Low birth weight to emerges big killer

Along With Premature Births, It Caused 55% Of Neonatal Deaths In 2015: Lancet

Low birth weight and pre mature births, the top cause of death for new born babies in India,

has steadily risen from 12.3 per 1,000 live births in 2000 to 14.3 by 2015. With other major

causes of neonatal mortality falling significantly , low birth weight and prematurity accounted

for about 55% of all neonatal deaths in 2015 compared to around a quarter in 2000, according

to a Lancet study .

Back-of the envelope calculations show that if the rate of mortality due to babies being born

too small or too early had remained the same in 2015 as in 2000, about half a lakh fewer

babies would have died that year.

Poor nutrition of mothers, under-age motherhood and inadequate pre-natal care are the major

causes for underweight or premature babies. Three causes -prematurity or low birth weight,

neonatal infections, and birth asphyxia or trauma -accounted for more than three-quarters of

neonatal deaths in 2000. Of these, neo natal infections and birth asphyxia or trauma fell

dramatically over the next 15 years in both rural and urban areas, rich and poor states.

However, prematurity or low birth weight mortality rates rose in rural areas from 13·2 per

1,000 live births in 2000 to 17 in 2015 and in poorer states from 11·3 to 17·8. They fell in

urban areas and richer states, but that wasn't enough to offset the damage.

In a clear indication of the effect of maternal malnutrition, the study found that most of the

increase in prematurity or low birth weight deaths was happening in babies born at full term

but with low birth weight and not in premature babies.

The study was based on data gathered as a part of the ongoing Million Death Study (MDS),

in which the Registrar General of India's surveyors do verbal autopsies of the deaths that

occurred after the previous census round. A verbal autopsy involves surveyors asking

detailed questions on the circumstances in which a death took place. Trained physicians then

study these autopsies and assign cause of death. The MDS captured 94,309 child deaths

(52,252 neonatal deaths and 42,057 deaths at ages 159 months) from 2001to 2013.

The study observed marked variation in the trends in mortality rates from prematurity or low

Birth weight, with increases in the rates in Madhya Pradesh, Uttar Pradesh, Rajasthan, Bihar,

Punjab, and Haryana, but declines in Odisha, Assam and most of the richer states. The study

revealed that annual mortality rate declines were faster in under-five children than among

newborns. Child mortality rates in India have substantially reduced since 2000, with the

steepest decline in 201015.

Source: The Times of India

Scientists see global threat as ‘super malaria’ spreads in South-East Asia

This form of malaria cannot be treated with existing anti-malarial drugs, reports the BBC

The rapid spread of “super malaria” in South-East Asia is an alarming global threat, scientists

have warned.

This dangerous form of the malaria parasite cannot be killed with existing anti-malarial

drugs, the BBC reported on Saturday.

It emerged in Cambodia but has since spread through parts of Thailand, Laos and has arrived

in southern Vietnam.

The team at the Oxford Tropical Medicine Research Unit in Bangkok said there was a real

danger of malaria becoming untreatable.

Professor Arjen Dondorp, the head of the unit, told the BBC: “We think it is a serious threat.

It is alarming that this strain is spreading so quickly through the whole region and we fear it

can spread further [and eventually] jump to Africa.”

In a letter, published in The Lancet Infectious Diseases, the researchers detailed the “recent

sinister development” that has seen resistance to the drug artemisinin emerge.

Major killer of children

About 212 million people are infected with malaria each year. It is caused by a parasite that is

spread by blood-sucking mosquitoes and is a major killer of children, the BBC has reported.

The first choice treatment for malaria is artemisinin in combination with piperaquine.

But as artemisinin has become less effective, the parasite has now evolved to resist

piperaquine too.

There have now been “alarming rates of failure,” the letter said.

Professor Dondorp said the treatment was failing around a third of the time in Vietnam while

in some regions of Cambodia the failure rate was closer to 60 per cent.

Could be cataclysm in Africa

Resistance to the drugs would be catastrophic in Africa, where 92 per cent of

Malaria cases happen.

Source: The Hindu

Non-communicable diseases cause 61% of deaths in India: WHO report

Cardiovascular Diseases Most Lethal Killers

Nearly 61% of deaths in India are now attributed to non-communicable diseases (NCDs),

including heart disorders, cancer and diabetes, according to data released by the World

Health Organisation (WHO) on Monday .Almost 23% of the population is at risk of

premature death due to such diseases.

The UN agency has warned countries, including India, against premature deaths caused by

NCDs and said governments must immediately step up efforts to tackle them. “Limited 

national progress has been made in the fight against NCDs -primarily cardiovascular and

chronic respiratory diseases, cancers and diabetes -which are the world's biggest killers, and

claim the lives of 15 million people aged 30 to 70 years annually,“ the WHO said.

