Health and Fitness Magazine
3/4/07
Wireless: Cellphones open front in global fight against disease
By Thomas Crampton
PARIS: To Rwanda's top HIV/AIDS official, communication within the national health care system can be slow enough to present an actual threat to health.
"Information from clinics is written on a piece of paper that a porter carries by hand to the district before the information can be brought to Kigali," said Dr. Innocent Nyaruhirira, who holds the cabinet-level post of minister for HIV/AIDS. "We are a country of one thousand hills, so it often takes one month to receive a message from the field about a disease outbreak or drug shortage."
The travel time cripples drug-supply management, prevents live tracking of disease outbreaks, undermines monitoring of health programs and delays delivery of laboratory test results back to patients.
Enter Voxiva, a U.S. company that has built a system for individual health workers to send reports by cellphone directly from the field. First deployed five years ago to track disease outbreaks in the Amazon basin, Voxiva's system is also being used in Indonesia for avian flu reporting and in India to test a new drug for leishmaniasis, a disease spread by sand flies.
In Rwanda, the system started tracking HIV/AIDS patients two years ago and now connects 75 percent of the country's 340 clinics, covering a total of 32,000 patients.
"By identifying individual patients in a central database, we can now follow up on individual patients, even when they change clinics," Nyaruhirira said. "The wonderful thing with Rwanda is that mobile phones are everywhere."
Leveraging use of mobile phones makes sense across the developing world, said Howard Zuckerman, assistant director general of health technology and pharmaceuticals at the World Health Organization.
"I was recently in Mozambique and saw a child who looked extremely malnourished, and unwashed standing next to a stream with dirty water," Zuckerman said. "The remarkable thing is that this same child was speaking on a mobile phone."
Phones could also fight the growing scourge of counterfeit pharmaceuticals, Zuckerman added.
"SMS messages could be used by patients to authenticate code numbers on individual bottles," he said. "We have only barely started exploring the uses for mobile phones in public health."
Hosted on servers in Kigali owned by the South African telecommunications operator MTN, the Rwanda system gets field clinic reports via cellphone text message, a voice-call system or on the Internet using a computer or Internet-enabled cellphone.
Each time a new patient enters the system, the information is sent in, while weekly reports cover data like the clinic's stocks of drugs and monthly reports cover the number of patients under treatment. Clinics receive messages including the results of laboratory tests and drug recall alerts sent by the Ministry of Health.
"Large companies use a series of integrated systems along with e-mail to communicate among their employees and customers around the world," said Paul Meyer, co-founder and chairman of Voxiva, which is based in Washington. "We have shown you can accomplish the same thing with nothing more than cellphones."
As the data are compiled, district health officials see reports on diseases in their regions, central warehouses can see drug shortages at clinics, while the Health Ministry gets an overall view of disease cases across the nation.
By reaching down to the level of field clinics, the system increases accountability for drug deliveries, said Mark Dybul, who heads the U.S. President's Emergency Plan for AIDS Relief.
"This level of accountability allows us to go back to the U.S. Congress and show where money has been spent," Dybul said. "You will eventually see additional benefits outside the realm of health care when you introduce this kind of information sharing."
A project between the WHO, GSM Association, the U.S. government and Voxiva will bring the system to 10 African nations by 2010.
For all the benefits, however, Nyaruhirira warns that implementation is not easy. "Health care workers have strong habits," he said. "People like me are so beloved of our hand notes that we must train a new generation of nurses and doctors that are comfortable with the mobile phone."
Copyright © 2007 the International Herald Tribune All rights reserved
¶ 8:06 PM 0 Comments
By Thomas Crampton
PARIS: To Rwanda's top HIV/AIDS official, communication within the national health care system can be slow enough to present an actual threat to health.
"Information from clinics is written on a piece of paper that a porter carries by hand to the district before the information can be brought to Kigali," said Dr. Innocent Nyaruhirira, who holds the cabinet-level post of minister for HIV/AIDS. "We are a country of one thousand hills, so it often takes one month to receive a message from the field about a disease outbreak or drug shortage."
The travel time cripples drug-supply management, prevents live tracking of disease outbreaks, undermines monitoring of health programs and delays delivery of laboratory test results back to patients.
Enter Voxiva, a U.S. company that has built a system for individual health workers to send reports by cellphone directly from the field. First deployed five years ago to track disease outbreaks in the Amazon basin, Voxiva's system is also being used in Indonesia for avian flu reporting and in India to test a new drug for leishmaniasis, a disease spread by sand flies.
