Tuesday, 30 December 2014

NAFDAC intercepts fake Tramadol Capsules


The National Agency for Food and Drug Administration and Control (NAFDAC) has began investigations to unveil those behind the importation of 158 cartons of fake Tramadol Capsules, a semi-synthetic opiod analgesic for the management of pain. Announcing the interception of the truck load of the counterfeit medications in Lagos, weekend, NAFDAC’s Director, Ports Inspection Directorate, Mrs. Maureen Ebigbeyi said, the NAFDAC enforcement has commenced investigations to apprehend the persons behind the importation. 

Ebigbeyi said the cartons containing the Tramadol Capsules 120mg, have no label. Neither do they have addresses to show name of the producing company and the country of manufacture. However, with intelligence works and investigations, she said NAFDAC enforcement will definitely get the importers of these products. The drugs, which are in high demand and often abused when taken at overdose level to keep alert, were brought in as transit products to the Republic of Benin, but ended up being intercepted when NAFDAC detectives observed that although, the destination country of the drug is the Republic of Benin, a French speaking country, the drugs are labelled in English Language. 

Photo: From L-r: Mrs Christiana Obiazikwor,  Head of Public Relations
National Agency for Food and Drug Administration and Control (NAFDAC)
Lagos,  Mrs Maureen Ebigbeyi, Director, Port Inspectorate Directorate,
NAFDAC, Mr. Hassan Abubakar Tanko, Regulatory officer, NAFDAC
Port during the press briefing on the seizure of unregistered TRAMADOL 
According to international law, if a product is going to be used in a particular country, they will be labelled in the language of that country. However, NAFDAC’s Director of Ports Inspection Directorate explained that because these drugs were labelled in English, “it is very certain that as they (the importers) know we are looking out for them, they will just move them to the Republic of Benin and bring them back to Nigeria. That is the reason we have intercepted these drugs.” She explained that when a consignment is on transit to another country, it is not usually allowed to be inspected, but because we know the style of drug counterfeiters, when we see such things, NARCO Shed handlers allow us to come in and take possession of them. “We have been working with NARCO Shed handlers, hence, when we see such things, they allow us to come in and take possession of them,” she explained. Besides, the director noted that normally, Tramadol should be either 50mg or 100mg, depending on the level of pain involved, the intercepted Tramadol is 120mg. What this means for the person that takes the drug is that the fellow will almost be taking an overdose, Ebigbeyi lamented, adding, “With overdose, you have more side effects and even it could lead to adverse effects.” 

Tramadol is presently, under Narcotics Control following high abuse and concerns by government and public health officials, meaning that it cannot be brought into the country without permit. Hence, Ebigbeyi said NAFDAC is putting all efforts to ensure that this drug of abuse is not easily accessed in the society. However, she noted that some unscrupulous people have gone ahead to bring a huge quantity of Tramadol to sell to unsuspecting people who will take this fake drug and be affected one way or the other. This interception is a landmark effort on the part of the NAFDAC officers who have been very vigilant at the NARCO Cargo Shed to ensure that fake and adulterated food and other unregistered NAFDAC Products do not come into this country, she said, adding, “We really want to warn the public that they should look out for this particular Tramadol Capsules with a high milligramme content.”

This story was published in Newswatch Times on October 3,  2013.

Govt urged to privatise clinical services in public health institutions – PSN

By: Chioma Umeha

The Pharmaceutical Society of Nigeria (PSN) has condemned the use of 88 per cent of health budget on recurrent expenditure, of which 82.5 per cent is dedicated to human resources overheads. Giving the breakdown, the PSN National President, Olumide Akintayo, said that about 61 per cent is gulped by salaries of sometime an over bloated clinical staff in federal health institutions of the total cost reserved for healthcare and staff emoluments. 

Akintayo a press briefing on the World Pharmacists Day, organised by the association at its corporate office, Pharmacy House, Anthony, Lagos, lamented that over 50 per cent of total health budget is dedicated to paying only one cadre of personnel in healthcare, in recent times. The PSN boss therefore called on immediate intervention of every level of government to cut down the 88 per cent recurrent expenditure on personnel emolument of some clinical staff and divert same to other capital projects as well as research and development initiatives. He regretted that Nigeria’s health budget has not exceeded six per cent, since the country joined other African countries to sign the ‘Abuja declaration’ in 2001 which stipulated that participating governments should dedicate 15 per cent of their budgets to healthcare. His words: “In 2001, the various Heads of Government of different African states met in Abuja and resolved under what is now popularly dubbed the Abuja declaration that National Governments should dedicate 15 per cent of their budgets to Healthcare. He continued: “Despite being a signatory to this declaration, the highest that has ever been dedicated to health since 2001 by the federal government is a meager six per cent of National budget in 2012.” 

He said the budget situation is inimical to the health system, insisting that this leads to worsening state of health infrastructure in the country. He said: “We at the Pharmaceutical Society of Nigeria continue to critically evaluate healthcare expenditure as a percentage of Gross Domestic Product and the analysis paints a very dangerous picture. He added: “The Pharmaceutical Society of Nigeria has observed that over 88 per cent of health budgets are dedicated to only recurrent expenditure. Out of this huge cost a whopping 82.5 per cent is dedicated to only personnel expenditure. “Of the total cost reserved for healthcare, staff emoluments about 61 per cent is gulped by salaries of sometime an over bloated clinical staff in Federal Health Institutions. In apocalyptic terms, what has played out in recent years is that over 50 per cent of total health budget is dedicated to paying only one cadre of personnel in healthcare, Akintayo. “The unfortunate scenario depicted above is one of the reasons why healthcare infrastructure remains in a limbo and endeavours which facilitate Research and Development are completely comatose in an ever dynamic health sector in the global arena,” he concluded. 

According to him, there is need to harness    the    potential    of    the    private sector    in redressing the country’s healthcare needs by promoting privatization of the services of public health institution in the country. “The Pharmaceutical Society of Nigeria is compelled to call on the federal government and indeed government at all levels to see an urgent need to drastically reduce the unproductive recurrent expenditure invested in personnel emolument of some clinical staff which can be diverted to fruitful capital projects as well as Research and Development initiatives,” Akintayo said. The PSN boss particularly advocated for the privatisation of some level of clinical services especially at the out-patient department levels – primary, secondary and tertiary healthcare in the country. He noted this approach will involve the use of proven private sector players from private hospitals to take over the running of some services in public sector hospitals. “In some areas where service might be in higher demand clinical service providers might be hired on locum basis as we have seen been successfully implemented by some state governments in Nigeria,” he said. 

The advantages inherent in this model are numerous, Akintayo said, adding that it is a check to incessant strike embarked by health institutions that suppose to provide services to the masses. The National President also noted that the value of the private sector in the area of service delivery which has remained under-utilized will be fully utilized in the health sector. He further reasoned that in the absence of an active public clinical service provider at some of the delivery points in the hospitals, government can dedicate more funds to revamp infrastructure and equipment of secondary and tertiary levels in particular. He said that the Nigeria institute of Pharmaceutical Research and Development as well as Nigeria Institute of Medical Research will also be beneficiaries of the process as substantial votes to these institutions will ultimately re-position healthcare in the country. Speaking on the theme of the year’s event which is: “Pharmacists – Simplifying your medicines use, no matter how complex,” Akintayo said it parallels the theme of the 73rd FIP world congress: “Towards a future vision for complex patients: integrated care in a dynamic continuum.” He observed: “Change is sweeping pharmacy and healthcare on a global scale. 

A new era of healthcare development brings with it much hope. As more solutions become available to patients – whether they are medicines, therapies or services provided by healthcare providers, pharmacists and pharmaceutical scientists can help with their ever more complex care, the National President said. He said: “Our pharmacists need to move away from the traditional role of just dispensing medicines to helping patients use their medicines more efficiently with the ultimate goal of optimizing the impact of medicines, minimising the number of medication related problems and reducing waste. “Our pharmacists need to be empowered to provide this much needed service to people in the community. Government bodies and other healthcare professionals need to understand the impact that pharmacists can have in promoting and increasing adherence to medicines and give their full support and collaboration to improve the health and wellbeing of the population,” Akintayo said. 

