Meningitis vaccine
Doctors are hoping to cut the
number of meningitis cases
among children after a new
vaccine was introduced to
the UAE market.About 100 clinicians gathered to learn about the use of Prevenar in combating the pneumococcus bacterium.
This microbe is the most common cause of bacterial pneumonia, associated with meningitis and other infectious diseases. Doctors heard about the use in the United States of Prevenar, a new vaccine launched by Wyeth Pharmaceuticals, which sponsored the meeting.
Dr Ali Al Marzouqi, director of the Department of Preventive Medicine, said the meeting was a useful opportunity for doctors to learn about advances in the fight against pneumococcal disease.
“The previous type of vaccine is proven to be effective, but importantly cannot be administered to very young children. Prevenar is a newer vaccine and is indicated for use in children younger than two years of age,” he said.
About 60% of children carry pneumococcal bacteria in the nose and throat, and the microbes can easily be spread through coughing and sneezing. In most cases they do not cause harm, but a wide spectrum of illnesses can result in susceptible people, such as children younger than two and those with compromised immune systems.
Pneumococcal disease is suspected of causing one million deaths each year, particularly among children in developing countries.
Count the casualties
An international group of public health experts has accused the British and American governments of being ‘wholly irresponsible’ over their failure to count Iraqi casualties.
In a statement published online by the BMJ in March, 24 experts from the United Kingdom, United States, Canada, Spain, Italy and Australia call for an independent inquiry into Iraqi war-related casualties. “We believe that the joint US/UK failure to make any effort to monitor Iraqi casualties is, from a public health perspective, wholly irresponsible,” they write.
They argue that the British Government’s reliance on Iraqi Ministry of Health figures is “unacceptable”. These figures “are likely seriously to underestimate casualties”, since they do not take into account deaths during the first 12 months since the invasion, only include violent deaths reported through the health system, and they do not allow for reliable attribution between different causes of death and injury.
The inadequacy of the current US/UK policy was highlighted when the Lancet published research suggesting that Iraq had suffered around 100,000 excess deaths since the 2003 invasion, but the UK Government rejected this survey as unreliable. The experts call for a large, scientifically independent study to “remove uncertainties that remain”, but both the British and American governments contend that they have no legal responsibility to count civilian casualties.
Afghan cry for healthcare
Afghanistan health minister, Dr Sayed Mohammad Amin Fatimi, has told the United Nations’ Regional Integrated Information Network (IRIN), that the country is facing a disaster worse than the tsunami that hit Indian Ocean nations in 2004 killing more than 300,000 people. The minister estimates that around 700 children under the age of five die every day in Afghanistan due to preventable diseases and that one woman dies every 20 minutes due to complications in pregnancy and childbirth.
Lack of resources and trained medical personnel, along with low levels of awareness and cultural factors, were the main reasons for the alarming figures in a country still recovering from almost three decades of conflict and international isolation.
"Traditionally in rural areas people won't let women be checked by male doctors," he said, adding that of just 3,000 doctors in the entire country, only one in six was female. "We need nearly 10,000 midwives and at the same time up to 10,000 female health workers," the minister said.
According to UNICEF, Afghanistan has the fourth highest under five-mortality rate in the world. Diarrhoeal diseases are recognised as the main killer of children, caused by limited access to safe water, sanitation and poor hygiene practices. But despite the current problems, UNICEF believes considerable progress has been made. Reported cases of measles among children have fallen from more than 8,700 in 2001 to less than 500 in 2004.
The health ministry estimates that the country needs US $255 million to address health issues in 2005. "We are lacking $110 million and if that is not immediately covered, the country will face a more severe health crisis," the minister noted.
Anti-obesity programmes
International experts on obesity and associated illnesses participated in meetings across the region in March and April to define potential programmes to help reduce the current chronic levels of obesity across the Middle East and launch a new campaign to help sufferers.
According to a recent study by the World Health Organisation (WHO), nearly 50% of the people in the Gulf are affected by obesity, which it defines as a chronic disease. The issue has been called ‘this generation’s greatest health challenge’, and health groups and ministries across the region have called for concerted action to combat the issue. Physicians from across the region attended a series of congresses in the United Arab Emirates, Qatar, Saudi Arabia and other Gulf states.
