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Trials conducted in Kenya and Uganda show preexposure HIV prophylaxis effective among couples

Posted by Administrator on March 7, 2012

March 7, 2012 (Seattle, Washington) — The partners of men and women infected with HIV-1 who were treated prophylactically with once-daily oral tenofovir or combination emtricitabine/tenofovir were at reduced risk for infection, according to a study presented here at the 19th Conference on Retroviruses and Opportunistic Infections.

The researchers conducted a randomized trial of 4758 heterosexual couples from Kenya and Uganda. In each participating pair, one individual was HIV-1 seropositive and one was HIV-1 seronegative. In 62% of couples, the uninfected partner was male. Seropositive participants were ineligible under national guidelines for antiretroviral therapy at the time of enrolment.

Couples received HIV-1 treatment and prevention services, including counseling and condoms.

Seronegative participants were randomized to receive once-daily tenofovir, combination emtricitabine/tenofovir, or placebo, and were followed for up to 3 years.

Jared Baeten, MD, PhD, associate professor of global health and assistant professor of allergy and infectious diseases at the University of Washington, Seattle, presented the findings. He said that medication adherence was 97% based on monthly pill counts; retention rate was 96%.

During the study period, 82 new HIV-1 infections were diagnosed. Of these, 52 occurred in the placebo group, 17 in the tenofovir group (risk reduction [RR], 67%; 95% confidence interval [CI], 44% to 81%; P < .0001), and 13 in the emtricitabine/tenofovir group (RR, 75%; 95% CI, 55% to 87%; P < .0001).

Risk reduction was observed in both men and women in the 2 treatment groups, but the difference between groups was not significantly (P = .23).

There was no difference in serious medical events in the groups. There were few cases of resistance. Of 8 subjects infected at randomization, 1 developed the K65R resistance mutation and 1 developed the M184V resistance mutation. None of the subjects who acquired HVI-1 infection after randomization developed K65R or M184V mutations.

The placebo group of the study was halted in July 2011 because of demonstrated success.

The researchers saw no evidence of increased incidence of risky behavior. In fact, condom use went up in all 3 groups, Dr. Baeten reported.

These findings are in contrast with other research presented at the meeting, which showed that a once-daily oral emtricitabine/tenofovir combination did not reduce the risk for HIV infection in 2120 women in South Africa, Kenya, and Tanzania.

The women were followed for 52 weeks, during which there were 33 new infections in the emtricitabine/tenofovir group (incidence rate, 4.7/100 person-years) and 35 in the placebo group (5.0/100 person-years; hazard ratio, 0.94; 95% CI, 0.59 to 152; P = .81).

The researchers noted that adherence was inadequate, according to pill counts and serum analysis of drug levels (detected in less than 50% of infected patients and uninfected control subjects).

The results of the couples study are encouraging, especially in light of the protective effect on women, said Chris Beyrer, MD, MPH, professor of epidemiology and international health at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and the North American representative for the International AIDS Society.

The protective effect of treatment on men is fairly consistent. However, “there have been other studies in women where the outcome was not efficacious. This is one of the few trials of [preexposure prophylaxis] in women that showed efficacy…. That’s encouraging,” Dr. Beyrer told Medscape Medical News.

The difference between the 2 trials presented might be attributable to adherence to the protocol, which “is a huge challenge. People think of [pre-exposure prophylaxis] as a biomedical prevention, but it turns out it’s a lot like condoms. It works great if you use it,” said Dr. Beyrer.

Dr. Baeten and Dr. Beyrer have disclosed no relevant financial relationships.

19th Conference on Retroviruses and Opportunistic Infections (CROI): Abstracts 29 and 32LB. Presented March 6, 2012.

Source: http://www.medscape.com/viewarticle/759818

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Documentary—-Hope positive: The search for HIV/AIDS cure

Posted by Administrator on January 18, 2012

This is an inspiring documentary on the search for a cure of the deadly disease AIDS. It touches on the progress on the ground and the efforts being poured into research to help in the search for a cure.

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Mentally Ill Mother Jailed Indefinitely

Posted by Administrator on April 21, 2011

A mother who went berserk and attempted to kill her two children was yesterday imprisoned indefinitely by an Embu Court.

Lilycate Gaturi Nyagah was sent to the Embu G K Prison where she will remain at the pleasure of the President. Principal magistrate Lucy Mutai said the suspect committed a very serious crime by permanently maiming her children.

She said Lilycate was found to have been mentally ill at the time of the incident, was treated at Mathari Mental Hospital and got well, and is still on medication.

