EPN - Ecumenical Pharmaceutical Network

e-Pharmalink is the e-mail newsletter of the Ecumenical Pharmaceutical Network (EPN) an independent, apolitical, non-profit Christian organization. This newsletter aims to alert pharmacists and other health professionals of information sources about international trends relevant to their work and opportunities that could support them in their efforts to provide effective and efficient services, particularly in poorer countries. It summarizes information reported by a wide range of publications or organizations and includes web links to the original sources. Anyone can receive this e-mail. If you have any information to contribute or comments on the content, or if you would like to unsubscribe, subscribe or recommend someone to receive it, please contact Info@epnetwork.org.

This edition includes:

News
Severe pneumonia in children treatable at home
Beyond good intentions: lessons on equipment donations
Paracetamol may be dangerous to health
HIV and AIDS
Tuberculosis (TB)
Malaria

Focus on Resources
Websites
Newsletters
Reports

Severe pneumonia in children treatable at home

Every minute, four children die from the lung inflammation pneumonia which can range in seriousness from mild to life-threatening. Pneumonia acquired in hospital can be particularly virulent. In developing nations, where children are most affected, about 60 percent of cases are caused by bacteria which, under current WHO guidelines, can be treated with antibiotics with severe cases referred to hospitals.

In poor countries, families often cannot easily access hospitals, and many children die before they reach hospital or are too sick to be treated once they arrive.

Citing a Boston University School of Public Health study it helped support, the WHO has said that antibiotic pills given at home were as effective as intravenous antibiotics against pneumonia. This could save scores of lives particularly those from poor nations where access to a health care facility may be difficult.

http://www.alertnet.org/thenews/newsdesk/L0363306.htm

Beyond good intentions: lessons on equipment donations

Most hospitals in resource-limited settings regularly receive equipment donations. Sometimes the equipment presents with some challenges. One such situation was the donation of more than 20 oxygen concentrators to the Royal Victoria Teaching Hospital (RVTH), the Gambia’s tertiary referral centre. The nursing staff reported immediate problems with the units. They typically worked for about 30 minutes before stopping. After an interval a unit would be able to be restarted only to stop again in a recurring cycle. To help solve this crisis a case study was initiated to explore the reasons for this failure and to learn lessons that could be applied to the development of locally appropriate oxygen delivery solutions and enhance the success of future equipment donations. This situation can be adopted and applied to other donations.

http://www.who.int/bulletin/volumes/86/1/07-042994/en/index.html

Paracetamol may be dangerous to health

A Ghanaian pharmacist has cautioned against the excessive use of paracetamol without prescription. A pharmacist at the Tema Municipal Health Directorate has said that "Paracetamol" is abused by many people on the least pain experienced in the body. She warned that continuous usage of the drug without prescription could lead to the damage of the liver.

http://www.modernghana.com/GhanaHome/NewsArchive/news_details.asp?id=VFZSVmVrNUVVWGM9&menu_id=1&sub_menu_id=0

HIV and AIDS

Diagnosis and treatment of CMV retinitis

According to investigators from Medecins Sans Frontieres (MSF), the diagnosis and treatment of CMV retinitis in resource-poor countries is realistic, but is being over-looked in current HIV treatment scale-up plans. In an article in the December 2007 edition of PLoS Medicine, CMV retinitis destroys the entire retina within three to six months, causing permanent blindness. To know how to diagnose and treat CMV specifically in resource-limited settings read:

http://www.aidsmap.com/en/news/463376E7-6DEA-41A3-93C1-22967D70A28F.asp

Kaletra monotherapy can reduce incidences of HIV in the brain

For the first time a single anti-HIV medication, ritonavir-boosted lopinavir (Kaletra), has been shown to bring down levels of HIV in the cerebrospinal fluid. The authors of the report, published in the online edition of Clinical Infectious Diseases, assert that the medication may be of particular help to patients with HIV-associated neurological disorders.

http://www.aidsmap.com/en/news/38321FCC-C8F0-4F77-8146-20A15B113ED1.asp

Starting antiretroviral therapy early at higher CD4 cell counts improves short term treatment outcomes in resource-poor countries