One of the key objectives of the congress was to launch ‘iDecide’, a new campaign for obese people looking to lose weight and keep it off. ‘iDecide’ will offer focused professional advice on weight loss techniques and if necessary provide medical treatments to help sufferers as part of a coordinated antiobesity campaign. The seminars focused on how doctors can take an action-oriented role in encouraging the patients to lose weight and maintain it on a long-term basis.
Iraq leishmaniasis epidemic
Health officials in Iraq are
concerned following an
outbreak of the disfiguring
parasitic disease cutaneous
leishmaniasis in Baqubah,
some 120 km from the
capital Baghdad, with as
many as 250 new cases
reported in just two weeks.Dr Abdul Jalil Nafi, director of the Infectious Diseases Control Centre (IDCC), told IRIN in Baghdad, that the discovery of such a high number was extremely worrying and that they feared that there could be an epidemic if prevention and control programmes were not put in place immediately.
Leishmaniasis is a disabling disease transmitted by the bite of the female sandfly. Dogs, rodents and other animals act as a source of infection from which the flies spread to humans. The disease leads to disfigurement of the face and hands, and social stigma, particularly for women and children. Leishmaniasis is linked to poor social conditions, especially in areas lacking sanitation and waste disposal.
Baqubah has been suffering from poor sewage treatment and accumulation of rubbish around the city. Nafi said that many areas in Iraq were suffering from poor hygiene and that poor distribution of information on prevention was compounding the problem. He explained that the most common type of leishmaniasis was urban, which is transmitted by human contact. Prolonged systemic treatment may be necessary for the disease and, in endemic areas, sandflies should be controlled by spraying homes with insecticide. Rubbish heaps, which are breeding areas for sandflies, should be eliminated.
“All our efforts could come to nothing if the government doesn’t take urgent action to reduce sewage on the streets and repair the water purification system in the country because, without it, the doors will still be open for the appearance of new diseases,” Nafi maintained.
Enteryx launched in Gulf
Enteryx, an injectable endoscopic therapy for gastro esophageal reflux disease (GERD), is now available for patients suffering from the disease. Boston Scientific launched the new product in a workshop for endoscopists and physicians from the UAE and Saudi Arabia, hosted by Professor Mark DeLegge, a researcher at the University of South Carolina.
Enteryx is a breakthrough therapy for Gastro Esophageal Reflux Disease (GERD). The procedure involves the injection of a specific liquid copolymer into the sphincter muscle to form a permanent implant that will enhance the gastro esophageal reflux barrier. If left untreated, GERD can lead to more critical conditions. Enteryx is now available in the Gulf region to relieve patients suffering from GERD, who do not wish to undergo a surgical procedure nor are willing to keep taking medication on a daily basis. It is a less invasive alternative to surgery and thus will improve the overall quality of patient care.
Medical informatics
A new association for healthcare informatics was launched at the Second Middle East Conference on Healthcare Informatics – MECHCI 2005 – held in Dubai in April.
The Middle East Association of Healthcare Informatics (MEAHI) will function as an autonomous Middle East regional chapter of the International Medical Informatics Association.
Speaking on the proposed Middle East Association of Healthcare Informatics Prof Iain Ledingham, Professor Emeritus of Medical Education, Honorary Consultant, Middle East Affairs, Faculty of Health Informatics, Royal College of Surgeons of Edinburgh said: “There is a strong and clear need for education and extensive research in the nascent field of healthcare informatics in the Middle East.
The formation of the association will be instrumental in addressing this need in a collective and professional way, and will act as key to continuous quality improvement in the healthcare sector in the region. The association’s primary mission will be to strengthen and support biomedical and health informatics activities in the region.”
Weight loss key
Effective weight management is the first vital step to delay and prevent type two diabetes, according to health experts citing Xendos – a landmark study on over 3,300 people.
“Excess weight is well recognised as the most important modifiable risk factor for the development of type two diabetes,” says Dr A Madani, consultant endocrinologist and Head of Medical Department at Dubai Hospital, “A number of recent studies have shown that lifestyle changes such as diet and exercise have a dramatic effect on delaying or preventing the development of type 2 diabetes.
