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SOUTH AFRICA: NEW TECHNOLOGY COULD REVOLUTIONISE TB DIAGNOSIS
31 December 2009 |
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A new technology being pioneered in South Africa may make screening for tuberculosis (TB) faster, cheaper and more reliable – and it’s all based on technology found on a typical trip through airport security.
The new computer diagnostic system known as TBDx takes digital pictures of sputum samples and searches them for TB’s structural “fingerprint.” Some airport scanners work in much the same way, searching luggage for the structural fingerprints of plastic explosives, for example.
The system is being pioneered by health research organisation, the Aurum Institute in partnership with South Africa’s National Health Laboratory Services (NHLS) and imaging specialists, Guardian Technologies International, and is the first in the world to pair advanced imaging technology with a digital microscope.
A prototype is already in the works and once fully automated will be able to run independently 24-hours a day. It has already proven 10 percent more effective at identifying TB bacilli than conventional TB tests which rely on laboratory technicians to manually load slides and look for the bacilli under a microscope.
With its combination of sensitive diagnostic technology and labour-saving automation, TBDx could revolutionize TB testing in high burden countries like South Africa that have seen a resurgence of TB in the last decade on the back of the HIV/AIDS epidemic.
About 70 percent of South Africans diagnosed with TB are co-infected with HIV and, despite being curable, the disease is the country's leading natural cause of death and one of the main factors behind South Africa's declining life expectancy.
“The diagnosis of TB is fraught with difficulties,” Dr David Clark, Deputy CEO of the Aurum Institute told IRIN/PlusNews.
He noted that current methods of TB diagnosis continue to rely on technology developed by Robert Koch, the German physicist who discovered TB a century ago. “If we were going to fight a war today with equipment we used 100 years ago, we’d be mad,” he said.
Testing the possibilities
TBDx can be operated by personnel with no special skills, freeing up a scarce supply of lab technicians to do other important work. It may also greatly improve working conditions for lab technicians who currently spend hours hunched over microscopes searching for tiny TB bacilli.
“Out of 100 slides that come to you...maybe six percent will be positive," said Clark, describing work in a high-volume laboratory. “The rest of your day is spent searching for something that isn’t there. These are highly trained technicians that could be doing other things.”
The new technology does not entirely do away with the need for skilled technicians. It can be set to flag slides that are difficult to diagnose – a function that Clark described as a potentially valuable training tool.
South Africa’s NHLS is waiting for the new technology to be costed before making a decision about whether to adopt it nationally, but TBDx is likely to be more cost effective than the current labour-intensive method of TB testing which costs about US$3 per slide.
“We will have to do the operational research and cost-effectiveness studies, but it’s very promising,” said Gerrit Coetzee, head of the National TB Reference Laboratory of the NHLS. He added that TBDx’s potential to increase lab productivity, and improve and standardise diagnosis were among its main draws.
If the NHLS does choose to adopt the technology, a national rollout is still at least three years away, according to Coetzee. The system would most likely be piloted in high volume laboratories before being scaled-down for use at lower levels of the health system.
Aurum acknowledges PlusNews as the source of this article
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IZINDABA - COLLABORATIVE PUSH TO ADDRESS TB CRISIS ON MINES
December 2009 |
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After a century of failed tuberculosis control strategies on South Africa’s mines, and three major but ineffective enquiries and commissions, a government-led ‘TB in Mines Task Team’ is being set up to address the deepening HIV driven crisis.
This was revealed by Professor Gavin Churchyard, CEO of the Aurum Institute for Health Research, a not-for-profit public benefit organisation with roots in the mining industry. He was addressing the annual Investigators Meeting of the international Consortium to Respond Effectively to the AIDS/ TB Epidemic (CREATE) in Cape Town in mid-October.
Churchyard revealed that the HIV-fuelled TB epidemic, compounded by rising drug resistance, is now estimated at 3 500 per 100 000 mine workers, with 40% of all autopsies on men who die working on the mines revealing they had TB.
Migration from rural areas throughout southern Africa to Gauteng and surrounding industrial areas to work in the mining, building and other dominant sectors is a major driver of the rampant TB epidemic.
Dr Lindiwe Mvusi, Director of TB Control and Management in the national department of health and chairperson of the new ‘TB in Mines Task Team’, said because the pandemic embraced all South Africa’s neighbouring countries it demanded a regional, multistakeholder
response.
A third delegate at the meeting, an ‘anxious and concerned’ Deputy Health Minister, Dr Molefi Sefularo, said national TB prevalence had increased nearly threefold in the past decade. South Africa was now among the 10 worst performing countries on TB control, and Statistics SA had found that for every 100 deaths in 2006, 13 were from TB, making it the leading cause of death.
Churchyard said less than 1% of all HIV-infected individuals in this country were accessing proven safe and effective isoniazid preventive TB therapy (IPT), a situation he calls ‘inexcusable’.
Aurum acknowledges Izindaba as the source of this article
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SOUTH AFRICA: NEW TECHNOLOGY COULD REVOLUTIONISE TB DIAGNOSIS
31 December 2009 |
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A new technology being pioneered in South Africa may make screening for tuberculosis (TB) faster, cheaper and more reliable – and it’s all based on technology found on a typical trip through airport security.
The new computer diagnostic system known as TBDx takes digital pictures of sputum samples and searches them for TB’s structural “fingerprint.” Some airport scanners work in much the same way, searching luggage for the structural fingerprints of plastic explosives, for example.
The system is being pioneered by health research organisation, the Aurum Institute in partnership with South Africa’s National Health Laboratory Services (NHLS) and imaging specialists, Guardian Technologies International, and is the first in the world to pair advanced imaging technology with a digital microscope.
A prototype is already in the works and once fully automated will be able to run independently 24-hours a day. It has already proven 10 percent more effective at identifying TB bacilli than conventional TB tests which rely on laboratory technicians to manually load slides and look for the bacilli under a microscope.
With its combination of sensitive diagnostic technology and labour-saving automation, TBDx could revolutionize TB testing in high burden countries like South Africa that have seen a resurgence of TB in the last decade on the back of the HIV/AIDS epidemic.
About 70 percent of South Africans diagnosed with TB are co-infected with HIV and, despite being curable, the disease is the country's leading natural cause of death and one of the main factors behind South Africa's declining life expectancy.
“The diagnosis of TB is fraught with difficulties,” Dr David Clark, Deputy CEO of the Aurum Institute told IRIN/PlusNews.
He noted that current methods of TB diagnosis continue to rely on technology developed by Robert Koch, the German physicist who discovered TB a century ago. “If we were going to fight a war today with equipment we used 100 years ago, we’d be mad,” he said.
Testing the possibilities
TBDx can be operated by personnel with no special skills, freeing up a scarce supply of lab technicians to do other important work. It may also greatly improve working conditions for lab technicians who currently spend hours hunched over microscopes searching for tiny TB bacilli.
“Out of 100 slides that come to you...maybe six percent will be positive," said Clark, describing work in a high-volume laboratory. “The rest of your day is spent searching for something that isn’t there. These are highly trained technicians that could be doing other things.”
The new technology does not entirely do away with the need for skilled technicians. It can be set to flag slides that are difficult to diagnose – a function that Clark described as a potentially valuable training tool.
South Africa’s NHLS is waiting for the new technology to be costed before making a decision about whether to adopt it nationally, but TBDx is likely to be more cost effective than the current labour-intensive method of TB testing which costs about US$3 per slide.
“We will have to do the operational research and cost-effectiveness studies, but it’s very promising,” said Gerrit Coetzee, head of the National TB Reference Laboratory of the NHLS. He added that TBDx’s potential to increase lab productivity, and improve and standardise diagnosis were among its main draws.
If the NHLS does choose to adopt the technology, a national rollout is still at least three years away, according to Coetzee. The system would most likely be piloted in high volume laboratories before being scaled-down for use at lower levels of the health system.
Aurum acknowledges Plus News as the source of this article
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HOPE FROM AN OLD REMEDY
11 December 2009, Jacqui Pile |
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A new way of tackling tuberculosis (TB) in the gold mining industry could cut prevalence rates and the cost of the treatment, compensation and management of TB among SA's mineworkers.
SA's gold mining industry has the highest incidence of TB in the world, with 3%-6% of the industry's 120 000 workers developing the active disease each year. This compare s with a TB incidence of about 0,96% in the general population and negligible rates in developed nations.
TB is legally defined as an occupational disease. In terms of present legislation claimants can obtain compensation from government for pain and suffering, medical expenses and loss of earnings. However, mining companies pay for compensation through contributions to the compensations fund. A study in 1994 by the Chamber of Mines showed that the annual cost of preventing, treating and compensating TB and providing management for the disease across the mining industry was about R700m/year.
The Aurum Institute, a specialist research organisation that focuses on TB and HIV prevention and treatment, estimates that the disease now costs the industry more than R1,2bn/year.
"Over the past two decades, the mining industry has implemented world-leading TB control programmes - but in the era of HIV, these are having little impact on controlling the disease," says Dave Clark, deputy CEO of the Aurum Institute.
The growth of HIV and TB are closely linked (see graph). In the context of reduced immunity linked to the HIV epidemic, TB has become the No 1 cause of death, according to Stats SA. It killed 13 of every 100 people who died in 2006.
The World Health Organisation estimates that almost 1% (461 000) of South Africans develop TB annually, and 40% of HIV-positive patients die of TB.
"Even with the best TB control programmes in force, people living with HIV/Aids are at very high risk of developing active TB over time," says Clark.
It's worse in the mining industry, where a history of migrant labour and the housing of workers in hostels has helped spread the disease. Silicosis, a lung disease caused by workers inhaling dust underground, also creates a "scaffold" in the lungs on which TB bacteria can thrive and multiply. "Our mines are dealing with a triple epidemic of HIV, TB and silicosis," says Clark.
But a study done in the 1950s among Alaskan Eskimos offers some hope. It involved administering daily doses of the TB drug Isoniazid as a prophylaxis to prevent TB. After taking the drug for a number of months, TB infection rates in the Eskimo population were radically reduced, by up to 60%. And the protective effect of Isoniazid prophylaxis was shown to persist for more than a year. Now the Aurum Institute is replicating the study in SA.
After securing funding in 2004 of US$27m over seven years from the Consortium to Respond Effectively to the Aids & TB Epidemic, the Aurum Institute began its Thibela TB programme. It used Isoniazid as a prophylaxis at some of SA's biggest gold mines, including those of AngloGold Ashanti, Gold Fields and Harmony. More than 30 000 workers have received the drug over the past four years.
The project had challenges, but it has achieved a volunteer participation rate of 95%. "That's basically unheard of, and represents a phenomenon that could possibly be harnessed to address the prevention of other diseases in communities, too," says Clark.
If the programme is successful, it could help prevent the disease in areas with high TB rates until a vaccine is developed. TB vaccines are being tested, but most are years away from being ready for mass deployment.
"Even if there is a drop of 30% in TB incidence, it would have a huge impact on the mining industry - not only for the bottom line, but in terms of workers' lives too," says Clark.
Aurum acknowledges Financial Mail as the source of this article
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AURUM CHAIRMAN DR PAUL DAVIS ON SABC INTERNATIONAL NEWS
8 December 2009 |
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Johannesburg – Dr Paul Davis, Chairman of the Aurum Institute was hosted on SABC International News programme “Health Matters” to discuss HIV in South Africa.
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TUBERCULOSIS AND HIV WITHIN PRISONS SKYROCKETING, A PUBLIC HEALTH THREAT
7 December 2009, Mara Kardas-Nelson |
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Overcrowding, low access to health care, lack of political will and the prominence of high-risk populations among prisoners all contribute to a "perfect storm" for HIV and TB infection among prison populations worldwide, researchers announced at the 40th Union World Conference on Lung Health this Saturday in Cancun, Mexico.
Dr Fabienne Hariga of the UN Office on Drugs and Crime and UNAIDS’ Dr Alasdair Reid both highlighted dismal health statistics for those behind bars. According to Hariga, up to 65% of some prison populations are infected with HIV.
Adding to this, says Reid, TB rates in prisons are up to fifty times higher than in the general population. Increased rates are found in prisoners who have served longer sentences, tying TB acquisition with prison time. Prisoners are also more likely to die from TB and/or default from treatment than non-incarcerated populations.
Dr Hariga insists that such poor indicators not only pose a threat to prisoners’ health, but the health of the general public as well. Given the high rate of return to society, prisoners’ HIV and TB are easily spread to communities.
Prison staff are also affected by the high incidence of HIV and TB. Dr Salome Charalambous of South Africa, speaking about HIV and TB prison projects sponsored by the country’s Department of Corrections and the Aurum Institute, notes that many prison staff supported greater testing, treatment and infection control because of concerns over their own health.
"Prisons are not isolated from the community," says Hariga. "You have people working in [them], you have prisoners moving in and out very often."
But despite dismal health statistics, effective penal reform that includes increasing health services for prisoners is far from a reality. Dr Hariga claims that "there is a lack of interest" among policy makers, resulting in a shortage of funds to address health problems for prisoners. "In many places in the world, there is no health-in-prison programme," she states.
The difficult nature of prison populations also contributes to the low number of programmes. Dr Charalambous cited logistical concerns that hampered the testing and treatment of prisoners in the South Africa study, who are often moved from prison to prison or released, interrupting HIV and TB follow-up and treatment.
In large part due to this mobility, 21% of patients initiated onto ART within one of the study’s programmes were lost. In another prison, seven of the 22 prisoners who were called for follow-up had been transferred prior to undergoing review.
In order to combat low programme retention, the ongoing study only enrolls prisoners with a sentence of four months or longer. Researchers also "tag" those enrolled, alerting prison authorities not to transfer them unless essential for trial purposes.
Additionally, using symptom-based diagnosis to identify possible TB patients is difficult among prison populations. In the South Africa study, 46% of patients demonstrated any symptom for TB, while 37% displayed a trio of symptoms.
However, Charalambous surmises that some of these can be attributed to the prison environment in general rather than TB infection specifically, and therefore states, "symptom screening might not be as effective in this environment."
Despite these challenges, Dr Charalambous is hopeful that prisoners present a captive audience for TB and HIV testing and treatment. Her study suggests that prisoners may be responsive to such programmes: in one site, 98% of prisoners agreed to join. Dr Reid agrees, claiming that prisons offer unique opportunities for treating marginalised populations.
In order to encourage more prison health programmes, Dr Reid calls for further research that assesses the rate of acquiring HIV and TB behind prison bars: while data that demonstrates the high rate of both infections among prison populations is readily available, numbers that point to prisons as conducive to their spread is harder to find.
In order to fuel political will, Reid condones the "advocacy, naming and shaming" of countries who boost some of the worst indicators for prisons with regards to overcrowding, HIV and TB, and human rights violations. "Global reporting is essential to get countries to take this seriously," he says.
References
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Charalambous, S. TB-HIV in prisons and the community response: the case of South Africa. Presented at the 40th Union World Conference on Lung Health, 2009.
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Hariga, F. Access to HIV and TB services in prison setting, injecting drug users in prisons: myths and realities. Presented at the 40th Union World Conference on Lung Health, 2009.
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Reid, A. Guidelines and advocacy: HIV/TB, prisons, IDU and poverty. Presented at the 40th Union World Conference on Lung Health, 2009.
Aurum acknowledges NAM as the source of this article
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TREATING OURSELVES OUT OF THE HIV/AIDS CRISIS - HYPOTHETICALLY
1 December 2009, Annabel Jacobs |
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Mail & Guardian Online - Johannesburg, South Africa
The scenario: all South Africans are tested for HIV annually and every person who tests positive is immediately given antiretroviral therapy (ART).
According to a controversial mathematical formula known as the Granich model, more colloquially known as the "test and treat" strategy, this approach could lead to a 95% reduction in new HIV cases in South Africa within 10 years -- and could see an end to the country's Aids epidemic by 2050.
The hotly debated model was published in the prestigious British medical journal, The Lancet, earlier this year, using data from South Africa and Malawi to demonstrate its impact. The "test and treat" approach is gaining support to such a great degree that the authoritative National Institutes of Health (NIH) in the United States has allocated funds and resources for in-depth studies into it; pilot studies are under way in New York's Bronx district and in Washington DC. According to Professor Gavin Churchyard, from the Johannesburg-based health research organisation the Aurum Institute, additional studies will be carried out in Vancouver in Canada and Hlabisa in KwaZulu-Natal.
"The question is: can we treat our way out of this epidemic?" asks Dr Guy de Bruyn, programme director of HIV prevention studies at the Perinatal HIV Research Unit at the University of the Witwatersrand. De Bruyn, who strongly supports the "test and treat" approach, says that current HIV prevention and treatment strategies will not make a positive impact in South Africa "if we don't manage to decrease the number of new infections and deaths".
Success with current methods is extremely limited, with 1500 new South African infections and 750 people dying every day from Aids-related complications.
Recently, the head of the US National Institute for Allergies and Infectious Diseases, Dr Anthony Fauci, affirmed in an NIH press release: "[The] test and treat [model] potentially could represent an important public health strategy for fighting HIV/Aids."
