KigaliHealth.com

Following confirmed cases of Ebola in neighboring DR Congo, and given the escalating outbreak of the Ebola virus disease in West Africa, the Ministry of Health on Monday again reassured the public that preventive measures are in place and there should be no cause for panic.

The Ministry, in a statement, reiterated that various preventive measures were already in place to contain the disease, including strengthening surveillance at all points of entry into the country, including border posts and airports.

“Referral hospitals, district hospitals and other health facilities are well equipped and staff have been trained to handle any cases,” reads part of the statement.

“The Ministry of Health in collaboration other concerned institutions through the national emergency preparedness teams has put in place actions for preparedness and elaborated plans to prevent any potential health risks of Ebola.”

With all the preventive measures in place “set according to the national standards,” the Ministry calls on the public to stay calm.

Over the weekend, the DR Congo government confirmed that an outbreak of what seemed a different strain to West Africa’s haemorrhagic fever in the north of the country has been identified as Ebola.

The BBC reports that tests on two people had confirmed the disease in Equateur province, where 13 had already died. A 100-square kilometer radius in Boende, a town lying on the Tshuapa River, east of Mbandaka in Equateur province, where the cases had been registered was reportedly being set up to contain the disease.

The cases in the DR Congo are the first reported outside West Africa since the outbreak there began.

The Sierra Leone parliament last week passed a new law making hiding Ebola patients a criminal offence and, if signed by the president, could see those caught facing up to two years in jail.

Even as the UN condemns travel bans by several countries to the three main countries – Sierra Leone, Liberia, and Guinea – hit by the deadly Ebola disease, several countries including the Ivory Coast, Gabon, Senegal, Cameroon and South Africa have ordered travel bans to the affected trio.

Last week, Kenya’s national carrier Kenya Airways (KQ) suspended its flights to Liberia and Sierra Leone over the Ebola outbreak.

Governments in the East African Community (EAC), sources say, are close to agreeing on a stronger widespread strategy that would seem the five-member states also regulate travel to the affected West African countries.

Ebola, one of the world’s deadliest diseases, with up to 90 percent of cases resulting in death, is spread between humans through direct contact with infected bloodily fluids.

Even as the UN condemns travel bans by several countries to the three main countries hit by the deadly Ebola disease, Minister of Health Dr. Agnès Binagwaho, on Saturday told The New Times that the government had an obligation to protect the lives of its citizens and would consider similar actions if the situation in those countries worsened.

@The New Times

Cholesterol is a fat, or lipid. It is also a sterol, from which steroid hormones are made. If you held cholesterol in your hand, you would see a waxy substance that resembles the very fine scrapings of a whitish-yellow candle. Cholesterol flows through your body via your bloodstream, but this is not a simple process. Because lipids are oil-based and blood is water-based, they don’t mix. If cholesterol were simply dumped into your bloodstream, it would congeal into unusable globs. To get around this problem, the body packages cholesterol and other fats into minuscule protein-covered particles called lipoproteins (lipid + protein) that do mix easily with blood. The proteins used are known as apolipoproteins.

The fat in these particles is made up of cholesterol and triglycerides and a third material I won’t discuss much, phospholipid, which helps make the whole particle stick together. Triglycerides are a particular type of fat that have three fatty acids attached to an alcohol called glycerol—hence the name. They compose about 90 percent of the fat in the food you eat. The body needs triglycerides for energy, but as with cholesterol, too much is bad for the arteries and the heart.

Inflammation of the nasal mucous membrane is called rhinitis. The symptoms include sneezing and runny and/or itchy nose, caused by irritation and congestion in the nose. There are two types: allergic rhinitis and non-allergic rhinitis.

Allergic Rhinitis occurs when the body’s immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, animal hair, industrial chemicals (including tobacco smoke), foods, medicines, and insect venom. During an allergic attack, antibodies, primarily immunoglobin E (IgE), attach to mast cells (cells that release histamine) in the lungs, skin, and mucous membranes. Once IgE connects with the mast cells, a number of chemicals are released. One of the chemicals, histamine, opens the blood vessels and causes skin redness and swollen membranes. When this occurs in the nose, sneezing and congestion are the result.

