Revitalizing diarrheal disease case management
Using the introduction of zinc for diarrhea treatment as a catalyst, USAID/BASICS has been working in a number of countries to revitalize diarrheal disease case management. In collaboration with Management Sciences for Health, A2Z, and USAID, and building on earlier work by Johns Hopkins University School of Public Health in Tanzania, USAID/BASICS developed a tool to assess country readiness for zinc introduction. The tool was first used in Madagascar, and adapted for Indonesia, DR Congo, and Senegal. It has also been shared with Uganda, Rwanda, Afghanistan, and Malawi. The tool covers case assessment, classification, and treatment; extension of diarrhea case management to community health workers; communication approaches and tools; logistics issues, including registration of zinc, as well as supply of both zinc and low osmolarity ORS; and data for monitoring and evaluation.
Challenges surrounding the acquisition of zinc by countries have been a primary obstacle for rapid revitalization of diarrhea case management. Still, Madagascar and DR Congo are making substantial progress with scale-up in spite of limitations in commodity availability. In both countries, more than 20 percent of districts are already covered. Moreover, DR Congo is planning a national launch of its diarrhea case management revitalization program.
Contributed by USAID/BASICS Case management of diarrheal disease
Rotavirus vaccines promise impact after clinical trials in Africa
Because oral vaccines often perform differently in varying settings, the World Health Organization (WHO) called for specific studies on the use of new rotavirus vaccines in the developing world, particularly among impoverished populations of Africa and Asia.
The GAVI Alliance, the public health community, and vaccine manufacturers made an unprecedented commitment to understand how these vaccines would work in developing-world conditions. Initiated in 2005, clinical trials conducted by PATH, the US CDC, WHO, and manufacturers evaluated the safety and efficacy of Rotarix® (GlaxoSmithKline) and RotaTeq® (Merck Sharp & Dohme Corp.) Rotarix® was evaluated in South Africa and Malawi, while RotaTeq® was tested in Ghana, Kenya, and Mali—as well as Bangladesh and Vietnam. In total, more than 12,000 infants were enrolled and most were followed into their second year of life. All populations studied represented low-income, high-mortality settings in which diarrheal disease is a major cause of child deaths.
Data from the studies revealed that rotavirus vaccines had a significant impact toward reducing severe rotavirus episodes, and illustrate the potential of rotavirus vaccines to have a dramatic impact on child mortality in the developing world.
Contributed by PATH
Water purifier dramatically reduces diarrhea in populations at risk
PUR Purifier of Water, developed by Proctor & Gamble (P&G) in collaboration with the US Centers for Disease Control and Prevention (CDC), is a powdered product that turns contaminated drinking water into purified water that meets World Health Organization standards for potable water and Environmental Protection Agency (EPA) standards for a water purifier. PUR uses the same ingredients used in municipal water treatment in a 4 g packet. The coagulant and flocculants in PUR remove dirt, greater than 98 percent of arsenic, and more than 99.9 percent of parasites like Giardia and Cryptosporidium. The chlorine disinfectant in PUR kills greater than 99.9999 percent of the bacteria and more than 99.99 percent of the viruses that cause cholera, typhoid fever, and dysentery. Results of five randomized controlled health intervention trials, conducted by the CDC and Johns Hopkins University, show that PUR reduces diarrheal illness by an average of 50 percent, with up to 90 percent reduction among particularly vulnerable people.
In 2004, P&G created the not-for-profit Children’s Safe Drinking Water Program and has committed to provide three billion liters of water from 2007 to 2012.To date, more than 2 billion liters of purified water have been provided in more than 50 countries during emergencies and for sustained efforts focused in Africa. This effort has focused on helping people during emergencies, reaching mothers at health clinics, providing safe drinking water to people living with HIV/AIDS, educating school children as positive catalysts for community change, and providing of safe drinking water to malnourished children.
Contributed by Proctor & Gamble's Children's Safe Drinking Water Program