Based on new evidence assessing benefits and risks, the World Health Organization (WHO) recommends the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.
Initial studies had highlighted a possible link between DTG and neural tube defects (birth defects of the brain and spinal cord that cause conditions such as spina bifida) in infants born to women using the drug at the time of conception. This potential safety concern was reported in May 2018 from a study in Botswana that found 4 cases of neural tube defects out of 426 women who became pregnant while taking DTG. Based on these preliminary findings, many countries advised pregnant women and women of childbearing potential to take efavirenz (EFV) instead.
New data from two large clinical trials comparing the efficacy and safety of DTG and EFV in Africa have now expanded the evidence base. The risks of neural tube defects are significantly lower than what the initial studies may have suggested.
The guidelines group also considered mathematical models of the benefits and harms associated with the two drugs; the values and preferences of people living with HIV, as well as factors related to implementation of HIV programmes in different countries, and cost.
DTG is a drug that is more effective, easier to take and has fewer side effects than alternative drugs that are currently used. DTG also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and nevirapine-based regimens. In 2019, 12 out of 18 countries surveyed by WHO reported pre-treatment drug resistance levels exceeding the recommended threshold of 10%.
All of above findings informed the decision to update the 2019 guidelines.
In 2019, 82 low- and middle-income countries reported to be transitioning to DTG-based HIV treatment regimens. The new updated recommendations aim to help more countries improve their HIV policies.
As for any medications, informed choice is important. Every treatment decision needs to be based on an informed discussion with the health provider weighing the benefits and potential risks.
WHO also stresses the importance of providing information and options to help women make an informed choice. To this end WHO has convened an advisory group of women living with HIV from diverse backgrounds to advise on policy issues related to their health, including sexual and reproductive health. WHO highlights the need to continually monitor the risk of neural tube defects associated with DTG.
Primary Healthcare: Oyo Govt. Engages More Medical Doctors, Renovate Facilities
• State insurance scheme to register beneficiaries online
Oyo State government has disclosed that it has extended its capacity towards engaging more medical doctors and renovate primary healthcare centers in the State to boost the State Health Insurance scheme and get more people to enroll in the programme.
The Health Insurance scheme covered many ailments at minimal cost and has enrolled almost 200,000 people of the State among whom were civil servants, organized private sector, traders and artizans..
The Executive Secretary Oyo State Health Insurance Agency, Dr. Sola Akande said the scheme was committed to effective healthcare delivery in line with Governor Seyi Makinde’s health service Agenda to transform Oyo State.
Akande stated this at the public/private Health providers forum held in Ibadan over the weekend, noting that Health Insurance Scheme has come to stay in Oyo State, as enrollees (beneficiaries) have benefited immensely from the scheme since inception.
“The scheme has immensely benefited a vast majority of people in the State for the opportunity of cheap access to medical care wherever you are in the State.
“We have succeeded in reaching out to the far corners of the State with the extension of the services of the Health Insurance Scheme at the local communities through the primary healthcare services and efforts are ongoing to engage more doctors and medical personnel to boost the efforts of those already engaged and we are also working currently to renovate the facilities to further attract enrollment.”
The Executive Secretary hinted that there would be enrollment centers in each of the Local Government headquarters across the State for appreciable enrollment by the people, adding that online enrollment would be made available to make participation and engagement easier.
Dr Akande added that the Agency would continuously ensure that healthcare providers comply with necessary regulations and provisional guidelines.
In their remarks, stakeholders at the event applauded the initiative behind the scheme, promising to keep with the scheme’s rules and regulations.
Oyo Govt. Kicks Against Environmental Saboteurs In Ibadan
Oyo State Government on Saturday said it has the mandate to enforce the Environmental sanitation laws, stressing that it would henceforth wield the big stick of the law against saboteurs of Environmental exercises in the State.
The Commissioner for Environment and Natural Resources, Rt. Hon. Kehinde Ayoola stated this while monitoring the Monthly environmental sanitation exercise observed in Ibadan, the state capital.
Speaking to some traders, the Commissioner said, “Oyo State Government is putting in so much to ensure that our environment is clean, and we would not tolerate any form of sabotage against this process. Enough is enough”.
Represented by the Permanent Secretary, Dr. Bashir Olanrewaju, he said the State Government was taking proactive steps to stop unhealthy waste disposal in the State through the revamping of some dump-sites.
Appealing to residents, especially traders to cooperate with the State Government, the Commissioner said, “We appeal to our people to please co-operate with the Engr. Seyi Makinde led administration. We have transited into a new waste management era and we would start experiencing community-based waste management system, which involves them playing their roles during sanitation exercises like this.”
In addition, Ayoola promised that the State Government would take seriously, the business of enforcement, saying the exercise would be extended to other parts of the State, in due course.
All we are asking for, is that our people should comply with the State Government’s laws. And we promise, that after proper check on refuse disposal in the State, Oyo State Government would take the next giant step of turning our wastes to wealth.
Though, today’s exercise did not restrict vehicular movements, traders, shops and business complexes whose goods and wares were displayed during the sanitation hours have been sanctioned.
The team of Environmental Health Officers led by the Permanent Secretary visited major markets in Ibadan such as Bodija, Oje, and Bere.
FG, US Govt Launch Special Campaign On Eradicating HIV/AIDS
The Federal Government of Nigeria and United States Government have led a campaign, code named “you equals you” aimed at eradicating the HIV and AIDS pandemic in Nigeria through active community participation.
The Director General of the National Agency for the Control of AIDS, Olokun Lawal and the US Deputy Chief of Mission Kathleen Fitzgibbon during the launch on Monday informed that Nigeria has made great progress in reducing HIV prevalence from 4.4 percent in 2005 to 1.4 percent in 2018.
They, however solicited support of communities to stop stigmatisation and encourage more people to know their status and be placed on treatment.
Photo credit : Channels Tv
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