Chief author of The Lancet study, World Health Organisation medical officer Dr Reuben Granich and his four co-writers base their predictions on scientific evidence that ART is remarkably effective at reducing the amount of virus in an HIV-infected person's blood. This ensures the person is significantly less infectious -- even if the person has unsafe sex. When placed on ART soon after infection, and if the individual takes his or her treatment correctly (even within multiple concurrent sexual relationships and without correct and consistent condom use), the chance of an HIV-positive person infecting his or her partner is often reduced to almost zero.
The researchers say that it's been widely proved that people newly infected with HIV are most infectious and if those people, who mostly are unaware that they're infected with the virus, receive HIV treatment, it could lead to a major reduction in infections.
Based on his experience of several HIV testing projects in Soweto, De Bruyn is convinced that it's possible to get all South Africans to test for HIV through the mobilisation of community leaders, the use of mobile testing clinics and post-test support groups. "Creative strategies such as refusing to renew citizens' driver's licences without them first producing proof that they have gone for an HIV test, and testing people at fast-food stands can also be considered," De Bruyn says.
But the contentious model presents many ethical as well as operational challenges, such as the cost of treatment and testing.
"Each HIV test costs about R96. To test everyone above 15 in South Africa will amount to R3,8-billion and almost 154 000 tests per day," says Wits Clinical HIV Research Unit deputy director Dr Francesca Conradie.
"How do you get all adults in this country tested for the virus once a year if most of them have up until now been reluctant to or even refused to go for a test? If you force them to, you are infringing on their human rights. And, without test results, you can't treat anyone," Conradie says.
It is estimated that 700 000 South Africans are on ART. For the Granich model to be effective, 5,8-million (the estimated number of HIV-infected people in the country) would need to be on ART -- more than eight times the current number. "South Africa simply has too many HIV-infected people for this strategy's implementation to be practical. We're not the US where the numbers are manageable," Conradie says.
Granich and his colleagues point out that, although the model would require more money in the short term, the financial burden would be alleviated as the number of infections start to decline and fewer people would need treatment.
But, Conradie says: "We should rather put all our efforts into well-established prevention methods such as medical male circumcision, which reduces men's risk to contract HIV by 60%."
Aurum acknowledges Mail & Guardian as the source of this article
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TAXI OPERATORS AND TRADERS MARCH IN SOLIDARITY AND SUPPORT OF MAKING HEALTH SERVICES ACCESSIBLE
1 December 2009 |
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1/12/09, Johannesburg, South Africa – Leaders of the taxi associations and drivers, informal traders and staff of the Metropolitan Trading Company marched from Bree Street Taxi Rank to Mary Fitzgerald Square today to show their support for the Aurum Institute Emthonjeni Clinic and deliver a memorandum to Qedani Mahlangu, MEC of Health and Social Development (Gauteng) this World AIDS Day.
The Aurum Institute’s "Emthonjeni" - an inconspicuous health centre providing screening for HIV, TB, STI’s, hypertension and diabetes too taxi operators, traders and commuters, was established in 2008 as a partnership between The Aurum Institute and Metropolitan Trading Company.
"People work here and thousands arrive for work and leave for work from this place," said Alfred Xolani Sam, CEO of the Metropolitan Trading Company.
"They can do their shopping here. So it is logical that the can access health services here too. And having this service here makes it anonymous. People feel comfortable here," continued Xolani Sam.
Eleven Taxi Associations and one Trader Association operate from the Metro Mall Taxi Rank in Bree Street, Johannesburg Inner City. This translates into 4500 taxi drivers transporting approximately 500,000 commuters to and from the rank daily. The drivers and queue marshals are based at the rank or are on the road for extended hours each day, Monday through to Saturday.
Recently published research (The Lancet, 17 October, 2009) has shown that health services need to be made accessible for men in particular to use them. Men, traditionally the breadwinners, aren’t easily able to get access health services. Aurum’s Emthonjeni is taking critical health services to the people. (See Lancet report attached)
Between March 2008, and May 2009, 14 494 people (57% men) were tested for HIV and received their results, of which 2432 (17%) were positive. 1784 of these are now in HIV care and 1069 have started antiretroviral therapy.
Says Bulelani Kuwane, Deputy Programme Director, the Aurum Institute’s Emthonjeni: "We believe that initiatives like this have potential to promote knowledge of HIV status among men and facilitate earlier access to antiretroviral therapy, thus reducing mortality."
The memorandum handed to the MEC stated the Taxi Associations strongly support the establishment of a clinic at the taxi rank to provide basic health services to taxi operators, traders and commuters. However people that need treatment are referred to government clinics for this and access to treatment is a challenge because of the nature of the work that taxi operators and traders do. The memorandum is calling for the Gauteng Department of Health and Social Development to support the Aurum Institute’s Emthonjeni by providing medication and laboratory services.
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AURUM INSTITUTE ANNOUNCEMENT
27 November 2009 |
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The Aurum Institute is pleased announce that Mr Gary Ralfe, former CEO of DeBeers, and Mrs Christine McDonald, CFO of the Market Theatre Foundation, have joined its Board of Directors.
Ralfe and McDonald join existing board members: Dr Paul Davis (Chairman), Dr Gavin Churchyard (CEO), Dr Dave Clark (Deputy CEO), Ms Phangasile Mtshali, Mr Ron Gault, Mr Nigel Unwin, and Professor Yosuf Veriava.
The Aurum Institute is an independent, not for profit, South African public benefit organisation that focuses on TB and HIV service delivery, management and research. The Institute has an international reputation for its work in the fields of tuberculosis and HIV/AIDS and is the recipient of research and other grants from South African and international agencies and institutions for this work.
In the field of TB in particular, Aurum is conducting a number of groundbreaking studies into the prevention of TB in gold mineworkers. This research has the potential to shift policy and practice in TB management worldwide.
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THE AIDS PANDEMIC ON BLOGSPOT
20 November 2009 |
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RUN TO COMMEMORATE
13 November 2009 |
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Join thousands of runners to commemorate World Aids Day by taking part in the Soul City Sports Club's (SCSC) annual race on November 29.
There are 5km, 10km and 21km events, starting and ending at the University of Johannesburg (UJ). In running the race, ordinary people along with celebrities and musicians will be committing themselves to the OneLove campaign.
There will be prizes for winners in each category as well as for couples who complete the race.
Colin Stone, organiser and treasurer of SCSC said, "In commemorating World Aids Day, we want to encourage people to take the OneLove campaign seriously."
"The message is to ensure that you protect yourself and your loved ones by having one sexual partner."
"OneLove is a massive regional campaign to stress the risk of multiple concurrent sexual partnerships in contracting HIV and to discuss cultural and other stereotypes that support this risky behaviour."
After the race, UJ will host a fun day of activities for the whole family starting at lOam.
Entrance to the fun day is free and visitors may enjoy food stalls, jumping castles and face painting for children as well as health check ups. These will include HIV tests, diabetes, eye and cholesterol tests.
The initiative is supported by some of South Africa's top musical acts, who will also be performing on the day, including Bucie, Siphokazi, Danny K, Zuluboy and Zonke.
SCSC was formed three years ago with the aim of promoting sports and exercise for improved health.
Stone explained the race route, "The race starts and ends at the university, which emphasises the importance of education in our lives. As they run past the Charlotte Maxeke Johannesburg Academic Hospital, participants are reminded of the importance of the health sector and the major role that Soul City has played in health development."
"The SABC is next and symbolises the crucial role the mass media has played in raising awareness of Soul City's health messages."
"Given the political history of South Africa, Constitution Hill evokes memories of how far we have come, while the importance of arts and culture are brought to mind when running past the Market Theatre."
"Fordsburg and Vrededorp evoke the cultural diversity in our communities and the importance of exercise in living a healthy lifestyle," he concluded.
 Run to commemorate artcile - 124KB
Aurum acknowledges North Eastern Tribune as the source of this article
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LETTER IN THE LANCET
17 October 2009 |
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Expanding HIV care in Africa: making men matter in Johannesburg
In their Viewpoint, Edward Mills and colleagues highlight the need to provide HIV testing and treatment services that are more accessible to men. As they note, men make less use of routine health services than women, partly because such services are often not easily accessible to those who are employed.
In South Africa, we have established services that provide screening, care, and treatment for HIV that target inner-city workers. The Emthonjeni centre is based in central Johannesburg at a large taxi rank used by an estimated 400 000 commuters daily. It provides screening for HIV and tuberculosis, along with blood pressure and glucose checks, and is convenient for commuters and those employed locally. Currently, those found HIV-positive are referred to nearby general practitioners with extended opening hours who provide HIV care and treatment; we plan to extend our services to provide HIV care on site. Taxi drivers are encouraged to be "ambas sadors", promoting Emthonjeni serv ices to their passengers. Additionally, Emthonjeni mobile units similarly provide screening to small (<100 employees) inner-city enterprises whose staff rarely have medical insurance.
Between March, 2008, and May, 2009, 14 494 people (57% men) were tested for HIV and received their results, of which 2432 (17%) were positive. 1784 of these are now in HIV care and 1069 have started antiretroviral therapy. We believe that initiatives like ours have potential to promote knowledge of HIV status among men and facilitate earlier access to antiretroviral therapy, thus reducing mortality.
Full Letter in the lancet document - 91KB |
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GLOBAL: FIRST POSITIVE RESULTS FROM AN HIV VACCINE
24 September 2009 |
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A six-year clinical trial in Thailand has yielded the first ever evidence that an AIDS vaccine can provide some protection against HIV infection.
The trial team in Bangkok, Thailand's capital announced on 24 September that rates of HIV infection were 31 percent lower in trial participants who got the vaccine than in those who received a placebo.
"These new findings represent an important step forward in HIV vaccine research," said Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases (NIAID), the main funder of the trial.
The study, known as RV144, began enrolling 16,000 HIV-negative men and women between the ages of 18 and 30 in October 2003. Half the volunteers received a placebo; the other half were given shots containing two different vaccines. The first, called ALVAC-HIV, used a disabled form of a bird virus known as canary pox to deliver synthetic versions of three HIV genes into the body. The second, called AIDSVAX, was composed of a genetically engineered version of an HIV protein.
The synthetic HIV components in both vaccines were based on subtypes B and E of the virus, which are most common in Thailand, the US and Europe. Scientists do not yet know whether the vaccine would be effective against other strains, such as subtype C, which is most prevalent in sub-Saharan Africa.
The trial was designed to evaluate whether the combined vaccines lowered HIV infection risk, and whether they had any impact on viral load [the amount of HIV circulating in the bloodstream] in the volunteers who became infected.
Of 8,197 people given the vaccine regimen, 51 became infected, compared to 74 of the 8,198 volunteers who received the placebo. This result is considered "statistically significant", meaning that the difference is unlikely to be a coincidence. The vaccine did not have any effect on viral load.
"Today's result is not the beginning of the end of the epidemic, it's the end of the beginning of finding an AIDS vaccine. It's a thrilling moment," Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition (AVAC), told IRIN/PlusNews on the phone from New York. However, he emphasized that additional studies and analysis were needed to confirm and understand the findings.
The vaccine's modest effectiveness means it is unlikely to be licensed or produced in large quantities in Thailand, where the rate of HIV infection is relatively low. However, Prof Gavin Churchyard, CEO of the Aurum Institute, a non-profit medical research organization based in South Africa, said even an AIDS vaccine that was only 30 percent effective could have an impact in southern Africa, where HIV infection rates are much higher, "but we would need to know if it would work in this population".
Churchyard said the results had come as a surprise to many in the vaccine field. "We weren't actually expecting a positive result," he commented. Previous efficacy trials of AIDSVAX, the second vaccine in the regimen, had found no benefit and the decision to go ahead with the large-scale trial in Thailand had generated controversy.
Warren noted that vaccine science had evolved considerably since the trial was launched in 2003. "There are new ideas and approaches that no one imagined six years ago. Anytime you start a trial, it's like buying a new computer - it's outdated before you even get it out of the box." He added that whether or not the approach used in the trial was determined to be the most effective, the findings would still influence future strategies.
Good news at last
The positive results from the Thai trial are expected to give a crucial boost to a field in desperate need of good news after a series of setbacks in recent years. A four-continent trial of a vaccine developed by pharmaceutical company Merck was halted in 2007 after preliminary results suggested that it not only did not provide protection against HIV, but might actually increase the risk of infection.
Dr Glenda Gray of the Perinatal HIV Research Unit (PHRU) at the University of the Witwatersrand in Johannesburg, chief investigator in the South African arm of the Merck vaccine trial, told IRIN/PlusNews the outcome in Thailand was "a huge step forward - it opens up the field again and gives us an indication that this [a vaccine] is possible."
The results are also significant for the future of two HIV vaccines that began small-scale human trials in South Africa in July. One of the vaccines uses components from the family of pox viruses similar to those used in one of the Thai vaccines. "It means, hopefully, there'll be more interest in our vaccine," said Gray, the lead investigator of the trials being conducted by the South AfricanAIDS Vaccine Initiative (SAAVI) and NIAID.
"We are planning a larger trial next year and having these results makes it much easier for us to convince funders to go ahead with the next phase," Gray said.
More information on the Thai trial results will be presented at an AIDS vaccine meeting in Paris in October.
Aurum acknowledges PlusNews as the source of this article
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SOUTH AFRICA: WHO'S WHO ON THE NATIONAL AIDS COUNCIL
8 September 2009 |
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The South African National AIDS Council (SANAC), long inactive, is showing signs of life. The revived secretariat moved out of the Department of Health and acquired a new CEO on 1 September, and recently flexed some of its new-found muscle when it recommended that government change outdated treatment guidelines.
IRIN/PlusNews introduces some of the faces behind what could soon be one of the country's most influential HIV/AIDS bodies.
Chairperson: Kgalema Motlanthe, South Africa's Deputy President
Motlanthe assumed the post of SANAC chairperson, always held by the country's deputy president, after national elections in May 2009. He earned praise from AIDS activist for replacing controversial health minister Manto Tshabalala-Msimang with the popular and efficient Barbara Hogan during his brief tenure as South Africa's President from September 2008 to May 2009.
Chief Executive Officer: Dr Nono Simelela
After becoming the first black South African woman to qualify as a specialist obstetrician and gynaecologist, Simelela spent 20 years working for the Department of Health before becoming head of the National HIV/AIDS/TB Programme in 1998 under Tshabalala-Msimang.
She stayed in the post until 2004, when she left for Britain to lead the International Planned Parenthood Federation's technical knowledge and support division in London. She outlined some of SANAC's future priorities in an August interview with IRIN/PlusNews.
Deputy Chairperson and Law and Human Rights Sector: Mark Heywood
Heywood was active with the local AIDS lobby group, Treatment Action Campaign, and spent years lobbying to revive SANAC before being elected its Deputy Chairperson in 2007. He also represents the Law and Human Rights Sector in SANAC, which works to safeguard the rights of people affected by HIV and AIDS.
He currently serves as executive director of the AIDS Law Project, which uses the law to protect the human rights of those with HIV/AIDS.
Children's Sector: Dr Ashraf Coovadia
One of the country's best-known HIV paediatricians, Coovadia was an obvious choice to represent the sector charged with ensuring that children's HIV care, treatment, support and prevention receive adequate attention.
Coovadia heads paediatric HIV services at the Rahima Moosa Mother and Child Hospital in Johannesburg, and has been a vocal advocate for scaling up prevention of mother-to-child HIV transmission services (PMTCT). He argues that improving these services is one of the sector's biggest challenges, along with reducing delays in diagnosing and treating HIV-positive children.
Women's Sector: Dr Samukeliso "Samu" Dube
A public health physician, researcher and activist, Dube says women need their own sector, with its own specific agenda, because of their greater biological and socio-economic vulnerability to HIV. "It's not a case of one size fits all; what works for men does not necessarily work for women."
The sector's priorities include increasing access to the female condom and ensuring that research addressing HIV prevention among women remains a priority.
Dube is the Africa programme leader for the Global Campaign for Microbicides, and a committee member of Physicians for Human Rights in her native Zimbabwe. She was co-investigator on several HIV-prevention trials at the University of Limpopo in South Africa.
Deborah Baron, coordinator of the Microbicides Media and Communication Initiative, noted that Dube's scientific background and passionate advocacy for women are critical to the sector.
Business Sector: Brad Mears
Before becoming CEO of the South African Business Coalition on HIV and AIDS (SABCOHA) in 2005, Mears worked as an industrial relations consultant and was head of the HIV and AIDS programme of the Chamber of Commerce and Industry in the east-coast port of Durban.
"He understands the business environment very well," Paul Davies, chairman of The Aurum Institute, a health NGO that has helped several large companies implement HIV policies in the workplace, told IRIN/PlusNews. "He brings a different perspective to SANAC in representing a sector that is quite capable and willing to participate in the management of HIV."
