of the participants were men, and 58.8 percent were females. The survey asked questions pertaining to socioeconomics, HIV/AIDS, and behavioural and health/functional indicators of active aging. The responses to the questions of Behavioural and Personal determinants were measured using indicators such as feeling hopeless, useless, unhappy or lonely. Health and functional determinants were measured using indicators toward yes or no questions of being able to squat, ability to walk freely, and ability to clean their own house. Economic determinants were measured using indicators toward questions such as: have you worked in the past 12 months, having opportunities for work, and having a steady flow of income.

In this study, Mapoma found that there were more respondents from urban areas rather than rural areas. 15.8 percent were found to have received higher education, 32 percent were reported to have never attended school, and 52 percent had received primary education. HIV/AIDS was included as a determinant of active aging specifically for Zambia among other factors such as gender, residence, health and physical environment because of the effects of taking care of children who had lost their parents to HIV/AIDS. When comparing residents who live in urban areas to residents who live in rural areas, Mapoma found that residents in urban areas participated in community activities more, are more self-fulfilled and more independent. Monthly income was also linked on a respondent's ability to participate and their independence. HIV/AIDS was also found to affect participation.

The study concluded that HIV/AIDS has a long-term effect on active aging, "feeling hopeless/useless" was a personal/behavioural factor in active aging. The study also indicated that having friends and socializing contributed to the probability of aging actively. The study further concluded that the 2002 WHO Active Ageing Framework is applicable to Zambia but only to a certain extent, as it overlooks HIV/AIDS, which is a factor that greatly affects the country.

Cost of Illness Due to Typhoid Fever in Pemba, Zanzibar, East Africa - Journal of Health, Population and Nutrition Vol.32 No.3

Today we are featuring "Cost of Illness Due to Typhoid Fever in Pemba, Zanzibar, East Africa" by Riewpaiboon et al in Journal of Health, Population and Nutrition vol.32 no.3.

Typhoid fever is still an ongoing economic burden within Pemba, Zanzibar, East Africa and the purpose of this study was to estimate said cost associated with this illness. The method used was an incidence-based cost-of-illness analysis from a societal perspective, paying close attention to new episodes of confirmed cases of typhoid fever in patients from inpatient and outpatient hospitals between May 2010 and December 2010. 

The overall cost associated with this illness was both the sum of direct costs and the costs of productivity, or in more fluid economic terms, the opportunity cost of the time lost. The sum of these costs, when broken down more specifically, looks like this: 

direct costs covered treatment, travel, and meals, whereas productivity costs were the loss of income of patients and caregivers. The analysis itself consisted of 17 episodes of confirmed cases with the mean age of the patients was 23 years (range= 5-65, median= 22). Thirty-five percent were inpatients, with a mean timespan of 4.75 days of hospital stay (range=3-7, median= 4.50). 

The results of the study may be surprising: the mean cost for treatment of typhoid fever was care was US$ 21.97 at 2010 prices (US$ 1=1,430.50 Tanzanian Shilling─TSH), with the average societal cost being that of $154.47 per episode. However, the most dramatic expenditure is the overall cost of lost wages of $128.02 (83%). These results help contribute to the economic evaluation of vaccination of typhoid fever in Zanzibar, as well as other sub-Saharan African regions.

For this article and others from this issue, click here.

Malaria Prevalence and Treatment Seeking Behaviour of Young Nigerian Adults - Annals of African Medicine Vol.5 No.2

Today we are featuring "Malaria Prevalence and Treatment Seeking Behaviour of Young Nigerian Adults" by Anumudu et al. in the Annals of African Medicine, vol. 5, no. 2.
  
This study was designed and conducted to determine the preferred treatment and control methods used by young adults in urban areas, as well as the presence and levels of anti-malaria antibodies as an indication of exposure. 

Researchers used questionnaires regarding malaria management and the treatment practices given to 307 undergraduate science majors, as well as follow up questionnaires given to a small portion of the students. 

Microscopy was conducted to determine parasitaemia and antibodies Plasmodium falciparum MSP-1 were measured using enzyme-linked immunosorbent assay (ELISA). 

The results of this study may be surprising to some. In the population, malaria prevalence was 17% (19/109) and the burden of the parasite was generally low. Antimalaria antibodies, however, were present in 93.6% of the volunteers confirmed malaria exposure within the volunteers. 

Analysis of the data revealed that self-treatment of the virus at home was a common practice among the study group. Approximately 25% of the volunteers treated themselves when initial symptoms began to show. This included the use of herbal remedies as well as multiple medications to treat a single episode of malaria. Cloroquine and Maloxine were most often used in these treatments. The study showed that 97.5% of the volunteers had malaria at least once within the prior 3 months of the study.

