One child or youth under 20 infected with HIV every 100 seconds: UNICEF

Agencies
November 26, 2020

Geneva, Nov 25: Approximately once every minute and 40 seconds, a child or young person under the age of 20 was infected with HIV last year, the UN Children's Fund (UNICEF) said on Wednesday.

Prevention efforts and treatment for children remain some of the lowest amongst key affected populations, and in 2019, a little less than half of children worldwide did not have access to life-saving treatment, UNICEF said in a new report.

Nearly 3,20,000 children and adolescents were newly infected with HIV and 1,10,000 children died of AIDS last year, the Xinhua news agency reported.

"Children are still getting infected at alarming rates, and they are still dying from AIDS. This was even before Covid-19 interrupted vital HIV treatment and prevention services putting countless more lives at risk," said UNICEF Executive Director Henrietta Fore.

According to UNICEF, the Covid-19 pandemic has worsened inequalities in access to life-saving HIV services for children, adolescents and pregnant mothers everywhere, and there are serious concerns that one-third of high HIV burden countries could face coronavirus-related disruptions.

"Even as the world struggles in the midst of an ongoing global pandemic, hundreds of thousands of children continue to suffer the ravages of the HIV epidemic," said Fore.

Data from the Joint UN Programme on HIV/AIDS (UNAIDS), cited in the report, showed the impact of control measures, supply chain disruptions, lack of personal protective equipment, and the redeployment of healthcare workers on HIV services.

Pediatric HIV treatment and viral load testing in children in some countries fell by 50 to 70 per cent, and new treatment initiation by 25 to 50 percent in April and May, coinciding with partial and full lockdowns to control the novel coronavirus.

Health facility deliveries and maternal treatment were also reported to have reduced by 20 to 60 per cent, maternal HIV testing and antiretroviral therapy (ART) initiation by 25 to 50 per cent, and infant testing services by approximately 10 percent.

Though the easing of control measures and the strategic targeting of children and pregnant mothers have successfully led to a rebound of services in recent months, challenges remain, and the world is still far from achieving the global 2020 pediatric HIV targets, said UNICEF.

Despite some progress in the decades-long fight against HIV and AIDS, deep regional disparities persist among all populations, especially for children.

While the Middle East and North Africa region recorded 81 percent pediatric ART coverage, only 46 per cent and 32 per cent were covered in Latin America and the Caribbean, West and Central Africa, respectively.

The South Asia region recorded 76 per cent coverage, Eastern and Southern Africa 58 per cent, and East Asia and the Pacific 50 per cent.

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Agencies
January 19,2021

People with fever, pregnant and breastfeeding women avoid Covaxin, says Bharat Biotech

Pune, Jan 19: Bharat Biotech's fact sheet on COVID-19 vaccine Covaxin, has advised pregnant or breastfeeding women, besides people with high fever or bleeding disorders, not to take the antidote.

The vaccine maker in the fact sheet on Covaxin, posted in its website, said the clinical efficacy of the vaccine is yet to be established and is being studied in Phase 3 clinical trial and hence it is important to appreciate that receiving the vaccine does not mean other precautions related to COVID- 19 need not be followed.

"You should not get Bharat Biotech's COVID-19 vaccine Covaxin if you have any history of allergies. Have high fever.

Have bleeding disorder or are a blood thinner.

Immune compromised or are a medicine that affects your immune system. Are pregnant. Are breast feeding.

Have received another COVID-19 vaccine. Any other serious health related issues, as determined by the vaccinator/ Officer supervising vaccination," the fact sheet said.

The fact sheet also asked people to inform the vaccinator or a supervising official about their medical condition before taking the vaccine.

Bharat Biotech said in an ongoing clinical trial Covaxin has been shown to generate immunity following two doses given four weeks apart.

Covaxin is a vaccine with approval for restricted use in emergency situations that may prevent COVID-19.

The Central Licensing Authority has granted permission for the sale or distribution of the antidote for restricted use in emergency situations in public interest as an abundant precaution, in clinical trial mode, the fact sheet said.

Covaxin is a highly purified and inactivated two-dose SARS-CoV-2 vaccine, manufactured in a Vero cell manufacturing platform with an excellent safety track record of more than 300 million doses, the company had said.

Covaxin is India's totally indigenous COVID-19 vaccine developed in collaboration with the Indian Council of Medical Research and National Institute of Virology.

The inactivated vaccine is developed and manufactured in Bharat Biotech's BSL-3 (Bio-Safety Level 3) biocontainment facility, one of its kind in the world.

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News Network
January 17,2021

Oslo, Jan 17: Norwegian officials said 29 people had died in the country a short time after receiving their first dose of the Covid-19 vaccine. Of those deaths, at least 13 have been autopsied, with the results suggesting that common side effects may have contributed to severe reactions in frail, elderly people, according to the Norwegian Medicines Agency.

Norway said Covid-19 vaccines may be too risky for the very old and terminally ill, the most cautious statement yet from a European health authority as countries assess the real-world side effects of the first shots to gain approval.

“For those with the most severe frailty, even relatively mild vaccine side effects can have serious consequences,” the Norwegian Institute of Public Health said. “For those who have a very short remaining life span anyway, the benefit of the vaccine may be marginal or irrelevant.”