The Xendos study shows that by adding Xenical, patients can achieve even better results.” The Xendos study (Xenical in the prevention of Diabetes in Obese Subjects) has found that people losing weight through a combination of healthy eating, exercise and weight loss medication Xenical are 37% less likely to develop type two diabetes than in patients losing weight through lifestyle changes alone.
Significant, sustained, longterm improvements in cardiovascular risk factors such as blood pressure and lipid profiles were also recorded in the Xenical treated patients in the study, compared to lifestyle intervention alone. The trial also showed that treatment with Xenical was effective and safely tolerated over the four year period. Xenical is the only weight loss medication which offers the dual benefit of weight-loss while also reducing the risk of developing type two diabetes and whose safety has been studied for this length of time.
The landmark four-year study is seen to offer hope in the UAE, which has a type two diabetes prevalence rate of 20% compared to an average 6% worldwide.
GCC students for MUB
Royal College of Surgeons in Ireland-Medical University of Bahrain, the constituent university of the prestigious Royal College of Surgeons in Ireland (RCSI), organised ‘open day’ events in Qatar, UAE, Kuwait, Bahrain and Oman for teachers, parents and potential students.
Each open day aimed to create awareness on the current and future roles of the Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSIMUB) and emphasise the state-of-the-art teaching facilities available at the university.
The school curriculum has been developed by the world-renowned medical expertise of the RCSI and will be delivered to the standards of the World Federation of Medical Education (WFME). The RCSI-MUB is owned and run by the RCSI and initially offers a six or five year degree programme in Medicine with additional courses such as Pharmacy, Physiotherapy, Dentistry and other health related professions to be added as the project develops.
Osteoporosis walk
The Osteoporosis Walk was held in Dubai in March in order to awareness of the silent disease.
The event
attracted hundreds of individual
participants. The
walkathon is the highlight of
the intensified, aggressive
campaign ‘ACT NOW’.
The eight-kilometre walk,
which started and ended at
Dubai Ladies Club, was
organised by 3B National
Alliance for Osteoporosis,
with dairy producer Almarai
as main sponsor and in
association with UAE
Osteoporosis Support
Group at Dubai Ladies
Club, Masafi and smaller
private organisations.
“While the event was successful and quite organised, what means more to us is that many women voluntarily signed up to be members of the first ever UAE Osteoporosis Support. We are looking forward for more participation and members who can contribute in any ways. This showed high interest among the community to do something about the silent disease,” said Dr Mariam Mohd Matar, family physician at DOHMS and health centre manager for Dubai Ladies Club.
Yemen population census
Yemen has announced that the population of the country has reached 19.7 million contrary to all estimates, following completion of a new census. Yemen's prime minister, Abdulqader Bajamal, said the December 2004 Population, Housing and Establishments Census showed the population consisted of 9,705,506 females and 10,016,137 males.
He pointed out that the results meant that the population growth rate had fallen to 3.2% from 3.7%. The Yemeni official also praised the achievements of his government, saying that the results show unemployment is down from 33% to 18% in 2004. However, at the ceremony, Yemen's president, Ali Abdullah Saleh, stressed the urgency for the need to bring the population growth rate in Yemen under control.
"We very badly need family planning which has very much to do with development. We call on the media, clerics and intellectuals to continue raising awareness towards family planning." More than 23,000 enumerators took part in the counting process between December and February, in Yemen's first census for a decade. Experts say the everincreasing population in the country is worrying.
It is estimated that by 2016 there will be more than 29 million people in the country and more than 35 million by 2025, putting a huge strain on resources. Officials acknowledge that population growth remains a challenge for Yemen, one of the poorest countries of the world. The growing population is exhausting the country's meagre natural resources, especially water.
Wider diabetic diet
A new pill could allow diabetics and coeliacs to eat foods that are normally offlimits, reports Chemistry & Industry magazine. The pill, which works by decreasing the permeability of the intestines, is being developed by US company Alba Therapeutics.
