December 04, 2015
A weekly roundup of news on drug resistance and other topics in global health.
Scaling up access to home-based newborn care (HBNC) in rural India saves lives and money. Using IndiaSim, an agent-based microsimulation model, CDDEP researchers led by CDDEP fellow Arindam Nandi evaluated two interventions for scaling up HBNC: 1) increase coverage, using the existing network of community health workers (60 percent coverage), to include all households without current access to newborn care; and 2) increase coverage to 90 percent by HNBC or other care. They reported in Health Policy and Planning that the first intervention would prevent 48 cases of severe neonatal ailments and 5 related deaths per 1000 live births, and the second would avert 57 cases and 6 related deaths. The interventions would also save $4411 and $5024, respectively, in out-of-pocket treatment costs, and provide $285 and $340 in incremental value of insurance per 1000 live births. The interventions are pro-poor, with greater benefits for lower income groups and poorer states. [Health Policy and Planning, CDDEP]
The November issue of GARPNet News, the newsletter of the Global Antibiotic Resistance Partnership, is now available online. The issue features GARP activities related to the first annual World Antibiotic Awareness Week, including events in Kenya and Nepal, and the launch of the Lancet series on antimicrobial resistance. Sign up to receive the bi-monthly newsletter here. [CDDEP]
Health and financial impacts of India’s ambitious Rashtriya Swasthya Bima Yojana (RSBY), a government-run hospital insurance program for the poor, are still unclear. CDDEP fellow Arindam Nandi led a review, published in the Indian Journal of Medical Research, that found serious limitations and biases in all the evaluations that have been published thus far. The published results vary and in some cases, conflict on key points. The review notes that RSBY’s impacts are potentially limited by inefficiencies—such as lack of administrative data, the long-term sustainability of the scheme, problems with fraud, etc. The researchers offer ideas on how more useful data can be generated as the program continues and grows, to facilitate meaningful evaluations. [Indian Journal of Medical Research]
A highly carbapenem-resistant strain of Enterobacteriaceae (CRE) has been found in 43 patients in 19 U.S. states since 2010, according to CDC in its Morbidity and Mortality Weekly Report (MMWR). The OXA-48-like carbapenemases identified are of particular concern because they occur on a plasmid that is transmissible to a range of bacterial species. Some of the cases seemed to indicate transmission within the United States, but most patients reported getting healthcare while traveling abroad. Five of the 43 patients had isolates that tested positive for both OXA-48-like carbapenemases and New Delhi metallo-beta-lactamase (or NDM-1), another gene that causes highly-resistant CRE. [CDC MMWR, The Washington Post]
A WHO report estimates that foodborne illnesses sicken 600 million people each year worldwide, causing 420,000 deaths. According to the 256-page report, alongside a collection of related papers published by PLOS Medicine, 1 in 10 people worldwide are sickened with a foodborne illness each year. Nearly half of the deaths are associated with diarrheal illnesses, frequently caused by bacterial pathogens such as Campylobacter, non-typhoidal Salmonella, and E. coli. Almost one-third of deaths are in children under five, who represent about 9 percent of the total population. [PLOS Medicine, WHO, CIDRAP]
The first plasmid-associated colistin-resistance gene, mcr-1, announced two weeks ago from human and animal samples in China, has now been identified from previously tested isolates in Europe. Researchers at the Technical University of Denmark announced this week that after the finding was published, they searched their database of genome-sequenced bacteria for the gene and found matches in five food samples and one human patient between 2012 and 2015. [Danish Technical Institute, National Geographic]
Zika fever, an illness caused by a mosquito-borne virus, has caused a severe spike in brain-stunting birth defects in Brazil. On November 28, the Brazilian health ministry linked cases of microcephaly, the birth defect, to infections with the virus. So far, more than 1200 cases have been reported, mostly in northeast Brazil—a more than 20-fold increase from last year. [BBC, The Guardian]
Pharmaceutical company Roche Holdings has discontinued its involvement in a project to develop an antibiotic for resistant infections. The project had been in Phase 2 trials, and Roche had originally planned to pay Polyphor, a privately-held partner pharmaceutical company, $483 million for rights to the product. Instead, a Roche spokesman said Monday that “a streamlined development path as originally planned is no longer an option for Roche.” [Reuters UK, STAT News]
Obsolete treatment guidelines and a lack of access to drugs are hampering national-level efforts to combat tuberculosis, according to a report co-authored by Doctors Without Borders (MSF) and the Stop TB Partnership. The report, the second edition published by the two organizations, assessed TB programs in 24 countries and found that most are not on target to meet 90 percent TB incidence reduction goals in the next 20 years. Suggested changes include implementing rapid diagnostics, eliminating compulsory hospitalization and phasing out the established re-treatment regimen. The nonprofit TB Alliance announced Wednesday that it hopes a new “child-friendly” drug combination, which will come in fruit-flavored liquid fixed dosages, will help solve the problem of medication noncompliance in children. [MSF, Medical News Today, Reuters]
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