People Living with HIV/AIDS Sector: Vuyiseka Dubula
Dubula is the secretary-general of the Treatment Action Campaign (TAC), a well-known AIDS lobby group that won a court case against the government in 2002, forcing it to begin providing prevention of mother-to-child HIV transmission (PMTCT) services.
She was diagnosed HIV positive in 2001, joined the TAC months later and worked her way up from local organizing in and around Cape Town to her current position, which she took up in 2008.
The sector advocates for the needs, rights and concerns of people living with HIV (PLHIV), but Dubula has her work cut out trying to unite the representatives of TAC and the National Association of People Living with HIV/AIDS (NAPWA), which each have their own PLHIV sector in SANAC and have yet to join forces.
Denise Hunt, executive director of the AIDS Consortium, a membership organization for local NGOs working in HIV and AIDS, said: "She's been at all the different levels of activism and ... is able to apply [that understanding] at a strategic level."
Research Sector: Dr Olive Shisana
As head of SANAC's research sector, Shisana will help formulate a research agenda that provides scientific support to national HIV/AIDS policies. In 2005, Shisana became the first black woman to be appointed president and CEO of South Africa's Human Sciences Research Council (HSRC).
In her almost 20 years in public health she has overseen the World Health Organization's Family and Community Health Cluster, served as director-general of South Africa's Health Department, and worked as principal investigator on a number of large studies, including the third National HIV Prevalence, Incidence, Behaviour and Communication Survey, released in June.
Shisana cites lack of funding for the sector's work as the main challenge to achieving top priorities such as further research into male circumcision and re-examining prevention approaches.
Aurum acknowledges PlusNews as the source of this article
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GUARDIAN TECHNOLOGIES INTERNATIONAL, INC. (GDTI.OB): SIGNATURE MAPPING TBDX(TM) READY FOR CLINICAL TRIALS IN SOUTH AFRICA
26 August 2009 |
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Guardian Technologies International, Inc. (OTCBB: GDTI) today announced that its Software Quality Assurance Team has completed all unit, component, integration, and systems tests of Signature Mapping TBDx™ (TBDx™) in preparation for September clinical trials in South Africa. Under rigorous internal performance testing of 740 sputum slides, TBDx processed each slide in minutes while maintaining a consistently high bacilli detection level of over 90%, with false positives of less than 3%. In a global environment where sputum microscopy detection is only 20%-60% accurate and final results can take up to eight weeks, TBDx represents a diagnostic transformation towards automated detection of tuberculosis (TB). Further, the Signature Mapping platform can potentially be applied to all laboratory diagnostic procedures (i.e. malaria, leprosy, HIV, etc.).
TBDx began with one objective: automate the process of TB diagnosis and eliminate the human factor limitations associated with routine sputum microscopy. Accomplishing this objective, Guardian overcame vast extremes in slide quality, stain penetration of the acid-fasting bacilli, and differing regional staining techniques. February 2009, Guardian completed and delivered to South Africa a working prototype for initial evaluation. Based on the successful performance of the prototype, Guardian entered into a Memorandum of Understanding with the South African National Health Laboratory Services (NHLS) in March 2009, and in cooperation with our clinical partner, The Aurum Institute for Health Research, Guardian has enhanced the application's performance and customized it to meet the diagnostic and quality management requirements of NHLS. TBDx is a robust and accurate automated diagnostic tool, with highly consistent performance and increased slide throughput, in a flexible software application that can be adapted to both rural and regional laboratory settings.
In April 2009, Guardian formed a medical advisory board of South African luminaries to assist in the development of specific global requirements and to advise on issues related to the detection of TB. "The members of this advisory board represent some of the best minds in medicine, specifically infectious diseases, and have provided invaluable advice and guidance. Each member brings the scientific, clinical and academic guidance that has significantly advanced our knowledge base on both the challenges facing TB detection, and the opportunities for the greatest advancements," stated Michael Trudnak, Guardian's Chief Executive Officer. The advisory board consists of: Dr. Gavin J. Churchyard, Thibela TB Principal Investigator; Dr. Gerrit Coetzee, Head of the National TB Reference Laboratory, NHLS; Dr. Bernard Fourie, Chief Scientific Officer, Medicine in Need; Dr. David Clark, Chief Operating Officer, Aurum Institute; Mr. Stan Harvey, Business Manager, Executive Regional Manager, NHLS; and, Dr. Natalie Beylis, Director of Laboratory TB Services, Braamfontein Hospital, NHLS.
Completion of TBDx is an achievement that fittingly reflects the Company's mission statement, "To Save Lives." Michael Trudnak stated, "We are very excited to be joining the global fight to stop the spread of TB. We are very pleased with the application's level of performance, which far exceeds our original design goals. Stress testing of TBDx with the South African National Labs will provide a tremendous opportunity to test all aspects of our system on large slide volumes. The National Labs conduct over four million sputum tests per year and will establish the benchmarks by which we will expand to the rest of the highly infected countries of the world."
TB is a pandemic worldwide challenge, further complicated by strains of drug resistant TB, which are being detected with increasing frequency. One-third of the world's population is infected with TB and up to ten million new cases are diagnosed worldwide annually. Someone dies from the disease every 20 seconds, accounting for approximately 2 million deaths annually. The World Health Organization annual estimates indicate $1 billion is spent annually to diagnose TB. To find out more information about the TB pandemic go to: http://www.who.int/mediacentre/factsheets/fs104/en/index.html
About Guardian Technologies International
Airport Security: Guardian's technology compliments and enhances current-generation baggage x-ray scanners with the ability to automatically and effectively detect, locate, and identify explosives and other types of threats.
Disease Identification: Existing medical imaging devices used in Computer Aided Detection (CAD) are further improved with Guardian's auto-diagnostic ability to detect anomalous tissue (e.g., tumors) and other potential disease states or conditions.
Forward-Looking Statements
Statements included herein may constitute "forward-looking statements." These statements are not guarantees of future performance or results and involve a number of risks and uncertainties. Actual results may differ materially from those in the forward-looking statements as a result of a number of factors, including those described from time to time in our filings with the Securities and Exchange Commission. The Company undertakes no duty to update any forward-looking statements made herein.
Aurum acknowledges Guardian Technologies International, Inc. as the source of this article
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SIGNATURE MAPPING TBDxTM READY FOR CLINICAL TRIALS IN SOUTH AFRICA
26 August 2009 |
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Guardian Technologies International, Inc. (OTCBB: GDTI) today announced that its Software Quality Assurance Team has completed all unit, component, integration, and systems tests of Signature Mapping TBDxTM (TBDxTM) in preparation for September clinical trials in South Africa. Under rigorous internal performance testing of 740 sputum slides, TBDx processed each slide in minutes while maintaining a consistently high bacilli detection level of over 90%, with false positives of less than 3%. In a global environment where sputum microscopy detection is only 20%-60% accurate and final results can take up to eight weeks, TBDx represents a diagnostic transformation towards automated detection of tuberculosis (TB). Further, the Signature Mapping platform can potentially be applied to all laboratory diagnostic procedures (i.e. malaria, leprosy, HIV, etc.).
TBDx began with one objective: automate the process of TB diagnosis and eliminate the human factor limitations associated with routine sputum microscopy. Accomplishing this objective, Guardian overcame vast extremes in slide quality, stain penetration of the acid-fasting bacilli, and differing regional staining techniques. February 2009, Guardian completed and delivered to South Africa a working prototype for initial evaluation. Based on the successful performance of the prototype, Guardian entered into a Memorandum of Understanding with the South African National Health Laboratory Services (NHLS) in March 2009, and in cooperation with our clinical partner, The Aurum Institute for Health Research, Guardian has enhanced the application's performance and customized it to meet the diagnostic and quality management requirements of NHLS. TBDx is a robust and accurate automated diagnostic tool, with highly consistent performance and increased slide throughput, in a flexible software application that can be adapted to both rural and regional laboratory settings.
In April 2009, Guardian formed a medical advisory board of South African luminaries to assist in the development of specific global requirements and to advise on issues related to the detection of TB. "The members of this advisory board represent some of the best minds in medicine, specifically infectious diseases, and have provided invaluable advice and guidance. Each member brings the scientific, clinical and academic guidance that has significantly advanced our knowledge base on both the challenges facing TB detection, and the opportunities for the greatest advancements," stated Michael Trudnak, Guardian's Chief Executive Officer. The advisory board consists of: Dr Gavin J. Churchyard, Thibela TB Principal Investigator; Dr Gerrit Coetzee, Head of the National TB Reference Laboratory, NHLS; Dr Bernard Fourie, Chief Scientific Officer, Medicine in Need; Dr David Clark, Chief Operating Officer, Aurum Institute; Mr. Stan Harvey, Business Manager, Executive Regional Manager, NHLS; and, Dr Natalie Beylis, Director of Laboratory TB Services, Braamfontein Hospital, NHLS.
Completion of TBDx is an achievement that fittingly reflects the Company's mission statement, "To Save Lives." Michael Trudnak stated, "We are very excited to be joining the global fight to stop the spread of TB. We are very pleased with the application's level of performance, which far exceeds our original design goals. Stress testing of TBDx with the South African National Labs will provide a tremendous opportunity to test all aspects of our system on large slide volumes. The National Labs conduct over four million sputum tests per year and will establish the benchmarks by which we will expand to the rest of the highly infected countries of the world."
TB is a pandemic worldwide challenge, further complicated by strains of drug resistant TB, which are being detected with increasing frequency. One-third of the world's population is infected with TB and up to ten million new cases are diagnosed worldwide annually. Someone dies from the disease every 20 seconds, accounting for approximately 2 million deaths annually. The World Health Organization annual estimates indicate $1 billion is spent annually to diagnose TB. To find out more information about the TB pandemic go to: http://www.who.int/mediacentre/factsheets/fs104/en/index.html
About Guardian Technologies International
Airport Security: Guardian's technology compliments and enhances current-generation baggage x-ray scanners with the ability to automatically and effectively detect, locate, and identify explosives and other types of threats.
Disease Identification: Existing medical imaging devices used in Computer Aided Detection (CAD) are further improved with Guardian's auto-diagnostic ability to detect anomalous tissue (e.g., tumors) and other potential disease states or conditions.
Forward-Looking Statements
Statements included herein may constitute "forward-looking statements." These statements are not guarantees of future performance or results and involve a number of risks and uncertainties. Actual results may differ materially from those in the forward-looking statements as a result of a number of factors, including those described from time to time in our filings with the Securities and Exchange Commission. The Company undertakes no duty to update any forward-looking statements made herein.
Aurum acknowledges Marketwire: Press release as the source of this article
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THE AURUM EMTHONJENI, BREE STREET INTERVIEW WITH THE TIMES
26 August 2009 |
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LITTLE HOPE IN SILENT EPIDEMIC
24 August 2009 |
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Thousands of miners with chronic diseases associated with their work may never get paid the compensation owed to them.
This is because of a complicated levy hike proposal which would leave many desperately ill miners - some of whom have waited for years - without access to any means of support or medical care.
The Chamber of Mines is taking the compensation commissioner for occupational diseases and the Health Department to court over a proposed hike in the statutory levy designed to compensate miners with chronic occupational diseases, including silicosis and tuberculosis.
The levy is imposed in terms of the Occupational Diseases in Mines and Works Act of 1973.
South Africa's gold miners and former miners face some of the highest TB rates in the world - the dual product of silicosis, a lung infection from exposure to silica dust released by drilling, and HIV.
Whereas the mines finance compensation, the commissioner and health department administer payments.
A 2004 investigation by Deloitte found that the fund - which has an estimated need of R1.5-billion - was short of R610-million and suggested a 15-year plan whereby the mines would fully fund the shortfall, paying 100 times their current contributions.
The chamber has agreed to some increase, but argues that companies are obliged to compensate only current employees and will not pay for former mineworkers. More than two-thirds of the estimated R1.5-billion is intended for former miners.
The initial Chamber of Mines case was filed in August last year, but no court date has been set yet.
According to Gavin Churchyard, chief executive of Aurum Health Research, which specialises in TB and mining: "The interaction between HIV and silicosis is multiplicative... those who have both face rates of TB 18 times higher than those uninfected."
South Africa's National Tuberculosis Strategic Plan estimates that TB rates in gold mines are some of the highest in the world and that the sector is responsible for 90% of the country's occupational lung disease.
As the fund stands, few of the hundreds of thousands of current and former mineworkers have access to payments, which come in one-off bundles of either R30 000 or R75 000, depending on the extent of disease.
The precise number of miners needing compensation is unknown, but an analysis of data for the 21 months before December 2003 showed that 28161 claims were received, but only 400 were paid.
A 1998 study estimated that more than 200 000 former mineworkers eligible for compensation did not receive payment. Successful applications can take five years to process.
Paula Akugizibwe of the Aids and Rights Alliance of Southern Africa said the current legislation is "fundamentally flawed -- its constitutionality has been questioned and the compensation is extremely low".
"This law was created to meet the financial comfort of mining companies. It's so incredibly messy that the companies, the commissioner and the health department can claim [low rates of compensation] are not their fault," Akugizibwe said.
"The mining sector is realising just how much this is going to cost them and they want out."
Coinciding with the chamber's challenge, 10 former mineworkers, all with occupational respiratory infections, have taken legal action against Anglo American South Africa, Anglo's former parent company, for negligent health and safety training on subsidiary mines.
According to Richard Meeran of Leigh Day, a leading British law firm representing the miners on behalf of the Legal Resources Centre: "The advice [Anglo] gave was inadequate and resulted in miners being excessively exposed to silica dust, contracting silicosis and also contracting TB because of the silicosis."
Meeran expects to appear before a judge in August 2010, nearly six years after the initial papers were filed. He hopes the case against Anglo will strengthen the compensation system.
"We need a scheme that ensures that people who have suffered from these conditions are compensated properly, because their job prospects are significantly diminished."
Aurum acknowledges Mail & Guardian online as the source of this article
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TB VACCINES TESTED IN SOUTH AFRICA
12 August 2009 |
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Two tuberculosis vaccines - developed with the support of the Aeras Global TB Vaccine Foundation - are being tested in South Africa. The MVA85A/Aeras-485 vaccine, developed by the South African Tuberculosis Vaccine Initiative, is being tested for safety in healthy babies, while a collaboration with The Aurum Institute will test the AERAS-402/Crucell Ad35 vaccine in HIV-infected adults
Aurum acknowledges SciDev.net as the source of this abstract
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YOUNG AURUM INSTITUTE STAFF ON "SHIFT" ABOUT MAKING A DIFFERENCE
12 August 2009 |
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The SABC 1 television programme "Shift" visited the Aurum Institute in Rustenburg to interview twenty-two year old Olebogeng Mpuleleng, a recently qualified Research Assistant, for a programme about young movers and shakers in South Africa.
The articulate and passionate "Ole", as she is called by friends, qualified with a four year degree in social sciences from the University of Pretoria and is now "living her dream". Her current role for the Institute involves recruiting community volunteers for a study currently underway.
"This study is very important as it will measuring incidence, or the rate of new cases of HIV in Rustenburg, which will assist government with planning and provision of public health services. So I'm busy speaking to people in the area about the study."
Ole went on to say that the response has been very encouraging. "We need everyone, regardless of their status or even if they don't know their status."
The programme aired on the 20th of July and also featured, Aurum HIV Counsellor Ntsiki Tisana in-studio. Ntsiki, from the Institute's SME programme in Selby, Johannesburg, said on-air: "So many people we counsel now ask for me by name. They know I am living with HIV and I am healthy and taking ARV's, so they feel comfortable to come to me. So I know this is the work I am meant to be doing."
Said the producer, Bongani Maphumulo: "It is so exciting to see the passion and enthusiasm of these young people - and hear and see the impact they are having in their own ways within their respective fields and communities."
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SOUTH AFRICA: ABCs AND HIV TESTS
3 August 2009 |
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A Johannesburg high school recently did something that for years has only been whispered behind closed doors in education circles - voluntary counselling and testing (VCT) for HIV was offered to students.
Last week, members of the senior class at St Mary's, a private high school for girls in Waverley, an affluent Johannesburg suburb, ran an HIV/AIDS awareness week that, for the first time, included onsite VCT provided by a Johannesburg-based NGO, the Aurum Institute. School nurse Colleen Davis said parents had to sign consent forms, and most welcomed the initiative.
Ashleigh Page
"It was my first time getting tested so I was terrified, I must be honest. In that five-minute period when you're waiting for the [results] ... I started thinking about what I'd done that could have possibly [put me at risk], like, 'Well, I had an injection this one time'. Honestly, I know there was probably a minimal chance, but there is that chance.
"I've never really thought about being tested until this week. We don't really talk about it as much as we should. I think the problem is that we all have this feeling that we are sort of stuck in this private-school bubble and we can't be affected by AIDS. I think this week sort of brought it home and made us realize it's not like that."
Jessica Standish-White
"On the Monday morning I showed the entire school how to test, so I actually took an HIV test in front of the whole school, which was a fairly terrifying experience.
