пятница, 26 сентября 2008 г.

malaria cost

Malaria battle given $3bn boost


U2's Bono attended the summit

World leaders and philanthropistshave pledged nearly $3bn (£1.6bn) to fight malaria at a summit in New York.

The meeting, at the UN, is looking at ways of meeting the Millennium Development Goals - targets on reducing global poverty by the year 2015.

Donors hope the money will be enough to eradicate malaria by that time.

The money includes $1.1bn (£598m) from the World Bank and $1.6bn (£870m) from the Global Fund to Fight Aids, Tuberculosis and Malaria.

The British government and private organisations such as the Bill and Melinda Gates Foundation have promised the rest.

Malaria still kills more than a million people each year

Malaria still kills more than a million people each year, according to the World Health Organization.

The funding, will be used to support rapid implementation of the first ever Global Malaria Action Plan (Gmap).

Long-term effort

World Bank President Robert Zoellick said in a statement that the extra money would help "sharply reduce the numbers of malaria-related deaths and illness" in the next three years.

According to Gmap's projections, more than 4.2 million lives can be saved between 2008 and 2015, if its plan is put into action, and the foundation can be laid for a longer-term effort to eradicate the disease.

The BBC's Heather Alexander says leaders are focusing on eradicating malaria to counter criticisms that the millennium targets will not be met.

If we build on this momentum, we can save million of lives and chart a long-term course for eradication of this disease
Bill Gates

British Prime Minister Gordon Brown joined the presidents of Rwanda and Tanzania as well as the UN Secretary General Ban Ki-moon to reassure the world that their goal is achievable.

Alongside the offers of money came reassurance from African leaders that efforts are working.

President Paul Kagame, of Rwanda, said malaria deaths have fallen by more than 60% in his country.

The Bill and Melinda Gates Foundation is to provide $168.7m (£91m) to fund a Malaria Vaccine Initiative for research on a new generation of anti-malaria vaccines.

Microsoft founder Mr Gates said: "We need innovation, new drugs, and the most dramatic thing we need is vaccine.

"If we build on this momentum, we can save million of lives and chart a long-term course for eradication of this disease."

Britain's Department for International Development pledged £40m ($73.5m) to support the Affordable Medicines Facility for Malaria.

It also pledged to increase its malaria research funding to at least £5m ($9.1m) a year by 2010 and supply 20 million of the 125 million bed nets still needed in affected areas.

среда, 17 сентября 2008 г.


Калужский центр по борьбе с ВИЧ-инфекцией поставил мигрантов на учетКалужский центр по борьбе с ВИЧ-инфекцией поставил мигрантов на учет. Проект рассчитан на полгода и проводится в рамках нацпроекта «Здоровье» по заказу Федеральной Службы Роспотребнадзора. В рамках проекта в Калуге работает команда, в которую вошли врачи-эпидемиологи, медицинские сестры и психологи.

Специалисты размещают информацию по профилактике и диагностике ВИЧ/СПИДа на официальном сайте управления федеральной миграционной службы. Проводят анкетирование среди мигрантов, консультируют их, раздают дезинфицирующие средства и витамины.

В 2007 году среди иностранных граждан, проходивших обследование для получения разрешения на работу, было выявлено 35 ВИЧ-инфицированных. Еще 34 - за 8 месяцев нынешнего года. Сейчас ведется работа по переводу всей профилактической информации на другие языки, для мигрантов, не владеющих русским языком.

вторник, 16 сентября 2008 г.

Lithuanian KAP

Lithuanian general practitioners' knowledge of confidentiality laws in adolescent sexual and reproductive healthcare: A cross-sectional study

Jeffrey V. Lazarus

Division of Social Medicine and Global Health, Lund University, Sweden, Jeffrey.lazarus@med.lu.se