Seasonal allergic rhinitis or hayfever occurs in late summer or spring. Hypersensitivity to ragweed, not hay, is the primary cause of seasonal allergic rhinitis in 75 percent of all Americans who suffer from this seasonal disorder. People with sensitivity to tree pollen have symptoms in late March or early April; an allergic reaction to mold spores occurs in October and November as a consequence of falling leaves.

Perennial allergic rhinitis occurs year-round and can result from sensitivity to pet hair, mold on wallpaper, houseplants, carpeting, and upholstery. Some studies suggest that air pollution such as automobile engine emissions can aggravate allergic rhinitis. Although bacteria is not the cause of allergic rhinitis, one medical study found a significant number of the bacteria Staphylococcus aureus in the nasal passages of patients with year-round allergic rhinitis, concluding that the allergic condition may lead to higher bacterial levels, thereby creating a condition that worsens the allergies.

Patients who suffer from recurring bouts of allergic rhinitis should observe their symptoms on a continuous basis. If facial pain or a greenish-yellow nasal discharge occurs, a qualified ear, nose, and throat specialist can provide appropriate sinusitis treatment.

Non-Allergic Rhinitis does not depend on the presence of IgE and is not due to an allergic reaction. The symptoms can be triggered by cigarette smoke and other pollutants as well as strong odors, alcoholic beverages, and cold. Other causes may include blockages in the nose, a deviated septum, infections, and over-use of medications such as decongestants.

Rhinosinusitis: Clarifying The Relationship Between The Sinuses And Rhinitis

Recent studies by otolaryngologist–head and neck surgeons have better defined the association between rhinitis and sinusitis. They have concluded that sinusitis is often preceded by rhinitis and rarely occurs without concurrent rhinitis. The symptoms, nasal obstruction/discharge and loss of smell, occur in both disorders. Most importantly, computed tomography (CT scan) findings have established that the mucosal linings of the nose and sinuses are simultaneously involved in the common cold (previously, thought to affect only the nasal passages). Otolaryngologists, acknowledging the inter-relationship between the nasal and sinus passages, now refer to sinusitis as rhinosinusitis.

The catalyst relating the two disorders is thought to involve nasal sinus overflow obstruction, followed by bacterial colonization and infection leading to acute, recurrent, or chronic sinusitis. Likewise, chronic inflammation due to allergies can lead to obstruction and subsequent sinusitis.

Other medical research has supported the close relationship between allergic rhinitis and sinusitis. In a retrospective study on sinus abnormalities in 1,120 patients (from two to 87 years of age), thickening of the sinus mucosa was more commonly found in sinusitis patients during July, August, September, and December, months in which pollen, mold, and viral epidemics are prominent. A review of patients (four to 83 years of age) who had surgery to treat their chronic sinus conditions revealed that those with seasonal allergy and nasal polyps are more likely to experience a recurrence of their sinusitis.

Minister Agnes Binagwaho and other health officials at the launch of prepex at Kanombe Military Hospital

Rwanda has become the first country to launch a nationwide scale-up of non-surgical adult male circumcision method (Prepex) to reduce the rate of HIV infections

Adult men will be able to access the Voluntary Medical Male Circumcision (VMMC) services which now targets over 700.000 adults (between 15-49 years) in the scale up program.

The non-surgical method was launched on November 26, 2013 in Kigali by Rwanda’s Minister of Health, Dr. Agnes Binagwaho.

The method was developed by Tzameret Fuerst, who are medical experts and co-founders of Prepex. It was first tried in Rwanda and has also been fully approved by the world health organization after a three year clinical and rigorous evaluation process.

Though the country’s HIV prevalence is at a low rate (3percent), the Minister of Health Dr. Agnes Binagwaho says that the method is timely and will enable the country to have a grip on the scourge by preventing more infections and enabling the infected ones to get assistance.

“This method is the first of its kind that will scale up the VMMC services and curb the rate of HIV infection in Rwanda. We will deploy it along other existing methods of prevention coupled with behavioral change initiatives,” Dr. Agnes Binagwaho said.