HIV treatment guidelines currently recommend starting anti-HIV treatment when CD4 counts are less than 200 cells/mm³ in HIV-infected patients. However, some patients already have considerable immunosuppression and experience HIV disease progression or even death within a few months of starting antiretrovirals. However recent findings of a paper published in the November 30^th edition of AIDS indicate that HIV-positive adults from Cote D’Ivoire who started antiretroviral therapy before CD4 counts fell below 350 cells/mm³ experienced significantly improved treatment outcomes with fewer deaths when compared to those who started treatment later.

http://www.aidsmap.com/en/news/AEB1F817-99AE-44E1-B51C-7507DC667383.asp

TUBERCULOSIS (TB)

Community-based support group leads to improved outcomes in Moldova

Earth’s Hope is the name of a support group founded by a small group of healthcare providers, social workers, and patients. The group has trained volunteers to monitor the treatment of TB patients undergoing out-patient care. The volunteers also oversee preventive treatment for children who have been exposed to tuberculosis.

http://www.aiha.com/en/WhatWeDo/CONNECTIONS/Connections%2007-SPRING2007/Connections%20SPRING2007%20PDFs/CN-SPRING2007-Moldova
%20TB.pdf

MALARIA

How to respond to malaria in low immunity areas

In areas where malaria transmission is low, unstable and occurring usually after heavy rainfall, the population often develops low immunity to the disease. This has lead to a study conducted by the Danish Institute for Health Research and Development, Ugandan Ministry of Health and the UK’s London School of Hygiene and Tropical Medicine. To view the results of the study, click on the link below:

http://www.id21.org/zinter/id21zinter.exe?a=1&i=h4rn3g1&u=47972f22

Malaria Control and prevention strategy (2006 – 2010)

This strategy developed by the African Medical and Research Foundation (AMREF) in conjunction with the Roll Back Malaria (RBM) project highlights proven-based interventions in the treatment and prevention of malaria particularly in areas where malaria is endemic. It also includes monitoring and evaluation activities for evidence-based advocacy.

http://www.amref.org/docs/malaria_strategy.pdf

FOCUS ON RESOURCES

WEBSITES

Procurement and supply management toolbox website

http://www.psmtoolbox.org/

WHO/AIDS Medicines and Diagnostic Services (AMDS) and its partner organizations initiated the development of this unique PSM Toolbox website for HIV-related health commodities. It has been developed as a central repository for a wide range of health-related procurement & supply management tools. The Toolbox contains a search engine to facilitate quick tool selection.

NEWSLETTERS

AMDSMail
The Aids, Medicine and Diagnostic Services (AMDS) is a network for supply management of HIV commodities and brokers cooperation between technical partners, funding agencies, manufacturing companies and other organizations.

Every three months AMDS produces the AMDSMail, a news letter whose purpose is to provide information on key procurement and supply management (PSM) related developments and activities by the AMDS team, and its partner organizations. The latest edition of the news-brief can be viewed at:

http://www.who.int/hiv/amds/AMDSmailDec07.pdf

Further information on how to receive alerts of the brief can be viewed at:

http://www.who.int/hiv/amds/amdsmails/en/index.html

REPORTS:

Managing meningitis in HIV infected persons in resource limited areas

This is a clinical review which covers meningitis particularly among HIV positive individuals in resource-limited settings. It covers the prevalence rates, diagnosis, treatment of the infection and prevention.

http://www.aidsmap.com/cms1256394.asp

Report on international training course on Promoting Rational Drug Use in the community

This course concentrated on methods to study and remedy inappropriate medicine use in the community, including an analysis of what influences the medicines demand. This report gives a detailed account of the topics handled during the course. They included what influences drug use, prioritizing community medicine use problems, conducting a rapid appraisal to analyze problems and identify solutions and, making an appraisal matrix and preparing tools.

http://mednet3.who.int/prduc/

WHO Global strategy on containment of antimicrobial resistance

This strategy covers six key points required to respond to the problem of antimicrobial resistance. They include disease prevention, access and appropriate use of antimicrobials, surveillance and, the need for appropriate legislation and focused research.

http://www.who.int/drugresistance/en/

To view the full strategy click on the link below:

http://www.who.int/drugresistance/WHO_Global_Strategy_English.pdf

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