He also said that pharmacists will devise strategies to help complex patients and tailor pharmacy education to optimize patient care as part of future initiatives in meeting global and international standards. 

This story was published in Newswatch Times on September 28,  2013.

Simple things that reduce stroke risk - Continued


Stay Healthy 

Hold your breath 
You can do this when you are around a smoker. University of Auckland researchers found that people exposed to second-hand smoke are 82 per cent more likely to suffer a stroke than those who never inhale. It seems that carbon monoxide promotes clot formation by interfering with nitric oxide, a biochemical that relaxes blood vessels. To get rid of every single bit of carbon monoxide after a night at the bar, you will have to breathe fresh air for about eight hours. But most of the carbon monoxide will be gone from your body in the first hour, according to Laurence Fechter, a professor of toxicology at the University of Oklahoma. So on your way home, make sure you roll down the car windows and start sucking in some clean air. 

Beat Homocysteine 
Research suggests that people with high blood levels of this amino acid are more likely to stroke out than those with low readings. Extra folate will help reduce the risk, but only for some people. “50 to 60 per cent will not respond with lower homocysteine,” said Dr. Seth J. Baum, medical director of the Mind/Body Medical Institute, a Harvard affiliate. Dr. Baum recommends 1,000 micrograms (mcg) of folate, plus 25 milligrams (mg) of vitamin B6, 1,000 mcg of B12, and 1,800 mg of the amino acid N-acetyl-cysteine (NAC). “With folate, B6, B12, and NAC supplements, almost everyone will have normal homocysteine levels,” said Dr. Baum. 

Pick up an iron supplement 
Aerobic exercise is anti-stroke medicine. If you cannot run or cycle to save your life; then, lift. Dr. Jerry Judd Pryde, a physiatrist at Cedars-Sinai Hospital in Los Angeles said: “Regular resistance training decreases blood pressure, elevates HDL cholesterol, lowers LDL cholesterol, and decreases the stickiness of the blood.” If you do not already weight-train, try the American Heart Association programme: Lift weights two or three times a week, targeting the major muscle groups. For each of the following, choose a weight you can lift eight to 12 times at most, and do one set to fatigue: bench press, shoulder press, lying triceps extension, biceps curl, seated row, lat pull down, crunch, squat, Romanian dead lift and calf raise.

This story was published in Newswatch Times on September 28,  2013.

MDGs 5: Nigeria faces bottlenecks in curbing 75% maternal deaths

By: Chioma Umeha

Mixed reactions greeted the news of the death of Margaret Akingbehin, a 45-year-old pregnant woman early February. She died at the Lagos University Teaching Hospital, (LUTH) Idi-Araba in Lagos due to alleged dereliction of duty by health care personnel. According to reports, Margret died after an agonising contraction and still-birth while waiting for surgery. For the Akingbehin’s family, their joy was untold over the pregnancy of Margret which came after 12 years she had her last child. Margaret in agreement with her husband, David registered for ante-natal at LUTH, where they were sure she would receive adequate care. 

She had a record of regular attendance of ante-natal appointments from medical officials at LUTH. The elated couple was said to have committed N2m to refurbish their home in expectancy of the bundle of joy. Margret was due between February and March, but she was scheduled for a Caesarean Section (CS) based on age.  Consequently, she quickly reported to the hospital when she noticed certain changes in her body. In fact, reports said that Margret quickly picked her purse, hospital card and drove her Sport Utility Vehicle to LUTH and later informed her husband who was not at home at the time. However, Margret was said to have died after a still birth of her baby following alleged negligence by nurses. According to reports, she was kept waiting at the pre-surgical room of the theatre from 7.00am to 4.00 pm, where she died in pains following contractions, immediately after the still birth. Margret is just one out of 1500 deaths per 100,000 live births across the country. 

In Nigeria, pregnancy and childbearing is a dangerous business, especially for poorer women. Africa’s most populous nation with about 160 million or more has one of the highest maternal mortality rates. According to the WHO/United Nations Children Fund (UNICEF), in 1995, Nigeria had the third highest number of maternal deaths in the world (approximately 45000 deaths). By the year 2000, for every 100,000 live births, about 800 women died in the process of child birth. Out of the 27 million Nigerian women of reproductive age back then about two million did not survive either pregnancy or childbirth. In 2008, according to UN report, the figure stood at between 1000 and 1500 deaths per 100,000 live births. The State of the World Children Report 2009 stated that one out of nine global maternal deaths occurred in Nigeria. At the moment, the country ranks second on maternal mortality rate in the world with about 144 girls and women dying daily from complication of pregnancy and child birth. 

One in every 18 women die giving birth compared to one in 4800 in the US. According to the survey conducted in February 2010, the record stands at between 165 per 100,000 live births in the South West and 1549 per 100,000 live births in the North East. World Health Organization (WHO) 2006 defines maternal death as the death of women while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to, or aggravated by the pregnancy or its management but not from accidental or incidental causes. Maternal mortality is a multi–dimensional problem which does not only affect the family involved but has a great effect on the society as a whole. The death of a woman during pregnancy, labour or pueperium is a tragedy that carries a huge burden of grief and pain, and has been described as a major public health problem in developing countries. When a mother dies, the children’s chances of reaching adult life is slim. This is majorly due to lack of everyday care and security. 

The young children may have to take care of themselves and this may in turn affect their school attendance. Lack of proper education may in turn weaken the child’s chances of reaching better life standards. Monitoring maternal mortality is difficult due to poor reporting and lack of proper methods to measure actual death rates. Estimating the real figure is difficult as only 31 per cent women deliver in health facilities. The gap of maternal deaths between rich and poor countries is wide with 99 per cent of these deaths occurring in the developing world. Out of the 49 countries which record highest maternal deaths, 34 of these countries are in Sub – Saharan Africa, where one woman in 16 dies from pregnancy or childbirth compared to one in 2800 in the developing world.  Some bleed to death at home because, amongst other reasons, they could not afford the transport to the facility. UNICEF observes that maternal mortality have many triggers, both direct and indirect. 

Poorly funded and culturally inappropriate health and nutrition services, food insecurity, inaccurate feeding practices and lack of hygiene are direct causes of mortality in both children and mothers. The indirect causes may be less obvious externally, but play just as large a role in mortality statistics. Female illiteracy adversely affects maternal and child survival rates and is also linked to early pregnancy. In many countries, especially where child marriage is prevalent, the lack of primary education and lack of access to healthcare contribute significantly to child and maternal mortality statistics. UNICEF also notes that discrimination and exclusion of access to health and nutrition services due to poverty, geographic and political marginalization are factors in mortality rates as well. The major reported causes of maternal deaths in developing world are: severe maternal bleeding; infections; obstructed or prolonged labour; unsafe abortion; hypertensive disorders of pregnancy especially eclampsia. 

Others are hemorrhage, sepsis, toxemia and complications from abortion account for 62 per cent of maternal deaths in Nigeria. According to research, the North West has the highest maternal mortality rate, seconded by North-East. Death from post partum hemorrhage (PPH) ranges between 23 per cent and 44 per cent of total maternal deaths especially in the Northern States. The ratio of women dying from PPH is 1 in 6 in the North East and North West as against one in 18 between South West and South East geopolitical zones. A break-down of the statistics is: eclampsia – 27 per cent, PPH – 25 per cent, infection – 15 per cent, unsafe abortion – 13 per cent and other causes – 20 per cent. Other health issues which affect women chances of healthy livelihood in the pre-natal and post partum period are high blood pressure, cancer, heart conditions and other non-communicable diseases. HIV/AIDS is an additional new concern for maternal/child health survival. Another statistics showed the break-down as follows: bleeding – 17 per cent, hypertension – 19 per cent, anaemia – 12 per cent, unsafe abortion – 11 per cent, infections – 10 per cent; obstructed labour – seven per cent and other causes – 24 per cent. Studies has also underlying factor of most maternal deaths is ignorance and apathy by women and the society in general. Commenting, a Head of Department (HOD) at LUTH who preferred to remain anonymous said that the attitude of doctors and nurses contribute to the increase of maternal deaths and morbidity in the country.  According to HOD, recent developments give credence to her claims. 

