Showing posts with label Guyana. Show all posts
Showing posts with label Guyana. Show all posts

Tuesday, 5 April 2011

TUBERCULOSIS: Guyana: $35M x-ray system to boost tuberculosis care

March 27, 2011  KNews


An estimated $100M is going to be expended by the Ministry of Health as part of its effort to improve the treatment and prevention of tuberculosis. As part of its plan, the Ministry will in a matter of weeks commission its first digital radiology system in the public health sector, a move which is valued at $35M, according to Minister of Health, Dr Leslie Ramsammy.
According to FXB Guyana Programme Director, Nicole Jordan, “That machine is going to create a one-stop shopping centre right at the Georgetown Chest Clinic…where patients can come and get their chest X-rays and they can be guaranteed their diagnosis will come earlier and health workers can guarantee that you will not lose them.”
The FXB Guyana Programme, which is slated to come to an end shortly, has been working for a number of years with the Ministry of Health and has helped the National Tuberculosis Programme (NTP) to develop a standard package of services which can be accessed within the public health sector.
The Ministry of Health as part of its efforts to further raise awareness about TB, on Thursday launched its ‘B TB free’ campaign as part of the local observance of World TB Day which is observed globally on March 24.
The campaign which represents a collaborative effort between the National AIDS Programme Secretariat and the National TB Control Programme, was designed to dispel myths about TB, as well as to disseminate factual information to the public about the disease, according to NAPS Prevention Coordinator, Jennifer Ganesh.
This move is seen as especially crucial as efforts are made to address the daunting “double-whammy” effect of HIV-TB co-infection, Ganesh added.
According to NTP Programme Manager, Dr Jeetendra Mohanlall, over the years the NTP had had the sustained support of one Non-Governmental Organisation, the Guyana Chest Society, but it is in need of more involvement from civil society to battle the dreaded disease.
The ‘B TB Free’ initiative, according to Dr Mohanlall comprises of a brochure, a poster, two radio messages and two television messages. And while it is intended to reach the general population, he noted that the male faction is especially being targeted. He disclosed that male TB patients are the ones that mostly default as it relates to the consistent use of their treatment.
In recognition of the fact that the fight against TB has remained a global challenge over the years, Minister Ramsammy said that Guyana has been making significant strides. At the moment there are 20 TB testing sites and there are plans to expand such facilities to Kamarang, Mahaicony and East Bank Demerara.
“While we are fortunate in Guyana to have access, we need to ensure that there are easier methods to test for TB that provide immediate results.”
The Ministry just over a few years ago was able to introduce the PCR-DNA test which could provide results in two hours and also detect multi-drug resistance strains, allowing health workers to treat and manage TB patients better.
According to Minister Ramsammy, the world has an opportunity, with the support of global partners, to make sure that (faster) tests become available to citizens in every part of the world, whether they live in poor or rich environments.
“I can make a commitment to Guyana that as soon as it is possible we will have that test in Guyana. We have already made contact …the World Health Organisation (WHO) is working with us, but the test is not yet commercially available for scaled-up activities.”
Efforts must also be directed to accelerate the availability of new, better and more potent TB vaccines, Minister Ramsammy said. He alluded to the fact that although the BCG vaccine is used in this regard it does not provide universal coverage and is less effective in adults.
“We need better vaccines and we need more research, therefore we need to commit ourselves to addressing barriers if the trajectory of elimination will become possible in Guyana and the world.
Detailing global statistics, the Minister said that there are nine million TB infections and 1.7 million deaths on an annual basis. He reported, too, that about two billion people carry the latent form of the disease, adding that one out of every three persons in the world has been exposed.
http://www.kaieteurnewsonline.com/2011/03/27/35m-x-ray-system-to-boost-tuberculosis-care/

