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Air pollution kills 600,000 children annually – WHO

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Exposure to toxic air both indoors and out kills some 600,000 children under the age of 15 each year, the World Health Organisation (WHO) warned Monday.

Data from the UN health body shows that every day, 93 percent of children under the age of 15 — a full 1.8 billion youngsters, including 630 million under the age of five — breath dangerously polluted air.

This has tragic consequences: In 2016 alone, some 600,000 children died from acute lower respiratory infections caused by polluted air, the WHO report found.

“Polluted air is poisoning millions of children and ruining their lives,” WHO chief Tedros Adhanom Ghebreyesus said in a statement.

“This is inexcusable. Every child should be able to breathe clean air so they can grow and fulfil their full potential.”

According to WHO data, more than nine out of 10 people on the planet breath dangerously toxic air, causing some seven million premature deaths each year.

Air pollution is especially dangerous for children, and accounts for nearly one in 10 deaths among children under five around the globe, the report found.

WHO’s study, which examined the health toll on children breathing health-hazardous levels of both outdoor and household air pollution, focused on dangerous particulate matter with a diameter of less than 2.5 micrometres (PM2.5).

These include toxins like sulfate and black carbon, which pose the greatest health risks since they can penetrate deep into the lungs or cardiovascular system.

The report found that children in poorer countries are far more at risk, with a full 98 percent of all children under five in low- and middle-income countries exposed to PM2.5 levels above WHO air quality guidelines.

That compares to 52 percent in high-income countrie, WHO said.Together, household air pollution from cooking and outdoor air pollution cause more than half of all cases of acute lower respiratory infections in young children in low- and middle-income countries, WHO said.

The report, launched ahead of the WHO’s first ever Global Conference on Air Pollution and Health, revealed that when pregnant women are exposed to polluted air, they are more likely to give birth prematurely and have small, low birthweight children.

It found that children are often more vulnerable to the impact of air pollution since they breath more rapidly than adults, and thus absorb more pollutants at a time when their brains and bodies are still developing.

They also live closer to the ground, where a number of pollutants reach peak concentrations, WHO said, pointing out that newborns and young children are also more susceptible to household air pollution in homes that use polluting fuels for cooking, heating and lighting.

Air pollution can impact a child’s development and cognitive ability, and can trigger asthma and childhood cancer, WHO said.

Children who have been exposed to high levels of air pollution may also be at greater risk for chronic diseases like cardiovascular disease later in life, it said.

“Air pollution is stunting our children’s brains, affecting their health in more ways than we suspected,” warned Maria Neira, the head of the WHO’s department of public health and environment.

The UN health body is calling for an acceleration of the switch to clean cooking and heating fuels, and for the promotion of cleaner transportation, lower emissions, and better waste management, among other measures.

“The world needs to reduce the overdependance we have on fossil (fuel), and accelerate to clean, renewable energy,” Neira told reporters in a conference call.

-NAN

Health

Live A Full Life With Sickle Cell Disease

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Kunle Tometi a Pharmacist, Entrepreneur and Public Health Advocate.

The World Sickle Cell Day is a United Nation’s recognized day to raise awareness about sickle cell disease (SCD) at a national and international level. On 22nd December 2008, the UN General Assembly adopted a resolution that recognizes sickle cell disease as a public health issue and “one of the world’s foremost genetic diseases.” The resolution calls for UN member states to raise awareness about sickle cell on June 19th of each year.

In this article, I would be creating awareness on sickle cell disease, the causes, symptoms, treatment and prevention.

What is sickle cell disease (SCD)

Sickle cell anemia (sickle cell disease) is a disorder of the blood caused by inherited abnormal hemoglobin (the oxygen-carrying protein within the red blood cells). The abnormal hemoglobin causes distorted (sickled) red blood cells.

Occurrence

SCD is more common in certain ethnic groups, including:

  • People of African descent,
  • Including African-Americans (among whom 1 in 12 carries a sickle cell gene)
  • Hispanic-Americans from Central and South America
  • People of Middle Eastern, Asian, Indian, and Mediterranean descent
  • Approximately 2000 infants are born annually with the disease
  • SCD affects approximately 200,000 Americans annually
  • 1 in 365 African Americans
  • 1 in 13 African Americans have the traits (carrying only 1 of the gene, S)

(CDC August 2017, Mayo Clinic)

Economics of SCD

10 years ago; Medical expenditure for children with SCD averaged $12,000 yearly for those with Medicaid and $15,000 yearly for those with commercial insurance.

There were also 113,000 hospitalizations costing over $500,000 paid by Medicare and Medicaid of which 75% of the visits were in adults and each with at least 3 Emergency Room visits per year. Children with SCD miss a minimum of 18 days per school year

Total healthcare costs nowadays for SCD is estimated at $2billion per year.