In Rwanda, the system started tracking HIV/AIDS patients two years ago and now connects 75 percent of the country's 340 clinics, covering a total of 32,000 patients.
"By identifying individual patients in a central database, we can now follow up on individual patients, even when they change clinics," Nyaruhirira said. "The wonderful thing with Rwanda is that mobile phones are everywhere."
Leveraging use of mobile phones makes sense across the developing world, said Howard Zuckerman, assistant director general of health technology and pharmaceuticals at the World Health Organization.
"I was recently in Mozambique and saw a child who looked extremely malnourished, and unwashed standing next to a stream with dirty water," Zuckerman said. "The remarkable thing is that this same child was speaking on a mobile phone."
Phones could also fight the growing scourge of counterfeit pharmaceuticals, Zuckerman added.
"SMS messages could be used by patients to authenticate code numbers on individual bottles," he said. "We have only barely started exploring the uses for mobile phones in public health."
Hosted on servers in Kigali owned by the South African telecommunications operator MTN, the Rwanda system gets field clinic reports via cellphone text message, a voice-call system or on the Internet using a computer or Internet-enabled cellphone.
Each time a new patient enters the system, the information is sent in, while weekly reports cover data like the clinic's stocks of drugs and monthly reports cover the number of patients under treatment. Clinics receive messages including the results of laboratory tests and drug recall alerts sent by the Ministry of Health.
"Large companies use a series of integrated systems along with e-mail to communicate among their employees and customers around the world," said Paul Meyer, co-founder and chairman of Voxiva, which is based in Washington. "We have shown you can accomplish the same thing with nothing more than cellphones."
As the data are compiled, district health officials see reports on diseases in their regions, central warehouses can see drug shortages at clinics, while the Health Ministry gets an overall view of disease cases across the nation.
By reaching down to the level of field clinics, the system increases accountability for drug deliveries, said Mark Dybul, who heads the U.S. President's Emergency Plan for AIDS Relief.
"This level of accountability allows us to go back to the U.S. Congress and show where money has been spent," Dybul said. "You will eventually see additional benefits outside the realm of health care when you introduce this kind of information sharing."
A project between the WHO, GSM Association, the U.S. government and Voxiva will bring the system to 10 African nations by 2010.
For all the benefits, however, Nyaruhirira warns that implementation is not easy. "Health care workers have strong habits," he said. "People like me are so beloved of our hand notes that we must train a new generation of nurses and doctors that are comfortable with the mobile phone."
Copyright © 2007 the International Herald Tribune All rights reserved
Labels: Cellphones, Disease, Wireless
¶ 8:06 PM 0 Comments
Gum Disease Leads To Heart Problems
Gum Disease Leads To Heart Problems – New Discovery Finds Improving Periodontal Health Keeps Artery Plaque From Building Up
(Best Syndication) Although previous research found a link between periodontitis and heard disease, researchers were not sure whether gum disease caused heart disease, or both were caused by the same inflammation. There were a lot of questions. Back in 2004 the American Academy of Periodontology reported that people with periodontal gum disease were twice as likely to suffer from coronary artery disease as those without periodontal disease. But the new research is getting us closer to answering that question.
At that time they had two theories. The first theory was that oral bacteria affected the heart after entering the blood stream. These bacteria could possibly contribute to “clot formation”. The other theory was that “inflammation caused by periodontal disease increases plaque build-up.” This could cause the arteries to swell up. At that time they noted that people with periodontal disease were also at higher risk for stroke.
Researchers in London and the U.S. treated patients with periodontal disease and found that this treatment “directly improves the health of blood vessels.” These clinical trials proved that relieving the inflammation in the mouth improve function of the arteries.
Dr Francesco D'Aiuto, project leader and therapist, University College of London (UCL) Eastman Dental Institute, explained the research. "Middle-aged subjects with severe periodontitis, but no evidence of cardiovascular disease, were randomly allocated to dental treatments of two levels of intensity. After six months, those who received the more intensive periodontitis treatment, which resulted in a marked improvement in their gum disease, also demonstrated a significant restoration of blood vessel function.
"The intensive treatment involved removal of plaque through scaling and root planning techniques, as well as extraction of teeth that could not be saved. This initially resulted in some inflammation and dysfunction of the blood vessels and arteries. However, that was short-lived and six months later the treatment led to an improvement in both oral health and arterial function."
