CDC HIV/Hepatitis/STD/TB Prevention News Update 09/07/2010 (AEGiS)
CDC HIV/Hepatitis/STD/TB Prevention News Update 09/07/2010 (AEGiS) -
CDC HIV/Hepatitis/STD/TB Prevention News Update
For Tuesday, September 07, 2010
The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2010, Information Inc., Bethesda, MD.
NATIONAL NEWS
INTERNATIONAL NEWS
- GLOBAL: HPV Takes Lead on Oral Cancers: Experts
- UGANDA: Unfriendly Nurses and Culture Hinder Male Involvement in HIV Prevention
MEDICAL NEWS
LOCAL AND COMMUNITY NEWS
- WASHINGTON: Health Officials Detain Patient with TB
- MAINE: Acadia Cuts Free Methadone to Uninsured Clients
NEWS BRIEFS
NATIONAL NEWS
UNITED STATES; EUROPE: This Won't Hurt a Bit; Researchers Are Developing Painless Alternatives to Needles
Diane Suchetka
Plain Dealer (Cleveland, OH) (08.24.10) - Tuesday, September 07, 2010
US researchers are working on developing new technologies that allow patients to receive injectable medicines without needle sticks - reducing the chance of spreading blood-borne diseases like HIV or hepatitis C and eliminating the need for doctors and nurses to administer the treatments.
A team from Emory University's School of Medicine and Georgia Institute of Technology has developed a Band-Aid- size patch covered with tiny microneedles. The number of needles range from a dozen to more than 100, depending on what type of medicine is being administered and how much. The microneedles, short enough to avoid nerves, are made up of the medicine itself, mixed with a Food and Drug Administration (FDA)-approved polymer and poured into a mold. What looks like miniscule upside-down ice cream cones are attached to the adhesive patch. The patient presses the patch into his or her arm, and the needles dissolve, leaving just a bandage to be discarded. Animal testing thus far has shown no adverse effects.
Mark Prausnitz, a professor of chemical and biomedical engineering at Georgia Tech, said the goal is to conduct human clinical trials within the next few years and obtain FDA approval within about five years.
Researchers at the University of California-Santa Barbara are working on a needleless injection that uses a single stream of liquid medicine about as thin as a hair strand. "A high-velocity jet pierces the skin and deposits the drug either into the skin or underneath it," said Samir Mitragotri, a chemical engineering professor at UCSB. Such jet injector technology has been in use for decades, usually to administer insulin, but the UCSB team is developing ways to "keep the penetration shallow and avoid the pain," Mitragotri said.
In Europe, scientists are testing the Painless Laser Epidermal System developed by Liechtenstein-based Pantec Biosolutions. This technology uses a handheld laser to painlessly create hundreds of tiny micropores over which a medicine-filled patch is applied; it reportedly remains a few years from market.
INTERNATIONAL NEWS
GLOBAL: HPV Takes Lead on Oral Cancers: Experts
Pamela Fayerman
Ottawa Citizen (09.03.10) - Tuesday, September 07, 2010
Infection with human papillomavirus has become a dominant risk factor for oral cancers in some countries as smoking rates decline, researchers say. Oral sex is believed to be the transmission mode, with one Canadian expert identifying the advent of oral contraceptives, and the concurrent rise of sexual freedom, as the tipping point for the increase in HPV-related oral cancers.
"HPV has been around for ages, but the use of oral contraceptives starting in the 1960s and '70s led to an increase in incidence of [STDs]," said Dr. John Hay, a radiation oncologist at the British Columbia Cancer Agency.
In the 1970s, 23 percent of oral cancers were HPV-linked, according to a Swedish study. By 2006, that had climbed to 93 percent. A US study showed the rate doubling in 10 years, with 80 percent of oral cancer biopsies HPV-positive.
The five-year survival rate for HPV-related oral cancer is about 75 percent, compared with about half that for smoking-related oral cancer.
Under the current rate of HPV vaccine uptake, it could take a decade before rates of both cervical and oral cancers have been reduced, Hay said. At this point, the vaccine is approved for boys but not recommended for them, so "only half" the population is protected against strains of HPV that cause both cervical and oral cancer, he said.
"It would make sense to vaccinate both girls and boys," Hay said.
