News from the BMJ
BMJ 2003;327 (16 August)
Use
of NSAIDs in pregnancy increases risk
of miscarriage
Using non-steroidal anti-inflammatory drugs
(NSAIDs), including aspirin, during pregnancy
increases the risk of miscarriage.
BMJ 2003;327:360 (16 August)
Officials
warn of multiple drug resistance in the
community
Roger Dobson, Abergavenny
Bacteria with multiple resistance to antibiotics,
until now found only in UK hospitals,
may have emerged in the community.
Samples taken from 57 patients, mostly
with urinary tract infections, in two
parts of the United Kingdom, have shown
evidence of Escherichia coli with multiple
resistance to drugs.
BMJ 2003;327:360 (16 August)
Indian
government faces court battle over antiretrovirals
Sanjay Kumar, New Delhi
A non-governmental organisation, the Punjab
Voluntary Health Association, has dragged
the Indian government and the National
AIDS Control Organisation to the Supreme
Court in a public interest writ over depriving
AIDS patients of antiretroviral drugs
in government hospitals, effectively leaving
them to die.
BMJ 2003;327:360 (16 August)
Libyan
government lets AIDS experts comment on
hospital deaths
Katka Krosnar, Prague
Fears remain that 16 medical workers accused
of deliberately infecting almost 400 Libyan
children with HIV could be sentenced to
death if convicted.
BMJ 2003;327:357 (16 August)
Cabinet
rules that South Africans must be given
antiretrovirals
Pat Sidley, Johannesburg
The South African cabinet announced at
the end of last week that it has ordered
the health minister, Dr Manto Tshabalala-Msimang,
to compile a plan for the roll out of
antiretroviral treatment for people with
HIV and AIDS.
BMJ 2003;327 (9 August)
Short
interpregnancy interval is associated
with adverse outcome
Conceiving shortly after giving birth is
independently associated with preterm
birth and neonatal death.
BMJ 2003;327:306 (9 August)
South
African government to withdraw antiretrovirals
for pregnant mothers
Pat Sidley, Johannesburg
South Africa’s first AIDS conference
got off to a painful start last weekend.
At the opening of the conference, AIDS
activists stood in silent protest at the
health minister, Dr Manto Tshabalala Msimang,
while others booed her loudly.
BMJ 2003;327:245 (2 August 2003)
HIV
cases rising sharply in India
Sanjay Kumar, New Delhi
India has seen a sharp increase in the
reported number of people who are HIV
positive, according to the new estimates
for 2002 released by India’s National
AIDS Control Organisation.
BMJ 2003;327:245 (2 August 2003)
Liberia
faces a humanitarian catastrophe, warn
aid agencies
Peter Moszynski, London
Humanitarian agencies are warning that
cholera and dysentery could be out of
control as conditions deteriorate in Liberia’s
beleaguered capital, Monrovia. A rebel
assault on the city that has killed hundreds
of civilians has left hundreds of thousands
more without access to food or clean water.
BMJ 2003;327 (2 August 2003)
Vitamin
A given soon after birth increases survival
of newborns
Giving newborn infants vitamin A soon after
birth can reduce mortality before 6 months
of age by over 20%.
BMJ 2003;327:182 (26 July)
EU
commits $1bn to global fund
Alexander Dorozynski, Paris
The president of the European Commission,
Romano Prodi, guaranteed a European contribution
of $1bn (£630m; €890m) for 2004 to the
Global Fund to Fight AIDS, Tuberculosis
and Malaria.
BMJ 2003;327:184 (26 July)
More
than half of male medical students don’t
practise safe sex on holiday
Roger Dobson, Abergavenny
Medical students on holiday are not setting
an example for safer sex. According to
a survey, fewer than half of male students
who have sex with a new partner when on
holiday always use a condom.
BMJ 2003;327:184 (26 July)
Food
emergency looms in war torn Sudan
Peter Moszynski, London
The UN World Food Programme has warned
that a serious funding shortfall, despite
growing evidence of a food emergency,
may lead to cuts in food distribution
in Sudan.
BMJ 2003;327:184 (26 July)
Free
retroviral drugs could save up to 1.7
million South Africans
Pat Sidley, Johannesburg
By offering free antiretroviral drugs to
the six million people with HIV/AIDS who
can’t afford them the South African government
could save or prolong the lives of about
1.7 million people, a new study says.
BMJ 2003;327 (26 July)
Patients
in Uganda prefer to die at home
A good death in developing countries like
Uganda, where resources are scarce, occurs
when the dying person is being cared for
at home, is free from pain and other distressing
symptoms, feels no stigma, and is at peace.
BMJ 2003;327 (19 July)
Girls
are less likely to survive infancy in
India
In India more female infants than male
infants die from easily treatable conditions.
In a retrospective analysis of verbal
autopsies collected by health workers
in three Delhi slums, Khanna and colleagues
(p 126) found an excess number of deaths
among girls due to conditions such as
diarrhoea. There were no significant differences
in deaths due to less preventable and
less treatable conditions like birth asphyxia.
Three quarters of the unexplained infant
deaths, for which no history of illness
and no sufficient explanation were found,
were in girls. In India, where there are
more men than women, the role of sex discrimination
is of wide concern; both antenatal sex
determination and female feticide are
incriminated.