The recommendation does not mean younger, healthier people should avoid being vaccinated. But it’s an early indication of what to watch as countries begin to issue safety monitoring reports on the vaccines. Emer Cooke, the new head of the European Medicines Agency, has said tracking the safety of Covid vaccines, especially those relying on novel technologies such as messenger RNA, would be one of the biggest challenges once shots are rolled out widely.

Pfizer and BioNTech are working with the Norwegian regulator to investigate the deaths in Norway, Pfizer said in an e-mailed statement. The agency found that “the number of incidents so far is not alarming, and in line with expectations,” Pfizer said.

Allergic reactions have been uncommon so far. In the US, authorities reported 21 cases of severe allergic reactions from December 14-23 after administration of about 1.9 million initial doses of the vaccine developed by Pfizer Inc. and BioNTech SE. That’s an incidence of 11.1 cases per million doses, according to the Centers for Disease Control and Prevention.

Though both Covid-19 vaccines approved so far in Europe were tested in tens of thousands of people -- including volunteers in their late 80s and 90s -- the average trial participant was in his or her early 50s. The first people to be immunized in many places have been older than that as countries rush to inoculate nursing-home residents at high risk from the virus.

Norway has given at least one dose to about 33,000 people, focusing on those considered to be most at risk if they contract the virus, including the elderly. The Pfizer-BioNTech vaccine approved late last year has been used most broadly, with a similar shot from Moderna Inc. approved earlier this month also now being administered.

Of 29 cases of potential side effects investigated by Norwegian authorities, almost three-quarters were in people age 80 or older, the regulator said in a January 14 report.

In France, one frail patient died in a care home two hours after being vaccinated, but authorities said given the patient’s previous medical history there is no indication the death was linked to the vaccine. The French pharmaceutical safety agency on Thursday reported four cases of severe allergic reactions and two incidents of irregular heartbeat after vaccination.

The first Europe-wide safety report on the Pfizer-BioNTech vaccine will probably be published at the end of January, the regulator’s key medicines committee said Friday. Vaccine makers are required to submit data monthly.

In the UK, which has carried out more immunizations per capita than anywhere else in Europe, authorities will assess safety data and plan to publish details of suspected reactions “on a regular basis,” the Medicines and Healthcare Products Regulatory Agency said, without giving a date.

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Agencies
January 16,2021

Scientists have developed a rapid blood test that can predict within a day of hospitalisation which patients with COVID-19 are at the highest risk of severe complications or death, an advance that may help identify those who may best benefit from specific investigational treatments.

The test, described in the journal JCI Insight, measures levels of mitochondrial DNA -- a unique type of genetic material that normally resides inside the energy factories of cells.

According to the researchers from the Washington University School of Medicine at St. Louis in the US, mitochondrial DNA spilling out of cells and into the bloodstream indicates that a type of violent cell death is taking place in the body.

"Doctors need better tools to evaluate the status of COVID-19 patients as early as possible because many of the treatments are in short supply, and we know that some patients will get better without intensive treatments," said study co-author Andrew E. Gelman.

"We need to understand why some patients, irrespective of their ages or underlying health in some cases, go into this hyperinflammatory death spiral. Our study suggests that tissue damage may be one cause of this spiral, since the mitochondrial DNA that is released is itself an inflammatory molecule," Gelman added.

Viruses are known to cause a type of tissue damage called necrosis that is a violent, inflammatory response to the infection, the researchers said, adding that this may lead to cells breaking open and releasing their contents including mitochondrial DNA.

"In COVID-19 patients, there has been anecdotal evidence of this type of cell and tissue damage in the lung, heart and kidney. We think it's possible that measures of mitochondrial DNA in the blood may be an early sign of this type of cell death in vital organs," Gelman explained.

The scientists believe the new test could help predict disease severity and also act as a tool to better design clinical trials -- identifying patients who might benefit from specific investigational treatments.

"We will need larger trials to verify what we found in this study, but if we could determine in the first 24 hours of admission whether a patient is likely to need dialysis or intubation or medication to keep their blood pressure from dropping too low," said Hrishikesh S. Kulkarni, another co-author of the research.

In the study, the researchers assessed 97 patients with COVID-19, measuring their mitochondrial DNA levels on the first day of their hospital stays.

They found that mitochondrial DNA levels were much higher in patients who eventually were admitted to the ICU, intubated or died.

According to the study, this association held independently of a patient's age, sex and underlying health conditions.

It noted that mitochondrial DNA levels were about tenfold higher in patients with COVID-19 who developed severe lung dysfunction or eventually died.

Those with elevated levels were almost six times more likely to be intubated, three times more likely to be admitted to the ICU and almost twice as likely to die compared with those with lower levels, the scientists said.

They said the test could also predict outcomes as well as, or better than, existing markers of inflammation currently measured in patients hospitalised with COVID-19.

According to the scientists, the test is quick to perform, returning results in less than an hour, and uses the same machinery that processes the standard PCR test for COVID-19.

They said the method allows mitochondrial DNA levels to be quantified directly from patient blood samples without requiring intermediate steps to extract the DNA from the blood.

The researchers hope to verify that the test is accurate in a larger multi-center trial before applying for approval from the US Food and Drug Administration.

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