The U.S. plans to launch a program to train health care workers in Mozambique in an effort to strengthen the country's health system and fight HIV/AIDS and malaria, Mozambican Health Minister Ivo Garrido announced Wednesday after a meeting with HHS Secretary Mike Leavitt and Mozambican President Armando Guebuza, AIM/AllAfrica reports (AIM/AllAfrica, 8/22). Leavitt and several U.S. officials are on a 10-day tour of four African countries to highlight programs funded by the President's Emergency Plan for AIDS Relief and the President's Malaria Initiative. Their first stop was South Africa, and they also plan to visit Rwanda and Tanzania (Kaiser Daily HIV/AIDS Report, 8/17).
Guebuza and Leavitt at the meeting discussed Mozambique's health infrastructure and ways to strengthen collaboration on health issues between the two countries. Garrido did not disclose further details on the training program but said priority will be given to health professionals working in rural areas in Mozambique. "We believe that we can do a lot more in this area, being the reason our discussions gravitated around issues such as training of human recourses," Garrido said.
Mozambique has a total of about 800 doctors, and there is about one doctor for every 24,000 residents, according to Garrido. This ratio is "frankly bad, when we consider that on average the developed countries have one doctor for less than 1,000 inhabitants," he said. Leavitt expressed his support for the country's efforts to fight HIV/AIDS and malaria, emphasizing that discussions held with Mozambican authorities will help both countries work together more closely. Current estimates show that Mozambique has an HIV/AIDS prevalence of 16.2%, and malaria is responsible for more than 40% of outpatient visits and 30% of deaths among people admitted to hospitals in the country (AIM/AllAfrica, 8/22).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
среда, 21 сентября 2011 г.
US Health Savings Accounts Attract Younger, Higher-Income FEHBP Members, Report Finds
Federal Employees Health Benefits Program members enrolled in high-deductible health plans associated with health savings accounts on average are younger than those enrolled in traditional plans and more likely to have annual incomes of $75,000 or more, according to a Government Accountability Office report released on Thursday, CQ HealthBeat reports. According to the report, which examined data for the first year in which HSAs became available in FEHBP, the average age of members who enrolled in high-deductible plans associated with HSAs was 46, compared with 59 for all members. In addition, the report finds that, when retirees are excluded, the average ages of FEHBP members who enrolled in high-deductible plans associated with HSAs was 44, compared with 47 for all members. However, according to the report, a new health plan unrelated to HSAs that recently became available in FEHBP also attracted a higher rate of younger members. The report states, "Thus it is not clear whether younger individuals were uniquely attracted to high deductible health plans, or if younger enrollees are typical of recently introduced health plans in general." The report finds that 43% of FEHBP members who enrolled in high-deductible plans associated with HSAs had annual incomes of $75,000 or more, compared with 23% of all members. According to the report, the results indicate that high-deductible plans associated with HSAs "uniquely attract higher-income individuals with the means to pay higher deductibles and the desire to accrue tax-free savings." The report also finds:
Cost-sharing for preventive care for FEHBP members enrolled in high-deductible plans associated with HSAs was "the same or less than (for) traditional plan enrollees and always covered certain preventive care services before the deductible was met," although the same services "were not always covered before the deductible by their traditional plan counterparts";
Traditional health plans were much more likely than high-deductible plans associated with HSAs to cover prescription drugs before the deductible was met; and
Monthly premiums for high-deductible health plans associated with HSAs averaged $91 for individuals and $208 for families, compared with $99 and $243, respectively, for traditional plans.
According to the report, more data is required to determine whether FEHBP members who enrolled in high-deductible plans associated with HSAs were healthier than all members. Rep. Pete Stark (D-Calif.) said the report "verifies" that high-deductible plans associated with HSAs "are designed for healthy, wealthy people," adding, "Despite this reality, President Bush is pushing them on low-income workers -- not to provide them with better health insurance, but to meet his long-term goal of dismantling employer-provided health care" (Reichard, CQ HealthBeat, 2/2).