"My dad's really big on HIV so I had my first HIV test when, I think, I was 12. I went for another one when I was 15, when [my friend] Steph and I went on an exchange [programme] to Australia.
My dad will sometimes randomly bring home ... [rapid HIV] tests because he gets them at work, so I don't know how many times I've been tested, but it's probably double figures, I would think ... I still get nervous every time I do it, but I think it becomes easier every time you do."
Lexi Stark
"At the beginning of the week, my parents weren't a hundred percent sure it was okay for a school to be doing [HIV tests], but when I came home last night and explained to them how everything worked and showed them the programme, explained to them the pre- and post-test counselling, they were so impressed. They thought every school should do something like this.
"My 15-year-old little sister got tested and she was terrified, but she said it was a brilliant thing. I think when you're sitting there, getting your test done, it brings it a lot closer to home.
"You start realizing how much it could actually affect you, even though you might not be infected, but you still know people who are, and you are still living with people who are."
Aurum acknowledges Plus News as the source of this article: http://www.plusnews.org/Report.aspx
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HIGH HOPES FOR NEW TB VACCINE TRIALS
By Kanina Foss
1 August 2009 |
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IF HIV is the killer, then TB is its henchman. And a new TB vaccine - soon to be tested in Johannesburg - could be the thing to foil their collusion.
TB is the leading cause of death among people living with HIV in Africa. Seventy-three percent of South Africans infected with TB are also HIV-positive.
A new vaccine (AERAS-402/Crucell Ad35) could significantly advance the fight against TB in both HIV-positive and HIV-negative patients.
Health systems management organisation The Aurum Institute will conduct a trial in Johannesburg to determine the safety of the vaccine in HIV-positive adults. The trial will also provide the first indications of whether the vaccine is effective.
"If we find a vaccine, it will be a major contribution to helping reduce the risk to TB-infected, HIV-infected individuals, and for controlling TB in high HIV prevalence settings such as South Africa," said The Aurum Institute's CEO, Dr Gavin Churchyard.
If the vaccine was effective in HIV-positive people, it was likely that it would be even more effective in HIV-negative people, said Churchyard. They hope to start vaccinating next month.
The advantage of a vaccine over treatment is that it's easier to roll out on a large scale.
There's also no need to worry about adherence to chronic medication, or adverse drug interactions.
"We believe that an effective TB vaccine is the best hope for the achievement of the millennium goals for TB reduction and the eventual elimination of this scourge from our planet," said Churchyard.
The current vaccine, BCG, was developed more than 85 years ago.
It reduces the risk of severe forms of TB in early childhood, but is not very effective in preventing pulmonary TB in adolescents and adults - the populations with the highest rates of TB.
Aurum acknowledges the Sunday Independent and the Sunday Tribune as the source of this article
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AURUM RESEARCH FELLOW RECEIVES IAS TB/HIV RESEARCH PRIZE |
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IAS TB/HIV Research Prize
The aim of the new US$2,000 IAS prize on TB/HIV research is to generate interest and stimulate research on basic, clinical and operations research in TB/HIV prevention, care and treatment. The IAS TB/HIV Research Prize is an incentive for young and established researchers to investigate pertinent research questions that affect TB/HIV co-infection and operational effectiveness of core TB/HIV collaborative services.
The winning abstract was selected through a rigorous process of blind submission and peer-review, and the top scoring TB/HIV abstracts were further reviewed by a steering committee of TB and HIV experts.
The award will be made to Dr Clare van Halsema, United Kingdom, for her abstract, Good tuberculosis treatment outcomes and no evidence of increased drug resistance in individuals previously exposed to isoniazid preventive therapy in a population with high HIV prevalence.
Aurum acknowledges IAS 2009 Conference website as the source of this abstract: http://www.ias2009.org/mainpage.aspx?pageId=379
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TB SCREENING PROGRAMME LAUNCHED FOR PRISONERS
Centre for the AIDS Programme of Research in South Africa (CAPRISA) Newsletter July 2009, Volume 8, Issue 7
July 2009 |
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AMANDA KUBEKA, "WHEN IT'S A POSITIVE RESULT ... IT'S NOT EASY TO TELL THE CLIENT"
July 2009 |
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When Amanda Kubeka saw her cousins in Johannesburg, South Africa, struggling to cope with their newly diagnosed HIV infection, she decided to do something about it by volunteering at a local clinic. She is now a counsellor at the Emthonjeni voluntary testing and counselling centre at one of the city's busiest taxi ranks. She spoke to IRIN/PlusNews about what it is like to assist people through a test that could change their lives forever.
"Sometimes it is [difficult to break the news]. It's easy when it's a negative result, but when it's a positive result and a person came in and was so sure they were negative, only to be disappointed to find out that they are positive, it's not easy to tell that client.
"If it's early in the morning and it's your first client, your spirit does go down; it's not nice. Then, if the next client again is positive, it spoils my day, but what can I do? I'm doing what I love and I've got passion for what I do.
"When you are doing counselling you need to be yourself first - you need to be honest, friendly, patient, and you need to empathise with the client; put yourself in their shoes.
"You need to deal with the client's feelings; you need to reflect on what they are feeling. Tell them, 'I see that you are feeling angry'. Ask them, probe, 'Why are you feeling like this? Do you understand what these results mean?'" You need to go deeper into their feelings.
"When you find discordant couples [where one partner is positive and the other is not] it is difficult because you have to deal with so many feelings – they blame themselves, and one [of them] may say, 'You brought this onto us'.
"[Safe sex] is a big challenge, especially with married couples, because they really don't understand why one is HIV-positive and the other is HIV-negative - they've been married for more than 20 years and now they have to introduce condoms.
"That's why we have sessions where we try to teach them how to initiate condom usage, and it's difficult, especially for women, to introduce condoms. Most women say: 'You know what? We feel like cannot introduce condoms to our partners, but we've got kids and we need to be there for our kids.'
"My favourite part [of the job] is those sessions ... [where] we empower women to take a stand, because sometimes they feel so helpless. At the end of the day, it's your decision whether you want to use a condom."
Aurum acknowledges PlusNews as the source of this article: http://www.plusnews.org/HOVReport.aspx?ReportId=85329
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TB VACCINE RESEARCH UPPED WITH NEW COLLABORATION ANNOUNCED IN SOUTH AFRICA
By Henry Neondo
27 July 2009 |
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The Aeras Global TB Vaccine Foundation and the Aurum Institute announced a new collaboration to begin safety trials for a TB vaccine in people living with the human immunodeficiency virus (HIV).
The trials will be conducted among the people living with HIV (PLHIV) at clinical trial site near Johannesburg, South Africa.
"We believe that an effective TB vaccine is the best hope for the achievement of the millennium development goals (MDGs) for TB reduction and the eventual elimination of this scourge from our planet," said Prof Gavin Churchyard, CEO of the Aurum Institute.
Dr Jerald C Sadoff, the President of the Aeras Global TB Vaccine Foundation said TB is a devastating problem among PLHIV and it is essential that new TB vaccines were found to protect them.
Preliminary but promising clinical trial data indicate that the TB Vaccine, AERAS-402/Crucell Ad35 has produced the highest levels of CD8 immune cells - key to vaccines effective against TB - ever seen in trials.
Data from a second Phase I study started in May 2007 in South Africa demonstrated induction of both critical arms of cellular immune system, CD4 and CD8 immune T-cells and showed that in those participants who responded, CD8 immune responses were much higher than had previously been seen in a TB vaccine study.
The Medicines Control Council of South Africa and two independent Ethics committee in South Africa have given approval to test the vaccine in South Africa.
The vaccine candidate has previously been tested for safety in healthy adults in the US and HIV negative adults and infants in South Africa.
A phase I clinical trial of the TB vaccine, done to test safety of the candidate vaccine in adults who had previously been vaccinated with BCG and who had or did not have latent TB infection was conducted by the Kenya Medical Research Institute/ Walter Reed Project in Western town of Kisumu in October 2008.
TB is the leading cause of death among PLHIV who are 20 times more likely to develop TB than those who are HIV negative.
According to WHO 2009 TB surveillance report, one in four TB deaths globally is HIV-related, twice as many as previously recognized.
In 2007, there were an estimated 1.37 million new cases of TB among people living with HIV and 456, 00 deaths. In South Africa, the country hosted the 5th International AIDS Society (IAS) conference on HIV Pathogenesis, Treatment and Prevention (Cape Town, South Africa - 19-22 July 2009), 73% of people with TB are also co-infected with HIV.
Aurum acknowledges HealthDev.net as the source of this article: http://eforums.healthdev.org/read/messages?id=25475
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HEAR OUR VOICES
27 July 2009 |
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A forum for people affected by HIV and AIDS whose voices are often not heard. These personal accounts document the impact of the pandemic, but also serve as testimony to people's strength and determination to meet those challenges. This forum seeks to encourage others to speak openly about the disease, tackling the stigma and denial that have led so many people to a silent and unnecessary death.
Aurum acknowledges PlusNews as the source of this article: http://www.plusnews.org/HOV.aspx
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SA'S WAR ON TB MAKES PROGRESS
By Claire Keeton
25 July 2009 |
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South Africa is surging ahead in the fight against TB but drug-resistant strains still pose a huge threat, according to new research at the International Aids Society conference in Cape Town this week.
South Africa has the greatest number of HIV-infected patients with TB and TB is the leading reported cause of death. The good news is that the country’s TB detection, cure rate, drug access and laboratory services have improved since 2005, the World Health Organisation's Stop TB delegation stated. However, infection control was weak and human resources were inadequate in some provinces.
Studies at the conference showed A 60% drop in new cases of TB among people with HIV in Khayelitsha, Cape Town, where 90% of people needing antiretrovirals were on treatment. Overall TB cases dropped by 20% between 2005 and 2008, Dr Keren Middelkoop of the UCT Desmond Tutu HIV Centre, said in a presentation.
- dramatic reductions in new infections among miners when the majority of the group is taking the anti-TB drug Isoniazid.
Professor Gavin Churchyard, CEO of the Aurum Institute - an HIV/TB research organisation - is running a clinical trial that aims to recruit 80000 miners in three provinces. Final results are due in 2012.
He said: "Isoniazid is safe, cheap and effective. In a short space of time we have massively interrupted TB transmission at a population level. This is the equivalent of a vaccine and it is possible to reduce infections by half, using this strategy."
In another milestone, the first baby was vaccinated in Worcester last week with a new TB vaccine - the first new infant vaccine in 80 years. This is one of four new candidates being tested in clinical trials by the SA Tuberculosis Vaccine Initiative. Two more are in the pipeline for 2010.
Dr Jerald Sadoff, director of Aeras Global TB Vaccine Foundation, said: "It is very exciting. Five years ago we had nothing and now we are about to start two efficacy trials."
He said new vaccines should be ready for infants and adults within five to seven years.
Diagnostic tools have improved significantly, allowing TB and drug-resistant strains to be rapidly identified, he said.
The latest South African studies at the conference showed:
- A 60% drop in new cases of TB among people with HIV in Khayelitsha, Cape Town, where 90% of people needing antiretrovirals were on treatment. Overall TB cases dropped by 20% between 2005 and 2008, Dr Keren Middelkoop of the UCT Desmond Tutu HIV Centre said in a presentation.
- Dramatic reductions in new infections among miners when the majority of the group are taking the anti-TB drug Isoniazid to prevent the disease spreading.
Aurum acknowledges The Times as the source of this article
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NEW TB VACCINE SET TO BE TESTED IN JOBURG
22 July 2009 |
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Trial to determine safety in HIV-positive patients
IF HIV is the killer, then TB is its henchman. And a new TB vaccine - soon to be tested in Joburg - could be the thing to foil their collusion. TB is the leading cause of death among people living with HIV in Africa. Seventy-three percent of South Africans infected with TB are also HIV- positive. A new vaccine (AERAS402/Crucell Ad35) could significantly advance the fight against TB in both HIV-positive and HIV-negative patients. Health systems management organisation The Aurum Institute will conduct a trial in Joburg to determine the safety of the vaccine in HIV-positive adults. The trial will also provide the first indications of whether the vaccine is effective.
"If we find a vaccine, it will be a major contribution to helping reduce the risk to TB- infected, HIV-infected individuals, and for controlling TB in high HIV prevalence settings such as South Africa," said The Aurum Institute CEO, Dr Gavin Churchyard. If the vaccine is effective in HIV-positive people, it's likely that it will be even more effective in HIV-negative people, said Churchyard. They hope to start vaccinating next month. The advantage of a vaccine over treatment is that it's easier to role out on a large scale. There's also no need to worry about adherence to chronic medication, or adverse drug interactions. "We believe that an effective TB vaccine is the best hope for the achievement of the millennium goals for TB reduction and the eventual elimination of this scourge from our planet," said Churchyard.
We hope we'll see the first glimpse of whether it may be effective
The current TB vaccine, BCG, was developed more than 85 years ago. It reduces the risk of severe forms of TB in early childhood, but is not very effective in preventing pulmonary TB in adolescents and adults - the populations with the highest rates of TB. There are several new TB vaccines in the pipeline. Preliminary clinical trial data has shown that the vaccine being tested by The Aurum Institute produces the highest levels of CD8 immune cells, a leading strategy in the pursuit of an effective TB vaccine. AERAS-402/Crucell Ad35 was developed by Crucell, a biopharmaceutical company based in the Netherlands, and is being funded by a non-profit organisation called the Aeras Global TB Vaccine Foundation.
It has previously been tested for safety on healthy adults in the US and South Africa, and on adults exposed to TB in South Africa and Kenya, but this is the first trial that will test safety in HIV-infected adults. One of the reasons why the results of the trial will be important is because vaccinations are generally administered en masse. "You don't want to have to worry about someone's HIV status," said Churchyard. Additionally, in low resource settings, many people do not know their HIV status. "We want to be sure that the vaccine doesn't cause HIV to progress more rapidly" Volunteers in the trial will have already been infected with HIV and will be at high risk of acquiring TB. "We hope that we will show it's safe, and that we will see the first glimpse of whether it may be effective," said Churchyard.
Aurum acknowledges The Star Newspaper as the source of this article
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YOUNG AURUM INSTITUTE STAFF ON “SHIFT” ABOUT MAKING A DIFFERENCE
20 July 2009 |
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Johannesburg – The SABC programme SHIFT featured young people making a difference in the country on the programme today.
A week before the programme aired, Shift producer Bongani Maphumulo and crew visited the Aurum Institute in Rustenburg to create an insert for the programme about twenty-two year old Olebogeng Mpuleleng, a recently qualified Research Assistant, working for Aurum in Rustenburg.
The articulate and passionate “Ole”, as she is called by friends, qualified with a four year degree in social sciences from the University of Pretoria and is now “living her dream”. Her current role for the Institute involves recruiting participants for a study currently underway.
“This study is very important as it will determine the prevalence of HIV in Rustenburg, which will assist government with planning and provision of public health services. So I’m busy speaking to people in the area about the study.”
Ole went on to say that the response has been very encouraging. “We need everyone, regardless of their status or even if they don’t know their status.”
The programme which aired on the 20th of July also featured Aurum Institute HIV Counsellor Ntsiki Tisana in-studio. Ntsiki, from the Institute’s SME programme in Selby, Johannesburg, said on-air: “So many people we counsel now ask for me by name. They know I am living with HIV and I am healthy and taking ARV’s, so they feel comfortable to come to me. So I know this is the work I am meant to be doing.”
Said producer Maphumulo: “It is so exciting to see the passion and enthusiasm of these young people – and hear and see the impact they are having in their own ways within their respective fields and communities.”
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AT HIV/TB SESSION, THE GOOD, THE BAD, AND THE PROMISING
20 July 2009 |
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Dr Gavin Churchyard provided an exciting update on a CREATE research study that is evaluating a massive scale-up of isoniazid preventive therapy (IPT) in South African miners. The scale-up of IPT in thousands of miners has been successful and there has been little evidence if isoniazid resistance - a frequent excuse used to not implement IPT.
Aurum acknowledges ScienceSpeaks as the source of this abstract: http://sciencespeaks.wordpress.com/2009/07/20/at-hivtb-session-the-good-the-bad-and-the-promising/
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AERAS GLOBAL TB VACCINE FOUNDATION AND THE AURUM INSTITUTE ANNOUNCE A NEW COLLABORATION TO CONDUCT A CLINICAL TRIAL OF TB VACCINE CANDIDATE IN PEOPLE LIVING WITH HIV
20 July 2009 |
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Contact:
Annmarie Leadman, Aeras, +1 240 599 3018,
Jennifer Heslop Spencer, Aurum, +27 83 778 1729,
ROCKVILLE, MD, USA / JOHANNESBURG, SOUTH AFRICA - The Aeras Global TB Vaccine Foundation (Aeras) announces today a new collaboration with The Aurum Institute on the first study to test the AERAS-402/Crucell Ad35 tuberculosis (TB) vaccine candidate for safety in people living with the human immunodeficiency virus (HIV). Aurum will conduct this trial in people living with HIV at its clinical trial site near Johannesburg, South Africa. The Medicines Control Council of South Africa and two Independent Ethics Committees in South Africa have given approval to test the vaccine in South Africa. AERAS-402/Crucell Ad35 has been previously tested for safety in healthy adults in the United States and HIV-negative adults and infants in South Africa.