UGANDA: Unfriendly Nurses and Culture Hinder Male Involvement in HIV Prevention
Wambi Michael
Inter Press Service (08.26.10) - Tuesday, September 07, 2010
Uganda has been a pioneer in the prevention of mother-to-child transmission of HIV, with programs dating back to 2000. Though PMTCT is now available at the county level across most of the country, gaps remain. Statistics from the Health Ministry show that while almost all women attending antenatal clinics agree to HIV testing and counseling, just two-thirds return for their results. Of those who test HIV-positive, only 17 percent deliver their babies at the hospitals.
Uganda currently has more than 110,000 HIV-positive children and continues to log around 25,000 new infections annually. Most infected children acquire HIV at birth, said Dr. Zainab Akol, head of HIV/AIDS programs at the Health Ministry.
Health experts say Ugandan men play a key role in reproductive health decisions. Yet male participation in PMTCT in Uganda hovers at just 5 percent, according to Robina Kaitrimba of the non-governmental National Coordinator of Uganda National Health Users/Consumers Organization. Failure to reach the sexual partners of HIV-positive women remains the biggest barrier to PMTCT, she said.
Research by Dr. Robert Byamugisha shows men feel antenatal clinics are not male-user friendly and midwives are impolite. In some instances, Byamugisha said, midwives "did not allow men to enter with their pregnant wives to the clinic."
Titus Namanda, who lives in Bunghokho village in Mbale district, vowed never to return to the antenatal clinic. "They made me wait for three hours and I witnessed them abusing my wife and other women," he said. "I decided not to go back."
Other men give financial reasons for not attending. Mutwalibu Wambete, a father of two, pays $5 a day to rent a motorcycle that he operates as a taxi. "So if I spend time at the clinic then we shall go hungry and the children will not go to school," he said.
MEDICAL NEWS
UNITED STATES: US Physicians' Intentions Regarding Impact of Human Papillomavirus Vaccine on Cervical Cancer Screening
Charlene Wong; Zahava Berkowitz; Mona Saraiya; Louise Wideroff; Vicki B. Benard
Sexual Health Vol. 7; No. 3: P. 338-345 (08..10) - Tuesday, September 07, 2010
"US cervical cancer screening recommendations have not changed since the human papillomavirus (HPV) vaccine introduction in 2006, but epidemiological and cost-effectiveness studies indicate that recommendations will need to change for fully vaccinated women," wrote the authors, whose goal in the current study was to evaluate physician intentions regarding HPV vaccine's impact on future screening.
In 2006-07, investigators surveyed a nationally representative sample of 1,212 primary care physicians (response rate 67.5 percent). The study, which included 1,114 physicians who provided Pap screenings, inquired about Pap test screening practices and intentions regarding HPV vaccine's impact on screening. Multivariate analyses were performed; distribution differences were assessed using ?² statistics.
In total, 40.7 percent (95 percent confidence interval [CI]: 37.6-43.8 percent) of physicians agreed that screening initiation will be affected by HPV vaccine, and 38.2 percent (35.0-41.5 percent) agreed that frequency will be affected by vaccination. "Significant differences in responses were found by specialty; internists were more likely to agree that vaccination would impact screening than other specialties," study results showed. "Belief in the effectiveness of new screening technologies was associated with intention to change screening initiation (odds ratio [OR]=1.66 (1.20-2.31)) and frequency (OR=1.99 (1.40-2.83)). Adherence to current Pap test screening interval guidelines was associated with intention to change screening frequency (OR=1.39 (1.01-1.91))."
Though many providers expect to adjust screening for vaccinated women, a significant group anticipates nothing will change or are unsure, the investigators concluded. "The present study provides important baseline data on intentions in the period preceding widespread vaccine diffusion and may help explain current and future trends in practice patterns."
LOCAL AND COMMUNITY NEWS
WASHINGTON: Health Officials Detain Patient with TB
Carol M. Ostrom
Seattle Times (09.03.10) - Tuesday, September 07, 2010
Last Wednesday, Public Health Seattle & King County (PHSKC) took the unusual step of securing a court order to detain and treat a person with an active case of TB.
"We have to do this in a very rare situation," said Dr. Masa Narita, the department's TB control director. "We try our best so we can cure all TB patients in King County while we are protecting the public's health."
The situation began on July 21, when the patient - whose name, age, and gender are being kept private - was diagnosed with suspected TB at Swedish Medical Center. Further testing confirmed the diagnosis.