BMJ 2003;327 (19 July)
First
WHO treaty tackles international tobacco
control
Tobacco control requires international
collaboration and action, but getting
governments to agree on strategies is
difficult. Shibuya and colleagues (p 154)
describe the development of the WHO’s
Framework Convention on Tobacco Control,
an evidence based global public health
treaty that was endorsed by member states
on 21 May 2003. It represents the first
time that WHO has used its constitutional
authority to develop a legal instrument
for improving health. Drawing on scientific
evidence, the convention includes measures
relating to reducing the demand for tobacco
(price and tax measures, restrictions
on tobacco advertising) and the supply
of tobacco (restriction of sales to minors,
economically viable alternatives for growers).
The authors state that these interventions
could reduce the global burden of disease
attributable to tobacco by up to 60%.
BMJ 2003;327:120 (19 July)
Lords
committee warns of gaps in infection control
measures
Lynn Eaton, London
England has a shortage of appropriately
trained experts in identifying infectious
diseases, says a report published this
week by the House of Lords.
BMJ 2003;327:124 (19 July)
HIV
testing should not be used to restrict
access to UK, report says
Debashis Singh, London
Testing migrants and asylum seekers for
HIV at the point of entry into the United
Kingdom to restrict access into the country
and to medical services would achieve
little more than to stigmatise HIV further,
a report from the All-Party Parliamentary
Group on AIDS said last week.
BMJ 2003;327:124 (19 July)
WHO
report calls for free anti-tuberculosis
drugs for AIDS patients
Fiona Fleck, Geneva
A new report by the World Health Organization
in the style of a glossy but hard hitting
brochure aims to draw attention to the
global tuberculosis epidemic that has
been spurred by the spread of HIV and
multidrug resistant tuberculosis strains.
BMJ 2003;327:122 (19 July)
AIDS
will affect us all eventually, Mandela
tells London audience
Daloni Carlisle, London
Nelson Mandela has called for a new war
against HIV/AIDS, arguing that it is claiming
more lives in Africa than the sum total
of all wars, famines, floods, and other
deadly diseases, such as malaria.
BMJ 2003;327:124 (19 July)
Anne Gulland, London
Researchers hope to see the first results
from the largest ever malaria vaccine
trial in children in Africa in just 18
months, the research team leader announced
last week.
BMJ 2003;327:124 (19 July)
Africa
has a right to support from international
community in its fight against HIV/AIDS,
malaria, and tuberculosis
Harry McConnell, Maputo
Africa has a right to demand support from
the international community in its fight
against AIDS, tuberculosis, malaria and
other diseases, Professor Jeffrey Sachs,
executive director of the Earth Institute
at Columbia University, told a meeting
of African heads of state in Maputo, Mozambique
last week.
BMJ 2003;327 (12 July)
Women
need full information for breast screening
decisions
The value of routine mammography is debated,
but women must be the ones to make informed
choices about the screening examination.
Thornton and colleagues (p 101) argue
that the focus of the debate in the media
and among scientists on the efficacy of
mammography misses the point. Women must
be empowered to make individual decisions
about screening, which the authors say
are essentially value judgements. This
can be facilitated by providing women
with full information on harms and benefits,
and doing so in a way that is understandable.
The authors state that unless women are
able to make true informed choices, support
and funding for routine mammography will
continue to be questioned.
BMJ 2003;327:72 (12 July)
Italian
EU presidency brings ambitious health
targets
Rory Watson, Brussels
The Italian government has set itself an
ambitious public health agenda as it presides
over European Union business for the next
six months. Heading the list are moves
to establish a European centre for disease
prevention and control and to increase
information to the public on the importance
of healthy lifestyles.
BMJ 2003;327:72 (12 July)
Women
in Ulster should have access to abortion
services
Linda Beecham, BMJ
Representatives at the BMA’s annual conference
criticised the fact that women in Northern
Ireland still do not have access to the
same abortion facilities as women in the
rest of the United Kingdom and called
on the government to rectify this anomaly.
BMJ 2003;327:10 (5 July)
Doctors
fear that rise in infection rates points
to a return to unsafe sex
Tony Sheldon, Utrecht
Numbers of cases of sexually transmitted
infection in the Netherlands have increased
by two thirds in three years, leaving
researchers “alarmed” because
it points to an increase in unsafe sex.
The total figure for all sexually transmitted
infections rose over three years from
about 5500 to 9500.
BMJ 2003;327:10 (5 July)
UN
report predicts shortfall in AIDS funding
in developing countries
Susan Mayor, London
Funding for the prevention and treatment
of AIDS in low and middle income countries
is only about half what is needed to provide
basic services, warned a report published
by the Joint United Nations Programme
on HIV/AIDS (UNAIDS) last week.
BMJ 2003;327:10 (5 July)
Unsafe
sexual practices are common, say US studies
Deborah Josefson, Nebraska
Unsafe sexual practices are common in people
infected with HIV and in those at high
risk of infection, warned two US epidemiological
studies published this week in the American
Journal of Public Health. Results suggest
that new preventive, educational, and
public health strategies are needed to
prevent HIV transmission and reduce the
risk of a new AIDS epidemic.
BMJ 2003;327:11 (5 July)
Aid
agency launches latest initiative to tackle
diseases in the developing world
Ganapati Mudur, New Delhi
The quest for drugs to fight the world’s
most neglected tropical infectious diseases
gained fresh momentum with the formal
launch of the “drugs for neglected
diseases” initiative this week.
BMJ 2003;327:12 (5 July)
US
scientists back bill for free access to
publicly funded science research
Janice Hopkins Tanne, New York
A star studded group of US doctors and
scientists is supporting legislation for
publicly funded research to be made available
free by “open access” on the
internet, an initiative spearheaded by
the Public Library of Science, a non-profit
organisation (www.plos.org).
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