The report is available online. Note: You must have Adobe Acrobat Reader to view the report.
Cost-sharing for preventive care for FEHBP members enrolled in high-deductible plans associated with HSAs was "the same or less than (for) traditional plan enrollees and always covered certain preventive care services before the deductible was met," although the same services "were not always covered before the deductible by their traditional plan counterparts";
Traditional health plans were much more likely than high-deductible plans associated with HSAs to cover prescription drugs before the deductible was met; and
Monthly premiums for high-deductible health plans associated with HSAs averaged $91 for individuals and $208 for families, compared with $99 and $243, respectively, for traditional plans.
According to the report, more data is required to determine whether FEHBP members who enrolled in high-deductible plans associated with HSAs were healthier than all members. Rep. Pete Stark (D-Calif.) said the report "verifies" that high-deductible plans associated with HSAs "are designed for healthy, wealthy people," adding, "Despite this reality, President Bush is pushing them on low-income workers -- not to provide them with better health insurance, but to meet his long-term goal of dismantling employer-provided health care" (Reichard, CQ HealthBeat, 2/2).
The report is available online. Note: You must have Adobe Acrobat Reader to view the report.
Benefits for Employers
In related news, the Wall Street Journal on Friday examined how HSAs "are generating savings on payroll taxes for companies that adopt them, and they could hasten a shift of health care costs from companies to employees." According to the Journal, HSAs might "be poised to become the 401(k)s of health care: a low-cost substitute for a once standard workplace-provided benefit." Employers receive tax benefits from HSAs, regardless of whether they "contribute a cent" to the accounts, and "the more of their own pay employees set aside each year, the bigger their employers' tax breaks" because of reduced payroll taxes, the Journal reports. According to Rebecca Miller, a tax specialist with McGladrey & Pullen, at a minimum payroll tax savings from HSAs "basically pay the administrative costs" of the accounts. Princeton University economist Uwe Reinhardt added that the payroll tax savings could provide employers with "an incentive to encourage contributions" to HSAs by employees. However, James Klein, president of the American Benefits Council, said, "In the scheme of what health care costs are, I doubt that would be a compelling reason to move to that kind of plan design" (Francis/Schultz, Wall Street Journal, 2/3).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
WHO EURO Region Ministerial Forum On TB Must Reach Out Beyond Borders Of Europe
The WHO EURO region's Ministerial Forum on tuberculosis on October 22, 2007, in Berlin, must take account of the threat of TB both outside as well as inside Europe if it is to be tackled adequately. These are the conclusions of authors of a Comment published in this week's edition of The Lancet.
The Comment is authored by Dr Bruce Currey, Professor Quazi Quamruzzaman, and Professor Mahmuder Rahman, Dhaka Community Hospital, Dhaka, Bangladesh. They say that in a 21st century that is becoming more and more global, to reduce the incidence of tuberculosis within Europe, European ministers must act together and act now, not simply to control, but also to eradicate poverty and tuberculosis in the source communities of Europe's migrant workers and major trade partners outside Europe. The Ministerial Forum must confront the raging red bull of tuberculosis infections outside Europe.
It goes on to say that the Berlin forum paper emphasises the 66 000 deaths from tuberculosis inside Europe in 2005, but overlooks the 1•6 million deaths outside Europe. It adds that radical reduction of the incidence of tuberculosis both inside and outside Europe requires prevention of the progression to new active cases as well as management of active cases. Eradication is possible, but not with drugs alone.
Further, it adds: "Trade and trade embargoes affect the incidence of tuberculosis. The Centres for Disease Control and Prevention has shown how radical intervention in the Hmong refugee centres of Thailand can reduce the incidence of tuberculosis and multidrug-resistant tuberculosis in the Hmong in Frenso, California."
The Comment authors propose a six-pronged approach to tackling the tuberculosis threat, including incorporating populations outside Europe, and the Forum accepting responsibility for actions such as arms trading and oil prices which increase inequality and tuberculosis incidence worldwide. The last of the six parts of the authors' suggested action calls on the Forum to get behind the UK Prime Minister's address to the UN in July 2007, to "act now" to tackle global poverty and "eradicate" the scourge of diseases such as tuberculosis, and his commitment that there are resources available to eradicate the disease.