Lina Jaruseviciene

Department of Family Medicine, Kaunas Medical University, Lithuania

Jerker Liljestrand

Division of Social Medicine and Global Health, Lund University, Sweden

Background: In Lithuania, the legislation addressing confidentiality in adolescent healthcare is contradictory and vague. Previous studies have also revealed that medico-legal knowledge among physicians is poor, and attitudes play a correspondingly greater role than legal knowledge in ensuring the confidentiality of patients. Objective: To survey the knowledge of Lithuanian general practitioner (GPs) of legal issues surrounding confidentiality for minors in sexual and reproductive healthcare. Methods: A 41-item questionnaire was sent to a random sample of 607 GPs. Their legal knowledge was evaluated with respect to the provisions of the Lithuanian Law on the Rights of Patients and Compensation for Health Damage. The analysis included descriptive statistics and binary logistic regression to estimate odds ratios for the eight independent variables (age, gender, type, location, ownership, size, frequency of consultations, and existence of a written office policy). Results: The response rate was 73.5%. Of these respondents, 49.3% proved to be knowledgeable about legal standards protecting the confidentiality of adolescents in healthcare. Knowledgeability was found to be higher among GPs who had a written office policy that was based on the law. Respondents stated that the most important measure to improve confidentiality in adolescent healthcare would be the development of an explicit legal framework to address it. Conclusions: GPs' unfamiliarity with existing confidentiality regulations implies that there are ways to improve confidentiality in sexual and reproductive care beyond merely changing the law. This study suggests the need for a comprehensive strategy, including the development of professional guidelines and written office policies coupled with legal educational programmes directed at GPs.

Kurdish fertility

Opinions on early-age marriage and marriage customs among Kurdish-speaking women in southeast Turkey
Journal of Family Planning and Reproductive Health Care. 2008 Jul;34(3):147-152.
Ertem M | Kocturk T
For women, marriage before the age of 18 years has adverse consequences for physical, mental and emotional well-being and constitutes a barrier for continued education. According to a national survey, about 50% of all women in Eastern Turkey were aged under 18 years at first marriage. This study explored women's opinions and experiences of early marriage and culture-specific marriage customs in the province of Diyarbakir, a region of Turkey populated mostly by people of Kurdish ethnicity. A random sample of 966 women aged 15 years or older living in urban and rural areas of the province completed a questionnaire on age at marriage and social status. Qualitative data on women's opinions and experiences were also collected through focus group interviews with 90 women. The frequency of early marriage ranged from 19% in the youngest age group to 63% in women aged 60 years or older. Analysis of focus group interviews through a qualitative modified content method showed that girls were considered marriageable some years after the menarche and considerations regarding the protection of family honour were key factors leading parents to arrange the early marriage of their daughters, sometimes without their consent. Some culture-specific marriage customs included cradle betrothal, cousin marriage and berdel (exchange of brides between two families). There is a need for public health and family planning workers to create greater awareness of the adverse consequences of early marriage through parental arrangements.

exploratory study

HIV infection returning to Mexico with migrant workers: An exploratory study

Journal of the Association of Nurses in AIDS Care. 2008 Jul-Aug;19(4):267-282.
Sowell RL | Holtz CS | Velasquez G
Men migrating to the United States are at high risk of acquiring HIV and spreading it to their wives and children in Mexico. Yet there is limited understanding of this phenomenon from the perspective of these men and their wives. This exploratory study used face-to-face interviews to gain insight into factors influencing the increased risk of Mexican men migrating to the United States for contracting HIV as well as the consequences of their infections on returning to Mexico. Transcripts from audiotaped interviews provided the data for analysis. Thematic analysis revealed two overall categories and six interrelated themes. Categories were HIV Risk and Living with HIV. Study themes included social isolation, lack of knowledge/ denial, machismo, powerlessness, and making the best of it. Results provide new insight into the spread of HIV in rural Mexico.

commercial sex workers in Tallinn

Sexually Transmitted Infections. 2008 Jun;84(3):189-191.
Uuskula A | Fischer K | Raudne R | Kilgi H | Krylov R

Estonia is confronted by a dramatic expansion of the initially injection drug use-driven HIV epidemic. Little is known about HIV occurrence in population groups at high risk other than injection drug users. The objective was to obtain data on the prevalence of HIV and hepatitis C virus (HCV) among female sex workers (FSW) in Tallinn. The design was an unlinked, anonymous, cross-sectional survey of FSW recruited in Tallinn from October 2005 to May 2006. 227 FSW were recruited for the survey and biological sample collection (HIV, HCV antibodies detection) using a combination of time-location, community and respondent-driven sampling. Among 227 women the HIV and HCV prevalences were 7.6% (95% CI 4.6% to 12.5%) and 7.9% (95% CI 4.5% to 12.6%), respectively. HIV prevalence was higher among FSW working in the street (odds ratio (OR) 6.4; 95% CI 1.1 to 35.6) and at the brothels and apartments
supervised by the organised sex industry (OR 5.0; 95% CI 1.3 to 18.4). The duration of sex work was negatively associated with HIV prevalence (OR 0.78; 95% CI 0.63 to 0.97). Prevention needs of FSW in this area include increasing rates of HIV testing and putting in place effective programmes that can help extend HIV prevention behaviours across a range of sexual and drug use risk behaviours.