"TB/HIV is a devastating problem in South Africa and many other countries, and it is essential that new tuberculosis vaccines protect people living with HIV," said Jerald C Sadoff, President and CEO of the Aeras Global TB Vaccine Foundation. "Aurum is a world-class organisation dedicated to TB/HIV research and health systems management, and we are pleased to be working with them to move forward this promising vaccine candidate in a population at increased risk of getting sick and dying from TB."
Preliminary but promising clinical trial data indicate that AERAS-402/Crucell Ad35 has produced the highest levels of CD8 immune cells ever seen in trials of any TB vaccine. Inducing CD8 cellular immunity is one of the leading strategies experts are pursuing to develop vaccines that will be effective against TB.
Tuberculosis is the leading cause of death among people living with HIV in Africa and Asia. People with HIV living in countries with high TB prevalence are 20 times more likely to develop TB than those who are HIV-negative. According to the World Health Organization's (WHO) 2009 TB surveillance report, one in four TB deaths globally is HIV-related, twice as many as previously recognised. In 2007, there were an estimated 1.37 million new cases of TB among people living with HIV and 456 000 deaths. Seventy-three percent of people with TB in South Africa are co-infected with HIV. A vaccine to prevent TB is needed for people with and without HIV.
"We believe that an effective TB vaccine is the best hope for the achievement of the millennium goals for TB reduction and the eventual elimination of this scourge from our planet," said Prof Gavin Churchyard, CEO of The Aurum Institute. "We are delighted to be partnering with Aeras in this key study en route to that era."
The safety of volunteers is of paramount importance, and all trials will adhere to the highest international standards of safety and ethics, including informed consent. Extensive safety information has already been collected about this candidate vaccine. Preclinical toxicology studies demonstrated safety in animals, and AERAS-402/Crucell Ad35 has been tested in seven clinical trials between 2006 and the present without a single serious adverse event related to the vaccine candidate reported.
AERAS-402/Crucell Ad35 trials
A Phase I small safety clinical trial launched in October 2006 in Kansas, USA indicated that the vaccine candidate is safe in healthy adults who have not previously been immunised with Bacille Calmette-Guérin (BCG), the only currently licensed TB vaccine, in the USA.
Data from a second Phase I study, started in May 2007 in South Africa, demonstrated induction of both critical arms of the cellular immune system, CD4 and CD8 immune T-cells, and showed that in those participants who responded, CD8 immune responses were much higher than had previously been seen in a TB vaccine study.
A third Phase I study in healthy adults in St. Louis, Missouri, USA was launched in December 2007 focusing on the immunogenicity (immune response) and safety of two AERAS-402/Crucell Ad35 boost doses, administered at three to six month intervals after BCG priming in healthy adults. Data from this study indicate that two injections of AERAS-402/Crucell Ad35 are immunogenic; these responses and those seen in South African adult volunteers who had been vaccinated with BCG around birth are some of the highest CD8 T-cell responses ever seen in a TB vaccine study. This immune response is greater than that detected in the absence of BCG prime, supporting the possible utility of AERAS-402/Crucell Ad35 as a booster vaccine. BCG prime alone shows limited immunogenicity.
An ongoing study in St. Louis, Missouri, USA is evaluating a longer prime-boost interval. Enrollment for the study has been completed, and there are no significant safety issues.
A Phase I clinical trial of AERAS-402/Crucell Ad35 was started in Kenya in October 2008. The study was conducted by the KEMRI/Walter Reed Project-Kisumu at their Kombewa Clinical Trials Centre near Kisumu, in Western Kenya. Its main objective was to test the safety of the candidate vaccine in adults who had been vaccinated with BCG and who have or do not have latent TB infection. This study is now complete, and specimen and data analysis is ongoing. No significant safety issues have been identified.
In October 2008, enrollment for the first Phase II study of AERAS-402/Crucell Ad35 began in Cape Town, South Africa. The study is being conducted by the University of Cape Town's Lung Institute in collaboration with the South African Tuberculosis Vaccine Initiative. The candidate is being tested in 82 adults who have had active TB. No significant safety issues have been identified.
A Phase I clinical trial of the vaccine candidate was started in South Africa in April 2009, with the objective to test AERAS-402/Crucell Ad35 in infants. The trial participants are 54 healthy infants who have not been exposed to TB or HIV.
About Tuberculosis
Tuberculosis is the world's second deadliest infectious disease, after HIV, with nearly 9.3 million new cases diagnosed in 2007. The WHO has estimated 1.8 million people died from TB in 2007. One-third of the world's population has been infected with the TB bacillus and current treatment takes 6-9 months. The current TB vaccine, Bacille Calmette-Guérin (BCG), developed over 85 years ago, reduces the risk of severe forms of TB in early childhood but is not very effective in preventing pulmonary TB. TB is changing and evolving, making new vaccines more crucial for controlling the pandemic. Tuberculosis is the leading cause of death for people living with HIV/AIDS, particularly in Africa. Multi-drug resistant TB (MDR-TB) and extensively-drug resistant TB (XDR-TB) are hampering treatment and control efforts.
About AdVac© technology and Ad35
AdVac© technology is a vaccine technology developed by Crucell and is considered to play an important role in the fight against emerging and re-emerging infectious diseases, and in biodefense. The technology supports the practice of inserting genetic material from the disease-causing virus or parasite into a 'vehicle' called a vector, which then delivers the immunogenic material directly to the immune system. Most vectors are based on an adenovirus, such as the virus that causes the common cold.
The AdVac© technology is specifically designed to manage the problem of pre-existing immunity in humans against the most commonly used recombinant vaccine vector, adenovirus serotype 5 (Ad5), without compromising large-scale production capabilities or the immunogenic properties of Ad5. AdVac© technology is based on adenoviruses that do not regularly occur in the human population, such as Ad35. In contrast to for instance Ad35 antibodies, antibodies to Ad5 are widespread among people of all ages and are known to lower the immune response to Ad5-based vaccines, thereby impairing the efficacy of these vaccines. All vaccine candidates based on AdVac© are produced using Crucell's PER.C6© production technology.
About PER.C6© technology
Crucell's PER.C6© technology is a cell line developed for the large-scale manufacture of biopharmaceutical products including vaccines. The production scale potential of the PER.C6© cell line has been demonstrated in an unprecedented successful bioreactor run of 20,000 liters. Compared to conventional production technologies, the strengths of the PER.C6© technology lie in its excellent safety profile, scalability and productivity under serum-free culture conditions. These characteristics, combined with its ability to support the growth of both human and animal viruses, make PER.C6© technology the biopharmaceutical production technology of choice for Crucell's current and potential pharmaceutical and biotechnology partners.
About Aeras
The Aeras Global TB Vaccine Foundation is a non-profit organization working as a Product Development Partnership to develop new tuberculosis vaccines and ensure that they are distributed to all who need them around the world. Aeras' major funders include the Bill & Melinda Gates Foundation, the Netherlands Ministry of Foreign Affairs, the Danish International Development Agency and the Research Council of Norway. Aeras, with more than 130 employees, is based in Rockville, Maryland, USA, where it operates a state-of-the-art manufacturing and laboratory facility. In 2008, the Aeras Africa Office was opened in Cape Town, South Africa. For more information, please visit http://www.aeras.org.
About Aurum
The Aurum Institute is an internationally-recognised, specialist research and health systems management organisation. Its focus is TB and HIV prevention, treatment, and care. The negative impact of the poor understanding and management of these epidemics is vast, affecting individuals, communities and economies. The recognition of the huge advantages of controlling these diseases is Aurum's motivation.
Aurum has an international reputation for its work in the fields of tuberculosis and HIV/AIDS and is the recipient of research and other grants from South African and international agencies and institutions for this work. In the field of TB in particular, Aurum is conducting a number of groundbreaking studies into the prevention of TB in gold mineworkers. This research has the potential to shift policy and practice in TB management worldwide. Aurum is based in Johannesburg, South Africa with operations throughout the country and collaborations across the globe.
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TB SCREENING PROGRAMME LAUNCHED IN JOHANNESBURG CORRECTIONAL FACILITY
9 July 2009 |
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Following an intensive TB awareness campaign within the Johannesburg Correctional Facility, the Aurum Institute, in collaboration with the Department of Correctional Services, the Chris Hani Baragwanath Hospital, the National Health Laboratory Services and the London School of Hygiene and Tropical Medicine launched a programme today to screen offenders and correctional facility staff members for TB.
The screening drive, named "Herisha Rifuba" (Tsonga for "kill TB") will inform a research study titled "A preliminary study of screening for tuberculosis in a South African correctional facility", within the Johannesburg Correctional Facility. Through this study the Aurum Institute will determine the burden of tuberculosis among offenders and correctional facility staff members and evaluate the best tool or combination of tools to screen for tuberculosis, thereby informing and guiding the Department of Correctional Services’ policy on screening for tuberculosis within correctional facilities.
The Aurum Institute has been working in collaboration with and supporting the Department of Correctional Services’ health programme since 2006, primarily to strengthen the Comprehensive Care Management and Treatment (CCMT) clinics within correctional facilities.
Read more about "Herisha Rifuba"
Read more about the launch of 'Herisha Rifuba' - 30KB
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TB PREVALENCE IN PRISON INVESTIGATED
9 July 2009 |
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Poor ventilation, overcrowding and HIV co-infection make prison an ideal breeding-ground for tuberculosis (TB), but a new study will be among the first in South Africa to quantify TB among inmates and personnel.
The study, "Herisa Rifuba" or "Stop TB" in Tsonga, will include about 3,500 prisoners and staff at the Johannesburg Central Prison, nicknamed "Sun City", after a well-known local hotel and casino. The correctional facility has around 12,000 inmates and receives about 500 new prisoners daily.
Study organiser Dr Lily Telisinghe, of The Aurum Institute, a non-profit medical research body, said the findings could lead to better diagnostic methods for identifying the illness in this high-risk group.
Inmate healthcare manager Dr Gladys Nthangeni said so far in 2009 the prison had recorded more than 100 cases of TB, about 10 percent of which were drug resistant.
In 2006, Johannesburg Central became one of the first prisons accredited to offer antiretroviral (ARV) treatment on site. About 530 of were receiving treatment from the prison clinic, said Joyce Lethoba, a project manager at The Aurum Institute, which helped the prison obtain accreditation.
If a prison does not have its own clinic, inmates on ARVs have to be transported to nearby state hospitals to fetch their medication, which carries a greater risk of escapes.
Spillover effects
The start of the study coincided with the graduation of peer educators, who had spent the past month educating their peers and potential study participants about TB.
"You have to make [prisoners] aware of what happens in jail, and we can't run away from the fact that sex happens in jail," an inmate said. "We tell them, 'Test at an early age, gentlemen'," he added. "We are tired of watching people die, and the grave[yards] are full."
About 190,000 men, women and juveniles are currently incarcerated in prisons in South Africa, according to the Institute for Security Studies.
Aurum acknowledges PlusNews as the source of this article: http://www.plusnews.org/Report.aspx?ReportId=85210
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HEALTH WORKER BURNOUT
6 July 2009 |
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Johannesburg - The burned-out health worker with the bad attitude has long been regarded as the patient's worst nightmare, and linked to everything from high teen pregnancy rates to poor patient tracking in South Africa.
The Aurum Institute, a medical non-profit organization based in Johannesburg, brought health workers in the HIV and AIDS field together this week to talk about the emotional and physical toll of heavy workloads, resource constraints and poor patient outcomes.
The low-down on feeling down
Aurum's training manager, Robin Hamilton, a psychologist with 20 years of experience in HIV/AIDS, said health workers bore an unforgiving and perhaps unrecognized burden.
"It's the human cost of the HIV pandemic," he told IRIN/PlusNews. "You have to deal with serious illness, high mortality, seeing patients get sick and die - that takes an emotional toll on many health workers."
Mo Sinclair is an HIV and AIDS counsellor who struggles to leave her work at the office after she knocks off. "In the middle of the night I wake up and I'm still doing stats in my sleep. I can't switch it off, I want an 'off-button'," she said.
"If I were an accountant I would get stressed about money, and that's not an emotional investment; if I were an accountant, maybe I'd get stressed once a month, [but] for us, it just goes on and on."
Health workers said they often experienced physical and emotional fallout from demanding jobs, suffering everything from headaches, upset stomachs and insomnia to an unhappiness that affected more than just their relationships with patients.
"When I get home I'm so demoralized," said Lungile Rabinda, another counsellor. "Whatever the kids do that is wrong, I relate it to those difficult patients. I put this on to them, and it's very unfair."
Getting health workers back on an even keel
Hamilton said the ideal way of solving health worker burnout is to get them to talk about their feelings with professionals, but Winnie Madiga has found a novel way of coping: she treats herself to a getaway weekend once a year.
"I will a book myself into a hotel and stay there for the whole weekend - it would be me, myself and I. That time is mine, and I reflect on what has been going on in my life and what I can do to change it," she said.
"The challenge is balance," Hamilton said. "We need to be managing ourselves better. It's important to think about that and not what we want management to do or how we want the system to change."
Aurum acknowledges IRIN News as the source of this article: http://www.irinnews.org/report.aspx?ReportID=85139
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THE AURUM INSTITUTE'S THIBELA TB PROGRAMME- WORKING TO REDUCE TB IN TEMBISA
June 2009 |
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The Aurum Institute is an internationally recognized research and health systems management organisation committed to improving the understanding and treatment of TB, HIV/AIDS and workplace diseases. The Institute began ten years ago to gather together all the research, knowledge and scientists working in TB and HIV/AIDS in the Southern African mining sector to form an institution.
Today, Aurum has programmes at the mines and in surrounding communities across South Africa employing over 400 people - from doctors and community health care workers to programme administrators and IT specialists.
The Institute's new premises in Parktown, Johannesburg, were officially opened on 25 March, by the CEO Professor Gavin Churchyard and the Honourable Minister of Health Ms Barbara Hogan in celebration of the Institute's 10 year anniversary and the commemoration of World TB Day.
One of Aurum's programmes, Thibela TB, is working hard in communities across South Africa to reduce tuberculosis (TB) through community wide isoniazid preventive therapy as well as standard TB control measures.
The Institute established a new partnership with the Tembisa Hospital and surrounding clinics to address HIV and TB treatment and to extend healthcare research into the surrounding community. The first research study being undertaken is the Rifaquin Study in Tembisa in August 2008 with the first patient, Tembisa community member, Mr Sindiso Mbengo, enrolled as a participant in the study on the 22nd August 2008. The study aims to find new ways of treating TB for shorter periods of time. TB usually takes 6-9 months to treat successfully. He completed his treatment in February 2009 and remains TB-free today.
Mbengo was pleased to speak to Mokhantso Malope, Study Coordinator for Aurum's Rifaquin Study in Tembisa, about his experience being a participant in the study. His involvement started he said, when he expressed an interest in the study after the nurses at Ethafeni Clinic told him about it. Members of the study team then visited him and provided him with more information.
"They were very informative and while I didn't know much about research, I immediately felt like being a part of the study,"said Mbengo.
Joining the study meant enrolling a friend, somebody at home, or a neighbor, to provide support and encouragement during the treatment period.
"I enlisted my sister and she was very supportive and helped me complete my Adherence and Treatment Card. The study team also played a big role in supporting me through home visits and telephonic reminders for my clinic schedules."
After six months of treatment, Mbengo was delighted to report that he remained TB-free.
"This was great news for me and I asked my sisters to get tested too, to which they agreed and they both tested negative!"
The study provides the first treatment (DOT dose - Directly Observed Therapy) at the study centre and the participant is provided six more packets of treatment to complete at home with the help of their supporter. Once completed, he or she returns to the study centre and is given another dose and another six packets to take at home over the period.
"This happened for over two months during after which time, I was tested for TB and was told that I was now well on the way to recovery, however, I had to complete my six months treatment."
Aurum acknowledges that this article came from the ISITHEMBISO Official Newsletter of Tembisa Hospital, Volune 1, Issue 1, June 2009
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MINING NEWS ARTICLES
By Marilyn Boyd
June 2009 |
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This month Mining News begins a series of features showcasing the projects currently underway at The Aurum Institute, an internationally recognised, specialist research and health systems management organisation based in Johannesburg.
Aurum focuses on TB and HIV prevention, treatment and care. The negative impact of the poor understanding and management of these epidemics is vast, affecting individuals, communities and economies, so Aurum is dedicated to improving the understanding and treatment of TB, HIV/AIDS and workplace disease in developing countries. Aurum receives grants for research and other activities from South African and international agencies and institutions for this work.
Aurum was originally founded as Aurum Health Research by AngloGold Ashanti in 1998, in recognition of the fact that most of South Africa's mineral deposits are found in remote areas not serviced by state or private health services. As a result, Aurum was set up as the industry's own medical service to care for the needs of its workforce.