The magistrate said in spite the of her mental health improvement, probation officers recommended that she be given a custodial sentence as they feared she might repeat the offence. She said she supported the proposal and because the suspect was a first offender, she committed her to the Embu prison.

Lilycate was charged that on July 23 2008 at Njukiri Village, Gatunduri South Location in Embu County she unlawfully assaulted her 10-year-old daughter and her three-year-old son. She was said to have woken up at dawn, and without provocation started slashing the children with a panga. She cut her son more than five times on the head and amputated three of his fingers.

Lilycate cut her daughter several times on her neck and back before their grandmother whom they lived with screamed for help when she was woken up by the childrens’ cries.

Neighbours and family members rescued the children and and took them to hospital. They took Lilycate to the police station. The children remained in the hospital for some period receiving treatment before they were later discharged.

The suspect was allegedly married before she separated with her husband after their relationship went sour before she went to stay with her parents.


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Who’s to blame when she aborts?

Posted by Administrator on March 30, 2011

I almost lost a friend to a botched abortion three months ago. Luckily, we rushed her to hospital in time and she got treatment.

I was very angry with her and wanted to know why she would risk her life like that. But when I met her family, I understood why she had made that risky decision.

They were so absorbed in condemning her for getting pregnant in the first place, they were blind to the fact that she had nearly died, and was battling a host of emotions, including guilt and regret.

Her brother refused to greet or talk to her, and when he did speak, he said, “You are a disgrace to our family. From today, don’t call me your brother.” And then he walked away.

To my horror, her father warned her never to set foot in his home again, telling her to go to whoever had made her pregnant. I expected her mother to plead with him to go easy on her, but instead she supported him.

As you read this, she is now doing odd jobs to pay her way through university. Her saving grace is the Higher Education Loans Board, which granted her a loan.

My friend’s experience convinced me that parents are the reason most young people seek abortions. It is common for girls who get pregnant out of wedlock to be shunned by their families. This usually marks the end of the girl’s education and leads to miserable and abusive relationships.

In most cases, the man responsible for the pregnancy refuses to shoulder the responsibility and the poor girl ends up in the cold alone.

In most cases, the girl will spend the rest of her life alone because, let’s face it, how many men are willing to marry a woman who already has a child with another man? Very few, I dare say.

Everybody makes mistakes. When we do, we all expect forgiveness from God and man. We also expect understanding, and support from our families, especially our parents.

Who, then, can we turn to if they are the first ones to throw the stone? What do we do when they become part of the crowd that jeers and ridicules us?

No woman wants to be in that difficult situation, so a girl who finds herself pregnant is likely to take what she considers to be the easy way out — abortion.

She will risk her life so that she can save herself the shame and rejection she knows will come should she decide to carry the pregnancy to term. I believe that if parents were more accepting of their children when they made a mistake and supported them at that vulnerable time, the rate of unsafe abortions would significantly reduce.

It’s about time adults realised that pre-marital sex among young people is a reality. Some parents don’t talk about protection and safe sex with their children, yet they expect them to sail through school unscathed.

When these children go to college, they are exposed to a lifestyle they aren’t used to, a lifestyle brimming with temptation. No one prepared them for it and they end up pregnant.

Most girls who fall into this trap are bright and given an opportunity, they would resume their education and become high achievers in their fields.

There is a common Swahili saying that “Kuteleza sio kuanguka” which means that slipping does not necessarily mean falling down.

Getting pregnant while in school, or out of wedlock does not spell the end of life. Who knows, that unwanted baby could turn out to be the next Obama.

Source: http://www.nation.co.ke/Features/Living/Whos+to+blame+when+she+aborts+/-/1218/1135128/-/2e9v5n/-/index.html

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Kenyan woman’s life changed when husband returned HIV positive

Posted by Administrator on March 15, 2011

For 10 years Amina Hassan (not her real name), 37, trusted her husband and had a happy married life in Nakuru, in Rift Valley Province, western Kenya. Even if her religion allowed him to marry other wives, he had always assured her that she was enough, and he would have no reason to marry anyone else. But she told IRIN/PlusNews that life changed when her husband went to work in the port city of Mombasa and he returned a different man.clearpxl

“I got married in 1994 at the age of 20 to a man who was five years older than me. Every time we talked, he assured me of his love for me and his commitment to making me happy all the time. He said he was faithful to me even though as a truck driver he traveled for long distances and many days.

“In return, I remained faithful to him, I would miss him when he traveled but kept off the temptations of having another partner. He had rented a house for us in Bondeni, Nakuru, and I made sure no man, even a relative, visited in his absence, lest speculations start spreading around.

“In January 2004 he told me he would be working around the costal town of Mombasa for three weeks but… he did not return as promised and told me on the phone that he would take a little longer, as he had been assigned more work.