Making reference to Margret’s death, she insisted that the doctors and nurses were careless.  The HOD further lamented the poor state of primary health care in the country and reckless attitude of health care personnel who are only concerned about enriching their pockets rather than care for patients. According to her, many of the doctors are more interested in running their private hospitals than provide the services which they were employed to do. She noted that over 90 per cent of the doctors in public institutions own private hospitals which occupy them and makes it difficult for them to effectively carry out their duties. Condemning the trend, she said, “Though their private hospitals lack basic facilities, like oxygen, yet these doctors keep redirecting patients from a public institution like LUTH to their clinic.”  She further reasoned that this is one of the factors that led to Margret’s death. According to her, doctors were not on ground to attend to Margret. While grieving over Margret’s death, she said that the deceased represent hundreds of women who die across the country due to pregnancy-related issues. Dr.  Ejike Oji, former Ipas Boss in Nigeria, also described maternal health as a public health crisis. 

He said; maternal health is “The Paradox of our times,’ adding –  ‘a sine qua non to development.” The Ipas Chief observed that most women ignore early warning signs due to lack of adequate knowledge and information about danger signals during pregnancy and labour and so delay to seek care. Also, adequate preparation for any emergency before, during and after delivery is also lacking. He listed other factors which contribute to high incidence of maternal death to include: educational attainment, socio-economic status and antenatal attendance, poor socio-economic development, weak health care system and socio – cultural barriers to care utilization. According to him, one of the socio-cultural variables in the prediction of maternal mortality is early marriage which accounts for about 23 per cent of maternal mortality due to severe hemorrhage resulting from obstructed and prolonged labour. The narrow pelvis of these women may also result to fistula and often time still births. Similarly, the Ipas Director said that poor family planning practice contributes to maternal deaths. 

According to him, unsafe abortions accounts for at least 13 per cent of all maternal deaths. He reasoned that there will be a lot of unwanted pregnancies among the young age group who are not aware of good contraceptive methods. They often resort to unsafe abortion with its resultant infections, haemorrhage and injuries to the cervix and uterus. Oji said that family planning will lead to a 30 per cent reduction in maternal deaths, but regretted the country’s heavy dependence on donors. He said; “donors have been driving our FP services. It should be in the national budget.” “Female genital mutilation (FGM) is a major indirect cause of maternal mortality in Nigeria. It is a risk factor for obstructed labour. Pains, infections and haemorrhage result from FGM, as well as the risk of tetanus and even HIV infections. Problem following FGM is that scar tissue stretches poorly in child birth leading to perineal tear and haemorrhage which also accounts for maternal deaths due to inadequate emergency obstetric care,” Oji said. He further noted that inadequate obstetric and post partum care contributes to maternal death. His words; “about 69 per cent of women still give birth in a traditional setting either at home or in a Church. Only 30 per cent of people in the rural areas have access to health care within 4 km distance. 

The same issue is applicable to people in the urban setting.” This is even as lamented that most attendants of these births in the churches are unskilled. He also bemoaned the role of illiteracy and poverty in increasing the incidence of maternal death. “The lack of primary education and lack of access to health care contribute significantly to child and maternal mortality statistics,” he said. He reasoned that women who complete secondary education are more likely to delay pregnancy, receive prenatal and post natal care and have their birth attended to by qualified medical personnel. Oji called for creation of emergency transportation services, upgrade of  transportation system and enhancement of  referral systems to enable women to reach health care centres and receive appropriate care on time. Oji’s view corroborates with Dr. Mahmoud Fathalla, Former President of Federation of International Gynaecologists and Obstetricians (FIGO). Bemoaning the increasing incidence of maternal deaths, Both Oji and Fathalla agree that girl child education is essential in reducing maternal deaths. 

According to them, the South East (SE) is a good evidence for this strategy. Experts have called for massive investment in the country’s educational system. “The first health care system is in the house hold. The more educated the house hold the better equipped they are to provide care either by self or purchase,” Fathalla said. Observing that women don’t receive prompt care at health facilities, Fathalla advocated for provision of 24 -hour obstetric care; upgrade of  quality of care at health facilities; establishment of  national protocols to treat obstetric complications; ensuring  adequate stocks of medical supplies and blood. According to the obstetrician, enhancing referral systems between communities and health facilities will help to reduce maternal deaths. He insisted that a woman must be able to exercise control over her sexual and reproductive health if she is to achieve her fullest potential as a human being. He urged government, health care providers, development partners, legal practitioners, especially the International Federation of African Lawyers (FIDA) among many others to increase their commitment in empowering women to enable them exercise their reproductive rights. Experts believe that the growing incidence of maternal deaths is an unhealthy trend which has become a matter of great concern and are calling for concerted approach from stakeholders to curtail it. 

For instance, Fathalla, lamented; “Women are not dying   because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” This is in line with the observation of Former United Nations Secretary-General Kofi Annan towards addressing poor health care in the continent including, high maternal deaths. Annan said: “It is my aspiration that health finally will be seen not as a blessing to be wished for, but as a human right to be fought for.” The Millennium Development Goals (MDGs) focuses attention, resources, and action on improving the well-being of all peoples. Two of the goals (MDGs 4 and 5) were to reduce the childhood mortality rate and maternal mortality ratio, by two-thirds and three quarters (75 per cent), respectively between 1990 and 2015. It is expected that decline in maternal mortality must accelerate substantially in the period to 2015, if any country is to reach these goals. The maternal mortality rate of any country is very significant and has implications for the attainment of the MDGs. 

However, there are indications that Nigeria is lagging behind in achieving universal coverage of key maternal and child health intervention and will unlikely meet the target of the MDGs. According to UNICEF Executive Director, Ann Veneman, “midway to 2015 deadline for MDGs, Nigeria continues to record unacceptably high maternal, newborn and child mortality”. Nigeria ranks as one of the 13 countries in the world with the highest maternal mortality rate and is still not listed among the 10 countries seen to have made rapid progress to meet the goals. The circumstance surrounding the death of women like Margaret has thrown a poser which must be answered: How prepared is Nigeria to meet MDGs Target 4 and 5?

This story was published in Newswatch Times on September 26,  2013.

NIMR DG receives another award

By: Chioma Umeha

Director General (DG) of Nigerian Institute of Medical Research (NIMR), Yaba Lagos, Professor Innocent Achanya Otoba Ujah, has added another feather to his long list of award in recognition of his valuable contributions to improve medical research and services as he received the Association of Professional Bodies of Nigeria (APBN) ‘Health and Medical Awards’ on Thursday. Professor Ujah was among the four persons who were honoured by APBN during the association’s 29th Annual General Assembly (AGA) awards held at Golden Gate Restaurant, Ikoyi. 

Prof. Ujah is a recipient of many awards including Oyo State National Youth Service Corps (NYSC) Chairman’s award in 1980; life membership award; and National Association of Resident Doctors of Nigeria (NARD) in 1987. In 1993 he received the Study Fellowship sponsored by Swedish agency for International and Technical Economic Cooperation, at the University of Uppsala Sweden, to study a diploma course on international maternal health. Most recently, Ujah received the Life Achievement Award by Lagos sector of Society of Gynaecology and Obstetrics of Nigeria (SOGON) and Honours Award by Faculty of Medicine Sciences, for contributing to the building of College of Medical Sciences, University of Jos, while serving as a Dean of Faculty. Professor Ujah joined the services of the University of Jos and Jos University Teaching Hospital in 1988 as lecturer/consultant and was promoted Professor of obstetrics & gynaecology in 2001. 