The Comment concludes: "If the Berlin Ministerial Forum wishes to act now to eradicate tuberculosis, it must reach out far beyond the borders of Europe."
The Lancet
The Comment is authored by Dr Bruce Currey, Professor Quazi Quamruzzaman, and Professor Mahmuder Rahman, Dhaka Community Hospital, Dhaka, Bangladesh. They say that in a 21st century that is becoming more and more global, to reduce the incidence of tuberculosis within Europe, European ministers must act together and act now, not simply to control, but also to eradicate poverty and tuberculosis in the source communities of Europe's migrant workers and major trade partners outside Europe. The Ministerial Forum must confront the raging red bull of tuberculosis infections outside Europe.
It goes on to say that the Berlin forum paper emphasises the 66 000 deaths from tuberculosis inside Europe in 2005, but overlooks the 1•6 million deaths outside Europe. It adds that radical reduction of the incidence of tuberculosis both inside and outside Europe requires prevention of the progression to new active cases as well as management of active cases. Eradication is possible, but not with drugs alone.
Further, it adds: "Trade and trade embargoes affect the incidence of tuberculosis. The Centres for Disease Control and Prevention has shown how radical intervention in the Hmong refugee centres of Thailand can reduce the incidence of tuberculosis and multidrug-resistant tuberculosis in the Hmong in Frenso, California."
The Comment authors propose a six-pronged approach to tackling the tuberculosis threat, including incorporating populations outside Europe, and the Forum accepting responsibility for actions such as arms trading and oil prices which increase inequality and tuberculosis incidence worldwide. The last of the six parts of the authors' suggested action calls on the Forum to get behind the UK Prime Minister's address to the UN in July 2007, to "act now" to tackle global poverty and "eradicate" the scourge of diseases such as tuberculosis, and his commitment that there are resources available to eradicate the disease.
The Comment concludes: "If the Berlin Ministerial Forum wishes to act now to eradicate tuberculosis, it must reach out far beyond the borders of Europe."
The Lancet
Uterine Infection In Pregnant Women Linked With Asthma In Preterm Infants, Study Finds
A study published Tuesday in the Archives of Pediatric and Adolescent Medicine suggests that preterm infants born to women who had a uterine inflammation known as chorioamnionitis face an increased likelihood of developing asthma by age eight, USA Today reports (Rubin, USA Today, 2/2). Chorioamnionitis, a bacterial infection, affects roughly 8% of pregnancies and, by some estimates, is linked with more than 50% of preterm birth -- those before 37 weeks' gestation. Symptoms of the infection include a fever higher than 100.4 degrees, high maternal or fetal heart rate, uterine tenderness, foul-smelling amniotic fluid and elevated white blood-cell counts (Maugh, Los Angeles Times, 2/2). However, the condition can be difficult to diagnose because the symptoms are not definitive and might not occur in some women who have the infection, according to lead author Darios Getahun, a scientist at Kaiser Permanente Southern California's Department of Research and Evaluation (USA Today, 2/2).
Getahun's team reviewed electronic health records for 397,852 births in Southern California from 1991 to 2007 (Allen, Reuters, 2/1). Black children whose mothers gave birth before 37 weeks and had chorioamnionits were 50% more likely to develop asthma by age eight. The likelihood was more pronounced for Hispanic and white babies, who were 70% and 66% more likely to develop asthma, respectively. The increases persisted after researchers accounted for other asthma risk factors. The study found no link between higher asthma rates and chorioamnionitis in full-term births or preterm births among Asians or Pacific Islanders. Getahun's team is now trying to identify a marker in the woman's blood that could verify if symptoms are caused by chorioamnionitis (USA Today, 2/2).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2010 The Advisory Board Company. All rights reserved.