According to (David A.N et al 2018), ‘In Nigeria, the prevalence of SCD is 20–30/1000 live births. The burden of the disease has reached a level where it contributes 9–16% to under-five mortality in many West African countries. Hemoglobinopathies alone represent a health burden comparable to that of communicable and other major diseases’

Causes of SCD

Healthy red blood cells are round, and they move freely through small blood vessels to carry oxygen to all parts of the body. In SCD, the red blood cells become hard and sticky and look like a C-shaped called a “sickle” and they are not able to carry enough oxygen. When they travel through small blood vessels, they get stuck and clog the blood flow.

The sites most often affected by clogging or stacking of sickle cells are found in the lungs, liver, muscle, bone, spleen, eyes, and kidneys and other parts and tissues of the body: explains why patients complain of a lot of pain in these areas as the symptom of the disease.

Patients also have immunity suppression which leads to infections by bacteria, and viruses.

Symptoms of SCD includes;

  • Excessive fatigue, irritability from anemia
  • Jaundice (yellowing of eyes and skin), may also include retina damage
  • Swelling and pain in hands, and feet, Pain in chest, back arms and legs, also damage of hip
  • Frequent infections,
  • Pain and problems in the spleen, (Nausea, vomiting, diarrhea)
  • Delayed growth
  • Stroke (20–30% of children stroke, 23% in African Americans)
  • Genitalia (priapism, a constant erection, in which severe episodes may lead to impotency)

Treatment of Sickle Cell Anemia

Treatment of SCD pain or crisis is done in the following manner:

Rehydration: with IV fluids, helps Red blood cells return to normal shape

Also Read: The ELMA Group of Foundations Commits ZAR 2 Billion to COVID-19 Response in Africa

Drugs:

  • Antibiotics: used to treat underlying infections. In some cases antibiotic prophylaxis, penicillins are recommended.
  • Pain medications to treat acute pain
  • Hydroxyurea: helps increase production of red blood cells

Immunization: Pneumococcal and Meningococcal vaccines have drastically reduced the rate of infections in SCD

Blood transfusion: improves oxygen and nutrients needed

Supplemental oxygen by mask makes breathing easier and improves oxygen levels in the blood

Bone marrow transplant: for severe complications and matching donors.

Prevention

  • Genetic counselling and testing (better before marriage and at pregnancy) can help prevent the likelihood of passing gene to your child
  • Preventing infections can be achieved by practising simple hand washing techniques at every opportunity. Hand sanitiser gels and wipes are also available and affordable
  • Immunisation is very important and one must assure shots and records are current to cut down on the rate of common infections.
  • Re-hydration with fluids at all times is essential.
  • Avoid staying in places with low concentration of oxygen, e.g. unpressurised air planes, or high altitudes

For more information about SCD, please speak to your Pharmacist or Doctor.

Article by Kunle Tometi a Pharmacist, Entrepreneur and Public Health Advocate.

Ref:

  • https://en.wikipedia.org/wiki/Sickle_cell_disease.
  • Mayo clinic https://www.gstatic.com/healthricherkp/pdf/sickle-cell-anemia.pdf
  • CDC https://www.cdc.gov/ncbddd/sicklecell/data.html
  • Sickle cell Disease: Public health agenda & Social, Economic and Health implications by CDR Althea M Grant, PhD September 2012
  • www.score_international.org/resources/conference_presentations
  • Overview of the management & prognosis of sickle cell disease, Joseph Palermo, D.O.
  • Economic impact of sickle cell Hospitalization. R Singh, Ryan Jordan and Charin Hanlon
  • www.bloodjournal.org/content/124/21/5971
  • Prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria

Prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria.

BAO Magazine

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Adaku Efuribe: COVID-19 treatment and the dangers of drug misuse in Nigeria

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Adaku Efuribe (Image credit: Adaku Efuribe)

Drug misuse is defined as the use of a substance for a purpose not consistent with legal or medical guidelines (WHO, 2006). It has a negative impact on health or functioning and may take the form of drug dependence, or be part of a wider spectrum of problematic or harmful behaviour (Department of Health, 2006).

At the moment there seems to be an increased risk of self-medication and drug misuse especially in countries where prescription only medicines could be bought without prescription. For instance, countries like Nigeria where some patent medicines dealers who are meant to sell GSL medicines end up dispensing pharmacy only medicines and prescription only medicines.

As soon as a new drug for managing COVID-19 is announced by mainstream media, people run off to the shops to buy these drugs, even people who have not tested positive for the coronavirus, indulge in self-medication in a bid to prevent contracting the virus.

I am worried about the recent announcement for Dexamethasone as a new drug for treating COVID 19. Information reaching me shows, following hours of announcing this drug by the media, some Nigerian resident has started trooping to their pharmacy, ‘chemist’ and illegal drug dealers to buy dexamethasone tablets.

Dexamethasone is a corticosteroid, it has high glucocorticoid activity, and it should not be used without the guidance of a clinician. According to the Electronic Medicines Compendium (EMC), depending on the dose and duration of therapy, adrenocortical insufficiency caused by glucocorticoid therapy can continue for several months and in individual cases more than a year after cessation of therapy.