“When he came back in July the same year, it was a joyous moment for me and our children. But unlike before, the joy did not last over the night.

“He had never before asked to have anal sex with me, but on that particular night he demanded that it had to be done ‘the modern way’. When I resisted, he threatened to leave me, saying I and the children would soon die from starvation as he would no longer provide for us.

“He even asked me to return 6,000 Kenyan shillings (US$75) that he had given me to shop for the house and children the following day. On that night I gave in, only to keep the money and avoid confrontation.

“I hoped that he would calm down and I would explain to him that it was not my preferred way of having sex. It was so painful, both in my heart and body, but it was a sacrifice I would make for my children.

“It later became the order of the day, though sometimes we would have sex the normal way, he preferred anal sex, claiming he derived more pleasure in it. I suffered bruises but had to bear the pain. I would cry during and after sex, but I still had to stick to this man, who provided and still provides for me and my children.

“Four months later my situation deteriorated. The wounds were more painful than ever and even started producing pus – that’s when I went to a government hospital.

“Though I felt hurt by the inquisitive nurses, I had to bear also with their sarcasm as they mocked me due to the nature of my injuries.

“Worse still, it was then that I tested HIV positive. I felt so betrayed, the first thing that came to my mind was that I should commit suicide.

“I still had sex with him, yet I could not disclose my findings as yet. I wondered whom I would share with my problems, but still I wanted to keep them to myself – it was the safest way.

“Later I met an old friend who had been open about his HIV status, and was running an organization for the infected. It was Paul Ndegwa, the founder of Ambassadors of Change organization who advised me to start ARV [antiretroviral] treatment.

“Though Ndegwa advised me to stop having anal sex and enlightened me on the dangers associated with it, I still cannot avoid it – it has become my way of life. My husband still insists on it, and threatened to abandon his own family.

“I do not have a job, I want to keep my promise to live with this man. I see no need of divorcing him when I am already infected. If only for my children, I will remain in this man’s house, being obedient and submissive. I know he hurts me, but I have already forgiven him.

“I keep going to hospital for the ARVs, which I take secretly and for treatment of anal injuries. For me sex is a punishment, no longer pleasure I would want to enjoy.

“I joined Ambassadors of Change as a member without his knowledge. I disclosed my status to him, but he just kept silent, just as if I had said nothing.

“I tried advising him to go for a HIV test, but he insisted he was sure that he was negative, and need not be tested. But I suspect he knows his status and is taking ARVs secretly because he still looks healthy.”

Read more: http://www.allheadlinenews.com/briefs/articles/90038383?Kenyan%20woman’s%20life%20changed%20when%20husband%20returned%20HIV%20positive#ixzz1FfM5hYNY

Posted in Kenya_Health | 6 Comments »

Kenya’s Mentally Ill Locked Up And Forgotten

Posted by Administrator on February 27, 2011

The tin shack looks like any other in a patch of small plots on the dusty outskirts of Nairobi. It’s the haunting sound that grabs you, the awful moaning and cries coming from within.

It’s Thomas Matoke’s home. But it’s more like a cell. Matoke, 33, is tied to a steel bedframe with a piece of blue rope. He’s surrounded by pools of his urine, his mattress soiled and ripped to shreds.

His moans are interrupted when he chews his hand or the bedframe. He can’t speak to tell his mother what he wants or feels. He’s alone in his world of screams and agony.

He’s been like this for 30 years.

Matoke got ill when he was a toddler and lost much of his high-level functioning. So his mother ties him up to prevent him from running away or hurting himself.

Countless trips to doctors and hospitals haven’t helped him. And poverty means there isn’t much medical help his family can afford.

“His siblings ask whether we wronged God, because we are really suffering,” said his mom, Milkah Moraa. “I can’t even hang his clothes outside because of the stink. The neighbors complain.”

Shunned by the community, Moraa does what little she can to ease his agony. Her life is consumed by trying to take care of her sick son.

But Matoke is not alone.

There are an estimated 3 million, mostly poor, Kenyans living with intellectual and mental disabilities, according to NGO and United Nations figures.

As part of a special investigation, CNN found that families are struggling to cope with their loved ones, receiving little help from the state and facing massive stigma from society.

CNN’s team filmed families locking up their loved ones, children discarded by institutions, cases of suspected sexual abuse. Kenya faces an epidemic of neglect.

“It is such a huge problem,” said Edah Maina, head of the Kenya Society for the Mentally Handicapped. “If somebody would understand the extent it is huge, then I think someone can begin to act.”