Upward Trend In Frequency And Cost Of Infections In US Hospitals
A new review of inpatient data from US hospitals shows that the number of infections caused by a common bacterium increased by over 7 percent each year from 1998 to 2003. The attendant economic burden to hospitals increased by nearly 12 percent annually. The research is published in the November 1 issue of Clinical Infectious Diseases, now available online.
Staphylococcus aureus (also known as staph) is a significant cause of a wide range of infectious diseases in humans, ranging from minor skin infections to life-threatening diseases such as pneumonia and meningitis. In 1998, US hospitals reported a little more than a quarter-million staph infections and slightly over 7 percent of those patients died. By the final year of this study, 2003, hospitals reported nearly 390,000 infections, representing 1 percent of that year's inpatient stays.
The authors suggest one possible reason for the increase in infections is the documented increase of a particularly dangerous type of antibiotic-resistant staph infection known as MRSA (methicillin-resistant Staphylococcus aureus). A more benign possibility is that doctors and hospitals have improved their infection detection and reporting practices.
The good news is that the staph-related in-hospital mortality rate dropped by almost 5 percent each year. The decrease in the in-hospital mortality risk may be due to the introduction of more stringent infection control programs or due to appropriate early treatment of MRSA infections with an effective antibiotic, the authors write.
Hospital expenditures associated with staph infections are substantial, increasing from $8.7 billion in 1998 to $14.5 billion in 2003. This economic burden incorporates such factors as extended length of hospitalization and additional surgery, medications, lab tests, and radiologic studies. Lead author Gary Noskin, MD, of Northwestern Memorial Hospital in Chicago, hypothesized that the reason the economic burden increased at a faster pace than the number of infections is because hospital costs are increasing more quickly.
The authors used data from the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample database, which contains data from approximately 7 million hospital stays annually.
Unfortunately, the authors were not able to determine the contribution of MRSA infections to costs or outcomes because hospitals generally use the same codes for MRSA and regular staph infections. "We do suggest that coding standards should be changed to more accurately reflect the difference between these two bacteria so we can better understand the impact of MRSA," said Dr. Noskin.
###
Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Arlington, Virginia, IDSA is a professional society representing more than 8,000 physicians and scientists who specialize in infectious diseases. For more information, visit idsociety/.
Source: Steve Baragona
Infectious Diseases Society of America
Staphylococcus aureus (also known as staph) is a significant cause of a wide range of infectious diseases in humans, ranging from minor skin infections to life-threatening diseases such as pneumonia and meningitis. In 1998, US hospitals reported a little more than a quarter-million staph infections and slightly over 7 percent of those patients died. By the final year of this study, 2003, hospitals reported nearly 390,000 infections, representing 1 percent of that year's inpatient stays.
The authors suggest one possible reason for the increase in infections is the documented increase of a particularly dangerous type of antibiotic-resistant staph infection known as MRSA (methicillin-resistant Staphylococcus aureus). A more benign possibility is that doctors and hospitals have improved their infection detection and reporting practices.
The good news is that the staph-related in-hospital mortality rate dropped by almost 5 percent each year. The decrease in the in-hospital mortality risk may be due to the introduction of more stringent infection control programs or due to appropriate early treatment of MRSA infections with an effective antibiotic, the authors write.
Hospital expenditures associated with staph infections are substantial, increasing from $8.7 billion in 1998 to $14.5 billion in 2003. This economic burden incorporates such factors as extended length of hospitalization and additional surgery, medications, lab tests, and radiologic studies. Lead author Gary Noskin, MD, of Northwestern Memorial Hospital in Chicago, hypothesized that the reason the economic burden increased at a faster pace than the number of infections is because hospital costs are increasing more quickly.
The authors used data from the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample database, which contains data from approximately 7 million hospital stays annually.
Unfortunately, the authors were not able to determine the contribution of MRSA infections to costs or outcomes because hospitals generally use the same codes for MRSA and regular staph infections. "We do suggest that coding standards should be changed to more accurately reflect the difference between these two bacteria so we can better understand the impact of MRSA," said Dr. Noskin.