The minister also stated that though Rwanda has been the first country to use the method, the problem of HIV/Aids is a crosscutting issue that calls for the involvement of everyone.

She said that Rwandans have showed a lot of interest in the Prepex method despite the fact that the country is limited by resources to meet the demand.

According to the Minister, government will open up more health centers, mobilize and train more human resource to provide the services at all community levels, and also solicit the funds needed to actualize the set goals of promoting male circumcision.

Studies have showed that voluntary medical male circumcision reduces risks of heterosexually acquired HIV/AIDS infections by roughly 60 percent. In 2007, international health experts announced plans to circumcise 80 percent of male adults (20 million men) in 14 countries in south and eastern Africa- which are hit hardest by HIV.

Prepex becomes the first device for adult circumcision to receive WHO approval and according to US Global AIDS coordinator Ambassador, Eric Goosby – it is believed to be “a method that will truly save lives”.

The UNAIDS estimates that the circumcision effort would prevent 3.4 million HIV infections and it will need about $16.5 billion for the goal to be achieved.

There’s nothing wrong with a little competition, especially if it improves access to health care in rural Rwanda. That’s the idea behind “Race to the Top,” a collaborative effort between Partners In Health’s Rwandan sister organization and the government of Rwanda that targets and improves specific health indicators where barriers persist.

PIH works in three districts in Rwanda—Burera, Southern Kayonza, and Kirehe. Each is home to a number of health centers that provide a range of outpatient services, from family planning to rapid malaria testing. These health centers are the first point of contact many patients have with the health system. Different districts face different challenges. Take Kirehe, where health centers have made enormous strides in recent years, yet malnutrition rates in children under 5 and maternal and newborn mortality rates are stubbornly high.

That’s where the “Race to the Top” comes in. It’s designed to foster healthy competition among health centers in each district and push them toward priorities identified by Rwanda’s Ministry of Health. For instance, the 16 health centers in Kirehe are working to see which can be the first to hit three specific targets: a 50 percent increase from the previous quarter in the number of women who have initiated family planning methods; the elimination of severe acute malnutrition in children under 5; and 90 percent enrollment of all patients in the health center’s catchment area in mutuelle de santé—Rwanda’s state-backed health insurance—or similar coverage. Health centers aren’t only competing for bragging rights; financial incentives are tied to progress on these indicators.

“‘Race to the Top’ encourages health center teams to work hard, concentrate their efforts toward reaching specific targets related to district priorities, and develop innovative approaches to overcoming challenges,” says Dr. Evrard Nahimana, Kirehe District’s clinical director. “For example, at Gashongora Health Center, the staff worked with local authorities to identify vulnerable families, which were then provided with land to cultivate and cows for milk production. The staff at Kabuye Health Center developed a program to provide fish for all kids under age 5. This type of combined social and clinical support is key to addressing malnutrition, maternal health, and similar challenges.”

One of the program’s biggest benefits, Nahimana says, is how swiftly it improves communications and information sharing among the health centers. When one team tried a new approach and it worked, the strategy was shared with other health centers. That’s the essence of positive competition; teams are not competing against one another, they’re competing together to achieve excellence.

“‘Race to the Top’ creates space for the different teams to share their experiences,” Nahimana says.

The goals of the program were set intentionally high. Nahimana notes that while no health center in Kirehe has hit all three goals in a single period, each has made steady, sustainable improvements. Some health centers provided family planning services to more than 1,000 women in the competition timeframe. Others saw significant jumps in the percentage of patients with health coverage. Strategies to improve food security will making lasting improvements for families and communities.

In the coming year, our Rwandan colleagues plan on working closely with local governments to expand this model to Burera and Southern Kayonza Districts. The program’s agile design allows us to modify the targeted health indicators to ensure we’re improving care for the most vulnerable patients in these communities.

“It is so impressive to see the innovations each health center implemented to push toward the program’s goals in Kirehe,” Nahimana says. “It’s exciting to know this program will help improve access to health care for patients facing different challenges in all of our districts.”

source: www.pih.org