It comes in the form of a controlrelease capsule that is taken 20 minutes before each meal. The active ingredient AT- 1001 is released in the intestine where it inhibits the action of the protein zonulin. Zonulin regulates intestinal permeability and is overproduced in people with auto-immune diseases like diabetes and coeliac disease.
Taking AT-1001 should restore the barrier function of the intestinal wall. Researcher Alessio Fasano of the University of Baltimore and Alba Therapeutics says this could put a lot of foods back on the menu for those normally on very restricted diets. Fasano's group has already shown that they can prevent diabetes in diabetes-prone rats using AT-1001 and that these rats can continue on a normal diet.
In the autumn, Fasano plans to test AT-1001 on coeliacs. Coeliacs cannot digest gluten. A study in diabetics is planned for early 2006.
Alzheimer’s expertise
In an attempt to bring the latest global research and policy developments of Alzheimer’s to the Arab world, Alzheimer’s Association in Lebanon held The Arab Conference on Alzheimer’s Disease 2005, March 2-4 in Beirut.
The conference was supported by the World Health Organisation (WHO), The Ministry of Public Health, The Lebanese Order of Physicians and the National Committee for Elderly. In the Arab world, Alzheimer’s associations are immensely underrepresented with only Lebanon and Egypt being established members of global organisations. Alzheimer's disease is the most common cause of dementia, with an estimated 30,000 cases in Lebanon and roughly 1.5 million cases in the Arab World.
There is currently no cure for Alzheimer's disease or for most other causes of dementia. Researchers are still at the stage of developing drugs that will merely slow down the progression of the disease. The conference seeks to develop a regional and national plan to raise the level of awareness on the disease and reach patients, caregivers, specialists, doctors, nurses, specialised international agencies and government and nongovernment organisations.
Dengue death toll rises
The death toll in the dengue fever outbreak in Yemen has risen to 12 and some 185 people have been infected so far, according to the public health ministry.
IRIN reported the head of the national centre for control in the public health ministry, Dr Jamal Emran saying that, “The treatment operation to fight and spray mosquitoes is continuing in the areas affected by this disease in Hudaidah province, [226 km southwest of the capital Sana’a].”.
At the start of March, at
least 124 people were
infected with the illness in
the province and there were
seven deaths. Field reports
indicate that the curve of the
epidemic is starting to fall,
compared to the early days
of the outbreak. Emran could not hazard a
guess as to when the
epidemic would stop
spreading, saying that in
addition to the huge efforts
of the treatment and control
operation, the fight against
the disease depended on the
public’s comprehensive cooperation.
As part of the operation, more than 50 medically equipped cars with over 250 technicians were dispatched to the affected areas in one of the largest medical campaigns in the country's history. It included wiping out mosquitoes, filling swamps where they breed and disinfecting areas where mosquitoes live to stop transmission of the disease.
Health authorities have asked people to cooperate by taking precautions and staying away from the mosquitoes breeding in places inside and outside their houses and to avoid drinking dirty water. Teams of people have been spraying homes in order to stop the spread of dengue fever.
Welcare World for DHCC
Welcare World Health Systems, the healthcare consultancy and management arm of Varkey Group, has signed up with Cansult Limited to design an ambitious 150-bed hospital project in Dubai Healthcare City (DHCC).
The Creek Hospital Dubai will be the group's second hospital within the DHCC and will be positioned as a key general healthcare provider in the market. Welcare World has previously entered into an agreement with DHCC for developing “The City Hospital”, a premium 210-bed hospital that will be positioned as a centre of excellence in Cardiology and Orthopaedics.
The hospital is currently under design by a leading US hospital designer firm; Ellerbe Becket; and is scheduled to commence operation by mid 2007. In line with DHCC’s vision, Welcare World has acquired the international affiliation of George Washington University Hospital (GWUH), thus ensuring the hospital's commitment to high quality standards of care throughout its planning and operational stages.
Due to great demand for extra space requirements at the Welcare Hospital, Cansult Limited has also been assigned to study the feasibility of adding an extra floor to the existing hospital building.
Pan-Arab Continence Society
Prominent physicians and medical school professors have set the groundwork for a constructive programme of continuing medical education, to include an annual conference that is expected to dramatically raise the Middle East medical community’s awareness about new treatments in the area of urinary incontinence, or overactive bladder.