###
Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Arlington, Virginia, IDSA is a professional society representing more than 8,000 physicians and scientists who specialize in infectious diseases. For more information, visit idsociety/.
Source: Steve Baragona
Infectious Diseases Society of America
Understanding how bacteria communicate may help scientists prevent disease
Rahul Kulkarni, assistant professor of physics at Virginia Tech, has been awarded a Ralph E. Powe Junior Faculty
Enhancement Award from Oak Ridge Associated Universities to continue his research on quorum sensing in bacteria. He is
modeling the sequence of events that initiate activity, such as virulence, by a bacteria colony once it has reached a
critical size.
The Powe award provides seed money of $5,000 to faculty members who are in the first two years of their tenure track as an
investment in promising achievements in an important area. The institution matches the award.
Much like a legislative body, some bacteria need a quorum, the presence of a critical number of individuals, before they can
engage in particular activities. Typically these are activities that are only productive when carried out in unison by a
community of bacteria.
The example often given is bioluminescence. Scientists noticed that once a population or colony of particular bacteria
reached a certain size, the colony began to emit light. "Now many people realize that other important activities also depend
upon a quorum, such as biofilm formation, releasing toxins, or becoming a virulent invader," said Rahul Kulkarni. While
Kulkarni works with Vibrio cholerae as a model bacteria, quorum sensing appears to be a universal process in bacteria. So
what he learns about the communication process known as quorum sensing could one day help scientists prevent a broad range of
diseases caused by bacteria that are human pathogens.
How do bacteria know how many are present? Each bacterium releases a small molecule, called an autoinducer. Each bacterium
also has receptors - proteins on its cell surface -- to sense autoinducers. As the amount of autoinducer reaches a critical
level, the bacteria know they have a quorum because a change is initiated in the receptor protein, which then causes a series
of further changes within each bacterium.
Kulkarni is looking at the network of genes involved in this process. Working with a group at Princeton University and at
Virginia Tech, "we are trying to understand how changes in the environment are integrated and result in changes in behavior,"
he said.
What was not known until recently is a crucial missing link in the network in each bacterium that results in the ability to
change behavior. Just before he came to Virginia Tech in August 2004, Kulkarni and his collaborators at Princeton solved the
mystery. Using bioinformatics and modeling, Kulkarni drafted theoretical predictions for the missing regulatory element,
which were confirmed experimentally by his colleagues at Princeton.
"We showed that the crucial missing element was a group of genes called small RNAs. ("The small RNA chaperone Hfq and
multiple small RNAs control quorum sensing in Vibrio harveyi and Vibrio cholerae," by D.H. Lenz, K.C. Mok, B.N. Lilley, R.V.
Kulkarni, N.S. Wingreen, and B.L. Bassler, published in Cell, July 9, 2004). "As it turns out, quorum sensing is a hot topic
in biology, and small RNAs is another hot topic. The convergence of these topics is exciting, and it has resulted in several
additional questions," Kulkarni said.
He will address these questions in his Powe-funded research. "We are asking, what are the environmental signals, apart from
quorum sensing, that are integrated by the small RNAs to initiate changes in behavior. An example might be the amount of
nutrients in the environment. Another question is why are there multiple RNAs? The sensing and communication circuit
functions even if some of the RNAs are removed - in fact, even if there is only one small RNA. Modeling the circuit will be
crucial in understanding how it functions and integrates signals from multiple inputs," Kulkarni said.
A third question is how the circuit regulates important biological processes, such as biofilm formation and virulence.
"Biofilms make bacteria resistant to antibiotics, so preventing the formation of biofilms or short-circuiting bacteria's
ability to become virulent by disturbing their communication network so they remain harmless, is an alternative strategy to
controlling disease," he said.
Kulkarni will continue his collaboration with the Princeton University group on V. cholerae and will collaborate with
Virginia Tech Biology Professor Ann Stevens, whose group is working on V. fischeri, the bacteria that causes luminescence and
whose genome has recently been sequenced ("Complete genome sequence of Vibrio fischeri: A symbiotic bacterium with pathogenic
congeners," by E. G. Ruby, M. Urbanowski, J. Campbell, A. Dunn, M. Faini, R. Gunsalus, P. Lostroh, C. Lupp, J. McCann, D.