Born on November 6, 1954 at Aidogodo-Okpoga in Okpokwu , Local Government Area (LGA) Benue State. He had his early education in Aidogodo Okpoga and Otukpo all in Benue state. He had secondary education at Government Secondary School, Katsina-Ala between January 1967 and December 1971, where he obtained his West African School Certificate (WASC). He attended Government College, Keffi for his Higher School Certificate (HSC) education, between, January 1972 and June 1973. Professor Ujah graduated from Ahmadu Bello University (ABU), Zaria in June 1978 with an MBBS degree. He is a fellow of Medical College of Obstetrics & Gynaecology (FMCOG) of the National Postgraduate Medical College of Nigeria by examination, Fellow of International College of Surgeons (FICS) and Royal Society of Medicine of England (FRSMed). 

Professor Innocent Ujah is a specialist gynaecologist, endocrinologist and endocrine infertility. He also holds a Diploma in International maternal health care from University of Uppsala, Sweden. Professor Ujah has published over 70 scholarly articles in reputable national and international peer-reviewed journals, in addition to over 100 conference papers, abstracts and has delivered many lectures. He has attended many national and international conferences and presented a number of quality scientific papers. Others who received the awards are: Hajia Maryam Ladi Ibrahim, who received the ‘Financial Awards’ and Mr. Nweke O. Umezuruike who received the ‘Environment/Engineering/Construction  Awards’ and Adm. Josiah A. Okoronkwo, who was honoured with the ‘Management/Communication Awards.’

This story was published in Newswatch Times on September 28,  2013.

GLOBAL HIV/AIDS EPIDEMIC WILL BE ELIMINATED – UN • As incidence of same-sex continues to rise

By: Chioma Umeha

The global HIV/AIDS epidemic could be over by 2030, a leading UN official has said, as new figures showed that infection rates have dropped by a third since 2001. Globally, there were 2.3 million new HIV infections in 2012, down 33 per cent, while new infections among children have dropped even further, down 52 per cent to 260,000. 

Speaking in New York, Dr Luiz Loures, the deputy executive director of the United Nation’s HIV/AIDS agency (UNAIDS), said that ending the epidemic in just 17 years’ time was a “viable target”. The UN is set to exceed its own goal of providing HIV treatment to 15 million people in low and middle income countries by 2015.  Nearly 10 million people in these countries were accessing life-saving antiretroviral therapy by the end of 2012 – a 20-per-cent increase in just one year, according to UNAIDS’s 2013 Report on the global AIDS epidemic. 

Progress has been made both in the treatment and in the control of HIV, Dr Loures said. AIDS related deaths have dropped by 30 per cent, since peaking at 2.3 million worldwide in 2005. “I think that 2030 is a viable target to say that we have reached the end of the epidemic,” Dr Loures said. “HIV will continue existing as a case here or there but not at the epidemic level we have today… We can get to the end of the epidemic because we have treatments and ways to control the infection.” Significant progress has been made since the UN targeted HIV/AIDS epidemic in the landmark Millennium Development Goals, which set out goals for poverty and disease reduction for 2015. “Over the years, the gloom and disappointments chronicled in the early editions of the UNAIDS Global report on the AIDS epidemic have given way to more promising tidings, including historic declines in AIDS-related deaths and new HIV infections and the mobilisation of unprecedented financing for HIV-related activities in low- and middle-income countries,” said UNAIDS executive director Michel SidibĂ© in his introduction to this year’s report. 

However, the report also found that progress has been slow in securing HIV services for people most at risk of HIV infection, including men who have sex with men, sex workers and people who inject drugs. The report warns that, in many countries, fear of disapproval were still preventing people from such groups from seeking help. Speaking to The Independent, Dr Loures added that the shape of HIV epidemic had changed, and was now concentrated in regional and population-specific “hotspots” that could be found all over the world. The epidemic among men who have sex with men was still “out of control”, he said. 

“This is where the epidemic is increasing and requires special attention. Homosexual men are getting AIDS because [in many countries] they cannot come out, they cannot go to health centres, they cannot even buy a condom,” he said. On Monday, the UK pledged £1 billion to the Global Fund to Fight AIDS, TB and Malaria, which would provide antiretroviral treatment to 750,000 people between 2014 and 2016, according to the Department of International Development (Dfid). 

This story was published in Newswatch Times on September 26,  2013.

Nigeria faces dearth of voluntary blood donors


Nigeria is currently reeling under the onslaught of serious dearth of safe blood and blood products with less than 10 per cent of citizens donating blood voluntarily. This is just as opinion leaders in the country, particularly, those in the rural communities have been enjoined to lead by example by donating blood voluntarily. 

The country is currently faced with a situation, whereby 60 per cent of all blood donations are from commercial donors and 30 percent from family replacement. Minister of Health, Professor Onyebuchi Chukwu, observed that 1,130,000 units of blood are collected annually in the country through the various types of donations as against 1,336,000 estimates of blood units required. The deficit, according to the Minister, has resulted in numerous preventable deaths especially among women and children and people living with certain diseases. 

A member of the Lagos State Blood Transfusion Committee (LSBTC) Mr. Solomon Eka, made the call during a blood donor drive organised by the LSBTC in conjunction with the State Water Corporation, maintained that as long as Nigerian opinion leaders are opposed to blood donation, the country will remain far from attaining the required blood units for survival of patients. Eka said: “Presently there are some opinion leaders that do not support blood donation. If these opinion leaders are meant to have a change of attitude, and also demonstrate by donating blood, their followers will also follow suit. So we need the opinion leaders to drive the campaign in the communities. 

To let people know that blood donation is not risky and is not having any negative effect.” In his lecture tagged; ‘Importance of Voluntary Blood Donation’, Eka explained that regular blood donation also helps refresh an individual’s blood. He said the State blood donation drive has helped discover hidden diseases in many persons walking around with blood disorders without knowing. Encouraging cultivation of the culture of donating blood every three months, he explained that not every donated blood is useable. ‘It is not everybody that can donate, you must attain certain criteria before you donate, which include; you must be 50 kg and above, blood pressure must be normal, PVC must at an acceptable level to avoid any unforeseen crisis. Only healthy people aged 18 -65 are likely to donate blood,’ he added. 

Chief Matron, Lagos State Water Corporation Staff Clinic, Aderoju Olusola, who observed that the exercise was part of their monthly health talk aimed at inculcating healthy living into the staff of the corporation. Olusola, who agreed that most Nigerians are afraid to donate blood out of fear, said donors stand to gain refreshed blood as well as prolonged life. Voluntary blood donation also provides support for persons in need of blood, accident victims, cancer patients, sickle cell anaemia patients and pregnant women in labour among others.

This story was published in Newswatch Times on September 26,  2013.

80% of heart disease caused by poor lifestyle habits – Experts


Heart disease is one of the most lethal disease killers and is particularly seen in overweight postmenopausal women. It is vital that women learn the truth about their heart disease risk and take action to protect themselves and their family.

In partnership with the World Health Organization (WHO), the World Heart Federation is to organise World Heart Day on September 29. Awareness events are hosted in more than 100 countries and this year’s theme is “Take the road to a healthy heart”.

According to the WHO, genetics is no longer the primary determinant in the development of heart disease and approximately 80 per cent can be attributed to poor lifestyle habits. In adults, unhealthy diets are linked to four of the top ten risk factors that cause premature death: high blood pressure, high cholesterol, overweight and obesity, and high blood sugar that are commonly seen in diabetes.

Recent changes to diets, physical activity levels and how you live make you prone to heart disease. Diets high in animal fat, low in fresh vegetables and fruit, and high in alcohol have been shown to increase the risk of heart disease and stroke. Choose a diet that is low in bad fat and salt.

Scientists now understand that fat – especially fat around the stomach – can significant impact blood pressure, blood cholesterol levels, and interferes with the ability to use insulin effectively. Insulin is needed for energy and one’s metabolism. Body Mass Index (BMI) and stomach circumference are two standardized methods of measuring one’s cardiovascular risk. As one gets fatter, the risks of developing type 2 diabetes and high blood pressure significantly rises. Statistics show that 58 per cent of diabetes and 21 per cent of ischemic heart disease can be attributed to a BMI above 21.

Children are vulnerable too. Physical inactivity learned in childhood often continues into adulthood. This contributes to a child’s increased risk of heart disease and stroke later in life. Physical inactivity also contributes to overweight and obesity. Over-weight children are growing concern and can set them up to suffer from diabetes and heart disease at a younger age.

