Weekly Digest: CDDEP Director on NPR’s TED Radio Hour; 15 million treated for HIV/AIDS

“Antibiotics completely transformed human lifespans—overnight. But the antibiotic revolution is starting to unravel.” CDDEP Director Ramanan Laxminarayan was featured on today’s episode of NPR’s radio show and podcast TED Radio Hour. In the episode, which focuses on living in a world of finite resources, Laxminarayan argues that antibiotic effectiveness is a limited natural resource, and drug development alone can’t solve the problem of resistance—only balanced stewardship and innovation can. Listen to the antibiotic resistance segment at the CDDEP blog, or the entire episode at NPR or on iTunes. [CDDEP, TED Radio Hour]

New CDDEP research uses structured expert judgement (SEJ) to assess intervention effectiveness in a low-resource healthcare setting. The study, published in BMJ Open, was the first to apply SEJ to a global health investigation, estimating long-term disability and death following obstetric fistula repair in low- and middle-income countries. [CDDEP, BMJ Open]

15 million people have now received HIV/AIDS treatment worldwide—meeting a United Nations Millennium Development Goal set 15 years ago, according to a UNAIDS report released this week that recapped progress on the goal since 2000. Between 2000 and 2014, annual HIV infections fell from 3.1 million to 2 million, annual AIDS deaths declined to 1.2 million from 2 million and the global investment in AIDS response more than quadrupled to $21.7 billion. Doctors Without Borders lauded the results, but warned: “[T]oday we must take our opportunity to curtail the epidemic, or risk sliding back to the same dismal mortality and infection rates as five years ago.” UNAIDS also launched an interactive website with maps and charts for cross-country comparison of indicators relating to HIV and AIDS worldwide. [UNAIDS, Science, Doctors Without Borders]

When health providers communicate both positive and negative treatment recommendations to parents of children with acute respiratory tract infections (ARTIs), they are less likely to prescribe antibiotics, according to research published in Annals of Family Medicine. In the cross-sectional study, positive recommendations included alternate options for alleviating the child’s symptoms and negative recommendations involved explaining why antibiotics may be ineffective or improper for the infection. Parents who received both types of communication were also more likely to give the provider the highest rating on a post-visit survey. [Annals of Family Medicine]

A measles outbreak is spreading in Cameroon, with 300 children infected in one week and several deaths. Health officials in the country said the epidemic occurred in part because some parents were refusing to vaccinate their children despite a vaccination campaign and free government-provided vaccines in local healthcare centers. They also cited childhood malnutrition as a contributor to mortality in the outbreak, which began earlier in the year near Yaounde, Cameroon’s capital, and has spread to the northwest. [Voice of America]

A multifaceted antibiotic stewardship intervention significantly decreased overtreatment of asymptomatic bacteriuria (ASB). Results of the controlled trial at two Veterans Medical Centers, reported in JAMA Internal Medicine, found that the intervention—which included guidelines that physicians not order urine studies in patients with nonspecific signs and symptoms of infection—reduced urine culture orders and antimicrobial use, and did not curtail appropriate prescription of antibiotics when indicated for the patient. The effects were particularly pronounced in long-term care settings. [JAMA Internal Medicine]

A new single-dose malaria drug, possibly effective both for treatment and prophylaxis, is ready for human trials. The compound, described in a Science Translational Medicine paper, is one of a new class of antimalarial drugs that targets a protein that the parasite needs to survive at several different stages in its life cycle. The drug was identified as part of an international partnership of more than 20 research institutions organized to accelerate drug development. Patent rights for the drug have been transferred to the Medicines for Malaria Venture, a Bill & Melinda Gates Foundation-supported not-for-profit public-private partnership. [Science, University of Washington]

The burden of dengue and chikungunya in South India is greatly under-reported, according to a report in PLOS Neglected Tropical Diseases. Researchers in Chennai collected blood samples from individuals in 50 randomly-selected locations and looked for antibodies to the two diseases to estimate exposure. Ninety-three percent of those tested had been exposed to dengue and 44 percent to chikungunya, but only 1 percent of participants recorded a history of dengue and 20 percent of chikungunya, suggesting a high proportion of either asymptomatic or sub-clinical disease and/or a lack of recognition of the diseases, [PLOS Neglected Tropical Diseases]

Using silver nanoparticles to combat bacteria is both effective and environmentally benign. The nanoparticles, developed by engineers at North Carolina State, eliminated E. coli, Pseudomonas aeruginosa and species of Ralstonia and Staphylococcus. The particles adhere to target microbes with a charged polymer layer and become depleted of silver as they work against the bacteria, but unlike other similar technologies, they degrade easily due to a core made of lignin, an organic substance found in plant cell walls. [Nature Nanotechnology, Infection Control Today]

As African economies prosper, healthcare systems will face new disease challenges—and the time to prepare for them is now.  An article in Quartz focuses on how Africa’s rapid economic and demographic shifts—such as urbanization and more sedentary lifestyles, higher life expectancy and the entrance of global fast food, alcohol and tobacco companies into African markets—pose significant non-communicable disease (NCD) threats across the continent. NCDs currently account for 35 of mortality in the WHO African region; by 2020, WHO anticipates an increase to 65 percent. [Quartz]

Many African countries have developed effective, local solutions to widespread health system problems. The Mail & Guardian Africa published a list of 11 African solutions to African problems in healthcare, from bike ambulances to mobile phone surveillance to pregnancy hostels. [Mail & Guardian Africa]