This condition is believed to affect one in three men and half of all women in the Middle East, according to physicians with the newlyformed Pan-Arab Continence Society (PACS). The Second Pan-Arab Continence Society Congress is set to take place in Dubai in December 2005, with more than 180 physicians from across the region expected to be in attendance.
“Millions of Arabs suffer from some degree of overactive bladder, but they ‘suffer in silence’ and fail to seek medical treatment for their condition,” said Professor M. Sherif Mourad, M.D., President of PACS, and chief organiser of the group. “The goal of PACS, is to raise the level of awareness about suitable medical treatments, and this awareness must begin with doctors before it can be fully and effectively communicated to patients,” added Mourad. The 2008 International Continence Society Annual Congress has been scheduled to take place in Cairo.
Cedars Jebel Ali expansion
Cedars Jebel Ali International Hospital has begun a major expansion to address the growing concern of residents for a comprehensive medical facility serving Jebel Ali and the surrounding areas.
The new expansion will fulfil the needs of the increasing residential and commercial community in the ‘greater Dubai’ region. The foundation stone for the new extension was laid in March by His Highness Sheikh Hamdan Bin Rashid Al Maktoum, Deputy Ruler of Dubai and UAE Minister of Finance and Industry. The first phase of expansion, spread across more than 13,500 sq metres, will include 5 operating theatres, a fully equipped General Surgery abdominal and Laparoscopic Surgery, Gyn-obs Department, Paediatric and Neonatology Department, Paediatric ICU, Cardiology and Cardiac and Vascular Surgery Department, Urology Department with Lithotripsy, Orthopaedic Department, Plastic and Reconstructive Surgery, Maxillo Facial Surgery, NeuroScience & Neuro Surgery and Oncology with possibly a PET Centre.
Established in 1999 as a full fledged 24-hour medical centre under the name of Jebel Ali Medical Centre, the Cedars Jebel Ali International Hospital today caters to the needs of the Free Zone companies, as well as the port, hotels and local residential areas.
The hospital’s mission is to become a tertiary care medical service provider focussing on quality and excellence, ensuring that medical care is accessible to everyone and at all times. At present Cedars Jebel Ali International Hospital has a 16-bed facility in addition to the ICU, one major and one minor operation theatre.
Smallpox vaccine policy
This year marks the 25th anniversary of the eradication of naturally-occurring smallpox but no-one in the region is immune to a possible recurrence through artificial cultivation, the region’s governments were cautioned during the seventh Global Vaccinology International Forum (GVIF) taking place in Dubai in April.
During the symposium, experts urged the Middle East’s governments to act to safeguard against the use of artificially recurring smallpox. Among the key recommendations from the specialists was the inclusion of a national smallpox vaccine policy within the region’s health programmes. Today, at least seven countries in the world have sufficient stocks to vaccinate their entire populations; they do not include any Middle Eastern countries.
Biodefence consultant Dr Jill Dekker-Bellamy told delegates that the threat of artificial dissemination had placed the global community at an unacceptable risk. In challenging conventional policies which rely on disease containment, Dr Dekker-Bellamy called for pre-event vaccination in all countries. “The current policies used by the international community highlight the inadequacies of our current understanding of the use of smallpox,” she said.
Yemen polio epidemic
The World Health Organisation (WHO) reports that as of the end of April, 22 cases of polio have been reported in Yemen.
Yemen had been polio-free since disease surveillance began in 1996 – a genetic investigation is ongoing to determine the precise origin of the outbreak. Experts fear that the number of cases will rise in the immediate future.
Four cases of polio were confirmed on 20 April in just one governorate in the southwestern part of the country, on the Red Sea coast. The latest 18 cases occurred across five governorates throughout Yemen, including in two districts in the country's capital Sana’a and suggesting the virus had spread across the country. Ongoing field investigations have identified additional suspected polio cases across the affected governorates in Yemen.
Low immunisation rates among Yemen's children may facilitate the spread of the virus. Experts are now planning an outbreak response, using the recently-developed monovalent oral polio vaccine type 1 (mOPV1).
