Medical/Public health interventions

[raula]

thx for the note dada-ni mzuri kukuona hapa tena. I hope mambo ni mazuri.

[NinBrown]

The way HIV/AIDS spreads makes it easier to spread in communities where there is high rate of promescouity & deviant sexual practices. Hence Africa, India and guy men.

You see here in the UK HIV/AIDS is exclusive to Guy men(60%)and african immagrants.

FF...why does it suprise you drug companies dont want to research inot drugs...cos at the end of the day their aim is to make money. Its upto public institutions to carry out this research..therefore there are no moral or ethical implacations for me in this matter.

 

There are almost 50 different brands of anti-hypertensives and only 5 brabds of antimalarials...whilst malria kills 2million kids each year....so its all about money..Hypretension..chronic..affects affluent nation..in comparison to malaria..acute infection..poor nations... did you know GSK(drug company) spent more money advertising/promoting one anit-hypertensive drug in the USA than Coca-cola spent spent advertising in the entire world...so its about money.

[NinBrown]

TB TB TB TB

 

I work in a hospital with a large Somali population....and TB is very common..in fact 80% of the TB workload are somali patients and the remainder are HIV patients.....even it got to the stage where my medical school exams all the TB question scenirios where Somalis...and now when I work in A%E(ER for the yanks)..we assume any Somali patient has TB unless otherwise prove.

 

Can the epedimiolagist and every1 else shed light on my is TB so common among Somalis, why is it a taboo subject and many patients hide their infection and consequently not take their medication....please educate me....and this hopefully will benift the patients at my hospital.

[raula]

Nino dear-you might want to go back to 1st and 2nd pages of this thread-hopefully, you will find tid-bits of info regarding why TB is so prevalent among Somalis.

 

NB: I assume that one crucial factor as to why TB rates are elevated in our population is because we have "GENERAL MEDICAL TERMINOLOGY" when referencing to symptoms of a disease-Iam talking about Mainstream somalis whose medical education level is minimal or informal. For instance, the earlier symptoms of TB and other respiratory diseases can be ignored by an individual because we have no SPECIFIC TERM for it-nevertheless, even with severity of the disease many are confused whether to term it as "qaaxo, bronkiito,etc" because when you check the description, they seem to entail similar symptoms/signs.

 

Nonetheless,unless acculturated to either western or other medicinal practices..many somalis still retain/maintain TRADITIONAL MEDICINAL PRACTICES(Herbal Medicine) as perhaps the cure to all infections regardless of its ETIOLOGY. The elderly especially, hesitate to seek medical services due to skepticism over western medical practices and its suspected consequences(which is logic in a way,... for instance in the book: The Spirit Catches You and You Fall Down-by Anne Fadiman: A Hmong Child, Her American Doctors, And the Collision of Two Cultures ). Bottom line: conflicts arise because many immigrant communities(including somalis) CONCEPTUALIZE health and disease differently than their western health care providers.

 

Lastly but not least: TB again I repeat-is a LATENT DISEASE (meaning one can be asymptomatic-not showing signs-without proper diagnosis). Therefore many assume that they do not have the disease, when indeed the opposite is true.

 

NB: in regard to HIV/AIDS-TB is an opportunistic disease and without proper nutrition(for AIDS patients that is), lack of access to ANTI-RETRO VIRAL Drugs-the result is dangerous(death).

 

 

So: NINO, I hope I have provided slight info-in regard to your questions. Iam no expert nor an epidemiologist-although I hope to be someday-IA.

 

Ma'salaama

[Mowgli]

To me the reason why there is such a high prevelance of TB within Somalis is because of the whole stigma that arises from the disease, this means they do not take their course of treatment (at all of even finish it but that is if they do decide to see a doctor in the first place) and not only increasing their chances of become resistant to the antibiotics, but also taking part in spreading the disease even further!

 

Somalis like to ignore problems, try talking about AIDS or even suggesting that there are Somalis in the world that have AIDS or have died because of it and what you get is "maya maya waaxas maa jiro"

 

I remember once asking a relative what the Somali word for depression is and their reply was "there is no word for depression, Somalis don't suffer from it"

 

I don't know how many of you read the New Scientist, but in last weeks issue (27th of November) they had an article on HIV and antibiotics, how by giving children a certain antibiotic usually used to treat pneumonia...I think (can't remember the name), it decreased their chances of dying by five fold.

 

Although it is in no way a cure for HIV, these antibiotics are much easier to obtain then antiretinovial drugs in Africa.

 

I'll try finding the article tomorrow inshaAllah.

