NEWS SCAN: Combo TB drug, Global Fund misspending, immunization-record access, HFMD in Vietnam, pathogens in the elderly

Jul 24, 2012

New combination TB drug shows promise in phase 2 trial
The first new combination drug treatment for tuberculosis (TB) killed more than 99% of patients' TB bacteria within 2 weeks, according to phase 2 results published yesterday in The Lancet. Researchers, including scientists from TB Alliance, a nonprofit agency that promotes new TB treatments, tested 85 TB patients in two South African clinics. They used a combination drug, PaMZ, which included PA-824, a novel TB therapy; moxifloxacin, an established antibiotic not yet approved for first-line TB therapy; and pyrazinamide, an existing TB drug. They also tested other drug combinations. PaMZ had significantly better bacteria-reducing results than the other combinations and was well tolerated. Another trial begun earlier this year in South Africa, Tanzania, and Brazil is testing PaMZ over a 2-month period. The results offer hope for a new treatment option for multidrug-resistant TB (MDR-TB), according to a TB Alliance news release. "These findings confirm the promise of novel TB regimens to be shorter, simpler, safer, and, compared with today's MDR-TB drugs, much less expensive," said TB Alliance CEO and President Mel Spigelman, MD.
Jul 23 Lancet abstract
Jul 23 TB Alliance press release

Audits reveal 3% of Global Fund disease money was misspent
About 3% of funding audited or investigated from 2005 to 2012 was misspent, misappropriated, or inadequately accounted for, according to the office of the Inspector General (IG) of the Global Fund to Fight AIDS, Tuberculosis and Malaria. "Although some of these funds were misspent, and are just ineligible expenses, a small percentage of funds are misappropriated through fraud. We actively pursue and expose all such cases," said Global Fund Chief Risk Officer Cees Klumper, who was quoted in an AllAfrica news story today. Since its inception in 2005, the Global Fund's IG office has compiled 28 reports on audits and investigations in 27 nations that have received a total of $3.8 billion in funding, or about 23% of all Global Fund disbursements. The breakdown of the 3% included ineligible expenses not covered by the grant, 1.1%; inadequately substantiated moneys, 1.1%; fraud, 0.5%; and inadequately reported funds, 0.3%.
Jul 24 AllAfrica story

Indiana announces patient access to immunization records from any computer
Indiana and federal health officials today unveiled "MyVaxIndiana," an online tool that provides state residents direct access to their immunization records from any computer, the Indiana State Department of Health (ISDH) announced in a release. "Our goal is to further improve immunization rates of Hoosiers by providing parents and patients ready on line access to their own vaccine records, 24 /7," said State Health Commissioner Gregory Larkin, MD. "Immunization records for school, travel or personal care are available on the patient’s on-line request."  The records provided are from the Indiana Children and Hoosiers Immunization Registry Program, which includes about 4 million state residents. The ISDH created MyVaxIndiana through a technology grant from the US Office of the National Coordinator for Health Information Technology (ONC) as part of the ONC Innovation challenge to provide consumers access to their healthcare information. Judy Murphy, an ONC program coordinator, applauded Indiana as a leader and said, "I would encourage every state to provide patients access to their immunization history." Indiana has seen recent increases in adolescent immunization rates but has also had several measles outbreaks in the past 2 years.
Jul 24 ISDH news release

CDC says HFMD outbreak in Vietnam reaches 57,800 cases, 29 deaths
Hand, foot, and mouth disease (HFMD) has occurred in about 57,800 people in 63 provinces of Vietnam since the beginning of the year, with 29 deaths in 14 provinces, said an update yesterday from the US Centers for Disease Control and Prevention (CDC). More cases have occurred in northern Vietnam, but more deaths have occurred in southern areas. The contagious viral disease, which typically affects young children, causes fever, mouth sores, and rash. It is transmitted through direct contact with saliva, nasal secretions, blister fluid, or stool from an infected person. Good hygiene, including hand washing, is the best way to lower risk of exposure. The Vietnam Ministry of Health is working on control efforts in coordination with the World Health Organization, the CDC said.
Jul 23 CDC update

Varied pathogens cause mortality in elderly
The number of pathogens associated with mortality in older individuals increases with increasing age, and influenza A is a significant contributor, concludes a Dutch study in the Journal of Infectious Diseases (JID). Regression models were used to associate weekly death counts from 1999 to 2007 stratified into three age-groups (65 to 74 years, 75 to 84, and 85 and older) with circulation of nine common pathogens—season-specific influenza A, influenza B, respiratory syncytial virus (RSV), parainfluenza, enterovirus, rotavirus, norovirus, Campylobacter, and Salmonella. Influenza A and RSV were significantly (P < 0.05) associated with mortality in all the age-groups. Influenza B and parainfluenza were additionally associated in the groups 75 years and older, and norovirus was additionally associated in those 85 and older. The proportion of deaths associated with multiple winter viruses were 1.4%, 4.4%, and 6.8% in the youngest to oldest age-groups, respectively, with great variations between years. Influenza A was associated with the largest numbers of deaths overall, but the number of deaths attributed to RSV was almost as high and in some years surpassed flu A deaths. The authors state that their findings confirm not only the large role of influenza A in mortality in the elderly but also the roles of RSV and other viruses, such as influenza B, which is generally considered to cause mild illness.
JID study abstract

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