But often, Maina and her charity are the only ones acting. Scores of cases of neglect and abuse flood their office every day: autistic children chained in chicken coops, epileptic adults sealed in filthy shacks, daughters raped by their fathers. They are overwhelmed.

Dr. Frank Njenga, president of the African Association of Psychiatrists and a leading expert in the field, believes the scale is “catastrophic.”

“We as a people have perfected the system of hiding our friends, relatives and other loved ones who have intellectual disability away from sight,” Njenga said. “Out of sight, out of mind, no funding, neglected completely.”

He says that the greatest neglect comes from the Kenyan government.

How teenager Kennedy survives

The Kenyan government spends less than 1% of its health budget on mental health, though its own figures show that one-quarter of all patients going to hospitals or clinics complain of mental health issues.

And the Health and Medical Services ministries have been plagued by a series of corruption scandals in recent years.

More than $3 billion in public money was stolen in 2009, according to the Kenyan Ministry of Finance. This could have funded the entire ministry responsible for mental health — for 10 years.

The minister of medical services, Anyang Nyong’o, says mental health is a high priority, but it needs more funding from his central government.

“It is definitely starved of resources, and that is not because we want to intentionally starve mental health; that is because the resource base as we have for running health services is very narrow,” he said.

“The policy is very clear,” Njenga said. “Mental health services are a priority in this country. The practice is also clear. They are not.”

Whatever the cause, it is ordinary Kenyan families who suffer. And often, it’s mothers who toil alone. Thomas Matoke’s father has been absent for most of the past 30 years. Moraa says Matoke’s condition pushed him out.

“For how long will I carry this burden?” she asked. “Since I got married, I have not had joy the way other people have joy. I have tried to encourage myself and think ‘God help me, because I have carried this burden for a long time.’ ”

They have been chased away from village after village by angry, fearful neighbors. And soon, she fears, they will have to move away from this place as well.

Links to the Kenyan issues

When the weather is good, she takes Thomas from his makeshift cell and ties him to an acacia tree outside. If she lets him go, he runs off. What she most wants is a place where he can get proper care.

But she says there is little chance of that happening.





Source: http://edition.cnn.com/2011/WORLD/africa/02/25/kenya.forgotten.health/

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What are the symptoms of an HIV infection?

Posted by Administrator on January 24, 2011

It costs about Sh10,000 per year to manage opportunistic disease associated with those with the HIV virus if they know their status compared to Sh250,000 for the same case for those who are not aware of opt to hide their situation. Photo/LIZ MUTHONI

It costs about Sh10,000 per year to manage opportunistic disease associated with those with the HIV virus if they know their status compared to Sh250,000 for the same case for those who are not aware of opt to hide their situation. Photo/LIZ MUTHONI

What are the symptoms of HIV infection?


Due to the nature of HIV infection and the resultant destruction of the immune system, HIV and AIDS may present themselves in widely varying ways.

Many of the symptoms do not result from the HIV infection, but from other infections that opportunistically occur due to the lowered immunity. To simplify the clinical picture, symptoms are classified in different syndromes:

1Acute Retroviral Syndrome — Soon after infection (6 to 8 weeks)

  • May have no symptoms
  • May bear mild to severe flu-like symptoms
  • Mononucleosis-like Syndrome
  • Fever
  • Swelling of lymph nodes/glands
  • Pharyngitis (sore throat)
  • Skin rash
  • Joint and muscle pains
  • Non-specific symptoms such as diarrhoea, nausea, vomiting, weight loss, fungal infections (either of the mouth or vagina) or nerve disorders.

2Asymptomatic Infection

May only present with persistent swelling of lymph nodes in different parts of the body.

3Symptomatic Infection (Usually long-standing symptoms, or recurrent ones, despite treatment)

  • Fever for more than one month
  • Diarrhoea for more than one month
  • Persistent vaginal thrush (fungal infection)
  • Various cancers
  • New onset or persistently recurrent genital or oral herpes (cold sores)
  • Herpes zoster (also called shingles)
  • Blood disorders
  • Persistent pelvic inflammatory disease (infection of the female reproductive tract)
  • Heart disease
  • Renal disease and/or renal failure
  • Skin disorders such as seborrheic dermatitis

4AIDS Defining Opportunistic Infections (When one presents with these, they are said to be having AIDS)

  • Cryptosporidiosis (fungal brain infection — headaches, fever, altered brain function)
  • Cryptococcus (fungal infection of brain, lungs or skin)
  • Cryptosporidiosis (fungal infection resulting in abdominal pain, prolonged diarrhoea, fever and weight loss)
  • Cytomegalovirus (viral infection affecting the liver and brain)
  • Herpes simplex (viral infection)
  • Histoplasmosis (bacterial infection affecting the lungs, liver and blood)
  • Isosporiasis (lung infection)
  • Mycobacterium infections (for example, Mycobacterium Tuberculosis or Avium Complex that affect any organs in the body)
  • Fungal pneumonia
  • Recurrent severe typhoid blood infection
  • Brain toxoplasmosis (parasitic brain infection)