Also Read: Lockdown Bozza: Developed to simplify the lockdown regulations in South Africa

Through immunosuppression, treatment with Dexamethasone can lead to an increased risk of bacterial, viral, parasitic, opportunistic and fungal infections. It can mask the symptoms of an existing or developing infection, thereby making a diagnosis more difficult. Latent infections, like tuberculosis or hepatitis B, can be reactivated.

Dexamethasone also has some side effects; the following side effects are common (occurring in greater than 30%) for patients taking dexamethasone:

· Increased appetite.

· Irritability.

· Difficulty sleeping (insomnia)

· Swelling in your ankles and feet (fluid retention)

· Heartburn.

· Muscle weakness.

· Impaired wound healing.

· Increased blood sugar levels

If only the media companies understood the fact that prescription only medicines could be bought without prescription in some countries, they would thread carefully and choose appropriate wording when announcing potential drugs for COVID-19 treatment.

It’s the duty of the Ministry of health and drug regulatory bodies of those countries where prescription medication could be bought in the market like sweets to continue to create awareness, educate the general public on the dangers of self-medication, drug misuse and drug abuse. They must not relent in their efforts of managing drug distribution/regulation.

My advice to people living in countries where you could buy prescription only medicines without prescription is this:

Do not run off to buy the latest drug announced for COVID-19 treatment.

This drug is a corticosteroid and should only be taken if prescribed by a clinician.

Please do not indulge in medication misuse and abuse. It could lead to adverse effects or even death

Author: Adaku Efuribe is a Clinical Pharmacist & Global consultant in Medicines Management

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Sickle Cell Disease Educational Resources Initiative(SERI)- Our Story

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Sickle Cell Disease Educational Resources Initiative(SERI)

Every year, nearly 300,000 children are born worldwide with this most painful disease and many of them will not survive beyond their fifth birthday. Discovered more than a century ago, Sickle Cell Disease (SCD) is an inherited genetic disease that is transmitted when both parents who carry hemoglobin S transmit it to their child.

SCD comes with many complications such as high blood pressure, kidney failure, kidney stones, growth delay, bone necrosis, stroke, retinopathy and increased risk of infection and sepsis. Treatment options include medications to manage the symptoms and blood transfusions to replace the sickled cells. A stem cell also known as bone marrow transplant might cure the disease. However, this procedure usually involves patients to have a matched donor, such as a sibling, who doesn’t have sickle cell anemia.

Both Agnes Nsofwa and Biba Tinga(Founders of The Sickle Cell Disease Educational Resources Initiative) gave birth to children with SCD type SS. Like all caregivers of children with a chronic illness, they had to face many challenges while managing their children’s health. Agnes, has a little girl who received a bone marrow transplant and was cured from SCD a year ago; She left a career in Business, trained to become a Registered Nurse in order to better understand the disease and care for her daughter. She fought hard for over 10 years to get her cured. Today her little girl is Sickle Cell free, but Agnes is still advocating for others who are still affected by SCD.

Agnes Nsofwa, Co-Founder at SERI

Biba has a young adult son living with SCD, but he is not a candidate for a bone marrow transplant to get cured. He will have to keep fighting every day of his life to stay healthy. As a treatment, he regularly receives Red Blood Cell exchanges or apheresis which allows him to avoid the terrible pain crisis. Their journey which started in Niger continues in Canada.

When they met for the first time in January 2020 in Amsterdam, they quickly realized they had been fighting the same battle. They have both been engaged in their respective communities, advocating on behalf of other families dealing with the same condition. Their combined years of experiences has taught them the need to unite. Because when life becomes a struggle, you engage with family. And sometimes family is someone who shares your life journey. After a short discussion, they knew they were going to join forces against this common cause and become friends.

Agnes had started the project translating sickle cell materials into her native language of Bemba from Zambia since 2018, in order to help others to better understand and care for their children since. When she shared this idea with Biba, she instantly agreed to come on board because she had also been sharing information in her native languages of Zarma and Hausa with parents of affected children.

Biba Tinga, Co-Founder at SERI

Together they want parents, to have access to information so that they can make the best decisions to care for their children. To do this, they created SERI, Sickle Cell Disease Educational Resources Initiative, a platform of educational and informative resources on sickle cell disease in various languages.

As they present it, “we created SERI because without education we could not have looked after our children properly. We want all mothers to have what we did not have. SERI is more than a platform; it is also a movement for awareness and education. Whether you speak Bemba, Tonga, Hausa, English, French, Yoruba, Arabic, Hindi, Twi, Spanish or any other language, SERI will offer the information in the language you understand.

SCD requires long continuous care. When the parents or the patient does not understand the basic information, the consequences could be fatal. SERI will also provide audio recorded version in the local languages to ensure that those who cannot read and write can listen and still receive the education that will empower them to better care for themselves.

Also Read: Lockdown Bozza: Developed to simplify the lockdown regulations in South Africa

SERI will also share the stories and the experiences of those who are fighting SCD because their stories matter.

The stories will tell our journeys, the stories will say who we are. We are SERI!”

Visit: Sickle Cell Disease Educational Resources Initiative(SERI)

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