UGANDA: Volunteers distribute AIDS drugs in rural Uganda

Early results from a rural pilot project in Uganda show that unpaid community volunteers can successfully distribute drugs to combat AIDS. Before, antiretroviral drugs were only available from health professionals in major urban hospitals.

The site chosen for the pilot project was Kabarole, a mostly rural farming district in Western Uganda. HIV prevalence among adults there is 10 percent, significantly higher than Uganda’s national rate of 6 percent. With treatment offered only in the district capital, many people cannot make the trip.

“The whole point was to look at the problem of how rural people access treatment,” said Arif Alibhai, the project’s senior manager. “We asked ourselves, it is possible to move the treatment to where the people are?”  

The researchers knew there was also a critical shortage of physicians to dispense the medication and monitor the patients.   Using a Haitian study as a model, community members were recruited and trained in small rural health clinics to perform the traditional duties of health professionals. The study was run by University of Alberta researchers; funding came from the Canadian Institutes of Health Research.

After six months, the project has shown strong results comparable to those found at the district hospital, with 90 percent of patients having successful treatment outcomes and virtually all patients adhering to their drug schedule. Upon hearing the positive results, more patients, especially women,are signing up for the program.  

Researchers will continue to study the program over the next two years. More funding is needed, not only to keep the program going in Kabarole but also to expand the projects to other areas of Uganda and other countries affected by AIDS. (Edmonton Journal (Alberta, Canada) Keith Gerein)

UNITED STATES: New study blames Columbus for syphilis spread

Christopher Columbus’ journey to the New World has been genetically linked to the earliest recorded syphilis outbreak in Europe, a study published Monday suggests.

US researchers studied the evolution of Treponema, the family of bacteria that includes syphilis (Treponema pallidum), and they found syphilis is closest in relation to a subspecies of the bacteria in Guyana that causes yaws – typically a childhood disease spread by skin-to-skin contact.

The team concluded that yaws was an ancient infection, but venereal syphilis “or a progenitor came from the New World to the Old World and this happened pretty recently in human history,” said Kristen Harper, the study’s lead author and an evolutionary biologist at Emory University.

Harper believes a non-venereal form of yaws evolved into sexually transmitted syphilis, though it is unclear how this occurred.

“All we can say is the ancestor of syphilis came from the New World, but what exactly it was like, we don’t know,” she said. “When you put together our genetic data with the epidemic in Naples in 1495, that is pretty strong support for the Columbian hypothesis.”

But the study’s conclusions rely too much on genetic changes from just two Guyana bacteria strains, Connie Mulligan of the University of Florida and colleagues suggest in a forthcoming editorial. Better evidence would come from DNA extracted from ancient tissue or bones, she said.

“This is a grainy photograph,” acknowledged Harper, who added that more research needs to be done.

The full report, “On the Origin of the Treponematoses: A Phylogenetic Approach,” was published in Public Library of Science Neglected Tropical Diseases; the related editorial, “Molecular Studies in Treponema Pallidum Evolution: Toward Clarity?,” is due to be published in next week’s issue. (Reuters: Julie Steenhuysen)

MALAWI: Malawi pays to improve nutrition of HIV-Positive workers

A senior Malawian government official recently announced a program that will pay U$35 a month for nutritional assistance to civil servants who have HIV/AIDS.

“It is not extra pay but a workplace program for nutritional support for people to respond to treatment quickly,” said Mary Shaba, principal secretary for the Nutrition-HIV/AIDS program.

Malawi began providing free antiretroviral treatments in 2004, but “the civil servants who are HIV-positive now need nutritional support,” Shaba said.

There are 120 000 public servants in Malawi, and officials estimate 14 percent of the population has HIV. The number of civil servants who are infected is unknown. (Agence France Presse)