— This is Part One of a three-part series on HIV/Aids. Catch more on the subject next week. Send your other medical questions to nation@askadoc.co.ke

Source: http://www.nation.co.ke/Features/DN2/What%20are%20the%20symptoms%20of%20an%20HIV%20infection/-/957860/1095038/-/mv4lagz/-/index.html

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Herb halts spread of HIV in blood

Posted by Administrator on December 23, 2010

Dr Michael Odotte exhibits his products at a recent Kenya National Academy of Science regional conference in Nairobi. Photo/NATION CORRESPONDENT

Dr Michael Odotte exhibits his products at a recent Kenya National Academy of Science regional conference in Nairobi. Photo/NATION CORRESPONDENT

A vine which grows wildly in western Kenya and found to have antiretroviral properties is among a handful of neglected inventions in Africa with the potential to change the continent’s health landscape.

Imbasa as it is called locally in Emuhaya, or Tylosema fassoglensis botanically, also grows in parts South Nyanza and Maseno Hills.

It has been the subject of intense study by researchers from Kenyatta University, Kenya Medical Research Institute, Maseno University and North Carolina University in the US.

Using an extract from the climber, researchers led by Dr Michael B. Odotte, have developed a food supplement called Sunguprot now under commercial incubation at the Kenya Industrial Research Institute.

“It is a protein based protease inhibitor, meaning that it stops the replication of HIV in the body, and has been certified by the Kenya Bureau of Standards as fit for human consumption,” said Dr Odotte.

Last week Sunguprot was part of a slew of papers published by Canada’s McLaughlin-Rotman Centre for Global Health identified as having the potential to offer Africa a home grown health solution.

Sunguprot, says the paper published in the UK-based BioMed Central, is a promising product but it is being held back by lack of advanced scientific equipment to isolate compounds and funding to carry out large clinical trials.

Writing a forward for the papers that included innovations by the Kenya Medical Research Institutes and the Nairobi based International Centre for Insect Physiology and Ecology, Kenyan scholar at Harvard University Dr Calestus Juma says this has come at an opportune time.

“The publication has come at a time when firms in industrialised countries are rethinking their global strategies, especially in relation to the location of new research and production facilities. These papers show that some African countries could be viable partners as they seek to become part of the global knowledge ecology.”

Sunguprot, which was featured in the Nation last year, and comes in the form of flour for porridge, is described as a herbal food supplement with both antiretroviral and nutritive properties, ideal for people suffering from HIV/Aids, the malnourished and the aged.

Talking to the Nation, Dr Odotte said safety and efficacy studies had been carried out in conjunction with the Kemri and it had been found to be safe in primates and significantly lowered the HIV in the blood.

“We were funded by the National Council for Science and Technology to carry out limited clinical trials but we would still need to carry out larger studies,” Dr Odotte said.

He said, they are working with Maseno University on how to domesticate the wild plant for both commercial and conservation. “Already some farmers in Nyatike and Rongo are growing the plant on experimental bases.”

The limited trials carried out under Prof John Mecham of the Department of Biology, Meredith College and Prof Michael Otieno, Department of Pre-Clinical Sciences, Kenyatta University,

Source: http://www.nation.co.ke/News/Herb%20halts%20spread%20of%20HIV%20in%20blood%20%20/-/1056/1077820/-/7im3l4z/-/index.html

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Warning! Your teen could be on Viagra

Posted by Administrator on December 21, 2010

Reproductive health experts as well as chemists say the youth — some as young as 16 — are actively buying sex-enhancing drugs.

In using the cheap aphrodisiacs, the youths are exposing themselves to serious health risks, including stroke, heart attack, and prostate cancer.

“From the feedback we are getting through health care providers, the youth is actively using sex-enhancing drugs,” says Mr Simon Wahome, a reproductive health expert with Family Health Options of Kenya.

Chemists interviewed admitted that youths are actively buying the sex-enhancing pills over the counter, especially over the holidays.

“Sometimes up to 10 come to our chemist asking for the drugs. They do not even ask for instructions on how to use them,” says one Nairobi chemist who did not want to be named for fear of hurting her business.

Reproductive health experts and chemists warn that pornography and alcoholism are fuelling the abuse of cheap aphrodisiacs among the youth.