Aurum Health Research was originally established to unite the large body of ad hoc research, treatment knowledge and scientists working on or with the mines, into one institution. It was tasked with conducting research into the surveillance, treatment and management of epidemic, occupational and other diseases occurring among mineworkers and their dependents. Aurum later expanded its activities beyond mining industry needs, especially in response to international demand for quality treatment and research sites and programme development around HIV/AIDS-related projects.
In 2005 The Aurum Institute was promulgated as an independent, not-for-profit Public Benefit Organisation. This positions the Aurum Institute to impartially represent the interests of working South Africans, their employers and the public. It has enjoyed significant success in informing, developing and working with communities within which its research work takes place.
Aurum, managed by an independent Board, is acknowledged by funders, companies, NGO's and communities as a partner capable of conducting ethical research and delivering reliable results. The Institute adds value by supplying the context, expertise and experience for our partners to make better informed health-related management and treatment decisions.
Please find the three related article below:
Aurum acknowledges Mining News as the source of these articles
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VACCINE TRIAL VOLUNTEERS CONTRIBUTING TO AIDS FIGHT |
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Although scientists hope that a vaccine will eventually offer the best protection against HIV infection, the complex biology of the virus has posed constant challenges and even a partially effective vaccine is still some years away.
A number of potential HIV vaccines have made it out of the laboratory, but clinical trials on humans are still only in the second of three phases. The primary goals in the current round of trials are to establish safety, dosage and their ability to trigger an immune response.
Thandi Nxamakele, 27, from Klerksdorp, a gold mining town in South Africa's North West Province, was one of 240 South Africans who took part in a phase II HIV vaccine trial conducted by the Aurum Institute for Health Research, an independent medical scientific organisation.
She described her participation in the trial, which is now coming to an end, as "a privilege". "Before, we were never given an opportunity like this, we thought people who took part [in trials] were people who've got qualifications, but then everybody is welcome to take part in this research," she told IRIN/PlusNews.
According to Samuel Rampho, a study coordinator at Aurum's research site in Klerksdorp, volunteers tend to view participation in vaccine trials as their contribution to the AIDS fight. "Most would say they're very tired of this pandemic. Even if they don't benefit directly, people behind them might, so they feel it's something good they're doing for their communities."
Rampho also estimated that about 80 percent of trial participants had seen people close to them battle with the virus.
Chuma Ludidi, 22, was motivated by the experience of watching her older sister suffer from AIDS-related illnesses while trying to keep her status a secret from their devoutly Christian mother. Ludidi heard about the vaccine trial when she came to Aurum's voluntary counselling and testing (VCT) clinic last year to find out what her own HIV status was.
"I wanted to join, but during the physical screening they found out I had anaemia," she said. After being treated for the condition, Ludidi volunteered for a new vaccine trial, which is recruiting 3,000 participants between the ages of 18 and 35 at five different sites in South Africa.
Volunteering for the trial, known as "Phambili" (going forward), meant making a four-year commitment to visit the clinic at regular intervals and, in the case of female volunteers, avoiding pregnancy.
Ludidi said she didn't hesitate. "I thought, if I volunteer it will motivate other youth to come here and know better about HIV and AIDS," she said.
The Phambili trial is being advertised at public health clinics, local non-governmental organisations (NGOs) and youth centres, with slogans like "AIDS will be stopped by South Africans like you!"
"Dude, are you mad?"
Prospective participants are invited to attend an information session, in which they learn how an HIV vaccine works, the potential risks and benefits of taking part, and what would be required of them. Before signing an informed consent form, potential recruits must be HIV negative, undergo a thorough health screening and receive extensive counselling.
According to Ludidi, it is not fear of side effects from the vaccine that has prevented many of her friends from joining the trial; it is the fear of learning their HIV status. "They say 'If I've got HIV, I don't want to know, I'd rather die with it'."
Thabo Bonaventure, 22, an engineering student from Klerksdorp who participated in the earlier trial, got a similar reaction from his friends. "They'd say, 'Me, test? Dude, are you mad!'" Some of Bonaventure's college friends even "mocked" him for taking part in the trial, telling him, "you're going to get AIDS".
Rampho said one of the main challenges in recruitment has been explaining that HIV vaccines do not work like traditional vaccines, in which a weak version of the virus is administered in order to trigger the body's immune response when it is exposed to the real disease.
Instead, the vaccine delivers harmless copies of three HIV genes made in the laboratory. "We had one case where the mother of a participant was convinced her son was being injected with the HI virus," Rampho recalled. "We have to explain it doesn't work like a flu vaccine."
Volunteers are given symptom logbooks to record any side effects they might experience after having a vaccine shot. Prof Gavin Churchyard, principal investigator at the Aurum Institute in Klerksdorp, pointed out that only one participant in the phase II trial had experienced an "adverse event" that may have been related to the vaccine.
Most participants volunteer for altruistic reasons, but several reported appreciating the initial health screening and the regular check-ups. "It's not easy to get a full health screening at the public clinic," said Loretta Jonathan, 43, who took part in the earlier trial. "I'd have to pay a lot of money because I don't have medical aid [health insurance]."
Reducing risky behaviour
In line with ethical requirements, vaccine trial participants receive regular risk-reduction counselling, HIV testing, male and female condoms, and treatment for sexually transmitted infections.
Trial results are dependant on the fact that, despite all these measures, not all participants will use condoms all the time, but Churchyard said trial participants tended to reduce risky behaviour.
Several participants IRIN/PlusNews spoke to confirmed that their involvement in the trial had improved their knowledge of HIV and AIDS, and had influenced their behaviour.
"When you're at this age, maybe you don't care, you just sleep with this person and forget about HIV, but being in the study has made me more aware of those things," said Nxamakele.
Both Nxamakele and Ludidi viewed their participation in the trial as going beyond simply receiving the vaccines. Ludidi has persuaded several friends and family members to make use of Aurum's VCT services, while Nxamakele recently joined the organisation as a full-time trial recruiter. Jonathan has distributed HIV/AIDS pamphlets at local taverns on her own initiative.
Aurum acknowledges PlusNews as the source of this article: http://www.plusnews.org/InDepthMain.aspx?InDepthId=64&ReportId=74209&Country=Yes
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YOUTH MONTH CELEBRATED IN STYLE WITH SCHOOLS
19 June 2009 |
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The Tubatse South African Police Service (SAPS) held a crime awareness with a focus on Youth Month. On Saturday 13 June they first addressed pupils from Mmiditsi High School, Moukangwe High School, Lehlaba High School and Ntlhatlole Science and Commercial College. They were given tips on how to avoid becoming victims of crime. They were also informed about the consequences of a criminal record and having previous convictions.
The focus also fell on drug and alcohol abuse as well as rape that often goes hand in hand with alcohol abuse.
The Aurum Institute was also available to help pupils find out their HIV status.
After the official proceedings which included an item or two, the schools took on each other in netball and soccer matches.
The winners walked away with trophies. In netball Mmiditsi High School played against Lehlaba High School in the final. Mmiditsi won the match.
Get the soccer results on page 16 of today's newspaper.
Youth month celebration - 351KB
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PROMISING NEW DRUG TO TREAT TB
17 June 2009 |
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Johannesburg - For the first time in nearly half a century, the world may be on the verge of adding a new drug to its arsenal against tuberculosis (TB) – one that would not only drastically improve the treatment of TB and its multidrug-resistant strains, but also shorten it.
Adding a new drug, TMC207 to standard multidrug-resistant TB (MDR-TB) treatment regimens dramatically cuts the period from when patients start treatment to their sputum testing negative for TB, according to a study published in the June issue of the New England Journal of Medicine, in the US. The drug is being developed by pharmaceutical research company, Tibotec.
After two months, almost 50 percent of MDR-TB patients on the drug had sputum samples that tested negative for TB, compared to about 10 percent of the study's placebo group. The new antibiotic, TMC207, targets the bacteria's energy-producing enzyme, killing it off.
As a bonus, the drug has proven relatively easy to stomach in more ways than one, with potential dosing as low as three times a week – a factor that bodes well for treatment adherence.
"Currently, TB requires six months of treatment ... if strains become resistant to first-line drugs, patients require the use of second-line drugs, which are expensive and require two years of treatment, usually," said the study's co-author, Dr Alexander Pym, chief special scientist at the TB research unit of the South African Medical Research Council (MRC).
"As a complete new class of antibiotic, it can be active against both TB and MRD-TB; the bugs have never seen [this drug] before; they haven't had opportunities to develop resistance."
But it remains to be seen whether it is a complete cure, what other drugs it must be combined with and whether it is completely safe.
TMC207 can also be stored at room temperature, cutting out the need for the costly refrigeration systems that are sometimes unavailable in developing countries, which bear the brunt of the world's TB burden.
Dr David Clark, CEO of the Aurum Institute, an independent health research institute in Johannesburg, South Africa, said the study - and the drug technologies produced by it - represented a breakthrough in TB treatment. The Aurum Institute runs one of the largest studies in TB preventative treatment in South Africa.
In 2007, an estimated 500,000 people globally were diagnosed with MDR-TB, but less than one percent received sufficient treatment, according to the latest Global TB Control report by the World Health Organization.
Although 13 percent of patients in the trial were HIV-positive, those on antiretroviral (ARV) treatment were excluded from this phase to allow doctors to isolate TMC207's effects without possible drug interactions between it and ARVs. However, the MRC's Pym said studies to look at the effectiveness of TMC207 in patients on ARVs were in the pipeline.
Dr Francois Venter, of the South African HIV Clinicians Society, told IRIN/PlusNews that despite the good news, TB remained a multifaceted problem:
"New drugs are exciting, especially for people with drug-resistant TB, but South Africa ... [still] needs to fix its TB and HIV health care provision."
Aurum acknowledges PlusNews as the source of this article: http://www.plusnews.org/Report.aspx?ReportId=84888
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AURUM STAFF MEMBER OF 2008 APPEARS ON “SHIFT”
27 May 2009 |
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Johannesburg – The South African Broadcast Corporation programme “SHIFT” hosted Aurum Institute’s HIV Clinician, Dr Mpho Maraisane to discuss influenza, particularly linked to HIV and TB.
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RECOGNISING EFFORTS TOWARDS AN HIV VACCINE IN KLERKSDORP
18 May 2009 |
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The Aurum Institute hosted an event on 18 May in Klerksdorp in recognition of World HIV Vaccine Day.
World AIDS Vaccine Day, also known as HIV Vaccine Awareness Day, is observed annually on May 18. AIDS vaccine advocates mark the day by promoting the continued urgent need for a vaccine to prevent HIV infection and AIDS. They acknowledge and thank the thousands of volunteers, community members, health professionals, supporters and scientists who are working together to find a safe and effective AIDS vaccine and urge the international community to recognize the importance of investing in new technologies as a critical element of a comprehensive response to the HIV/AIDS epidemic.
Speaking at the event, Dr Dave Clark, Deputy CEO of the Aurum Institute said: "There are three reasons for hope of an HIV vaccine in the next 10 years. First, the lessons in the history of medicine say there is hope. For example, the discovery of penicillin in 1927, which was the only viable antibiotic at that time.
"Today, only 80 years later we have a myriad of antibiotics and life saving drugs for various infections. The Smallpox vaccine took more than 200 years to develop and disseminate but the disease is now eradicated from the earth. The Polio vaccine took more than 25 years to bring to registration for human use, and is widely used today for the prevention of this once very common but now rare disease. We are only 20 years into the development of a vaccine to fight HIV.
"Secondly, there is the courage and perseverance of community. It took the Israelites 400 years to be freed from Egyptian slavery and a further 40 years to reach the promised land. It took this country over 100 years and perhaps longer to break apartheid and bring freedom. Communities like these examples knew what was right and did not give up the fight until they were free – the same is true for HIV.
"And lastly, we are not without weapons in the fight. In 1992, when I graduated from medical school, there were no antiretrovirals – today millions of people around the world are living with HIV, not dying from it. South Africa has the largest antiretroviral programme in the world. VCT is widely available and free. Preventive and curative medicines for TB, PCP pneumonia and cryptococcal meningitis are available to tackle these "executioners" of HIV. There are extensive networks of partnerships between governments, provinces, municipalities, NGOs and communities to get care to people and to tackle the scientific challenges of this war on HIV. This is no better evidenced than in Matlosana and the community of Khuma.
"Thus there is every reason for hope whilst science walks the path to an HIV vaccine. The work has not stopped – it has in fact intensified, supported by governments and funders the world over. Aurum is glad to be a partner in the Matlosana District in the fight against HIV/TB.
"On this HIV vaccine day we celebrate with you the community all the hard work done to win this war. We have every reason to hope for the future, only let us cling to that hope and the courage that we have as a community. To quote Sir Winston Churchill in an address to scholars at Harrow School "Never give in! Never, ever, ever, ever, ever, ever, ever give in!"
The concept of World AIDS Vaccine Day is rooted in a May 18, 1997 commencement speech at Morgan State University made by then-President Bill Clinton. Clinton challenged the world to set new goals in the emerging age of science and technology and develop an AIDS vaccine within the next decade stating,
"Only a truly effective, preventive HIV vaccine can limit and eventually eliminate the threat of AIDS," said Clinton.
In Klerksdorp, the Aurum Institute has established 2 Community Advisory Boards (adult and adolescent), a diverse group of volunteers, to provide community input into study design and local procedures. Community Advisory Board members include community activists and/or professionals associated with HIV/AlDS and TB prevention and services delivery. Their role is to help the community understand the science of HIV/AIDS and TB vaccines/drugs, as well as the methods of research and the clinical trials process. These discussions include candid conversations about fears and concerns related to government-sponsored research. Building strong relationships and a sense of trust between Aurum researchers and the community is crucial to the success of research.
A brief outline of the HIV vaccine
- In 1987 the 1st Phase I HIV vaccine trial was started.
- In 1998 the 1st Phase II HIV vaccine trial was started with a hope of a vaccine in 10 years.
- In 2003 a leading medical journal published an article expressing the hope of a vaccine in 10 years.
- In 2007 the Phambili trial running here in Klerksdorp and elsewhere in the world was stopped for lack of effect.
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DR SELLO MASHAMAITE ON HIV
4 May 2009 |
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Johannesburg – Dr Sello Mashamaite, a sub-investigator in Aurum’s Rifaquin trial in Tembisa, participated in a discussion on HIV on SABC’s ‘Shift’ program on 20 April, 2009.
According to the South African Broadcast Corporation (SABC): “The talk show Shift is a project of SABC Education, and aims to inspire viewers to ‘shift’ their mindsets, attitudes and perceptions by thinking and talking about the issues dealt with on the show’.
This particular episode focused on HIV prevention and treatment and included Dr Sello and guests from Soul City and Zuzimpilo HIV projects. The discussion was led by the program presenters, Rhulani Baloyi and Bongani Zindela, who posed questions to the panel.
The panel made contributions to the topic from the perspective of People Living with HIV/AIDS (PLWAs), project management and clinicians. Due to the fact that the program was not live, the public could not actively participate by telephone as is the norm on ‘Shift’. The recorded program was broadcasted on 4 May, 2009.
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PREVENTION THE BEST MEDICINE FOR TB
26 March 2009 |
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Findings from an ongoing South African study into preventative tuberculosis (TB) therapy suggest that prevention really may be the best medicine.
In the Thibela TB study, one of the largest of its kind, almost 40,000 gold miners in South Africa received a nine-month course of isoniazid, a standard first-line TB drug. None of the miners was actually suffering from TB, but the high prevalence of both HIV and silicosis in South African mines makes miners extremely vulnerable to the disease.
Isoniazid preventive therapy (IPT) is usually given to people living with HIV to reduce their risk of developing TB, but the Thibela study is testing the theory that treating an entire community with the drug could have a significant impact on TB rates for a period of about 10 years.
The study, which is being conducted in three of the country’s nine provinces, is only expected to conclude in 2012, but preliminary findings released on Wednesday suggest that isoniazid has already been effective in reducing TB incidence among participants.
"We've had very few subsequent infections in those taking the preventative treatment," said Dr Dave Clark, deputy CEO of the Aurum Institute, the health research NGO conducting the study.
The results could also influence case management of HIV-positive people in South Africa, who are around 20 times more likely to develop TB than those who are HIV-negative – 75 percent of new TB patients are HIV-positive.
The World Health Organization (WHO) has recommended IPT for people living with HIV in countries with a high prevalence of TB, but less than one percent of HIV-positive people in South Africa are receiving it, according to Clark.
Although many feared the preventative treatment would increase the incidence of drug-resistant TB, the number of such cases in the study has been negligible. Most patients also showed a surprising wiliness to adhere to treatment.
"Asking mineworkers, who are ostensibly well, to adhere to treatment is difficult," Clark said. "We've had an 80 percent success rate to date with adherence, and it's caught on. We've had cases where workers have asked, 'Is this something we can take back to our communities, to our wives?'"