The vast majority of tobacco users began when they are adolescents and if a child’s parents smoke; they are three times more likely to smoke themselves. Smoking produces inflammation and damages the lining of blood vessels, increases blood clots and strokes, and negatively affects blood cholesterol levels.

This story was published in Newswatch Times on September 26,  2013.

Saturday, 27 December 2014

Simple things that reduce stroke risk

By: Chioma Umeha

Studies show that that 20 per cent often die when they are attacked by stroke, while 40 per cent are at risk of being disabled with 25 per cent chance severely disabled. Confirming this, Dr. David Spence, director of the Stroke-Prevention Center at the Robarts Research Institute in Canada, said that one of approximately 600,000 Americans who have stroke dies. Spence also added that if you have stroke, then, “your chance of dying is 20 percent-but you have a 40 percent chance of being disabled and a 25 percent chance of being severely disabled.” 

An ischemic stroke—the kind that affects most men—occurs when an artery to the brain is blocked by arterial plaque that has broken loose and caused a blood clot. In fact, it is just like a heart attack, only instead of heart cells dying for lack of blood, brain cells are kicking off-thousands of brain cells. Perhaps paralyzing half of your body; or slurring your speech; or even plunging you into senility. But a “brain attack” is not inevitable. David Wiebers, a professor of Neurology at the Mayo Clinic and author of Stroke-Free for Life noted: “50 to 80 percent of strokes can be prevented.”  Wiebers further observed that there are simple steps one can take from age 25 to 35 to prevent stroke. He said: “Making the simple choices at 25, 35, or 45 years of age can make an enormous difference in preventing stroke when you are in your 60s, 70s, or 80s.” 

Here are seven strategies you can use strike back at stroke. 

Loma Linda University researchers found that men who drank five or more 8-ounce glasses of water daily cut their stroke risk by 53 per cent compared with guys who drank fewer than three glasses. Water helps to thin the blood, which in turn makes it less likely to form clots, explained Dr. Jackie, the lead study author. But do not drink your extra water at once. “You need to drink water throughout the day to keep your blood thin, starting with a glass or two in the morning,” adds Dr. Chan. 

Drink less soda 
Unless it is the diet stuff; the Loma Linda University researchers also discovered that the men who drank large quantities of fluids other than water actually had a higher risk of stroke—46 per cent higher. One theory is that sugary drinks like soda draw water out of the bloodstream, thickening the blood. Another explanation may be the boost in triglycerides caused by sipping liquid sugar. Dr. Daniel Fisher, an assistant professor at the New York University School of Medicine observed that elevated levels of triglycerides – any level above 150 – is a risk factor for arterial disease. 

Avoid anxiety 
You may have just lowered your stroke risk. In a study published in the journal Stroke, researchers noted that of 2,100 men, the anxious guys were three times more likely to have a fatal ischemic stroke than the more serene men. Dr. Ernest Friedman, a professor of psychiatry at Case Western Reserve University said: “anxiety causes chronic overproduction of dopamine, a neurotransmitter that regulates the brain’s control of circulation.” Dr. Friedman added that counting to three—or reining in your racing mind in any other way—helps by stabilizing your levels of serotonin, the antidote to excess dopamine.  

Hold your breath 
You can do this when you are around a smoker. University of Auckland researchers found that people exposed to second-hand smoke are 82 per cent more likely to suffer a stroke than those who never inhale. It seems that carbon monoxide promotes clot formation by interfering with nitric oxide, a biochemical that relaxes blood vessels. To get rid of every single bit of carbon monoxide after a night at the bar, you will have to breathe fresh air for about eight hours. But most of the carbon monoxide will be gone from your body in the first hour, according to Laurence Fechter, a professor of toxicology at the University of Oklahoma. So on your way home, make sure you roll down the car windows and start sucking in some clean air. 

Beat Homocysteine 
Research suggests that people with high blood levels of this amino acid are more likely to stroke out than those with low readings. Extra folate will help reduce the risk, but only for some people. “50 to 60 per cent will not respond with lower homocysteine,” said Dr. Seth J. Baum, medical director of the Mind/Body Medical Institute, a Harvard affiliate. Dr. Baum recommends 1,000 micrograms (mcg) of folate, plus 25 milligrams (mg) of vitamin B6, 1,000 mcg of B12, and 1,800 mg of the amino acid N-acetyl-cysteine (NAC). “With folate, B6, B12, and NAC supplements, almost everyone will have normal homocysteine levels,” said Dr. Baum. 

Pick up an iron supplement 
Aerobic exercise is anti-stroke medicine. If you cannot run or cycle to save your life; then, lift. Dr. Jerry Judd Pryde, a physiatrist at Cedars-Sinai Hospital in Los Angeles said: “Regular resistance training decreases blood pressure, elevates HDL cholesterol, lowers LDL cholesterol, and decreases the stickiness of the blood.” 

If you do not already weight-train, try the American Heart Association programme: 
Lift weights two or three times a week, targeting the major muscle groups. For each of the following, choose a weight you can lift eight to 12 times at most, and do one set to fatigue: bench press, shoulder press, lying triceps extension, biceps curl, seated row, lat pull down, crunch, squat, Romanian dead lift and calf raise.

This story was published in Newswatch Times on September 21,  2013.

Health providers’ demands legitimate – PSN

By: Chioma Umeha

FG should be committed to their new roles
The Pharmaceutical Society of Nigeria (PSN) has urged the committee set up by the federal government to redress the grievances of health workers on controversial professional issues to be committed and impartial in tackling the various issues.

A statement yesterday signed by Olumide Akintayo, national president, PSN, noted that the demands of the health workers are their human rights and should be respected.

Akintayo stressed the need for government to recognise the different hierarchical order, professionalism, application of nomenclatures such as consultants and directors in hospitals, among other issues.
He said: “The Pharmaceutical Society of Nigeria wishes to urge the Committee of the Federal Government set up to redress the grievances of health workers on contentious professional matters to be steadfast, bold and upright in tackling the various matters arising without fear or favour.”

“Pharmacists under the umbrella of the Pharmaceutical Society of Nigeria wish to put the record straight by declaring that agitations for recognition of professional roles, optimising career aspirations, appropriate designation of specialist roles and implementation of non-discriminatory salary wages remain the constitutional rights of citizens of the Federal Republic of Nigeria which we shall continue to both champion and uphold,” the PSN boss added.

He regretted that the healthcare sector is structure in a manner that undermines some health professionals.
He said: “It is an irony of fate that the status quo in healthcare in our nation is deliberately structured to impair the legitimate aspiration of some health workers to optimize their potentials in the health sector for many years now.”

He further called for fair treatment to all professionals in the health sector. “The Pharmaceutical Society of Nigeria is not unmindful of threats of persons who issue ultimatums on adherence to obnoxious “hierarchical orders” in the health sector. We insist and declare our readiness to attain fair justice to all concerned in the health industry in Nigeria,” Akintayo said.

This story was published in Newswatch Times on September 14,  2013.

34 years on, medical college bemoans poor funding

By: Chioma Umeha 

After 34 years of existence, the National Postgraduate Medical College of Nigeria, Ijanikin, Lagos has cried out for financial help to upgrade current facilities at the college. 

In its 31st pre-convocation ceremony briefing yesterday in Lagos, the College President, Prof. Victor Wakwe said the institution has been financially struggling for survival since inception in 1979, pointing out that the unhealthy development has constrained the college from optimal performance. He explained that the reason the college had been neglected and its inability to access funds from Tertiary Education Trust Fund (TETFUND) was tied with its establishment under the Ministry of Health, while TETFUND was planted to handle education affairs. The president however argued that the postgraduate college was a tertiary institution that should benefit from such purse to enable it meet with international standard.  