Due to advances in communication technology, pornography is readily available as long one has an Internet-enabled cellphone which can be had for as little as Sh2,500.

Sexual enhancement drugs marketers largely ply their trade through the Internet, as well as easily available pornographic magazines. And with increased access to the Internet, the marketers are carving a niche in what reproductive experts call the experimenting age.

“Pornography makes sex look like fun — something you can do continuously. In the absence of correct information, young people swallow this lie, leading to their misuse of sex-enhancing drugs,” says Mr Wahome.

These revelations might shock many parents. Sex-enhancing drugs are, after all, largely associated with elderly men seeking medical help for erectile dysfunction.

The National Campaign Against Drug Abuse Authority (NACADA) admits to having little concrete data on the abuse of sex-enhancing drugs among the youth. However, it categorises them as the fifth most abused prescription drugs in the country, after painkillers, sedatives, stimulants, and steroids.

Some of the easily available sex-enhancing drugs include Vega, Stamina, Miagra, Cialis, Levita, and Enzoy.

Pharmacists say Enzoy, a starchy powder sold at Sh50 a sachet, is the most popular with the youth.

Experts say these cheap aphrodisiacs, which have flooded the market, can only complicate matters for a country that has no official sex education syllabus, although 20 per cent of youths admit to experimenting with sex by their 16th birthday.

They claim that these cheap aphrodisiacs help them live up to the benchmarks of sexuality mostly set by un-censored information readily available on the Internet.

“It is about image; they all want to impress their girlfriends with their sexual prowess,” says Denis Junior, a First Year business student at Mount Kenya University.

Although Denis does not use the drugs, he confides that they are the latest sexuality trend among young men eager to live up to their Casanova image.

In the tumultuous world of relationships, he says, young men live in constant fear of their girlfriends walking out if certain performance benchmarks are not met. And much of the information regarding sex falsely sets the benchmark around virility.

The Centre for the Study of Adolescence concurs. As long as the mass media, more so, the Internet, continues to portray the ideal man in sexual terms, then more young people will continue to experiment with such drugs.

“In the absence of adequate and correct information about sexuality, the youths are experimenting with what they gather from the Internet and the mass media,” says Mr Albert Obbuyi, a researcher at the Centre for the Study of Adolescence.

The National Aids/STD Control Programme (NASCOP) warns that more young people are likely to engage in unprotected sex if the abuse of sex-enhancing drugs is not checked.

Dr Nicholas Muraguri, the NASCOP director, says as more young men fall victim to the macho image of sexuality served up by the mass media, sexually transmitted diseases, including HIV and Aids, will take their toll on the youth.

“The urge to show that you are a good performer is likely to lead a person to have multiple partners. And young people are likely to have unprotected sex,” says Dr Muraguri.

According to NASCOP, one in every five teenagers in the country admits to experimenting with sex by their 16th birthday. Only 25 per cent of them use protection.

“If they now start experimenting with sex-enhancing drugs, the gains we have made against the spread of STDs will be reversed,” says Dr Muraguri.

So what is the way forward? Definitely not restricting the avalanche of information about sex-enhancing drugs available to the youth today, says the Centre for the Study of Adolescence.

“On the contrary, we need to talk to them more about their sexuality, at school, at home, and in churches. Give them adequate and correct information on sexuality,” advises Mr Obbuyi.

This approach, he says, will counter the avalanche of un-censored information that is luring the youth to the sex-enhancing drugs market. “Above everything else,” adds Mr Obbuyi, “it will counter the macho image of manhood that revolves around sexual performance and size.”

But for the national sexually transmitted diseases control watchdog, NASCOP, pharmacies should simply stop selling sex-enhancing drugs over the counter.

“These are prescription drugs for people suffering from erectile dysfunction. It is illegal to sell them over the counter,” says Dr Muraguri.

But NACADA concedes that policing thousands of pharmacies around the country to ensure that they don’t sell the drugs to the youth is currently not a priority.

The authority says it is preoccupied with fighting harder drugs like heroin and cocaine.

“We have not done much basic research on the abuse of sex-enhancing drugs among the youth,” concedes a NACADA official.

The Pharmacy and Poisons Board warns that abuse of sex-enhancing drugs exposes the youth to a host of medical complications, including stroke, heart attack, and priapism — a condition in which the penis is continually erect. It is painful and seldom caused by sexual arousal.

“A drug like Sildenasil, or what is commonly called viagra, was initially meant to treat high blood pressure. Abusing it could lead to low blood pressure, causing a host of other medical complications,” warns Dr Jayesh Pandit, head of medicines information at the Pharmacy and Poisons Board.