Findings from the study might also influence the way health workers and policy-makers handle epidemics other than TB. "If this methodology can work in this setting, there is huge potential that the approach would work in the case of other diseases, such as diabetes and hypertension," said Clark.
In the latest global TB control report released by WHO on Tuesday, South Africa's incidence of TB ranks second only to Swaziland's, the highest in the world. South Africa also has the world's fourth highest burden of multidrug-resistant (MDR) TB.
Aurum acknowledges PlusNews as the source of this article: http://www.plusnews.org/Report.aspx?ReportId=83665
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AURUM HOUSE OFFICIALLY OPENED BY THE MINISTER OF HEALTH
25 March 2009 |
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Johannesburg, South Africa - Professor Gavin Churchyard and the Minister of Health Ms Barbara Hogan officially opened the new Aurum House, home of the Aurum Institute, in commemoration of World TB Day and celebration of the Institute's 10th Anniversary.
The Aurum Institute was started by AngloGold Ashanti, was based in Welkom with just Churchyard and a secretary, and the objective of gathering together the large body of ad-hoc research, treatment knowledge and scientists working in TB and HIV/AIDS in the Southern African mining sector to form an institution. In 2005, Aurum became an independent, not-for-profit Public Benefit Organisation.
Over the past 10 years the Institute has grown substantially and now employs over 400 people working in programmes across all nine provinces in South Africa. It is still their remit to conduct research into the surveillance, treatment and management of epidemic, occupational and other diseases occurring amongst communities in SA and notably in mineworkers.
On March 24th, World TB Day, the WHO released its 2009 global TB control report with its revised estimates of TB and particularly HIV associated TB, which has previously been underestimated. According to the Aurum Institute, since 2004 the burden of TB has continued to increase and South Africa is currently ranked fifth in the world in terms of absolute numbers, but second only to Swaziland with respect to the rate of new TB cases per 100,000 population per year
“The TB epidemic is driven by the one of the most severe HIV epidemics in the world and South Africa has the largest number of HIV-positive TB cases globally Yet the implementation of interventions to reduce the risk of TB in people living with HIV, such as intensified TB case finding and isoniazid TB preventive therapy is notably poor. Although South Africa has made progress in improving the TB case detection rate and treatment success rate it is not yet meeting the targets set by the World Health Organization for detection and cure,” said Churchyard.
“However we have made progress by improving the TB case detection rate and treatment success rate and it is encouraging to note that TB rates are slightly lower than that reported for 2008, suggesting that the TB epidemic in South Africa has plateaued and may be starting to decline as has been observed for other high HIV prevalent African countries.”
Drug resistant TB has added another complex dimension to the equation and South Africa sits with the highest number of drug resistant TB cases in the world. According to Churchyard this of particular concern because of the threat it poses to the gains both TB and HIV programmes have made nationally, and to TB control across the region due to the lack of continuity of care when patients with drug resistant TB return home to neighbouring countries.
Over the past 10 years Aurum has established a large programme of research on TB and HIV.
“The jewel in the crown of Aurum led studies is ‘Thibela TB’, which means Prevent TB. Thibela TB, funded by the Consortium to Respond Effectively to the AIDS TB Epidemic and the Mine Health and Safety Council, is evaluating the role of community-wide TB preventive therapy as a means to controlling TB in high HIV prevalent settings.”
From the Institute's research, approximately 89 percent of gold miners in South Africa have been infected with TB, and many have active TB despite well implemented TB control programmes. This is largely attributable to a high prevalence of silicosis, an escalating HIV epidemic and the combined effects of HIV and silicosis.
The study is being conducted among 80,000 gold miners in three provinces, in partnership with labour organisations, the Ministry of Minerals and Energy, the major gold mining companies and the London School of Hygiene and Tropical Medicine. Although the final results of this study are expected in early 2012, it aims to reduce TB in this population by more than 60% with an effect lasting up to 10 years after the intervention is completed.
“This remarkable programme,” said Churchyard, “has demonstrated that it is feasible to mobilize more than 80 percent of a community to take up TB preventive therapy and achieve more than 80 percent adherence. To date more than 26,000 gold miners have volunteered to start TB preventive therapy in 30 months.”
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Notes for editors - 31KB
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MINISTER OF HEALTH'S ADDRESS AT THE 10th ANNIVERSARY CELEBRATION OF THE AURUM INSTITUTE FOR HEALTH RESEARCH
Ms Barbara Hogan (Minister of Health)
25 March 2009 |
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“Programme director
Chairman of the Aurum Institute Board
Representatives of funding and partner organisations
Committee members, managers and staff of the Institute
Guests and well-wishers
“It is a great pleasure to join you to celebrate the Aurum Institute's 10th anniversary and to participate in the official opening of your new head office.
The Aurum Institute has come a long way in a decade and gives an interesting meaning to that hard-worked term, “transformation”. The Institute was a child of the gold mining industry, born at a time when we were beginning to appreciate the size of the approaching AIDS epidemic. Aurum Health Research, as it was called in 1998, was set up by Anglogold Ashanti to deal in a focused way with diseases related to the migrant labour system and the particular health hazards of gold mining. Ten years later it is a truly unique feature on the South African health landscape. But there is a lot more it has to do.
- Despite its corporate pedigree, the Aurum Institute is now an independent non-profit organisation. However, its parentage gives it unique access to the mining industry where research can be undertaken in unusually controllable circumstances among communities of workers. Aurum arguably has access to some of the world's largest “real life” laboratories.
- The Institute is one of very few South African entities that has the capacity to do large-scale research without extensive public sector funding. In contrast to Aurum, our major health research bodies – such as the Medical Research Council and the National Institute for Communicable Diseases – are government funded, while most of our specialised research centres are off-shoots of public universities.
Aurum has attracted its own funding through the excellence of its researchers, the standing of its partners and the unique research opportunities it offers.
- And the Aurum Institute, unlike many research bodies, maintains a balance between research and health programme management, giving it a very firm grasp of the realities of service delivery in its primary areas of interest, the prevention and treatment of AIDS and TB.
The Institute was a key player in the mining industry's decision to go ahead with the large-scale provision of antiretroviral treatment to mineworkers living with AIDS. The industry made this move almost two years ahead of the public health sector. It must now lend itself to efforts in the private sector to collaboratively monitor and evaluate its ARV programme so that we fully understand the entire picture in our country. ... ”
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Full text of Minister's speech - 28KB
Keywords: Barbara Hogan, Aurum, Aurum Institute, Mining Industry, Health Research, TB, HIV, AIDS, Tuberculosis, Mineworkers, Thibela
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CEO'S ADDRESS AT THE 10th ANNIVERSARY CELEBRATION OF THE AURUM INSTITUTE FOR HEALTH RESEARCH
Prof. Gavin Churchyard (CEO of the Aurum Institute for Health Research)
25 March 2009 |
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“The Honorable Minister Hogan, MEC of Health for Gauteng, Honorable Justice Kate O’Regan, invited guests, colleagues, members of the media, ladies and gentleman,
In 2004 at the International AIDS Conference in Bangkok, former president Mr Nelson Mandela said “The world has made defeating AIDS a top priority…. But TB remains ignored. Today we are calling on the world to recognize that we can’t fight AIDS unless we do much more to fight TB as well.”
Yesterday we celebrated World TB day. The World Health Organisation released its 2009 global TB control report with its revised estimates of TB and particularly HIV associated TB, which has previously been underestimated. How has South Africa fared since 2004 when Mr Mandela called the world to action to do more in the fight for TB?
Since 2004 the burden of TB has continued to increase and South Africa is currently ranked 5th in the world in terms of absolute numbers but second only to Swaziland with respect to the rate of new TB cases per 100,000 population per year. The TB epidemic is driven by the one of the most severe HIV epidemics in the world and South Africa has the largest number of HIV-positive TB cases globally. Yet the implementation of interventions to reduce the risk of TB in people living with HIV, such as intensified TB case finding and isoniazid TB preventive therapy is notably poor. Although South Africa has made progress in improving the TB case detection rate and treatment success rate it is not yet meeting the targets set by the World Health Organization for detection and cure. It is encouraging to note however that TB rates are slightly lower than that reported for 2008 suggesting that the TB epidemic in South Africa has plateaued and may be starting to decline as has been observed for other high HIV prevalent African countries. ...”
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Full text of CEO's speech - 42KB |
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SCHOOL UNIFORMS FROM HIV TESTS
11 January 2009, Tshepo Mogotsi |
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Staff members at the Aurum Institute took HIV tests with the intention of helping school kids. Now 239 school kids from disadvantaged background will be starting their schooling with a positive note. For each staff member that took the test, the company gave a school uniform to a needy child.
Project coordinator for Aurum, Refilwe Mophoso, said helping children with their school needs helps shape their future. "This is a way of encouraging children by showing our support. If a child goes to school without a proper uniform his or her self-esteem becomes low. By doing this we are encouraging the children to stay at school," said Mophoso.
Aurum Institute is a medical company conducting research on HIV and TB. Mophsolo said the company is constantly encouraging their staff - and the general public - to go for tests. They saw this as a golden opportunity to encourage their workers to go for testing. "While we encourage our workers to know their status, we also want to contribute to the well-being of the children in this country," said Mophoso.
The 239 children that benefit come from many different organisations and schools. Twilight Children's shelter in Hilbrow, Joberg, is one of the shelters that benefitted from the initiative. Twilight takes care of 70 homeless boys. Sibusiso Mohapi (37), a child care supervisor at Twilight, said this initiative came as a real blessing because it was the beginning of the year. "The lack of school uniforms is one of our biggest challengers, so this will take us a step further to reaching our goals as a school," said Mohapi.
Download article - 191KB
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TABLE OF CONTENTS FOR HIV/AIDS IN SOUTH AFRICA
2008, edited by SS Abdool Karim and Q Abdool Karim |
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TB REMAINS CONCERN AT MINES
2 July 2008 |
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Nineteen people showed signs of TB at a recent awareness campaign held at the Pamodzi (Grootvlei) mine in Springs. The National Union of Mine Workers (Num), in partnership with Aunim institute for Health Research, initiated the campaign to create awareness among its members and with an attendance of more than 4 000 people, organisers hailed it a phenomenal success.
"With the forthcoming 2010 World Cup, there is a lot of construction activity in the country and due to the occupational TB exposure to our members, we need to undertake a campaign to foster awareness of such exposure," Num organiser Charles Mkhumane said.
Mkhumane also said through these campaigns, he hopes to encourage mine staff to act responsibly, eliminate exposure and take proper control of hazardous chemicals. Miners were urged to take TB tests, mobilise against environmental pollution and the use of asbestos, which is one of the major causes of lung diseases
Gauteng Department of Health official Thandi Chaane said while the campaign was well received, she reiterated that people must get tested for both TB and HIV as the two are closely related. Following Chaane's message, 106 people were tested for HIV, 45 were screened for TB, 177 had their blood pressure checked, 57 tested their blood sugar and a total of 8 500 condoms were handed out.
The campaign is expected to be extended to other construction sites and mines outside Gauteng, especially where the 2010 Soccer World Cup stadium construction is happening.
The Aurum institute acknowledges that this article was taken from "Die Springs Advertedrder"
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AURUM INSTITUTE SOUTH AFRICA WINS TOP RESEARCH AWARD
7 September 2007 |
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At a gala event held at London's Gibson Hall last night, the Aurum Institute for Health Research (Aurum), a Proudly South African independent research organisation, won a prestigious international award for good clinical practice in clinical research. The 2007 inaugural GCPj Awards were developed by The Good Clinical Practice Journal to recognise excellence in the clinical trials industry.
The award was made for the Thibela TB study being conducted by Aurum into new strategies for the prevention of tuberculosis in gold miners. The organisation received the award in the category: Most Innovative Patient Recruitment Strategy. Aurum was also a runner up in the category of Clinical Research Programme which Best Promoted Access to Medicine.
Receiving the award on behalf of the organisation, Aurum's CEO Prof Gavin Churchyard said: "Just to have been nominated for these awards is an honour, but to have actually won an award in such prestigious company is fantastic! We are really pleased and grateful to the GCPj for recognising our work in this way."
"This award is a tribute to the unique community ownership of the Thibela study by all the stakeholders in this ambitious project: the National Union of Mineworkers, mine management, the Mine Health and Safety Council, Aurum's Thibela TB leadership and team, and the thousands of mineworkers taking part", commented Dr Dave Clark, Aurum's Executive Director of Operations. "We look forward to the day when TB is eradicated from South African communities through approaches based on the Thibela TB study results", said Clark.
At the same event in London, the award for the Most Successful Global Clinical Trial was won by Pfizer Global Research and Development, whilst Novartis Pharma AG was adjudged the Best Clinical Research Team.
Photos from the gala event:
About the Aurum Institute for Health Research
Aurum is an internationally recognised, specialist research and health systems management organisation, focused on TB and HIV/AIDS prevention, treatment and care. It is based in Johannesburg and has research and treatment sites throughout South Africa.
Contact:
For more information or to schedule interviews, contact:
Mambrie May,
Fleishman Hillard,
Johannesburg +27 11 548 2041 or +27 82 782 0985 or ;
or
Dr Dave Clark,
Aurum Institute,
Johannesburg +27 11 638 2604 or +27 82 556 5536 or .
For more information about the Aurum Institute for Health Research, see www.auruminstitute.org
For more information on the GCPj Awards, see www.gcpjawards.com
For more information on The Good Clinical Practice Journal, see www.gcpj.com
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PROMISING RESULTS IN HIV VACCINE STUDY
3 September 2007 |
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Preliminary results of an HIV vaccine study look promising; this is according to Gavin Churchyard, CEO of Aurum Institute for Health Research.
The vaccine HVTN 204 is expected to strengthen the immune system of infected persons, thus slowing down the progression of the HI virus into full-blown Aids. The vaccine will also reduce the amount of the virus circulating in the blood of newly infected persons, thus curbing the spread of HIV from person to person.
The study, which commenced in August 2006, has now reached the end of the second phase which is aimed at determining the safety of the vaccine as well as its ability to generate an immune response. The vaccine was tested on 480 HIV-negative adults between ages 18 to 50, 240 of whom were from South Africa.
Churchyard was pleased to report that the majority of those who participated in the clinical test experienced positive immune responses, providing strong support for the study to move into the third phase where efficacy is tested.
“The development of a vaccine is particularly important in countries such as South Africa, where behavioural interventions have failed to have significant mass results,” says Churchyard. “Vaccines would not be reliant on human behaviour and would be cost-effective as they are incredibly cheap to produce in bulk,” he adds.
The study will soon be entering into phase three but South Africans will have to wait at least seven more years before the vaccine becomes available. “We still have a long way to go, but vaccines are the best bet to fighting HIV,” says Churchyard.
Aurum acknowledges South Africa The Good News as the source of this article
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AURUM SIGNS SUPPORT MOU WITH DCS JHB
7 February 2007 |
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Aurum is pleased to announce that it has concluded a Memorandum of Understanding with the Department of Correctional Services - Johannesburg to provide support services to the DCS - Jhb HIV/TB Programme.
The project, in cooperation with The Department of Health, seeks to usher in a new approach to HIV/AIDS and TB care in Johannesburg prison.
The parties will now develop a model for care provision to culminate in a fully accredited HIV/AIDS and TB clinic at the correctional facilities.
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MINISTER VISITS THIBELA TB
2006-10-19 |
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The Minister of Minerals and Energy, the Honourable Ms Buyelwa Patience Sonjica, paid a welcome visit to the Thibela TB site at Tau Tona Gold Mine in Carletonville on Thursday 19th October 2006.
Thibela team members were excited to receive the Minister and eagerly showed her around the research facility where over 2,000 mineworkers are now taking Isonaizid, an anti-tuberculosis drug to prevent the development and the spread of the disease.
In addressing the gathering of Thibela healthcare workers, mine management, unions and associations as well as representatives of the Mine Health and Safety Council, the Minister praised all the stakeholders for their support of this project to rid the mines of TB once and for all. She also thanked especially the mineworkers who daily are lining up to volunteer for the study and be counted to Prevent TB.
The Thibela TB project is scheduled to broaden to Great Noligwa Mine in Orkney in the North West Province early in November 2006.
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XDR TUBERCULOSIS SYMPOSIUM
2006-09-29 |
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An Update for the South African Mining Industry.
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VENUE:
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Pharmaceutical Society of SA Conference Facility
52 Glenhove Road, Melrose, Johannesburg
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DATE:
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29th September 2006
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COST:
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R395 +VAT per delegate
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REGISTRATION:
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08h00 – 09h00
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PROGRAMME RUNS:
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09h00 – 15h00 (includes a light lunch)
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Click here for more information regarding the symposium.
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THIBELA NEWS FLASH: ORKNEY INITIATED AND ENROLLING! WELL DONE TO THIBELA ORKNEY
2006-08-10 |
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Congratulations to our THIBELA Team in Orkney who, together with key stakeholders and workers at the Great Noligwa Mine, gathered to the beat of drums that formed part of a roadshow to initiate an auspicious event on the 10th of August. Orkney initiated and enrolling!