Sunday, 19 December 2010

TUBERCULOSIS: BCG in France

On 11 July 2007, the French Minister of Health launched the National Tuberculosis Control Program and a new policy on Bacille Calmette-Guérin (BCG) vaccination. The latter includes the suspension of universal mandatory BCG vaccination of children with a shift to selective vaccination. BCG vaccination is now strongly recommended for children with a high risk of contracting tuberculosis (TB). These children are defined as those born in a country with a high incidence of TB, or with at least one parent born in such a country, or any child planning to stay at least one month in such a country, or with a history of TB in his/her close family. Children living in the Ile-de-France (Paris and suburb) or French Guyana regions, and children considered by a physician as living in an environment with a high risk of exposure to TB are also targeted by the new BCG recommendation. This decision is the result of a debate initiated in 2000 by the Institut de Veille Sanitaire, Saint Maurice (National Institute for Public Health Surveillance, InVS), the Advisory Board on Immunisation and the Ministry of Health. This led, in 2002, to the discontinuation of all BCG revaccinations and all routine tuberculin testing (other than those performed as part of an investigation of a contagious TB case or those performed before vaccination).


Several factors have contributed to the change in BCG policy. France is considered to have a low incidence of TB, with 8.9 cases per 100,000 population in 2005. As in other western European countries, TB in France has declined over the last century and tends to be concentrated in areas and in certain population groups such as the homeless, immigrants coming from countries with a high prevalence of TB and the elderly. In 2005, France’s TB incidence was below 10 per 100,000 in all regions, except in Ile de France and French Guyana (19.7 and 44.0 per 100,000 respectively). The notification rate was also higher in homeless persons (210/100,000), in persons born abroad (41.5/100,000), especially in those born in sub-Saharan Africa (160/100,000) and in persons aged 80 years and older (21.7/100,000) [1]. The incidence of sputum smear-positive cases of TB and the incidence of meningitis in children have decreased and in 2002-2004 were below the thresholds recommended by the International Union Against Tuberculosis and Lung Diseases (IUATLD) [2] for considering a possible discontinuation of BCG vaccination.
In 2005, the Advisory Board on Immunisation recommended the shift to a selective vaccination under the condition of reinforcing TB control in France. Following this recommendation, the debate was triggered by the withdrawal from the market in January 2006 of the BCG multi-puncture device, almost exclusively used for primary vaccination, and its replacement by the BCG SSI to be administered intradermally. The difficulty of using this technique in young infants for untrained medical staff as well as its less favourable safety profile compared to the multipuncture technique – in a context where the targeting of BCG to high-risk children was already under discussion have led to a decrease in BCG vaccination coverage of more than 50%, despite the vaccination still being mandatory.
The potential for discrimination linked to the criteria used to define the children for whom BCG vaccination would be recommended was addressed through consultations with the Comité Consultatif National d’Ethique (National Ethics Committee) and the Haute Autorité de Lutte contre les Discriminations et pour l’Egalité (Authority against Discrimination). In addition, the Ministry of Health called for a citizens' conference. This was held by the French Society of Public Health (SFSP) in late 2006.
Following these consultations and the finalisation of a national TB control program, the Advisory Board on Immunisation issued new recommendations in March 2007 on which the new BCG policy is based. The new TB control programme should lead to an improved control of the disease, therefore decreasing the risk of exposure for unvaccinated children. The programme aims to maintain the decrease of TB incidence and to reduce inequalities. It is based on six major objectives:
To ensure an early diagnosis and an adequate treatment for all TB cases
To improve TB screening
To optimise the BCG policy
To maintain anti-TB resistance at a low level
To improve the epidemiological surveillance and the knowledge on the determinants of TB
To improve the piloting of TB control
These objectives will be reached through measures such as improving TB awareness and information about access to health care and social rights for population at higher risk of TB, the development of guidelines and training of health care workers and the strengthening of control measures for contagious cases. TB surveillance has already been adapted to enable monitoring of the impact of both the implementation of the plan and the modification of the BCG policy. The recent changes include the collection of new information on the notification of TB cases in order to more effectively identify the target population for BCG (place of birth of the child and his/her parents for children younger than 15 years, and history of TB in the closed family) as well as the implementation of treatment outcome monitoring. Specific coverage surveys will have to be regularly carried out in order to monitor BCG coverage in the newly targeted population, before the routine vaccine coverage monitoring tools can be adapted to the BCG selective policy.
The challenge will be the rapid implementation or strengthening of TB control measures, other than BCG, included in the national TB control programme, and the capacity to maintain a high coverage in high risk children targeted by the new recommendations.