HIV in Estonia

A continuing HIV epidemic among new injectors is of critical public health concern. Interventions to prevent initiation into injecting drug use and scaling up HIV prevention programs for IDUs in Estonia are of utmost importance.

CC in Serbia

a significant number of Serbian gynaecologists neither use modern methods of contraception themselves nor have adequate knowledge to advise their patients. Thus, education and training of gynaecologists in all methods of available contraception is a priority in Serbia.

Estonia KAP

Factors associated with Estonian adolescents' sexuality-related knowledge: Findings from the 1994 and 1999 KISS studies
Authors: Kai Part a; Kaja Rahu bc; Mati Rahu bc; Helle Karro d
Affiliations: a Tartu Youth Clinic,
b Department of Epidemiology and Biostatistics, National Institute for Health Development,
c Estonian Centre for Excellence in Behavioural and Health Sciences, Tallinn/Tartu, Estonia
d *Department of Obstetrics and Gynaecology, University of Tartu,
DOI: 10.1080/13625180701800631
Publication Frequency: 4 issues per year
Published in: journal The European Journal of Contraception & Reproductive Health Care, Volume 13, Issue 2 2008 , pages 173 - 181
First Published: 2008
Subject: Fertility & Contraception;
Formats available: HTML (English) : PDF (English)
Article Requests: Order Reprints : Request Permissions

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Objective To identify changes in factors associated with Estonian adolescents' sexuality-related knowledge. The relationship between self-reported school sexuality education and good sexuality-related knowledge is addressed.

Methods The study is based on the results of two consecutive studies conducted in 1994 and 1999, based on anonymous self-completed questionnaires in schools, which involved 2256 respondents from random samples of primary school 9th grade pupils. Information on 16 sexual knowledge items, experience of sexual intercourse, discussions about sexuality with parents and school sexuality education was collected. A multivariate logistic regression analysis was used to account for the simultaneous effects of independent determinants on good sexuality-related knowledge.

Results The results showed improvement in the respondents' level of sexuality-related knowledge between the two study years. Whereas in 1994, good sexual knowledge was positively associated solely with experience of sexual intercourse, in 1999, good sexual knowledge was also positively associated with school sexuality education.

Conclusion The improvement of sexuality-related knowledge and its positive association with school sexuality education in 1999 may be a result of the mandatory sexuality education introduced into the school curriculum in 1996. These findings have important implications for the further provision of school sexuality education in Estonia.


Piot lecture

UNAIDS Executive Director delivers lecture on AIDS response

As part of the London School of Economics and Political Science’s (LSE) speakers series on AIDS (LSEAIDS), UNAIDS Executive Director Dr Peter Piot delivered a public lecture titled “The future of AIDS: Exceptionalism Revisited” on May 15. In his lecture, he reviewed the global response to AIDS to date and considered what is needed in the longer term. He also examined the epidemic within the context of pressing wider health and development issues. LSEAIDS brings together leading social scientists and experts at the LSE to explore some of the long-term effects of AIDS that risk being overlooked. The group defines the AIDS epidemic as a 'long-wave' event whose full social and economic effects will be with us for decades. This was Dr Piot’s second LSEAIDS lecture; he first addressed this forum in February 2005.

The event was chaired by Professor Tony Barnett, LSEAIDS and hosted by the LSE, LSE Health and the UK Government’s Department for International Development (DfID).

You may also Listen to UNAIDS Executive Director's lecture(15 May 2008) on line.

