News
MSF nurse emerges winner of HIV-TB prize for life-saving TB test research.
Chenai Mathabire, Zimbabwean Doctors Without Borders (MSF) nurse and researcher has won an HIV/TB Research Prize at this year’s International Aids Society Conference on HIV Science (IAS2017). Through a study conducted in Malawi and Mozambique, Chenai has provided strong evidence that an easy-to-use point-of-care TB LAM test, which quickly diagnoses tuberculosis (TB) in severely ill HIV patients, is feasible to use in real-life clinics with high numbers of HIV-TB patients.
TB is the biggest killer of people living with advanced HIV, with over 400,000 patients dying each year from the disease. People with advanced HIV, also known as Acquired Immune Deficiency Syndrome (AIDS) have very weakened immune systems, leaving them susceptible to common infections, which can quickly become deadly.
Successfully treating ill AIDS patients involves rapidly assessing the strength of their immune systems and putting them on the right treatment straight away, whether they have TB or another disease deadly to HIV patients, cryptococcal meningitis.
However, in poorer countries, limited laboratory and X-ray facilities, and the time spent waiting on results can mean long and often deadly delays for sick patients arriving at clinics or hospitals. At the same time, people with late-stage HIV often can’t produce enough sputum for more common TB sputum tests so common tests such as sputum microscopy cannot be done. X-rays are also less useful to detect TB in people with advanced HIV.
At $3 per test, the TB LAM test offers a quick, simple and cost-effective alternative that gives on-the-spot results in 30 minutes. Yet despite being available since 2010, only 140,000 TB LAM tests are used each year.
“In Malawi, some HIV patients with suspected TB were waiting months for laboratory or X-ray results to come back. Clinicians don’t like to start patients on treatment based only on clinical signs and symptoms, they prefer to have a diagnostic test result,” says Chenai, who was responsible for implementing and supervising the study. “The TB LAM test helped them make that decision, and they felt better about starting HIV patients on TB treatment. It doesn’t replace existing tests, but adding this test helps us identify more TB cases and can improve the patients’ chances of survival.”
The test uses the HIV patient’s urine to detect LAM (Lipoarabinomanan), a protein created when TB bacteria cells break down. The lower the patients’ immunity, which is measured by numbers of CD4 T-cells, the more LAM appears in the urine and the more sensitive the test becomes. This is why the test is recommended for use in patients with CD4 cells below 100. The MSF study found the test was well accepted by staff, easy to use, and led to better, faster results than sputum or X-ray tests. Nearly 99% of TB LAM test patients received a timely result, versus 70% with sputum and 35% with X-rays.
Currently the main barrier to wider use of the TB LAM test by national governments is that it isn’t included in country guidelines and national TB programmes are not actively pushing it. Use of the TB LAM test has been recommended by the new WHO guidelines for advanced HIV for use in severely ill patients in hospitals but not yet in primary care, given the test’s decreased accuracy in patients with stronger immune responses.
MSF will use the study to advocate for health ministries in countries with high HIV TB burdens to use the TB LAM test in primary care and hospital centres, as well as include TB LAM within a diagnostic package for patients with advanced HIV. This would include point-of-care tests for CD4 (to allow rapid bed-side assessment of immune strength), cryptococcal meningitis and TB to help quick diagnosis and, most importantly, improve patients’ chances of survival.
MSF currently uses TB LAM as part of a diagnostic package in HIV projects in Democratic Republic of Congo (DRC), Guinea, Kenya, Malawi, Mozambique, Niger, Uganda and Zimbabwe. MSF currently supports over 230,000 people living with HIV on antiretrovirals in 19 countries, with a focus on free quality care, and provides free hospital-based care for people living with advanced HIV in DRC, Kenya Guinea, and Malawi.
Dangote Petroleum Refinery has made headlines by announcing a further reduction in the price of diesel, dropping it from ₦1200 to ₦1000 naira per litre.
The refinery’s decision comes on the heels of its recent supply at a significantly reduced price of ₦1200 per litre, which was introduced three weeks ago, signifying a remarkable 30 per cent decrease from the previous market price of approximately ₦1600 per litre.
This substantial reduction in diesel prices at Dangote Petroleum Refinery is expected to reiterate positively throughout various sectors of the economy, potentially serving as a catalyst in alleviating the persistently high inflation rate in the country.
In a statement last week, Aliko Dangote, Africa’s wealthiest individual and the owner of the refinery, expressed his optimism regarding the potential impact of the price reduction on inflation in Nigeria.
“I believe that we are on the right track. I believe Nigerians have been patient, and I also believe that a lot of goodies will now come through. There’s quite a lot of improvement because if you look at it, one of the major issues that we’ve had was the naira devaluation that has gone very aggressively up to about ₦1900,” he remarked.
As anticipation builds around the implications of this move by Dangote Petroleum Refinery, stakeholders and consumers alike remain hopeful for the positive effects it could bring to the Nigerian economy in the coming months.
More than 50,000 Russian military personnel have died during the Ukraine conflict, the BBC reported Wednesday, citing its own reporters, independent media group Mediazona and volunteers.
They found that more than 27,300 Russian soldiers died during the second year of the war, a 25-percent increase on the first year.
BBC Russian, Mediazona and volunteers have been counting deaths since February 2022, using open-source information from official reports and the media, as well as using satellite images of Russian cemeteries to estimate the number of new graves.
The figure of more than 50,000 is eight times higher than the official toll acknowledged by Moscow in September 2022. It does not include deaths of militia in Donetsk and Lugansk in eastern Ukraine.
Ukraine said in February that it had lost 31,000 soldiers, but that figure is also likely to be significantly lower than the true toll.
Russian losses spiked in January 2023 as it launched a large-scale offensive in Donetsk and again months later last year during the battle for the city of Bakhmut.
Russian President Vladimir Putin announced a “special military operation” at dawn on February 24, 2022, which has since turned into a bloody and attritional war, isolating Russia from the Western world.
Responding to the report, the Kremlin said it did not disclose any information on military deaths and casualties, which falls under the remit of the defence ministry.
Kremlin spokesman Dmitry Peskov added official secrets laws and those covering what Russia calls its “special military operation” in Ukraine meant it was “absolutely understandable” that the ministry did not release the figures.
The National Identity Management Commission (NIMC) has disclosed that 95 million Nigerians need to enroll for the National Identification Number (NIN) to meet its target of 200 million enrollments by 2025.
Kayode Adegoke, Head of Corporate Communications at NIMC, emphasised the importance of this enrollment during an interview on X over the weekend.
He stated, “For NIMC to meet the 200 million target by 2025, 95 million Nigerians need to register for the NIN.”
Adegoke revealed that over 105 million NINs have been issued to Nigerians and legal residents so far.
He assured Nigerians of the commission’s commitment, saying, “We want to assure Nigerians that within the next one or two years, we will reach our target of enrolling all Nigerians.”
“The NIN serves as a unique identifier for each citizen and has become increasingly important for various government initiatives aimed at improving security, governance, and service delivery.”
Adegoke highlighted the efforts to streamline the modification and enrollment processes under the leadership of Abisoye Coker, the director-general of NIMC. He announced the development of a self-service platform, allowing Nigerians to make necessary modifications such as changing names, dates of birth, email addresses, and phone numbers from anywhere, using different devices.
Emphasising the convenience of the self-service modification portal, Adegoke encouraged Nigerians to utilize this innovative solution.
He noted the evolution of the process, citing the past requirement for applicants to visit NIMC offices for data corrections.
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