 

salaams

[Vanquish_V12]

Believe or not, TB is not as easy to cure as u believe simply by taking ur six month long antimicrobial treatment, first of all most antibiotics are useless due to resistance furthermore, unlike most bugs once phagocyotized are rendered harmless and are degraded, TB through mechanism we are now begining to understand prevents the fusion of endosome and lysozyme hense preventing also it inhibits the activation of macrophages by the either T or B cells hence preventing its demise and it's therefore able to live within the macrophages away from extrecelluralar antimicrobial drugs. there is so much of this bug we dont understand its redicules, hey who cares most of the people dying from it are africans nways.

[raula]

^^^Very skewed aren't we-if africans are the ones dying from this disease(I have no idear where you got this slanted facts/figures :rolleyes: )-what makes you think that this disease wont diffuse to other populations-mind you it being a highly communicable disease? W/C back to reality bro-TB is prevalent in our populations).

 

NB: If TB is comprimising the immune system of the host(as its inhibiting effects on the microphage and phagocytic cells- T & B cells)-dont you think that the combination with HIV virus-which affects the T-cells(CD4 count)-inturn by initiating a reverse-transcriptase reaction)will be a DEADLY catastrophe :eek: :eek: Hence that's why TB is a detrimental consequence for patients inflicted with HIV/AIDS.

 

Think bro Vanquish-I know you are smarter than that-maybe eggzams are just killing ya-Same here but atleast I haven't lost it yet

 

Somalis aren't angles immune to the catalysms of this world-stop being impractical.

[MR ORGILAQE]

Very skewed aren't we-if africans are the ones dying from this disease(I have no idear where you got this slanted facts/figures )-what makes you think that this disease wont diffuse to other populations-mind you it being a highly communicable disease? W/C back to reality bro-TB is prevalent in our populations).

 

 

Right what was it you were saying? you lost me after that.You folks here are too clever for me!!!!!

[raula]

^^^Iam not following your question either -what are you asking?

[Vanquish_V12]

I feel compelled to give a brief clinical describtion of TB.

 

1/3 of world population approx 2 billion have what is called Tubercolous infection. meaning they have been exposed to the pathogen and got infected with it. however only 10% of those progress to the disease n contagious stage known as Tuberculosis infection.

 

TB kills about 2 million a year, and approx 20 million cases become active per year, meaning they get tuberculosis.

 

now, ur question about the synergestic nature of HIV and TB, although epidemiological studies have shown Having HIV will increase ur chance of progressing to the disease stage of tuberculosis infection, it merely reflects ur inability to fight the bug because of comprimes immunity and has nothing to do wit activation of reverse transcriptase.

 

infact approx 25% of AIDS victims die of TB in subsaharan africa.

[Vanquish_V12]

yea i think i trully lost it cuz i just read what u wrote again, n seems like i completely miss understood ur assertion.

 

nways, i hope u cant find in ur heart to forgive me

[Bess.]

Because ppl are not as informed as they need to be about thier health they sometimes makes things worse for themselves by not taking them seriously....wheather its from shame or ignorance...we have to learn how to arm ourselves with information and knowledge to battle this diseases....

Drug-resistant TB is caused by inconsistent or partial treatment, when patients do not take all their medicines regularly for the required period because they start to feel better, because doctors and health workers prescribe the wrong treatment regimens, or because the drug supply is unreliable. A particularly dangerous form of drug-resistant TB is multidrug-resistant TB (MDR-TB), which is defined as the disease caused by TB bacilli resistant to at least isoniazid and rifampicin, the two most powerful anti-TB drugs.

From a public health perspective, poorly supervised or incomplete treatment of TB is worse than no treatment at all. When people fail to complete standard treatment regimens, or are given the wrong treatment regimen, they may remain infectious. The bacilli in their lungs may develop resistance to anti-TB medicines. People they infect will have the same drug-resistant strain. While drug-resistant TB is generally treatable, it requires extensive chemotherapy (up to two years of treatment) that is often prohibitively expensive (often more than 100 times more expensive than treatment of drug-susceptible TB), and is also more toxic to patients.

 

Alot of third countries are suffering from the lethal combination of HIV and TB, each speeding the other's progress. HIV weakens the immune system. Someone who is HIV-positive and infected with TB is many times more likely to become sick with TB than someone infected with TB who is HIV-negative. TB is a leading cause of death among people who are HIV-positive. It accounts for about 13% of AIDS deaths worldwide. In Africa, HIV is the single most important factor determining the increased incidence of TB in the past 10 years.

[MR ORGILAQE]

Doctor Raula ZZZZZZZZZzzzzzzzzzzzzzzzz....... sorry i fell asleep halfway through your paper on .....Malaria and Aids and hepatitis now i dont knwo what to eat what kind of a diet would you suggest?.

[Alle-ubaahne]

Dr. Raula,

 

Who doctors/treats you when you get sick? I believe doctors can get sick as well. So my question to you is how best would you seek for medical attention if something goes wrong with you?

 

Don't tell me you take some bills, ok.

[MR ORGILAQE]

Don't tell me you take some bills, ok.

 

 

i didn't know bills can cure!!!!