So treating gums may save lives. Dr Aroon Hingorani, UCL Division of Medicine, a co-author on the study said "Elevations in blood pressure and cholesterol, as well as smoking and diabetes, are recognized as the main risk factors for cardiovascular disease, and these can be effectively treated. Nevertheless, heart attacks and stroke remain a major cause of disability and death. Intriguing links have emerged between inflammation and heart disease and so it is important to better understand the nature of this connection, and whether it could lead to the development of new treatments. The current study points to disease of the gums as a potential source of this inflammation."
But not all of the questions have been answered. The researchers said that the mechanism by which periodontitis affects endothelial function in the body is still uncertain. The gum disease involves a bacterial infection that invades the tissue around the teeth. One possibility is that the bacteria disturb endothelial function directly, since some bacteria can enter the bloodstream. Alternatively, the periodontitis might trigger a low grade inflammatory response throughout the body that has a detrimental effect on the vascular wall.
Professor John Deanfield, senior author, UCL Institute of Child Health said "Previous studies have shown an association between periodontitis and blood vessel dysfunction, heart attack and stroke. However, a clinical trial was required to test whether these links could be causal. This is the first time that a direct link has been made between treatment for gum disease and improved circulatory function, which is relevant to some of the UK's biggest killers: heart attack and stroke."
The research is published in the latest edition of the New England Journal of Medicine (NEJM).
See what others are saying and join the discussion at our Forum
By Dan WilsonBest Syndication Writer
¶ 3:55 AM 0 Comments
Gum Disease Leads To Heart Problems – New Discovery Finds Improving Periodontal Health Keeps Artery Plaque From Building Up
(Best Syndication) Although previous research found a link between periodontitis and heard disease, researchers were not sure whether gum disease caused heart disease, or both were caused by the same inflammation. There were a lot of questions. Back in 2004 the American Academy of Periodontology reported that people with periodontal gum disease were twice as likely to suffer from coronary artery disease as those without periodontal disease. But the new research is getting us closer to answering that question.
At that time they had two theories. The first theory was that oral bacteria affected the heart after entering the blood stream. These bacteria could possibly contribute to “clot formation”. The other theory was that “inflammation caused by periodontal disease increases plaque build-up.” This could cause the arteries to swell up. At that time they noted that people with periodontal disease were also at higher risk for stroke.
Researchers in London and the U.S. treated patients with periodontal disease and found that this treatment “directly improves the health of blood vessels.” These clinical trials proved that relieving the inflammation in the mouth improve function of the arteries.
Dr Francesco D'Aiuto, project leader and therapist, University College of London (UCL) Eastman Dental Institute, explained the research. "Middle-aged subjects with severe periodontitis, but no evidence of cardiovascular disease, were randomly allocated to dental treatments of two levels of intensity. After six months, those who received the more intensive periodontitis treatment, which resulted in a marked improvement in their gum disease, also demonstrated a significant restoration of blood vessel function.
"The intensive treatment involved removal of plaque through scaling and root planning techniques, as well as extraction of teeth that could not be saved. This initially resulted in some inflammation and dysfunction of the blood vessels and arteries. However, that was short-lived and six months later the treatment led to an improvement in both oral health and arterial function."
So treating gums may save lives. Dr Aroon Hingorani, UCL Division of Medicine, a co-author on the study said "Elevations in blood pressure and cholesterol, as well as smoking and diabetes, are recognized as the main risk factors for cardiovascular disease, and these can be effectively treated. Nevertheless, heart attacks and stroke remain a major cause of disability and death. Intriguing links have emerged between inflammation and heart disease and so it is important to better understand the nature of this connection, and whether it could lead to the development of new treatments. The current study points to disease of the gums as a potential source of this inflammation."
But not all of the questions have been answered. The researchers said that the mechanism by which periodontitis affects endothelial function in the body is still uncertain. The gum disease involves a bacterial infection that invades the tissue around the teeth. One possibility is that the bacteria disturb endothelial function directly, since some bacteria can enter the bloodstream. Alternatively, the periodontitis might trigger a low grade inflammatory response throughout the body that has a detrimental effect on the vascular wall.
Professor John Deanfield, senior author, UCL Institute of Child Health said "Previous studies have shown an association between periodontitis and blood vessel dysfunction, heart attack and stroke. However, a clinical trial was required to test whether these links could be causal. This is the first time that a direct link has been made between treatment for gum disease and improved circulatory function, which is relevant to some of the UK's biggest killers: heart attack and stroke."
The research is published in the latest edition of the New England Journal of Medicine (NEJM).
See what others are saying and join the discussion at our Forum
By Dan WilsonBest Syndication Writer
Labels: Disease, Gum, Heart Problems
¶ 3:55 AM 0 Comments