“This is a tertiary education, therefore, TETFUND needs to release money to the institution so as to operate successfully. We are aware that this Trust Fund begs universities to access the fund, why should our case be exempted,” he queried. As the college continues to suffer dearth of academic infrastructures, such as inadequate examination hall, absence of performance and cognitive skills examination centre and inadequate training facilities of personnel that will train resident doctors, Wakwe decried that there has been no response from TETFUND despite the Minister of Health recent intervention. “This college is the only college owned by the country that caters for more than 90 percent of postgraduate medical training of doctors and dentists. Less than 10 percent of the postgraduate training of doctors and dentists in this country and most Commonwealth countries are done by universities. 

But colleges like ours in these Commonwealth countries carry out professional postgraduate medical training,” he said. The president also complained of insufficient foreign training for some of the resident doctors, lamenting that less than 60 were sent abroad last year against the 200 suggested by the college, grieving more that none has been sent this year. He was not also comfortable with the fact that from 2007 till date, the Medical and Dental Council of Nigeria (MDCN) has not functioned due to the removal of the council’s chairman. MDCN, serving as a law court which punishes erring medical practitioners, Wakwe noted that many cases of malpractice would have piled up in the sector, thereby appealing to the President Goodluck Jonathan to appoint a new chairman to discontinue non-regulated medical services in Nigeria.

This story was published in Newswatch Times on September 14,  2013.

Avocados: Natural cure for Alzheimer’s, cancer, others

By: Chioma Umeha

Many dismiss avocado as too fattening forgetting that is also packed with natural health goodness. Avocado has been called the world’s most perfect food. It has achieved this distinction because many nutritionists claim it not only contains everything a person needs to survive — but it has also been found to contribute to the prevention and control of Alzheimer’s, cancer, heart disease, diabetes and other health conditions. 

The avocado (Persea gratissima or P. americana) originated in Puebla, Mexico and its earliest use dates back to 10,000 years B.C. Since AD 900, the avocado tree has been cultivated and grown in Central and South America. In the 19th century, the avocado made its entry into California, and has since become a very successful commercial crop. 95 per cent of U.S. avocados are gown in Southern California. 

Here are other health benefits of avocado: 

  • Helps control blood pressure 
  • It contains potassium which is known to help control blood pressure. 
  • Helps to regulate blood sugar levels Avocados contain good soluble fibre which helps keep a steady blood sugar and also fats which can actually reverse insulin resistance that helps to regulate blood sugar levels. 
  • Helps in weight gain Due to the high healthy calorie content in avocados (For every 100 grams, an avocado contains about 200 calories) it makes for the best ingredient for those trying to put on weight. 
  • Helps to lower bad cholesterol levels Avocados contain a compound called beta-sitosterol which helps to lower blood cholesterol levels LDL which is bad cholesterol and increase HDL which is good cholesterol. 
  • Contains anti-inflammatory properties Avocados contain Phytonutrients such as polyphenols and flavonoids which have anti-inflammatory properties. These reduce the risk of inflammatory and degenerative disorders. 
  • Helps to prevent birth defects Avocados contain folic acid which plays a huge role in the prevention of birth defects, such as neural tube defect and spina bifida. 
  • Helps to fight free radicals Due to the glutathione content in avocados, a diet with an inclusion of avocados can free your body of free radicals. Contains anti-aging properties Avocados are rich in antioxidants which help slow aging symptoms. 
  • It also contains minerals which may boost the immune system, encourage a healthy nervous system. 
  • Reduces strokes risk If you eat a diet rich in folate, you may be able to evade getting a stroke. 
  • Promotes eye health 
  • Avocados are a good source of carotenoid lutein known to help protect against age-related macular degeneration and cataracts. 
  • Helps to maintain a healthy heart Avocados contain vitamin E, glutathione, and monounsaturated fat, which help in the maintenance of a healthy heart. They also contain vitamin B6 and folic acid, which help regulate homocysteine levels which are known to increase the risk of heart disease. 
  • Offers protection against cancer Studies have shown that the avocado with its oleic acid is effective in preventing breast cancer. And can also inhibit the growth of prostate cancer. 
  • May cure halitosis They are a natural mouth wash as they cleanse the intestine which is actually the real cause of bad breath and coated tongue.

This story was published in Newswatch Times on September 14,  2013.

How Nigeria will save billions from anti-malaria discovery

By: Chioma Umeha

Last Tuesday’s news about the discovery of a substance which will eliminate malaria, one of the world’s most deadly diseases, is no doubt cheery to many across the world, especially Nigerians. This is not surprising as Nigeria is one of the world’s endemic malaria countries. 

This report is coming on the heels of a recent report published in Science – a scientific journal, which announced the success of a phase 1 trial of the early-stage clinical evaluation of an investigational malaria vaccine known as the PfSPZ Vaccine, conducted by researchers at the National Institute of Allergy and Infectious Diseases, NIAID, part of the National Institutes of Health. In reaction, global researchers had observed that preliminary studies have confirmed that the vaccine is safe to generate an immune system response, and to offer protection against malaria infection in healthy adults. Experts in Nigeria also described this as a welcome development. However, it is believed that the latest discovery which was announced Tuesday could be used to help stamp out deadly diseases such as malaria, which kills approximately one million people yearly. 

Also, the Daily Newswatch investigations has shown that if this latest discovery is fast-tracked, Nigeria will save N160 billion between now and next year. The World Health Organisation (WHO) just before the dawn of this year announced that 80 per cent of malaria deaths occur in 14 endemic countries, with Nigeria, Democratic Republic of the Congo and India among the worst hit. In its last year’s annual assessment report on malaria, which was released at the United Nation (UN) Headquarters in New York, WHO further said that to stave off backsliding and resurgences in 2013 and 2014, 2.4 billion U.S. dollars was urgently required, of which one billion dollars was needed in Nigeria alone. The report noted that the initial funding scale-up saved 1.1 million lives, stressing that 58 per cent of them were in countries where the disease was widespread. It explained that the international funding for malaria appeared to have reached a plateau “well below the level required to reach the targets set by world governments and institutions in 2,000 with the adoption of the MDGs, which have a target deadline of 2015’’. 

The WHO report stated that an estimated 5.1 billion U.S. dollars was needed yearly between 2011 and 2020 to achieve universal access to malaria interventions in the 99 countries with ongoing malaria transmission. It added that the slowdown in funding threatened roll-back impressive gains made against the preventable mosquito-borne disease over the last decade. However, the agency report yesterday said that U.S. scientists are working on an ‘invisibility cloak’ for mosquito-plagued people, pets and livestock. According to the report, the ‘invisibility cloak’ will replace traditional repellents The researchers noted that some compounds found in human sweat attract mosquitoes while chemical compounds, including 1-methylpiperzine, block mosquitoes’ sense of smell. They explained that the substances which they discovered occur naturally on human skin and block mosquitoes’ ability to smell and target their victims. Scientists believe the research could be another step in the fight to stamp out deadly diseases such as malaria. Speaking at the National Meeting & Exposition of the American Chemical Society, research chemist Ulrich Bernier said that far from being a nuisance, mosquitoes are more deadly to humans than any other animal. In the U.S. alone, mosquitoes spread rare types of encephalitis, an inflammation of the brain as well as transmitting heart worms to pet dogs and cats. 

Dr Bernier said: “Repellents have been the mainstay for preventing mosquito bites.” In Nigeria, there are several popular repellent and are hardly effective. Though they have been in use for a long time, many do not like the feel or the smell of the repellant. In US, the most widely used repellant, DEET, is quite effective and has been in use for a long time but some people don’t like the feel or the smell of the repellant, Bernier said. “We are exploring a different approach, with substances that impair the mosquito’s sense of smell. If a mosquito can’t sense that dinner is ready, there will be no buzzing, no landing and no bite,” he explained. Female mosquitoes, which suck blood to obtain a protein needed to produce fertile eggs, can smell people from over 100 feet away. A person’s scent, Dr Bernier explained, comes from hundreds of compounds on the skin, many emitted through sweat and others produced by bacteria. To identify which of these attract mosquitoes, Bernier and colleagues at the Mosquito and Fly Unit at the U.S. Department of Agriculture’s Agricultural Research Service Centre for Medical, Agricultural, and Veterinary Entomology in Florida, used a special mosquito cage divided by a screen. They sprayed various substances into one side of the cage and documented the effects in attracting mosquitoes. 