Because the patient has alcohol and drug problems, PHSKC paid for a motel room where department personnel could observe him/her taking the prescribed medications. The room was stocked with groceries so the patient did not need to shop. "You don't want to see this person in the grocery store," Narita said.
However, the patient began leaving the motel and missing treatment appointments, and he/she broke an agreement to enter drug treatment, citing illnesses that resulted from bingeing on alcohol and drugs, including heroin.
It was further feared that the patient had missed so many treatments that his/her TB strain was in danger of becoming drug-resistant.
"Of course, the detention is the last thing I want to do," Narita said. "But after many discussions, I really thought this would be the most appropriate option."
When the 72-hour hold expires on Tuesday, PHSKC could ask for the patient to be held for an additional 45 days. This is only the second time since 1986 that PHSKC has sought a court order to detain a patient who resisted treatment.
MAINE: Acadia Cuts Free Methadone to Uninsured Clients
Meg Haskell
Bangor Daily News (09.03.10) - Tuesday, September 07, 2010
Bangor's Acadia Hospital will no longer provide free methadone treatment to patients as a part of its hospital services, officials say. The change began to take effect in early August to ensure the methadone program's financial viability, said Brent Scobie, the hospital's vice president and chief of clinical services.
All acute-care hospitals in Maine are non-profit and must provide a level of free care to poor patients without insurance. However, Acadia moved its methadone program from hospital services to the Acadia Healthcare Corp., a community-based nonprofit that is not required to offer free treatment.
Many methadone clients do not qualify for MaineCare, the state's Medicaid program, which pays for the majority of services offered at Acadia, a 100-bed psychiatric facility. Of the methadone program's 550 clients, about 100 were receiving free care, said Scobie. Acadia delivered $4.5 million in unpaid services last year, "a significant majority" of which was provided by the methadone clinic, Scobie said.
MaineCare will pay slightly less for methadone treatment offered by Healthcare Corp., $72 per patient a week, but the loss is more than offset by dispensing with the requirement to provide free care, Scobie said. The Acadia program was the only hospital- based methadone clinic in the state, said Guy Cousins, director of Maine's Office of Substance Abuse. Eight private non-profit treatment clinics offer 4,400 residents methadone treatment, and none offers free treatment, he said.
Of the clinic's 100 patients receiving free treatment in early August, about 70 have opted to pay the $72 per- week fee to continue therapy, Scobie said. The others have been working with clinicians for several weeks to taper their daily methadone dosing to an end. Acadia is encouraging them to participate in the hospital's abstinence- and 12-step-based recovery program, which includes professional counseling.
"For many of these people, when they are provided with the right level of therapeutic support, to say there are no other options [than methadone maintenance], really minimizes the potential for recovery," Scobie said.
NEWS BRIEFS
SOUTH AFRICA: South Africa Nears Deal with Unions
Celia W. Dugger
New York Times (09.07.10) - Tuesday, September 07, 2010
After almost three weeks on the picket lines, South Africa's trade unions on Monday suspended a strike that had closed schools and wreaked havoc on health care. Public health experts had warned about the strike's effects on the treatment, particularly for AIDS and TB, of millions of people too poor to access care through private hospitals. The government's proposed wage increase, 7.5 percent, is less than the 8.6 percent the unions demanded but still is double the rate of inflation. Some observers criticized the unions for seeking raises for workers who already have good jobs at the expense of the one-third of South Africans who remain unemployed. In order to pay for increased salaries and benefits for the 1.3 million affected workers, new hiring may have to be frozen, the government said.
CANADA: Sick Food Handler Sparks Hepatitis Alert
Richard Warnica
Edmonton Journal (09.04.10) - Tuesday, September 07, 2010
Alberta Health Services officials are responding to two potential exposures to hepatitis A. Over the weekend, clinics were being set up to vaccinate persons who ate food from a McDonald's - 217 3rd Ave. South, Lethbridge - on Aug. 20, 21 or 22. A worker there reportedly contracted the virus while traveling abroad. Also, disease investigators are trying to contact as many as 250 people who may have been exposed to the virus by a food handler at a private function in Edmonton. AHS spokesperson Kerry Williamson said the event, which he would not identify, was held during the week of Aug. 23. Williamson stressed that the staff and management of the event facility "did everything right" and that there is no reason for the general public to be concerned. AHS staff should be able to contact all the guests, he said.
Copyright © 2010 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.
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