Mine management, organised labour, municipal management, mine health services, advisory group and peer educators were all represented at the event. After some entertaining crowd games hosted by the mines, the Thibela staff danced to the tune of the Thibela song, explaining the different aspects of Thibela TB study to the audience. The mayor, the mine manager and the NUM spokesperson endorsed the project and confirmed its significance.
The official Thibela drama was staged by our now well known Emzini wezinsizwa actors, followed by a Q&A session that saw correct answers being rewarded with the signature Thibela T-shirt. The event ended at 17h30 with a very pleased and satisfied audience, as confirmed by a congratulatory communication from the mayor's office the next day.
Our THIBELA Team followed this up by initiating recruitment into the Baseline Prevalence Survey on the 17th of August and we are pleased to report that all is going according to expectations.
Well done to Kathy and her Team, as well as our project team supporting the regions!
Viva Thibela, Viva!!
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ANGLOGOLD ASHANTI FUND DONATES ONE MILLION RAND TO THE AURUM INSTITUTE
2006-08-01 |
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Aurum is excited to announce that it has received One Million Rand donation from the AngloGold Ashanti Fund towards the core funding of the non-profit organisation.
In handing over the cheque from the Fund, Dr Brian Chicksen, AngloGold Ashanti's medical consultant, said: "This donation represents a parting grant towards the sustainability of the organisation AngloGold Ashanti created. We wish you a successful future as you grow your independent status."
Aurum's chairman, Dr Paul Davis, responded with thanks and noted that "The gracious support by AngloGold Ashanti will position Aurum favorably to seek out and motivate further grants and donations from other organisations that recognize the importance of the work being conducted at Aurum to improve health for all people in South Africa."
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AURUM STARTS FIRST HIV VACCINE TRIAL IN THE NORTH WEST
2006-07-25 |
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Aurum is delighted to announce that the first HIV vaccine trial (HVTN204) has started in the North West Province at its clinic in Klerksdorp, part of the Matlosana District.
Aurum starts first HIV vaccine trial in the North West This great news heralds a new hope for communities ravaged by HIV and is the culmination of years of preparation by Aurum and the community for the big day. Excited Aurum staff gathered from early to put the final preparations in place to welcome the first volunteer to be registered on the programme and scientists from the HIV Vaccine Trials Network in the USA were on site to witness the event.
Prof Gavin Churchyard, Aurum's CEO and the Principal Investigator for the site said: "This is a groundbreaking achievement for Aurum and the community. We are proud to be part of the international quest for an effective HIV Vaccine: the world's best hope to end AIDS, and we invite members of the community and other interested groups to visit us here and be part of that hope."
The site project manager, Dr Mampedi Bogoshi, added her enthusiastic voice: "We have walked a long road to this event today, but the effort has been worth it. We are finally delivering on all the promises to the community and we thank them for all their support and patience during the past three years of preparation."
This study will continue for the next few months and will be followed up by another trial, HVTN 503 later this year.
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LIVING POSITIVELY WITH HIV/AIDS
2006-07-01 |
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Robin Hamilton
Introduction
A person who is tested and then diagnosed as HIV positive often goes through a profound psychological process before they are able to accept their status. This initial period varies in length from person to person, and often involves feelings of anger, sadness, fear, disbelief, blame, shock.
If the person is able to get access to non-judgemental and supportive counselling, they are much more likely to come to terms with their status and learn to live with HIV. It is important to understand that this process takes weeks or months, depending on the individual.
There is nevertheless a great deal a person living with HIV/AIDS can do to look after themselves in the period before they become sick enough to need ART. A person living with HIV/AIDS who looks after themselves will be healthy for longer, cope better emotionally, and be better prepared for ART.
Counselling on living positively
Many of the ideas utilised in living positively apply to people irrespective of their HIV status. These ideas are simple ideas of how to live a healthy lifestyle.
As health-care workers, we need to be realistic about the expectations they have of people living with HIV/AIDS in terms of lifestyle changes. How many of these ideas do we as health-care workers implement in our own lives? If we cannot make these changes in our own lives, are we being realistic in expecting people living with HIV/AIDS to make radical changes overnight?
Clearly not.
It is important when counselling a person living with HIV/AIDS not to bombard them with ideas. These ideas are best shared in small doses over a period of time. Encourage patients to realistically aim to make one or two small changes at a time.
Here are some ideas to offer people living with HIV/AIDS:
- Learn about the disease and become informed. Read about it and ask questions.
- Eat healthily. Avoid fatty foods, junk food, very spicy food, and food which is not prepared hygienically or which has been stored for a long time. Eat plenty of fresh vegetables, fruit, and well-cooked protein.
- Exercise moderately. Do exercise regularly that you enjoy, whether it is gym, soccer, walking, jogging or even gardening.
- Disclose your status to people you trust, including your partner. The support you get will really benefit you. It is worth the risk.
- Use condoms to avoid re-infection and avoid infecting others.
- Join a support group to learn more about living with HIV.
- Get a reasonable amount of sleep at night.
- Cut down on alcohol, drugs and smoking. All these are bad for your immune system.
- Take multivitamins and immune boosters. However, once you start ART, you need to cut out any other supplements.
- Develop your spirituality and religious faith. Get support from your church or faith group. Attend prayer meetings and take part in church activities, not to get cured, but to get the support and strength to face the disease.
- Ask your doctor or nurse questions about HIV/AIDS whenever you need to. You have a right to understand the disease and how you are treated.
- Learn to laugh. Laughing and having a sense of humour are very good boosts for the immune system.
- Talk to a counsellor if you find yourself struggling with the emotional difficulties of HIV/AIDS. It isn't a weakness to ask for help.
- Go for regular medical check-ups. If you do, you will stay healthy for longer.
- Get any medical problem or infection treated as soon as possible, to avoid it becoming a bigger problem.
- Learn to live with your disease. Learn that HIV/AIDS is NOT your whole life, and you have a life apart from the virus.
This study will continue for the next few months and will be followed up by another trial, HVTN 503 later this year.
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TRADITIONAL MEDICINES AND ART: SUGGESTIONS FOR COUNSELLING
2006-06-01 |
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Robin Hamilton
- Research conducted by the Aurum Institute has shown that up to 80% of black patients use traditional medicines at some point in their lives. Amongst white and coloured patients, many will use homeopathic and non-western medicines, whose interaction with ART is also often unclear.
- This means that many patients who are on ART are likely to be using traditional medicines alongside ART.
- It is not helpful to merely discourage patients from using traditional medicines and homeopathic remedies. If we do this, patients will hide their use. They will continue to use them but not tell health care workers about what they are doing.
- Some common remedies, such as garlic supplements and St John's wort, are helpful, even for HIV-positive patients. However, when a patient is on ART, these same remedies may interact with ART and reduce the levels of the ART drugs in the blood so that they are no longer effective.
- Not all traditional medicines are necessarily bad in combination with ART. The problem is that many traditional medicines are not fully understood by western medicine, and so we do not know what they contain or how they will interact with ART.
- One strategy that some counsellors have tried is to encourage patients who are not sure about whether to use traditional medicines or ART, to first try out traditional medicines. Then, if these do not improve the patient's health, the patient can return to the clinic and then try ART. This is a useful strategy if the patient is already ill but not too ill that he or she is likely to worsen rapidly.
- Some patients have heard this instruction from nurses: "Don't mix ART and traditional medicines". The patients then respond as follows: they take ART for some time according to the correct instructions. Then, when they want to take traditional medicines (perhaps for some other ailment), they stop ART for a while, take the traditional remedies, then resume ART when the traditional medicine is finished. The problem is that if they do this, especially more than once, the danger of resistance arises. Don't give this simplistic instruction!
- Rather tell patients as an overriding rule: whatever you do, don't miss doses of ART, even if you are taking traditional medicines. This golden rule is: never stop ART unless the doctor suggests this.
- Encourage patients to tell you about any traditional or homeopathic medicines they take, as well as over-the-counter remedies. Don't be disapproving - it is always better to be informed than not to know.
- The following forms of traditional medicines are likely to be less harmful, so we could encourage patients, where they take traditional medicines, to take these: medicines that are not swallowed or ingested, medicines rubbed into the skin, medicines that are burned as incense, rituals for healing.
- Encourage patients, where they find this helpful, to talk to their traditional healers about ART treatment, and to make use of the counselling and healing rituals offered by traditional healers.
- We need, too, to make contact with traditional healers in our areas, and to have two-way communication with them. This means informing them about ART and how it works, as well as listening to traditional healers talk about their own approaches.
- The better the relationship we have with traditional healers, the more they are likely to be supportive of patients on treatment, and the more adherent the patients will then be.
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UNDERSTANDING HIV/AIDS STIGMA
2006-06-01 |
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Robin Hamilton
Stigma and discrimination
Stigma can be defined as a mark of disgrace associated with a particular circumstance, quality or person.
Discrimination means make an unjust distinction in the treatment of different categories of people, especially on the grounds of race, sex, or age.
Stigma can be described as an attribute or quality that significantly 'discredits' an individual in the eyes of others. This means that people will look at someone and have a negative attitude towards that person because of a certain quality or characteristic, for example the person is known or suspected to be HIV-positive.
Stigma allows people living with HIV/AIDS (PLHA) to be treated differently from other people. This is what we mean by discrimination. Discrimination is a form of behaviour that results in unequal/unjustifiable treatment. It is important to note that stigmatising attitudes do not always translate into discrimination, but the effect of the negative attitude may still be damaging or hurtful to the PLHA.
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WORLD AIDS DAY: 1 DECEMBER
2005-12-01 |
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We stand with our treatment and research colleagues worldwide
in solidarity with all people living with the effects of HIV/AIDS.
Let us all act now!
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RESEARCH COULD REDUCE TB BY SIXTY PER CENT
2005-11-30 |
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In a world first, The Aurum Institute of Health, backed by the Mine Health and Safety Council and the Bill & Melinda Gates Foundation, is undertaking a massive research project on South Africa's gold mines which could provide the blueprint for reducing the incidence of TB by up to sixty per cent. It is called ThibelaTB, or "Prevent TB" in Southern Sotho.
Currently TB is soaring in southern Africa with some countries reporting a fourfold increase in disease incidence. On South Africa's gold mines, in spite of an intensive TB control programme, the incidence of the disease in recent years has more than doubled. Deaths from TB are twice as high as those caused by mining accidents.
CEO of The Aurum Institute, Professor Gavin Churchyard says these statistics are not so much a sign of failing strategies but rather a signal for new ones.
The Aurum Institute is embarking on a $14 million study which, ultimately, will mobilise about 60 000 participating miners on a voluntary basis. They will be divided randomly into two groups. The first will receive standard treatment while the second will receive both standard as well as preventative treatment in the form of one Isoniazid tablet a day for nine months.
"At a cost of R60 per person for this course of treatment, we regard this as highly cost-efficient," says Professor Churchyard.
According to computer models developed by Aurum Institute, together with prior evaluation of the medication, it is believed that this regimen will reduce the risk of TB in the research population by sixty per cent.
The object of this research is to reduce TB in communities with a high incidence of HIV and, in turn, to provide findings which could transform global policy. This would result in a major decline in TB admissions, deaths, lost productivity and compensation payments on South Africa's gold mines. Furthermore, the expertise could be exported to other sub-Saharan countries where TB is soaring as well as other countries in the world.
Aurum Health is doing just that by harnessing the co-operation of 60 000 gold miners to participate in the nine month long ThibelaTB field programme which will require volunteers to take one tablet of medication a day over this period and to attend regular monthly checks. Together with vanguard pilot studies and the analysis of data collected from the field, the results are only likely to emerge two years or so from now.
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THIBELA TB OFF TO A FLYING START!
2005-07-07 |
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Thibela TB off to a flying start! Over 100 volunteers arrived on the first day to sign up for INH and the number has been steady over the past 3 days. After months of preparation and getting systems in place, trained Thibela study workers were ready to welcome the first volunteer (see picture). Recruitment was done at the crush and hostel areas as well as access points, on a one-to-one basis as well as with loudhailers and posters at strategic points. After being explained the process in a group consent discussion, individuals were consented by Thibela study staff and consent signed, weighed by research assistants, sent off to Xray and after a final check up by a medical doctor the INH was dispensed. If TB suspects are found a sputum is taken and referral done to the medical station. Participants were given a calendar to mark their use of the INH as well as and ID card and return appointment. On first return visit in a months time They will be given a T-shirt. Part of the retention and adherence included campaigns, pick a box, a participant advisory group and ongoing use of peer educators. Participants will also be followed up by SMS and reminded to take their tablets and return in a month's time.
Thibela TB wishes to thank everyone who assisted us in reaching this important milestone! Your ongoing support is appreciated - and spread the word - Thibela TB is on the roll !!!
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CREATE RECEIVES PRESTIGIOUS GATES FOUNDATION GRANT
2005-06-23 |
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Aurum Health Research is proud to announce that it is to participate in a US $44.7 million grant from the Bill and Melinda Gates Foundation that has been awarded to the international Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE). The grant, to be supplemented by R2,7 million from the local Safety In Mines Research Advisory Council, will fund a new ground-breaking TB research study in the South African gold mining industry.
The study will be undertaken after extensive consultation with several gold mining companies, including AngloGold Ashanti, Gold Fields and Harmony, various labour unions and associations, the Departments of Health, Labour and Mineral and Energy, and in collaboration with international scientists from the Johns Hopkins University and the London School of Hygiene and Tropical Medicine.
Aurum Health Research, a subsidiary of AngloGold Ashanti, has been at the forefront of TB and HIV/AIDS research in South Africa for nearly eight years. It has made significant contributions to the international body of knowledge of these diseases, as well as to programmes to reduce their impact on the lives of working South Africans. Nonetheless, a comprehensive TB-control programme, which includes all aspects of the WHO's TB control strategy as well as X-ray screening, has still not reduced the rate of TB among gold miners, mainly because of the impact of the HIV/AIDS epidemic. Says Prof. Gavin Churchyard, head of Aurum Health, "CREATE was established in response to a growing recognition among international TB and HIV experts that innovative and even radical approaches to TB control will be necessary to reverse the trends in the rate of TB in the developing world."
The study aims to demonstrate that offering TB preventive therapy to all individuals in a community, in addition to a standard TB control programme, is an effective way of rapidly reducing the burden of TB, and can improve TB control in areas with a high burden of HIV/AIDS. If the intervention proves effective in reducing TB rates in this particular group, then the strategy could also be applied to other communities with similar high rates of TB and HIV.
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LUNG FUNCTION PREDICTION EQUATIONS DERIVED FROM HEALTHY SOUTH AFRICAN GOLD MINERS
2000-05-25 |
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OBJECTIVES
To estimate lung function prediction equations and to identify appropriate normal reference values for the population of about 250?000 of South African gold miners.
METHODS
Data from a lung function screening programme conducted at a large South African gold mine from 1994 to 1998 were used to estimate the lung function prediction equations. The most reliable period of lung function testing was identified in a previous study of a temporal pattern in reliability, and lung function tests from this period were used. Miners with a history of pulmonary tuberculosis or with radiological abnormalities were excluded from the study. The prediction equations were estimated cross sectionally on 15 772 black and 2752 white miners, and published reference equations that fitted most closely the observed data were identified.
RESULTS
The estimated prediction equations for forced vital capacity (FVC) are as follows: for black men, FVC (l)=- 2.901-0.025×age+4.655×height; and for white men, FVC(l)=-4.407-0.036×age+ 5.940×height. For forced expiratory volume in one second (FEV1) these equations are: for black men, FEV1(l)=-1.654- 0.30×age+3.665×height; and for white men, FEV1(l)= -2.341- 0.038×age+4.314×height. Units are years for age and metres for height. Knudson's and the European Community of Coal and Steel (ECCS) reference values provided the closest fit to the data on lung function of white miners, but the lower limits of normal from the ECCS equations were the closest to the observed one sided lower 95% confidence intervals (95% CIs). For black miners, reference equations that fitted best were derived by Louw et alon asymptomatic black South African men unexposed to occupational dust. There were significant differences between the two groups of miners in the estimated height adjusted mean lung function values for a 40 year old 1.7 m tall man (220 ml (5.2%) for FVC and 110 ml (3.2%) for FEV1); white men had higher FVC and FEV1, but lower FEV1/FVC ratio. The ECCS reference values scaled by a conversion factor of 0.93 for the FVC and 0.95 for the FEV1provided close fits to the data for black miners, but the rate of decline with age was higher than that in the observed data. None of the linear equations provided a good fit for the 20–29 and more than 55 years old age categories.
CONCLUSION
The ECCS and Knudson equations provided the best fit to the data for white miners, whereas the equations by Louw et alestimated on asymptomatic black South African bank workers provided the best fit to the data for black miners. The ECCS reference values scaled by a factor of 0.93 for FVC and by 0.95 for FEV1 provided close fits, but the rate of decline with age was higher than that in the data for black miners.
Aurum acknowledges BJM as the source of this piece
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