Although Alaska had the highest STD rates in the nation for years, the Alaska Section of Epidemiology reported that the incidence of chlamydia and gonorrhea has declined since 2010. Alaska’s chlamydia rate still exceeds the national rate of 448 cases per 100,000 people, but it dropped to an incidence rate of 749 per 100,000 Alaska residents in 2012.
Nurse Susan Jones, who manages Alaska’s STD/HIV program, suggested that in addition to high rates, Alaska’s practitioners have been diligent in testing for and reporting STDs. Factors that might have influenced the drop in rates include improved educational outreach and expedited partner therapy, which allows a patient diagnosed with an STD to obtain antibiotics for sexual partners without requiring them to be examined.
Alaska’s gonorrhea rate rose from below the national average to the “third worst” in the United States in 2008, but has since declined to 100 cases per 100,000 residents. Jones stated that the state watched gonorrhea incidence very closely since some strains were drug-resistant. She expressed concern over an “uptick of the case count” in late 2012.
Chlamydia and gonorrhea may have no symptoms, but can cause a “burning sensation when urinating and vaginal or penile discharge.” Soreness or itching may result from an infection in the anus or throat. Untreated infections may cause chronic pelvic pain, male and female infertility, and arthritis.
Detailed information on chlamydia and gonorrhea rates in Alaska is available at http://www.epi.alaska.gov/hivstd/std2010/atlas.html.
Médecins Sans Frontières (MSF; Doctors Without Borders) has strongly urged the Indian government to address ongoing shortages of pediatric TB drugs and medicines used to treat drug-resistant TB (DR-TB). Under current policy, the Indian central government purchases TB drug supplies and distributes them to the states, which are responsible for providing treatment to TB-infected patients. However, TB drugs routinely are out of stock, which is one reason India has such high incidence of DR-TB, according to Leena Menghaney, India manager of MSF’s Access Campaign.
Dr. Homa Mansoor, TB medical referent for MSF India, explained that if pediatric TB medicines were unavailable for children who had travelled long distances to obtain treatment, doctors had to resort to “breaking adult pills,” which could result in an incorrect dose. Other desperate patients have purchased lower-dose TB medications from retail pharmacies, since proper dosages were not available to them through government sources. Drug resistance can develop in under-dosed patients.
The World Health Organization released interim guidelines for use of bedaquiline, which the US Food and Drug Administration approved for TB treatment in 2012. MSF recommended strict regulation and control of new drugs and studies to determine more effective drug combinations that might be taken for shorter duration with less toxicity.
Researchers from the Scripps Research Institute (TSRI), Howard Hughes Medical Institute, and Albert Einstein College of Medicine of Yeshiva University have discovered a promising new anti-TB compound that can fight TB bacteria in two ways. The researchers were searching for a drug that cleared TB infection quickly and was effective against replicating and nonreplicating TB infection.
Feng Wang, of the Schultz laboratory at TSRI and first author of the study, created a screening test to detect compounds that block TB’s persistence-related ability to form biofilms. He used a related, but nondisease-causing mycobacterium for the high-throughput test. After screening 70,000 compounds, he found one called TCA1 that was able to inhibit mycobacterial biofilms. When the researchers tested the compound in a biosafety level 3-certified laboratory, TCA1 was very active against TB, killing both replicating and nonreplicating TB bacteria. By itself, TCA1 killed more than 99.9 percent of actively replicating TB bacteria in three weeks; in combination with isoniazid and rifampin, the compound killed 100 percent in that time period. TCA1 was very effective against drug-resistant TB, removing all signs of one strain within a week when combined with isoniazid. When tested against a highly fatal “super-bug” strain from South Africa, which resists all conventional TB drugs, the new compound killed more than 99.999 percent in three weeks.