понедельник, 15 сентября 2008 г.

red hero

Изъята крупнейшая за всю историю Красноярского края партия героина

В Красноярске изъята крупнейшая за всю историю края партия героина. Как сообщили ИА REGNUM-KNews в пресс-службе УФСБ России по Красноярскому краю, с поличным при проведении сделки задержаны и арестованы 5 активных членов группы, в том числе организаторы наркотрафика, граждане Таджикистана и России из Душанбе и Москвы, прибывшие накануне в Красноярск.
В ходе операции УФСБ из незаконного оборота изъята крупнейшая в истории края партия героина афганского происхождения общим весом около 107 кг, что по некоторым оценкам сопоставимо с годовым объёмом потребления этого типа наркотиков в Красноярском крае. Стоимость изъятой в ходе операции партии героина оценивается в 250 млн. рублей.
Как выяснилось, группа длительное время осуществляла преступную деятельность на территории России, имела разветвленные межрегиональные связи. Группа была высоко организована, мобильна, применялись строгие меры конспирации.
Следственным отделом УФСБ России по Красноярскому краю 11 сентября возбуждено уголовное дело по статье 228 ч.1 УК РФ. Все задержанные помещены под стражу, проводятся дальнейшие следственные действия.

Любопытно, что дельцов словила ФСБ, а не наркокомитет
Численность населения Кюкрая на 1 янв 2007 -- 2 894 тыс чел, без Таймыра (38 тыс) и Эвенкии (17)
  • 250 млн / 107 кг = 2.336 млн за кило, соответственно 2.336 руб за 1 грамм
  • 107 кг / 2 894 тыс = .4 г на нос
  • 250 млн / 2 894 тыс = 86.39 руб на 1 чел в год
после этого разумно предполагать что-то о преваленсе и концетнраци
и потребления

суббота, 13 сентября 2008 г.

master program

Место для комментариев, пожаланий и тому подобного

вторник, 2 сентября 2008 г.

Is AIDS still an emergency?

The rate of new HIV infections, which has fuelled the global HIV/AIDS epidemic since the 1980s, has peaked throughout the world and is now declining.

But population growth and the life-prolonging effects of antiretroviral (ARV) treatment mean that the total global number of HIV-infected people is likely to remain about the same for another two decades and will continue to increase in sub-Saharan Africa.

Based on these findings from the study, Has the HIV epidemic peaked?, published in the June issue of Population and Development Review, its lead author, John Bongaarts, believes it is time for the international community and governments to rethink their prioritisation of AIDS over other infectious diseases.

"AIDS has gotten special treatment because of its emergency status; that view is no longer valid because the epidemic has peaked," he told IRIN/PlusNews on the phone from the New York headquarters of the Population Council, an international non-governmental research organisation of which he is vice-president.

The study, which Bongaarts carried out with three demographers from the United Nations Population Division, examined the course HIV epidemics have taken in different regions and used mathematical models that combined population projections with data collected by UNAIDS to project the future demographic impact of HIV/AIDS.

The authors explain that peaks in HIV prevalence, which reflect the total number of people living with the virus, lag about a decade behind peaks in HIV incidence - the rate of new infections. This is because someone infected with HIV can live with the virus for about a decade after infection, and for much longer if they start ARV treatment.

Research showed that the global peak in HIV incidence occurred as long ago as 1995, with the first peak occurring in North America in the early 1980s, and the last in Eastern Europe in 2001. According to Bongaarts, this finding is not new, but it has been against the interests of agencies like UNAIDS to highlight it.

"I think UNAIDS was afraid that donors would decide not to spend so much money on AIDS and, secondly, that governments would say, 'this is no longer something to worry about'," he said. "My own feeling is that the amount that's devoted to AIDS treatment is out of proportion to other health problems."

His comments come on the heels of recent admissions by former senior UNAIDS and World Health Organisation officials that they exaggerated the size of the HIV epidemic and its potential for further growth to create public alarm and maintain the flow of donor money to the global industry that AIDS had spawned.

The backlash against global HIV expenditure started in February with an article in the British Medical Journal by Roger England of Health Systems Workshop, a health-policy charity, who pointed out that AIDS receives about a quarter of global health aid but constitutes only five percent of the disease burden in low- and middle-income countries.

Speaking to IRIN/PlusNews, Bongaarts agreed with England's argument that more lives could be saved by investing in strengthening health systems and combating other diseases with inexpensive interventions like immunisations, mosquito nets and family planning.

"AIDS should now be treated like any other disease, and the world community should look at its investments in health and prepare the most cost-effective interventions," he said. "I'm not advocating less money for AIDS treatment, but I want more spent on AIDS prevention and other diseases. We can save lives for a few dollars."

What is new about the Population Council study are the predictions it makes about the future demographic implications of the HIV epidemic. According to the authors, the presence of AIDS will not prevent populations from increasing. Even in sub-Saharan Africa, where the death toll from AIDS will continue to be high, the population is expected to grow by one billion between 2005 and 2050.