In summary, the study indicated that most of the volunteers had been exposed to malaria, yet the virus did not transmit into illness, possibly due to the knowledge of malaria transmission and prophylactic use of antimalarial medication. Additionally, the study indicates that although treatment for malaria by a doctor is best, many episodes of the sickness are treated outside of the formal setting of a hospital or care facility.  

For this article and others from this issue, click here.

UCP2 Interactome As Targets For Novel Anti-Diabetic Drugs

Today we are featuring "UCP2 Interactome As Targets For Novel Anti-Diabetic Drugs" by Musanabaganwa et al. in the Rwanda Medical Journal vol.70 no.4.

The purpose of this study was to assess the role of mitochondrial dysfunction in the onset and progression of diabetes to identify the proteins that interact with UCP2 and evaluate their suitability for novel anti-diabetic drugs. 

The proteins were detected using the STRING 9.0 database. The proteins identified for the use of anti-diabetic drugs were leptin (LEP), peroxisome proliferator-activated receptor gamma (PPARG), ghrelin/obestatinprepropeptide (GHRL), as well as many others. 

In addition to the identification of proteins, the E values associated were also identified using STRING 9.0. The predicted interactions are supported by the use of such methods as text mining, occurrence, neighbourhood, database, fusion, experimental, and co-expression data. 

To this end, development of lead compounds against these targets will help to address the burden of diabetes and help to provide effective and safer anti-diabetes medications in the near future. 


For this article and others from this issue, click here.

Education, income and health insurance a factor in adherence to medication of patients with #Diabetes - Tropical Journal of Pharmaceutical Research Vol.13 No.6

Awareness of several health issues in Canada are dedicated to the month of November. One of these issues is diabetes. Bioline has a variety of articles on Diabetes mellitus from several different journals. One of the latest articles uploaded on Bioline is in the Tropical Journal of Pharmaceutical Research vol.13 no.6, and titled "Evaluation of Adherence to Diabetic Treatment in Northern Region of United Arab Emirates" by Koprulu et al.

In this article, researchers explored the reasons adhering or not adhering to certain medications for patients with diabetes in the northern region of the United Arab Emirates. The study occurred between May 2012 to April 2013, in which two hundred randomly selected patients with type 2 diabetes mellitus were evaluated. The patients came from five different diabetes clinics and three outpatient hospitals in the northern region of the United Arab Emirates.

The results indicated that 40% of patients were non-adherent to their medication. Researchers also found that there was a significant correlation between education level and adherence to medication, as results indicated that 75% of patients had no or primary-level education, and a higher prevalence of non-adherence to medication. Monthly income was also a factor in whether or not a patient would be adherent to medication, as researchers found that patients who earned less than ten thousand Emirati dirham had a high prevalence of non-adherence. Non-adherence was also prevalent in patients without health insurance.

For more articles published on Bioline on diabetes, click here.

Researchers study several cases in the 2012 Ebola hemorrhagic fever outbreak in Uganda - African Health Sciences Vol.12 No.4 #ebola #EHF

Ebola, also known as Ebola virus disease (EVD) or Ebola hemorrhagic fever (EHF) is a disease that has caused 4546 deaths in Guinea, Liberia, and Sierra Leone, as the World Health Organization (WHO) indicates in a report released on Oct.25.

Uganda previously had an outbreak of Ebola hemorrhagic fever, which ended on August 2012 and resulted in 17 deaths. African Health Sciences vol.12 no.4 was published in Dec.2012 and includes "Repeated outbreaks of Viral hemorrhagic fevers in Uganada" by Mbonye et al., which aims to present an epidemiological picture of outbreaks of the Marburg virus, which is related to Ebola and also causes hemorrhagic fevers.

Hemorrhagic fevers have occurred in different parts of Uganda since an outbreak of EHF in Gulu occurred in 2000.

For this study, researchers evaluated Marburg hemorrhagic fever outbreaks that occurred in 2012 in Ibanda and Kibaale. They collected information through several case studies of how often the symptoms were distributed and the probability of cases. By Nov.12 2012, there were 9 confirmed and 5 probable cases of Marburg virus, in which 7 cases resulted in death.

From these results, researchers found there were several important questions to discuss. Some questions include: 

• How has the virus genome changed, and does this change allow it to infect many unknown hosts? 
• How can more surveillance detect infections? 
• How does the Marburg virus change the way humans interact with animals? 

The study concluded that viral hemorrhagic fever outbreaks in Uganda required further investigation and study to determine the source of the outbreaks.