But all these fly in the face of a multi-million sexual enhancement drug industry, one that is backed by a powerful mass media that continues to propagate the ideal sexual man myth.

And until something is done to counter these sales drives, more youths will continue swallowing the myth that ideal manhood can be purchased — over the counter.

Source: http://www.nation.co.ke/Features/DN2/Warning%20Your%20teen%20could%20be%20on%20Viagra%20/-/957860/1076374/-/item/1/-/beo3xcz/-/index.html

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Kenya teetering on the edge of a colossal cancer disaster

Posted by Administrator on December 14, 2010

Dr Peter Kagotho of the cancer section at the Kenyatta National Hospital prepares a patient for therapy. The two outdated Cobalt 60 machines in use at the hospital cannot adequately meet the needs of the swelling list of patients referred to the facility, and medical specialists in the private sector argue that, at the moment, the country has few specialist cancer surgeons. This means that some of the work best handled by specialists is left to general surgeons, who operate on a broad range of diseases and conditions, especially in provincial and district hospitals.

Dr Peter Kagotho of the cancer section at the Kenyatta National Hospital prepares a patient for therapy. The two outdated Cobalt 60 machines in use at the hospital cannot adequately meet the needs of the swelling list of patients referred to the facility, and medical specialists in the private sector argue that, at the moment, the country has few specialist cancer surgeons. This means that some of the work best handled by specialists is left to general surgeons, who operate on a broad range of diseases and conditions, especially in provincial and district hospitals.

The cancer situation in Kenya is worrying and is characterised by a rapidly growing demographic of new cases and few treatment and management opportunities.

This dark reality came to the fore after a mission from the International Atomic Energy Agency (IAEA) visited the Kenyatta National Hospital in June. The daunting report born of that visit was released recently.

“The cancer situation in Kenya is dire,” the IAEA audit reads in part, “with a severe lack of medical practitioners and a large number of new cancer cases being diagnosed annually.”

The IAEA may strike a familiar chord in the minds of many Kenyans, especially because of its activities in containing the nuclear arms threat in North Korea and Iran. But as cancer spreads its malignant effects in Kenya, all indications point to a bigger and more prominent presence of the agency on Kenyan soil.

Diagnostic kits

Apart from controlling nuclear arms proliferation, the organisation is also a leader in the production of diagnostic kits and the treatment of some cancers.

The June mission, the first of its kind in the region, was aimed at “establishing a sound understanding of where Kenya stands in its attempt to control cancer, and what measures must be taken to ensure that the best possible treatment, prevention, and care measures will be available to all of citizens in the future,” according to the IAEA.

The task ahead is huge, no doubt, but experts have already embarked on the long voyage, says Prof N.A. Othieno-Abinya, head of oncology at the Aga Khan University Hospital and chairman of the Cancer Research and Communications Organisation.

“Although we don’t have reliable local data, we have started to record increasing cases of cancer in our hospitals,” said the consultant in a recent interview with DN2.

But despite the lack of reliable data, he says, two things are clear; cancer is not necessarily a disease of the rich, and that those who seek treatment do so quite late, when treatment is expensive and, generally, not curative.

Prof Othieno-Abinya, who also co-chairs a committee of the African Organisation for Research and Training in Cancer, advises Kenyans to adopt a routine screening culture so that the disease can be diagnosed early.

“Cancer seems to be running ahead of us,” he warns, adding that the Aga Khan University Hospital is already putting up a modern, appropriately equipped cancer screening and treatment centre.

A comprehensive cancer policy for the country has for years been crawling along the bureaucratic corridors and, as it trudges along, it will come out to the agonising reality that the only two therapeutic radiotherapy machines at the Kenyatta National Hospital are way past their use-by date.

The government has finally acknowledged that cancer poses a real threat to its people and, by extension, the economy. A paper it prepared specifically for the IAEA on the cancer situation in Kenya contends that, while a lot more needs to be done, something is already happening.

That “something” includes the recent adoption of the Alcoholic Drinks Control Act, 2010, which aims to restrain the consumption of alcoholic beverages in the country. The Act is relevant in the fight against cancer because alcohol has been found to be a major risk factor for cancers of the mouth and throat.

Biggest percentage

A study by the Kenya Medical Research Institute (Kemri) found that, of the 2,292 cancer-related deaths recorded in Nairobi during a two-year period, oral tumours claimed the biggest percentage of victims.

“Of these, cancer of the oesophagus was the leading cause of death, accounting for 10 per cent (236) of all cancer-related deaths,” says Joseph Omach of the Cancer Research and Communications Organisation, and who has been involved in compiling cancer registry data at Kemri.