For further information
On the new tuberculosis control programme and the new BCG policy in France:
http://www.sante.gouv.fr/htm/dossiers/tuberculose/sommaire.htm
On the epidemiology of tuberculosis and the surveillance system in France:
http://www.invs.sante.fr/surveillance/tuberculose/default.htm
References:
Antoine D, Che D. Les cas de tuberculose déclarés en France en 2005. Bulletin Epidémiologique Hebdomadaire, No 11, 2007. Available from: http://www.invs.sante.fr/beh/2007/11/beh_11_2007.pdf
International Union Against Tuberculosis and Lung Disease. Criteria for discontinuation of vaccination programmes using Bacille Calmette-Guérin (BCG) in countries with a low prevalence of tuberculosis. Tubercle and Lung Disease [75], 179-180. 1994.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3268

Monday, 19 April 2010

Guyana: Increase in malaria; failure to use nets

Minister of Health, Dr. Leslie Ramsammy, who has been visiting sites in the hinterland to look at hot spots for malaria, has pointed to an increase in malaria cases so much so that “we are on the verge of reversing all the gains we have made over the last five years.”For the first time since 2005, the number of malaria cases for the January period has increased in Guyana by about 15 per cent. In spite of increased efforts by the health sector, malaria cases have increased every epidemiological week since last October.Dr Ramsammy, in a press release noted that the increased mining activities have led to mining operations in many hard-to-reach places for health workers.“This makes it incumbent for operators of these activities to work closely with the Ministry of Health and with Regional Health Authorities to ensure we do not lose the battle against malaria,” he stated.The Minister is disappointed that after the Ministry has distributed thousands of impregnated mosquito nets, most people in the mining camps do not use nets to sleep.The most troublesome issue is finding that the use of mono-therapy with medication not approved by the Ministry of Health is still evident. In addition, the team has found that many persons diagnosed with malaria and who have been given approved medicines, are not completing their treatment.The failure to use the complete course is causing malaria to return to that person. Thus, many of the cases being recorded as new ones are in fact the same cases because there was a failure to cure.“We urge persons to complete their course of treatment because it is the only way to cure the body of malaria. Incomplete treatment will lead to a return of malaria,” Dr Ramsammy stated.Minister of Health, Dr. Leslie Ramsammy, who has been visiting sites in the hinterland to look at hot spots for malaria, has pointed to an increase in malaria cases so much so that “we are on the verge of reversing all the gains we have made over the last five years.”For the first time since 2005, the number of malaria cases for the January period has increased in Guyana by about 15 per cent. In spite of increased efforts by the health sector, malaria cases have increased every epidemiological week since last October.Dr Ramsammy, in a press release noted that the increased mining activities have led to mining operations in many hard-to-reach places for health workers.“This makes it incumbent for operators of these activities to work closely with the Ministry of Health and with Regional Health Authorities to ensure we do not lose the battle against malaria,” he stated.The Minister is disappointed that after the Ministry has distributed thousands of impregnated mosquito nets, most people in the mining camps do not use nets to sleep.The most troublesome issue is finding that the use of mono-therapy with medication not approved by the Ministry of Health is still evident. In addition, the team has found that many persons diagnosed with malaria and who have been given approved medicines, are not completing their treatment.The failure to use the complete course is causing malaria to return to that person. Thus, many of the cases being recorded as new ones are in fact the same cases because there was a failure to cure.“We urge persons to complete their course of treatment because it is the only way to cure the body of malaria. Incomplete treatment will lead to a return of malaria,” Dr Ramsammy stated.
http://www.kaieteurnewsonline.com/2010/04/18/malaria-on-the-increase-%E2%80%93-dr-ramsammy/