TCA1 also worked well against nonreplicating TB. Tests with mice showed TCA1’s effectiveness and suggested that combining TCA1 and isoniazid could be a more powerful treatment than the present anti-TB drugs. The compound showed no sign of toxicity or adverse side effects in cell culture and experiments with mice and no tendency to create drug resistance. Experiments and analyses to investigate how the new compound kills TB bacteria so efficiently indicated that the compound targets two enzymes in TB bacterium: one that supports TB replication and another TB dormancy and persistence.
With funding from the Global Alliance for TB Drug Development, Wang and colleagues are working to find improved variants of TCA1. If the preclinical tests are successful, the researchers will need a pharmaceutical partner to sponsor clinical trials in TB patients.
The full report, “Identification of a Small Molecule with Activity Against Drug-Resistant and Persistent Tuberculosis,” was published online the journal Proceedings of the National Academy of Sciences (2013; doi:10.1073/pnas.1309171110).
The Circle Care Center at 618 West Avenue, Norwalk, Conn., is a unique new healthcare center for lesbian, gay, bisexual, and transgender youth. It combines the services of World Health Clinicians, the Triangle Community Center, and the Mid-Fairfield AIDS Project under one roof. Recently, Jack Mackenroth, a New York City designer and fashion model and a 2008 contestant in the television show “Project Runway,” attended the center’s dedication and ribbon cutting. Mackenroth, who was diagnosed with HIV infection 24 years ago at age 20, emphasized the need to reach out to young men ages 16–35 to put a face on HIV and eliminate the stigma, which keeps people from getting tested. Mackenroth talked about the attitude of the young generation who did not experience the devastation from AIDS in the 80s and 90s and how important it was to stress getting tested, getting treated, protecting oneself, and fighting stigma.
City Health Commissioner Vickie Ionno declared that Ohio’s New Philadelphia City Health District’s free HIV testing program has been going extremely well. Offered since March 1, 2012, the program tested more than 125 people last year, with no one testing positive. So far in 2013, the program has tested 97 people, with only one person testing positive. CDC has recommended that everyone be tested, particularly baby boomers.
The health district’s program also has been testing Tuscarawas County Jail inmates for HIV, a first for the city as well as the county. The county jail began testing on January 3. Health officials conduct the tests the first and third Thursday morning of each month, and have tested approximately 40 persons so far. Ionno noted that the program tests only inmates who volunteer. She commented on the importance of the inmates’ testing, since incarcerated persons often take part in risky behaviors—tattooing and intravenous drug use—in unsterile environments. Ionno commended Lt. Jeremy Everett of the Tuscarawas County Sheriff’s Department for his cooperation in making the program possible for inmates. The program keeps all testing and results confidential.
The Canton City Health Department funded the free testing through the Ohio Department of Health. Last year, Ionno applied for and obtained a grant for the free testing.
A report published in Lisbon by the European Monitoring Centre for Drugs and Drug Addiction demonstrated that Greece’s HIV rates have risen by 200 percent since 2011. According to the report, the dramatic rise is due in particular to intravenous drug use within the country and deep cuts that have dismantled the national healthcare system and drug treatment programs. Thirteen hospitals are scheduled to close within the next few months and just in the Athens area alone, 4,000 physicians have emigrated from the country within the past three years.
The Philadelphia nonprofit organization “Manna” celebrated a major milestone on June 17 by delivering its 10 millionth meal. Founded in 1990, Manna originally delivered nutritious meals to the area’s HIV/AIDS population, but expanded its services to include those with other significant illnesses. Executive Director Sue Daugherty told KYW Newsradio, “It’s not only just a celebration of the 10 million meals, it’s really the over 17,000 lives we’ve impacted.”
Auburn, Ind., held its sixth annual HepFest on June 15 in Rieke Park. Free of charge and open to the public, the event featured games, prizes, live Christian music, and a raffle. HepFest focused on raising hepatitis C awareness. Event Organizer Christie Soaper emphasized that people needed to erase the stigma of hepatitis. She urged everyone to participate in free testing at their local health departments.
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