Research also indicates that people who develop a liver condition called cirrhosis, in many cases caused by too much alcohol and hepatitis B and C viruses, can develop liver cancer. And women who take more than three alcoholic drinks a day increase their risk of breast cancer.

To complement the new alcohol law in the anti-cancer crusade is the recently passed anti-tobacco Bill, the government says. This is because smoking has also been identified as a major risk factor for cancer, and accounts for almost 30 per cent of all cancer-related deaths worldwide.

Poor facilities

But this two-pronged campaign is likely to be hampered by the dismal availability of facilities in the country, a capacity that would otherwise help hospitals mitigate against the effects of the disease on the population.

The Kenyatta National Hospital plans to replace one of its decommissioned radiotherapy machines by 2011, even though this will hardly give the country any additional capacity to handle the current demand.

This leaves the private sector to take up the challenge. The Cobalt 60 machines used by KNH are the remnants of an old generation, and are equipped with limited capability to optimally treat complex cases. The only centre in the country with newer technology, called Linear Acceleration, is the Cancer Care Unit at the MP Shah Hospital in Nairobi.

But, while this technology is more accurate and handles a higher load than Cobalt 60, it is much more expensive and has very high maintenance demands.

“The machines require a resident engineer and, at the moment, we don’t have such a trained person in the region,” explains Prof Othieno-Abinya.

The installation of two such machines at the Aga Khan University Hospital, planned for early next year, will give Kenya the biggest cancer radiology capacity in Eastern and Central Africa.

The facility will provide wide-ranging treatment in both cardiology and cancer, including radiation therapy and open heart surgery.

“We have to make sure that we get it right by having the right personnel, equipment, and specialised buildings to house these technologies,” says Prof Othieno-Abinya.

However, radiology equipment is only part of the struggle against cancer since not all tumours require this kind of treatment.

“For example,” explains Prof Othieno-Abinya, “Bukitt’s lymphoma, which is a major problem around the lake region and at the Coast, is so aggressive that you can hardly use radiotherapy to cure it. Only appropriate chemotherapy can work.”

Most cancers, he says, require a combination of treatments involving chemotherapy, radiotherapy, and surgery.

A good cancer policy will require an effective drug regulatory authority that ensures that patients get the most effective treatments “because this is not a hit-or-miss disease”.

“A miss may not allow a second chance, and that may cost you a life. However, the high cost of cancer drugs — and cancer care as a whole — needs to be addressed,” says Prof Othieno-Abinya.

Spurred by the growing cases of cancer across the country, the Ministry of Medical Services has made public its plans to open specialist centres in all provincial hospitals. Currently, some patients have to travel more than 600 kilometres to Nairobi, only to be put on an eight-month waiting list.

Medical specialists in the private sector argue that, at the moment, the country has very few specialist cancer surgeons. This means that some of the work best handled by specialists is left to general surgeons who operate on a broad range of diseases and conditions, especially in provincial and district hospitals. This, of course, means that cancer patients are not afforded the opportunity to get quality care.

Dr Jessicah Wambani, chairperson of the Kenya Radiation Protection Board, says there is no academic institution in the country that offers medical physics as an area of study. “The five medical physicists we have were trained abroad,” she told an IAEA publication recently.

And, in a brief to the IAEA, the government says several medical doctors from provincial hospitals have already been seconded to KNH for training as radiation oncologists, while therapy technologists have been recruited for placement in peripheral cancer care centres.

On the flip side, the advent of more radiology machines and other recent diagnostic and imaging technologies presents Kenya with a new problem; that of over-exposure to radiation for medical staff as well as the use of old machines that may not guarantee the correct dosages to patients and users.

There has been an explosion in Kenya of many radiation-using medical facilities, such as CT (computed tomography) scanners, MRI (magnetic resonance imaging) machines as well as ultrasound services, without a corresponding training of technical staff.

According to the IAEA, Kenya has about 5,000 workers in radiation-related jobs at 600 medical facilities. However, only about a quarter of these nurses, patient assistants, dentists, radiographers, and radiologists are monitored for exposure.

“We don’t have national guidelines and standards in diagnostic radiology in Kenya… because we don’t have enough data due to lack of funds,” Dr Wambani told the IAEA.

The agency is working with the KNH and the Moi Teaching and Referral Hospital, Eldoret, to gather radiology dose information to create reference levels for Kenya.

And Dr Wambani says attempts are being made to expand the project to all the hospitals in Kenya’s eight provinces.

Source: http://www.nation.co.ke/Features/DN2/Kenya%20teetering%20on%20the%20edge%20of%20a%20colossal%20cancer%20disaster%20/-/957860/1072328/-/101gdu2z/-/index.html

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