Some compounds, like lactic acid – a common component of human sweat – were definite mosquito lures, drawing 90 per cent of the mosquitoes to the screen. With other compounds, however, many of the mosquitoes did not even take flight or seemed confused. Dr Bernier said: ‘If you put your hand in a cage of mosquitoes where we have released some of these inhibitors, almost all just sit on the back wall and don’t even recognise that the hand is in there. We call that anosmia or hyposmia; the inability to sense smells or a reduced ability to sense smells.’ He said that a group of chemical compounds, including 1-methylpiperzine, block mosquitoes’ sense of smell. This may help explain why mosquitoes fly toward some people but not others. 

The substances have a molecular architecture found in ingredients in dozens of medicines and other products and they appear suitable for use in cosmetics, lotions, clothing and other products that currently incorporate mosquito repellants, he said. The Mosquito and Fly Unit has been doing research on mosquito repellents since the 1940s. In the 1990s, it accumulated information on substances secreted through the human skin or formed by bacteria on the skin that make some people more attractive to mosquitoes than others.

This story was published in Newswatch Times on September 12,  2013.

There’s need to dismantle myth surrounding rape – Anaba

Mrs. Itoro Eze Anaba the Executive Director/Managing partner, Partnership for Justice in an interview recently decried the plight of rape survivors. Anaba spoke to CHIOMA UMEHA (HEALTH EDITOR) on the goals of the Sexual Assault Referral Centre (SARC) the Lagos State University Teaching Hospital (LASUTH) which will provide respite for survivors. Excerpts: 

Recently, your organisation announced that it was going to establish a Sexual Assault Referral Centre (SARC) the Lagos State University Teaching Hospital (LASUTH). Give details of your plans. 
We have commenced training for medical practitioners on forensic medical examinations and provision of other support services for victims of rape and sexual assaults. Partnership for Justice is setting up a sexual assault referral centre that will provide timely professional and victim friendly services for survivors of sexual assault. And one of the major aspect of the project is to train doctors and nurses to provide them with adequate and specialized skills so that when victims of rape and sexual assault come in to the hospitals they have specialized skills to treat them in a way that it will leave them with their dignity intact so that they are not further traumatized. We also have nurses that will work in therefore centres so that can provide like victim friendly services. We want a situation where victims walk into the centre and are able to receive psycho-social services like counselling services as well as medical services. The centre is going to be set up at LASUTH and the hospital has kindly given us a space.  Throughout July, we were training the doctors and subsequently trained counsellors. It is only after that the centre will be open to the public. An interesting aspect of the centre is that services provided at the centre will be free. Both counseling, basic medical treatment will be provided free for the victims and in addition we are going to have large publicity programme on this project because it does not make sense to set up a centre and at the end of the day nobody knows about it. We are going to run radio jingles, postals, flyers put in place. We will be visiting schools and already targeting about 20 schools in Ikeja to train officials of the schools to act as community monitors so that within the school environment they are able to detect the symptoms of rape. If any of the girls has suddenly changed if it was because she was sexually abused or assaulted. Those officials will be able to identify those students and refer them to the centre. Ultimately, we would also want to work with the family support unit which is another programme with e aim providing the police with necessary skills to investigate and prosecute cases of rape and sexual assault. Already, we have trained medical practitioners to be equipped with the skills. 

Number of doctors trained
We trained about 30 doctors drawn from various hospitals such as Island hospital, Ikorodu hospital, but majority are from LASUTH because the centre is located at LASUTH. Anybody can walk in to receive services.  Anybody can walk in to receive services. Other department can refer; for instance, the Police and other civil society organization. An individual can be referred to this centre and they will walk in and receive treatment at any time. Right now it is being funded by Justice for all programme of the Department for International Development; we would want the state government to step in as well.   Already LASUTH has given us a small building but for the sake of privacy and confidentiality there is need to have a separate building or section for this kind of services.  We are hoping that with time the government we give us a large space in the new building they are putting on. For now it is free and we hope it will be continue to be free because the high cost of medical care is also an obstacle to receiving treatment. 

Benefits to survivors 
Generally survivors find it difficult because they do not really know where to go to report cases of assault and it is even more difficult when the perpetrator is a family member. At times they go to their religious leaders and they do not believe them and they go around with that trauma.    When they go to hospital, the delay to receiving treatment is there and at times they do not have money to buy drugs and take care of other medical services but this centre is going to provide all those services. Now, you have a place where you can walk in and make a report and receive treatment free. The staff at the centre will believe you when you come in.   The centre is going to provide pregnancy tests, initial medical services will include possible HIV tests but everything has to be done with the consent of the victim. All information to be kept confidential private and more importantly we are going install a system that will provide aggregated data so that at the end of day we will be able to say how many that have been affected by rape in Lagos state, how many came from Ikorodu, Yaba, etc; and among these areas, what age group of people are more prone to rape or who are the perpetrators. Why social class, religious. All these compilation will be provided at the same time.  

It appears that rape is on the increase
It is really difficult to say that it is on the increase because it could be that there is more awareness now and people are making more report not necessarily because it is on the increase.  But what we can say now is that there is increased awareness and increased publicity on sexual report.   But for us to say that there is increase, we must have a data which we do not have. We cannot back up a data, but there is publicity and awareness that rape is actually becoming an epidemic that is why the centre is going to provide such data. Over the years, the society is beginning to agree that these things are happening.  There is need to start dismantling this whole myth as secrecy surrounding rape so that those affected will feel free to receive the support services. 

We need to remember that we cannot do without the community because perpetrators live within the community. So we need to take steps to protect our communities from rape incidents and make sure that our girls and women are actually free from rape. Do they report? There mixture of reasons some people also report but some people feel that there is no need for them to report and some do not want to report immediately. But they can access the support at the centre which will make them have the confidence to report in future. 

This story was published in Newswatch Times on September 12,  2013.

Mammograms before 50 reduce deaths from breast cancer – Researchers

By: Chioma Umeha

A new study which has caused fresh debate, on Monday proposed that women should begin routine breast cancer screening before age 50 to reduce deaths from breast cancer. This new recommendation flies in the face of concerns that screening women for breast cancer increases their risk of ‘overdiagnosis.’ The study which was conducted by Harvard University researchers stated; “mammograms before age 50 could dramatically cut deaths from breast cancer.” According to an agency report, a team of researchers led by Dr. Blake Cady of Massachusetts General Hospital identified women diagnosed with breast cancer between 1990 and 1999 at two Boston hospitals and tracked their cases until 2007. They found that out of 609 confirmed breast cancer deaths, 395 of these women — 71 per cent — never had a mammogram prior to diagnosis. 

Moreover, half of the breast cancer deaths in the study were in women younger than 50. Only 13 per cent of breast cancer deaths occurred in women 70 or older. Breast cancer is the second most common cancer in women. For years, a debate has raged about when a woman should begin getting mammograms. In 2009, the United States Preventive Services Task Force (USPSTF) released a controversial recommendation that women should get mammograms starting at age 50, and that these tests should occur every other year until age 74. Before this recommendation, doctors had traditionally told their patients to get mammograms every one to two years starting at age 40. The USPSTF made its recommendations with the aim of striking the best balance between catching the most cases of breast cancer early while still limiting potential downsides of testing, like false positives and screening costs. To make their decision, they looked at eight large, high-quality studies to determine the age range in which it would be most beneficial for women to get mammograms. 

At the time, the USPSTF argued that there were too many unnecessary biopsies and other unneeded treatments being performed in young women. Meanwhile, the American Cancer Society has continued to maintain that early screening and detection saves lives. They say women should get mammograms starting at age 40, once every year, while they are in good health. Cady said his team’s findings support the idea that screenings should start sooner rather than later. “I have watched the mortality rate from breast cancer fall from 50 per cent in the 1960s to 9.2 per cent today with the advent of early detection with mammography,” said Cady, who added that he recommends his patients get yearly mammograms beginning at age 40. “To a certain extent [the study results are] intuitive because younger women don’t get screened,” he said. “Without screening, they’re just like the women in the 1960s who died without ever knowing they had breast cancer.” 