Millikan, A. Schaefer, E. Stabb, A. Stevens, K. Visick, C. Whistler, and E. P. Greenberg, published Feb. 22, 2005 in the
Proceedings of the National Academy of Science.).
Kulkarni received his Master of Science degree in physics from the Indian Institute of Technology in Kanpur and his Ph.D. in
physics from Ohio State University. He was a postdoctoral researcher at the University of California, Davis, and a
postdoctoral research scientist at the NEC Laboratories America Inc. in Princeton, N.J.
Contact: Susan Trulove
STrulovevt.edu
540-231-5646
Virginia Tech
vtnews.vt.edu
Enhancement Award from Oak Ridge Associated Universities to continue his research on quorum sensing in bacteria. He is
modeling the sequence of events that initiate activity, such as virulence, by a bacteria colony once it has reached a
critical size.
The Powe award provides seed money of $5,000 to faculty members who are in the first two years of their tenure track as an
investment in promising achievements in an important area. The institution matches the award.
Much like a legislative body, some bacteria need a quorum, the presence of a critical number of individuals, before they can
engage in particular activities. Typically these are activities that are only productive when carried out in unison by a
community of bacteria.
The example often given is bioluminescence. Scientists noticed that once a population or colony of particular bacteria
reached a certain size, the colony began to emit light. "Now many people realize that other important activities also depend
upon a quorum, such as biofilm formation, releasing toxins, or becoming a virulent invader," said Rahul Kulkarni. While
Kulkarni works with Vibrio cholerae as a model bacteria, quorum sensing appears to be a universal process in bacteria. So
what he learns about the communication process known as quorum sensing could one day help scientists prevent a broad range of
diseases caused by bacteria that are human pathogens.
How do bacteria know how many are present? Each bacterium releases a small molecule, called an autoinducer. Each bacterium
also has receptors - proteins on its cell surface -- to sense autoinducers. As the amount of autoinducer reaches a critical
level, the bacteria know they have a quorum because a change is initiated in the receptor protein, which then causes a series
of further changes within each bacterium.
Kulkarni is looking at the network of genes involved in this process. Working with a group at Princeton University and at
Virginia Tech, "we are trying to understand how changes in the environment are integrated and result in changes in behavior,"
he said.
What was not known until recently is a crucial missing link in the network in each bacterium that results in the ability to
change behavior. Just before he came to Virginia Tech in August 2004, Kulkarni and his collaborators at Princeton solved the
mystery. Using bioinformatics and modeling, Kulkarni drafted theoretical predictions for the missing regulatory element,
which were confirmed experimentally by his colleagues at Princeton.
"We showed that the crucial missing element was a group of genes called small RNAs. ("The small RNA chaperone Hfq and
multiple small RNAs control quorum sensing in Vibrio harveyi and Vibrio cholerae," by D.H. Lenz, K.C. Mok, B.N. Lilley, R.V.
Kulkarni, N.S. Wingreen, and B.L. Bassler, published in Cell, July 9, 2004). "As it turns out, quorum sensing is a hot topic
in biology, and small RNAs is another hot topic. The convergence of these topics is exciting, and it has resulted in several
additional questions," Kulkarni said.
He will address these questions in his Powe-funded research. "We are asking, what are the environmental signals, apart from
quorum sensing, that are integrated by the small RNAs to initiate changes in behavior. An example might be the amount of
nutrients in the environment. Another question is why are there multiple RNAs? The sensing and communication circuit
functions even if some of the RNAs are removed - in fact, even if there is only one small RNA. Modeling the circuit will be
crucial in understanding how it functions and integrates signals from multiple inputs," Kulkarni said.
A third question is how the circuit regulates important biological processes, such as biofilm formation and virulence.
