Introduces Hib Vaccine Bangladesh

January 21st, 2009 healthwiki Child Health,HIV-Aids 0

Bangladesh has recently introduced a new combination vaccine that will protect its children against five killer diseases in one injection, including, for the first time, the deadly bacterium Haemophilus influenzae type b (Hib) that causes some severe forms of pneumonia and meningitis.

In a ceremony in Khulna District, southwest of the capital Dhaka, the Minister of Health and Family Welfare, Professor A. F. M. Ruhul Haque, along with other health officials and representatives of UN agencies and development partners administered the first shots of the combination vaccine to Bangladeshi children on January 15, 2009.

Hib is one of the causes of severe pneumonia and meningitis among children. The majority of them are children under five years of age. Even with treatment, thousands of children die of Hib disease every year. Survivors are often permanently disabled—paralysed, deafened or brain damaged.

The vaccine can prevent about one third of life-threatening cases of bacterial pneumonia, the leading infectious cause of death in children worldwide. In Bangladesh, it is estimated that 24% of under-five child deaths is due to pneumonia.

The vaccine will be provided under the routine immunisation programme (EPI) to nearly four million children born in Bangladesh every year. As Bangladesh records high routine immunisation coverage, it is estimated that Hib vaccine can save about 20,000 children’s lives annually year.

“This life-saving vaccine represents an important step forward in preventing childhood diseases in Bangladesh”, said A. M. M. Nasir Uddin, Secretary of the Ministry of Health and Family Welfare at the launch. “It will greatly help our country to achieve the Millennium Development Goal 4 which aims at reducing under-five mortality.”

In South-Asia, Sri Lanka and Pakistan introduced the Hib vaccine in 2008.

The new combination or 5-in-1 vaccine will protect children against Hib and four other deadly diseases: diphtheria, tetanus, pertussis, and hepatitis B. Instead of three different injections (for DPT, Hepatitis B and Hib), children will only need one injection at three different times during their first year of life: at the age of 6 weeks, 10 weeks and 14 weeks.

This will make it easier for health workers who will need less time and less logistics to immunise all children. It will also increase the uptake of vaccine as each child will get all five vaccines at once. At the same time, it will drastically reduce the system loss of the vaccines.

“We are proud to be part of this new initiative by helping with the procurement of the vaccines and supporting the training of about 60,000 health workers together with WHO,” said Unicef Deputy Representative in Bangladesh, Dr. Iyorlumun J Uhaa.

The introduction of the 5-in-1 vaccine in Bangladesh is carried out with financial and technical support from the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation) and its key partners including Unicef, WHO and the Hib Initiative.

GAVI will spend more than US$95 million for procuring more than 27 million doses for 2009—2010. The Government of Bangladesh will co-finance the purchase by investing US$5.6 million during the same period.

“Vaccines and improvement in health and immunisation systems are much needed in this part of the world,” said Dr. Julian Lob-Levyt, Executive Secretary of the GAVI Alliance. “We applaud Bangladesh for taking this important step to help prevent more childhood diseases.”

With high poverty, low literacy levels, and limited access to healthcare, many sick children in this densely populated country of 155 million never reach a hospital and often die at home. Vaccines that protect children against preventable high-mortality infections, such as Hib, were urgently needed. Now more children will be saved from early grave.

Dr Tareq Salahuddin…

Protected From Cervical Cancer

January 10th, 2009 healthwiki Women's Health 0

Cervical cancer is cancer of the cervix — the lower part of the uterus, which opens into the vagina. Cervical cancer is the second-most-common type of cancer that strikes women worldwide after breast cancer.

It is estimated that nearly 250,000 deaths are associated with cervical cancer globally every year. According to the World Health Organisation, there were 500,000 new cases of cervical cancer in 2005.

The tragedy of cervical cancer is that it often strikes when a woman is still young. It tends to happen in women between the age of 35 and 55 years. She may be trying to raise her family or may be she has not had children yet.

A population-based survey reported that the coverage of cervical cancer screening in Bangladesh is less than 1%. Older and poor women are at the highest risk of developing cervical cancer in Bangladesh.

Cause of cervical cancer
99% of cervical cancers are caused by Human Papillomavirus (HPV), which spreads through sexual contact. There are over 100 different types of HPV. The majorities of viruses are considered Low Risk and do not cause cervical cancer. However, HPV-16 and HPV-18 often referred to as High Risk HPV types are associated with more than 70% of cervical cancer cases.

The body’s immune system usually fights off the infection as a result most women never suffer from HPV infection. However, in some women the infection does not go away. When the virus remains active in the body for a long period of time, cervical cells begin to change and the risk of cervical cancer increases.

There are other factors can increase the risk that an HPV infection develops into cervical cancer:

* Sexual intercourse at an early age

* Multiple sexual partners

* Multiple full-term pregnancies

* Chlamydia, gonorrhoea, syphilis, or herpes simplex virus type 2 infection

* Cigarette smoking

* Use of oral contraceptives for a long period of time

* Weakened immune system or HIV infection • Mother or sister with a history of cervical cancer

* Low levels of folic acid (a type of Vitamin B)

Cervical cancer is usually a slow-growing cancer, typically takes 10-15 years before invasive cancer develops. Once cervical cells begin to change, it first becomes “pre-cancerous” a condition also known as “dysplasia” or Cervical Intraepithelial Neoplasia (CIN).

In the early stages cervical cancer often causes no symptoms. However, when symptoms do occur, they may include:

* Bleeding between regular menstrual periods

* Bleeding after sexual intercourse

* Bleeding after douching

* Bleeding after a pelvic exam

* Pelvic pain not related to your menstrual cycle

* Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor

* Increased urinary frequency

* Pain during urination

These symptoms can be caused by cervical cancer, or by a number of serious conditions, and should be evaluated promptly by a medical professional.

Cervical cancer is diagnosed through a series of examinations. A Pap test is most commonly used to screen and detect the possibility of a cervical cancer or dysplasia.

An HPV DNA test is used to determine the high-risk strains of HPV infection, which is most likely to lead to cervical cancer. If an abnormality is found during a Pap and HPV DNA tests, a Colposcopy is performed.

Finally, a Cone biopsy is performed by removing a cone-shaped piece of tissue from the cervix for microscopic examination. A pathologist examines the sample for confirmation of precancer or cancer cells.

Options for treating cervical cancer depend predominantly on the stage of disease — the size of the tumor, the depth of invasion, and whether the cancer has spread to other parts of the body.

Other factors that are considered are the patient’s age and if she wishes to have children. The primary forms of treatment are surgery or combined radiation therapy and chemotherapy.

* Surgery to remove the uterus

* Radiation therapy to kill the cancer cells

* Chemotherapy to stop the growth of cancer cells

The vaccine is now available for prevention of HPV infection. Studies show that women who receive cervical cancer vaccine between the ages of 15 and 25 have 100% protection against the HPV-16 and HPV-18.

The vaccine is given in three shots over six-months. Centers for Disease Control and Prevention (CDC) recommended this vaccine for girl’s ages 11 to 12, although it may be used in girls as young as age 9.

Ideally, females should get the vaccine before they are sexually active. The vaccine is also recommended for 13-26 year-old girls who have not yet received or completed the vaccine series. This allows a girls immune system to be activated before she encounters HPV. Vaccinating at this age also allows developing the highest antibody levels. The higher the antibody levels the greater the protection.

Abu Siddiqui…