According to the data, NCDs are responsible for 70% of deaths worldwide. In India, diseases

like cancer, diabetes and heart problems were estimated to have killed a total of 58,17,000

people in 2016. While the percentage of deaths from NCDs is still lower in India as compared

to many other countries, experts are concerned the burden is rapidly increasing because of

changing lifestyles and factors like pollution, and tobacco and alcohol consumption.

Four risk factors responsible for a significant proportion of these diseases are tobacco use,

unhealthy diet, physical inactivity, and harmful use of alcohol. The major metabolic risk

factors are obesity , raised blood pressure, raised blood glucose and raised blood cholesterol

levels, the report says.

Cardiovascular diseases (coronary heart disease, stroke, and hypertension) contribute to 45%

of all NCD deaths, followed by chronic respiratory disease (22%), cancer (12%) and diabetes

(3%).

Cancer, diabetes and heart diseases alone account for 55% of all premature deaths in India in

the age group of 30-69 years.

“Bolder political action is needed to address constraints in controlling NCDs, including the

mobilisation of domestic and external resources and safeguarding communities from

interference by powerful economic operators,“ said Tedros Adhanom Ghebreyesus, 

director general of WHO.

Of late, the health ministry has initiated several measures to tackle the increasing burden of

NCDs. For instance, the ministry has started a massive free door-to-door screening

programme for early detection of cancer, heart disorders and diabetes. The programme,

flagged off in February , aims to cover 200 districts by 2018.The government has also started

schemes to set up cancer centers across the country. While 31 such hospitals have already

been built, 49 more are to be set up by 2020.

Source : The Times of India

NO QUICK-FIX SOLUTION - Don't use packaged food to fight malnutrition: Govt

The women and child development ministry has written to all states and UTs that there isn't

enough evidence to support the use of Ready-to-Use-Therapeutic foods (RUTF) for the

management of severe acute malnutrition (SAM). This is a blow to the multi-crore complex

of international NGOs, who push packaged food as a strategy to address severe malnutrition

and firms that produce them.

The WCD letter pointed to the concern that “use of RUTF may replace nutritional best

practices and family foods that children should normally be eating“. It said this could impact

negatively on continued breastfeeding in children older than six months and undermine the

importance of providing nutritional counselling.

The letter referred to the health ministry's February 2009 letter that categorically stated that

the use of RUTF for management of malnutrition is not an accepted policy of the government

and that its instructions in this respect should be “strictly complied with“. Recently,

responding to public health activists and paediatricians protesting against the promotion of

commercially produced RUTF for treating SAM, the health ministry had stated that it was

only “temporarily helpful for nutritional rehabilitation“ and not of benefit to “a common

household in developing appropriate food habits for children as against home augmented

food“. The health ministry added that based on these findings of the SAM alliance

constituted by the government, which includes the department of biotechnology and ICMR, it

had concluded that what was required was a “comprehensive family-centric approach

involving care-givers instead of a food centric approach“.

Published studies set in India repeatedly showed that RUTF, which showed remarkable

results in treating children with SAM in Africa, has proved much less effective in trials here.

This had prompted paediatricians and nutritionists to write a letter to the PM cautioning

against “quick fixes“ of buying commercial products instead of focusing on sustainable

measures such as care support for mothers, clean drinking water and food security .

International organisations pushing RUTF as a strategy include Unicef and the Global

Alliance for Improved Nutrition (GAIN), whose donors include governments of countries

such as the US, UK, Canada and France and the Bill and Melinda Gates Foundations. GAIN

also has alliances with food MNCs. These organisations have funded pilot projects and

persuaded states to use pre-packaged energydense pastes to fight SAM.

Source : The Times of India

Pen-like tool can spot cancer cells `in seconds'

One of the biggest worries for patients undergoing cancer surgery is whether surgeons will

miss some of the diseased tissue. That worry could be over with a new pencil-sized tool

developed by scientists and engineers at the University of Texas at Austin, according to a

study published on Wednesday.

The tool, dubbed the MasSpec Pen, allows surgeons removing a tumor to detect cancerous

cells in tissues in seconds, allowing them to know immediately if they have found and

removed all of the cancer.

Currently , it can take days to determine if the surgeons got everything. What they miss

could lead to a return of the cancer. The study in `Science Translational Medicine' said when

the pen is touched to a tissue during surgery , it draws up small molecules to be analysed by a

miniaturised mass spectrometer built inside the stylus. The pen can identify cancerous cells

through distinct molecules called metabolites. That identifies any residual cancer, with a

monitor linked to the pen declaring “normal“ or “cancer“. Tests on tissues removed from 253

human cancer patients showed the new tool was “more than 96% accurate“, according to the

study.

Source: The Times of India