"Biofilms make bacteria resistant to antibiotics, so preventing the formation of biofilms or short-circuiting bacteria's
ability to become virulent by disturbing their communication network so they remain harmless, is an alternative strategy to
controlling disease," he said.
Kulkarni will continue his collaboration with the Princeton University group on V. cholerae and will collaborate with
Virginia Tech Biology Professor Ann Stevens, whose group is working on V. fischeri, the bacteria that causes luminescence and
whose genome has recently been sequenced ("Complete genome sequence of Vibrio fischeri: A symbiotic bacterium with pathogenic
congeners," by E. G. Ruby, M. Urbanowski, J. Campbell, A. Dunn, M. Faini, R. Gunsalus, P. Lostroh, C. Lupp, J. McCann, D.
Millikan, A. Schaefer, E. Stabb, A. Stevens, K. Visick, C. Whistler, and E. P. Greenberg, published Feb. 22, 2005 in the
Proceedings of the National Academy of Science.).
Kulkarni received his Master of Science degree in physics from the Indian Institute of Technology in Kanpur and his Ph.D. in
physics from Ohio State University. He was a postdoctoral researcher at the University of California, Davis, and a
postdoctoral research scientist at the NEC Laboratories America Inc. in Princeton, N.J.
Contact: Susan Trulove
STrulovevt.edu
540-231-5646
Virginia Tech
vtnews.vt.edu
The rapid "feminization" of the AIDS pandemic must be confronted
A Johns Hopkins physician and scientist who has spent a quarter-century leading major efforts to combat HIV and AIDS
worldwide has issued an urgent call for global strategies and resources to confront the rapid "feminization" of the AIDS
pandemic.
In an article appearing in the journal Science online June 10, Thomas C. Quinn, M.D., professor of infectious diseases at
Hopkins and a senior investigator at the National Institute of Allergy and Infectious Disease, reports that women have in the
last 20 years moved from those least affected by HIV to those in whom the disease is spreading fastest. "There has been a
shift in the AIDS pandemic, and the victims are different now," says Quinn, senior author of the Science article.
"Women make up nearly half of the 40 million people worldwide currently infected with HIV, the virus that causes AIDS, and in
some developing countries, women represent the vast majority of those living with HIV/AIDS," Quinn writes, whereas, at the
start of the pandemic in the early 1980s, men accounted for almost 90 percent of cases in developed countries. In the United
States from 1999 to 2003, the yearly increase in AIDS cases rose by 15 percent, but only by 1 percent in men.
"HIV/AIDS first targeted gay men and hemophiliacs in the early 1980s, then subsequently spread most quickly among intravenous
drug users and heterosexuals," he adds. "Now, it is having the most profound impact on women."
Internationally, Quinn and his team have led clinical trials of the first effective treatments that prevent HIV from
replicating, helped establish laboratory and treatment facilities in the Democratic Republic of the Congo, India and Uganda,
and counseled other governments across Africa and Asia about control efforts.
In the new article, he argues that women deserve a separate strategy because of the increasing and disproportionate numbers
becoming infected, and the social consequences of so many young mothers dying and leaving behind children who may also be
infected as well as orphaned. He also points out that medical research suggests hormonal and developmental factors place
young women at greater risk than men for contracting the virus when exposed to it.
In sub-Saharan Africa, 60 percent of people living with HIV are female, Quinn says, and in South Africa, Zambia and Zimbabwe,
young women ages 15 to 24 are three to six times more likely to be infected than men. Women make up half the adult population
living with the virus in the Caribbean and one-third of those in Latin America.
The reasons for the rise in female cases differ among countries, with 97 percent of female HIV infections in the United
States due to heterosexual transmission (81 percent) and intravenous drug use (16 percent). In the developing world,
heterosexual transmission is responsible for nearly all of the infections among women, and mother-to-child transmission
during childbirth further contributes to the spread of the disease. Women are particularly vulnerable to such cultural
factors as their relative lack of power in sexual relationships, widespread poverty, policies that deny women an education
and tolerance of violence against women.