Robert Smith, senior director of cancer screening for the American Cancer Society, said the findings bolster the Society’s recommendations on mammograms. “While the analysis reveals that regular screening will not prevent all breast cancer deaths, it also reveals that even with improvements in treatment there still is a significant advantage of detecting breast cancer with mammography before symptoms develop,” Smith said in an e-mail to ABC News. Experts So what does this mean for you, your family members, or your loved ones? As with most things in medicine, every woman is unique. If you have any risk factors, such as a family history or a genetic predisposition toward breast cancer, you need early and regular screening with the guidance of your doctor. For women without risk factors, consider self breast examinations at home and see your physician for a clinical breast exam every two to three years starting in your 20s. If your breasts look or feel different, seek medical care. Every medical test including mammograms has risks and benefits, which each woman should weigh for herself in conjunction with her physician.

This story was published in Newswatch Times on September 12,  2013.

Friday, 26 December 2014

Our new human virology laboratory will expand services, reduce cancer – Ujah

Professor Innocent Ujah is the Director-General (DG) and Chief Executive Officer of Nigerian Institute of Medical Research (NIMR) Yaba, Lagos. Ujah recently addressed journalists on the efforts of the institute since the past three years when he assumed duty. CHIOMA UMEHA (HEALTH EDITOR) was there and has the details. Excerpt:

Professor Innocent Ujah
Discuss the link between the recent expansion in the services of human virology laboratory (HVL) and improvement health care delivery by the institute?
In order to expand and improve the quality services of the Human Virology Laboratory (The Only ISO Certified Laboratory in the country), we had to carry out extension of the Laboratory.   I am delighted to report that the building extension is completed, fully furnished and have been commissioned by the former Minister of State for health, Dr Mohammed Ali Pate. It is also necessary to state that in the HVL, is a newly procured COBAS 4800 MACHINE, a machine used for screening for Human Papilloma virus (1IPV), the virus that is known to cause cancer of the cervix. It will be used to conduct a national survey on the prevalence of Human Papilloma virus. In addition, the machine will be used to study the genotypes (sub-types) of the virus and will generate evidence that will inform policy on cancer of the cervix prevention in the country as well as providing clinical service to women. Our Institute is the first and only Institution that has this type of machine in the West African Sub-region.

How has the recent upgrading of Biological Safety Level-3 laboratory for MDR-TB research helped to increase your capacity in service delivery?
Recently, our TB Laboratory was upgraded to a Bio-Safety Level-3 Laboratory and has been fully furnished and equipped with the state-of-the art equipment. The Bio-Safety Level-3 Laboratory will enhance our research into Multi-drug Resistant TB (MDR-TB). The project was executed courtesy of Family Health International (FHISGO) with support from USAID. Also, the building of Bio-safety Level-3 Laboratory and extension of the HVL have created jobs for over 1000 skilled and unskilled workforce and this effectively contributes to the federal government’s effort at providing jobs and empowerment for Nigerians, which also helps to keep miscreants out of the street.

Assess efforts of the institute in the dissemination of research findings?
As a research institute, one of our mandates is to disseminate research findings. In response to this mandate, NIMR has institutionalized Annual Scientific Conference and an International conference which is done every three years. The conferences have huge participation and  are used to disseminate our research findings and share experiences among researchers from across the globe that will be benefit not only the scientists but also policy makers and organised private sector. We also produce policy briefs for policy makers which are made available to the Federal Ministry of Health from time to time. In addition, we have regularly engaged the media during which we present some of our research findings for the benefit of the public. We also have upgraded and improved the quality of the Institute’s Journal, The Journal of Clinical and Biomedical Research.

Assess the scope of research by the institute?
Our Research Institute is the only medical research in the Nigeria, therefore, the entire country is our constituency. But unfortunately, the Institute has only two outstations (Kainji in Niger State and Maiduguri in Borno State). Our desire to expand our operational base has been stiffened by inadequate funding. We need to refocus our research activities in all the geopolitical zones, as each zone has distinct social, cultural and religious background that may make it difficult to extrapolate research findings from one geopolitical zone on another. There is therefore the compelling need to establish research offices in the zones where currently none exists.

A recent report stated that Africa has access to only five per cent of research grants. What are the innovations for improved access to research grants in the country?
We are aware that government alone cannot fund research and therefore, we were determined to source for funds from other sources.  We engaged ourselves in advocacy to many organisations and agencies. One of such agencies is CDC Nigeria. The Country Director Dr Okey Nwanyanwu must be commended as he drew our attention to the need to register with National Institute of Health (NHI) and obtain DUNS (Data Universal Numbering System) to access funds directly from NHI in response to calls for proposals.

As I speak, the Institute has effectively registered and now has a DUNS number. The immediate consequence from the registration is success recorded in three of our proposals which have been approved for funding. The first research study for funding will commence this September. As a Research Institution, I consider this as a very  major achievements, as it is the first time ever the Institute is accessing fund directly without going through a third party.

Assess efforts of the institute in creating enabling work environment for research?
For the first time in the history of the Institute, a five-year-strategic plan was developed to give direction to the operation of the Institute. Since the past three years, we have intensified efforts in building capacity of our staff, researchers and scientists from other institutions in the country and abroad. Such capacity development and knowledge management courses include; grants writing workshops and mentorship which is to ensure that our proposals are competitive. Others are; Malaria microscopy training for physicians, scientists, laboratory scientists and laboratory technicians. In addition, we carry out yearly training courses on molecular biology and bioinformatics with impressive attendance and participation. Over 200 scientists and IT students have benefited from our capacity building training courses during this period under review.

Discuss the institute’s collaboration and partnerships with international organizations?
The Institute has continued to expand its collaboration and partnership. The long standing relationship between Partec (Germany) and NIMR has resulted in the signing of an MOU whereby Partec will establish a centre for excellence for training laboratory technologists and technicians. NIMR also have a long standing relationship with both Roche Diagnostics and Roche Pharma from which both the institute and the general public have benefitted greatly.

For Instance, our DNA studies of Hepatitis 13 and C viruses has been made possible through our collaboration with Roche Diagnostics. Also, the Cobas 4800 Machine was given to NIMR by Roche Diagnostics, through an arrangement which makes it easier to pay, otherwise, it would have been impossible to procure the equipment at this time of poor funding of the institute. We also enjoy excellent collaboration with the Centre for Global Health, Northwestern University and also International Association of National Public Health Institutes (IANPHI).

State your achievements, challenges and plans ahead of 2015 which the terminal year of the MDGS.
On assumption of duty in the Institute on the May 22 2010, I outlined the structure of my administration with well defined objectives anchored on good governance, respect for due process, accountability and rule of law, which are the basic ingredients for re-positioning taking the foremost Health Research Institute in Nigeria to be a centre of excellence for health research. I believe that we are working in line with this principle of my administration. The celebration of the anniversary was used as a platform to discuss evidence-based study that seeks to proffer solutions to common health problems that afflict our people. This we did by selecting a topic on contemporary health issue and practically discussed possible solutions. The key topic was: Humanitarian Disaster risk Management: The case study of flooding in Nigeria which tackled social, economic and health consequences of flooding, as witnessed between August and November, last year. 

There is need to x-ray the problem of flooding and find permanent solutions to avert it. Experts in from different discussed this component of humanitarian crisis that has assumed International concern. We also used the occasion to review our activities during the past year and re-strategize for improved performance in the coming year, apart from increasing awareness among policy makers and other Nigerians on the mandate of NIMR and the available facilities for research, clinical services, capacity development and partnership for promoting quality of health research, and other services through shared knowledge and experiences.
We need to intensify our efforts in sustaining health capacity development to generate new knowledge that will impact the health of Nigerians. We need to develop a commercial unit of the institute using NIMR Consult currently being registered with Corporate Affairs Commission (CAC). We have to Intensity our advocacy to policy makers to appreciate the value of research so that they can substantially invest in health research for national development.

This story was published in Newswatch Times on August 29,  2013.

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