However, AIDS will slow population growth in the worst-hit countries: in South Africa, for example, the population size by 2050 is projected to be 29 percent lower than it would have been without the presence of AIDS. - PLUSNEWS

aids hiv mortality

Kathleen Beegle, Sofya Krutikova
Adult mortality and children's transition into marriage (по ссылке PDFник)
Adult mortality due to HIV/AIDS and other diseases is posited to affect children through a number of pathways. On top of health and education outcomes, adult mortality can have significant effects on children by influencing demographic outcomes including the timing of marriage. This paper examines marriage outcomes for a sample of children interviewed in Tanzania in the early 1990s and re-interviewed in 2004. We find that while girls who became paternal orphans married at significantly younger ages, orphanhood had little effect on boys. On the other hand, non-parental deaths in the household affect the timing of marriage for boys.

понедельник, 1 сентября 2008 г.


Former Soviet states at AIDS tipping point

Mexico City - experts are concerned that some of the states that emerged from the former Soviet Union are on the brink of widespread HIV/AIDS epidemics, the global AIDS conference heard on Wednesday.

Concentrated cases of infection among intravenous drug users, sex workers and gays are now placing some countries "on the verge of a generalized epidemic," Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, TB and Malaria, told a special session here.

"I'm very concerned about the epidemic in the region, very concerned," Kazatchkine said, saying experts fear entrenched HIV epidemics among high-risk groups could leap into the general population.

Last year 110,000 people became infected by the human immunodeficiency virus (HIV) in Eastern and Central Europe, bringing the tally to around 1.5 million, according to figures issued last week by the UN agency UNAIDS. Around 58,000 people died of AIDS.

Almost 90 percent of those infected live in either Russia (69 percent, or 1+ mln) or Ukraine (29 percent), and the majority are intravenous drug users, sex workers and their various partners.

At the session devoted to the AIDS pandemic in 12 countries, speakers said there had been some progress towards rolling out antiretroviral drugs to those in need but money and political support were lacking.

Efforts to prevent the spread of HIV were stuttering at best.

Stigma and homophobia, which provide fertile conditions for letting the virus propagate in silence, were deep-rooted, the experts said.

Needle-exchange programs, a proven [???] method of discouraging the spread of the virus through tainted hypodermics by drug users, were only now getting off the ground.

More than half of the countries had policies, legislation or regulations that were an obstacle to care, treatment and prevention.

According to UNAIDS, only one person in every four badly infected individuals has access to the lifeline treatment in Eastern Europe and Central Asia.

"The fight against HIV is a new problem. It's very challenging and it involves a lot of issues," said Farida Tishkova, of the Tajik Scientific and Research Institute for Prevention Medicine.

"Some of the work we do can be incompatible with the laws and practices of our countries."

A Ukrainian field worker, Anna Koshikova, said that heterosexual incidence of HIV in the general population in her country had increased in the last year or so, emerging out of vulnerable niche groups.

Koshikova, with the All-Ukrainian Network of People Living with HIV/AIDS, said people with HIV found more tolerance in the big Ukrainian cities, but in the countryside could be driven out by stigma.

"When a village finds out that a person has HIV, life becomes very difficult, almost impossible. Their children can't go to school, there could be physical violence, they may not receive medical help because they are afraid of revealing their [HIV] status.

"Many decide to move."

At present, 8,000 people in Ukraine receive treatment, but there has been a problem with imported antiretrovirals that are below standard and lack sufficient active ingredients to repress the virus, she said.

"There's a very high level of corruption in government and non-transparency in [drug] procurement. It's a huge problem," she said. [Any free funding corrupts]

According to UNAIDS statistics, the average prevalence of the AIDS virus across the region, a category that also includes Bulgaria, Romania and the former Yugoslav states of Croatia and Bosnia-Hercegovina, was 0.8 percent among people aged 15-49 in 2007, a doubling since 2001.

Prevalence varied from 0.1-0.2 percent in most of the Caucasus and Central Asia, to between 1.0-1.5 percent in Russia and 1.5 to 2.0 percent in Ukraine.

Infection numbers are rising in Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan and especially Uzbekistan, which "now has the largest epidemic in central Asia," according to the updated UNAIDS assessment of the pandemic.

Source: AFP, 7 August 2008

My additions in red