Excessive biological vulnerability to HIV among young women, although not fully understood, is believed to be due to an
immature genital whose mucosal lining is easier for the virus to penetrate; to hormonal factors, such as the use of birth
control pills; and to a high incidence of sexually transmitted diseases, which inflame the female genital area and provide
additional target cells for the virus to infect.
According to Quinn, "societal changes will help over the long run, but immediate and faster action requires coordinated
efforts to focus on women, develop effective microbicides that women can use themselves and a gender-specific vaccine program
that takes into account the different immune responses between women and men."
Also needed, he says, are cultural programs for reshaping gender roles, such as educating more women about safe-sex
practices, use of condoms, lessons on negotiating safe sex, and awareness campaigns about where to seek testing and
treatment.
"Women are different when it comes to HIV infection," says Quinn. "If medical progress is to continue on how best to prevent
and treat the disease, then developing specific strategies that empower women will be key to its success."
For more information or to schedule an interview with Quinn, please contact David March at 410-955-1534, or dmarch1jhmi.edu.
Johns Hopkins Medical Institutions
hopkinsmedicine
worldwide has issued an urgent call for global strategies and resources to confront the rapid "feminization" of the AIDS
pandemic.
In an article appearing in the journal Science online June 10, Thomas C. Quinn, M.D., professor of infectious diseases at
Hopkins and a senior investigator at the National Institute of Allergy and Infectious Disease, reports that women have in the
last 20 years moved from those least affected by HIV to those in whom the disease is spreading fastest. "There has been a
shift in the AIDS pandemic, and the victims are different now," says Quinn, senior author of the Science article.
"Women make up nearly half of the 40 million people worldwide currently infected with HIV, the virus that causes AIDS, and in
some developing countries, women represent the vast majority of those living with HIV/AIDS," Quinn writes, whereas, at the
start of the pandemic in the early 1980s, men accounted for almost 90 percent of cases in developed countries. In the United
States from 1999 to 2003, the yearly increase in AIDS cases rose by 15 percent, but only by 1 percent in men.
"HIV/AIDS first targeted gay men and hemophiliacs in the early 1980s, then subsequently spread most quickly among intravenous
drug users and heterosexuals," he adds. "Now, it is having the most profound impact on women."
Internationally, Quinn and his team have led clinical trials of the first effective treatments that prevent HIV from
replicating, helped establish laboratory and treatment facilities in the Democratic Republic of the Congo, India and Uganda,
and counseled other governments across Africa and Asia about control efforts.
In the new article, he argues that women deserve a separate strategy because of the increasing and disproportionate numbers
becoming infected, and the social consequences of so many young mothers dying and leaving behind children who may also be
infected as well as orphaned. He also points out that medical research suggests hormonal and developmental factors place
young women at greater risk than men for contracting the virus when exposed to it.
In sub-Saharan Africa, 60 percent of people living with HIV are female, Quinn says, and in South Africa, Zambia and Zimbabwe,
young women ages 15 to 24 are three to six times more likely to be infected than men. Women make up half the adult population
living with the virus in the Caribbean and one-third of those in Latin America.
The reasons for the rise in female cases differ among countries, with 97 percent of female HIV infections in the United
States due to heterosexual transmission (81 percent) and intravenous drug use (16 percent). In the developing world,
heterosexual transmission is responsible for nearly all of the infections among women, and mother-to-child transmission
during childbirth further contributes to the spread of the disease. Women are particularly vulnerable to such cultural
factors as their relative lack of power in sexual relationships, widespread poverty, policies that deny women an education
and tolerance of violence against women.
Excessive biological vulnerability to HIV among young women, although not fully understood, is believed to be due to an
immature genital whose mucosal lining is easier for the virus to penetrate; to hormonal factors, such as the use of birth
control pills; and to a high incidence of sexually transmitted diseases, which inflame the female genital area and provide
additional target cells for the virus to infect.
According to Quinn, "societal changes will help over the long run, but immediate and faster action requires coordinated
efforts to focus on women, develop effective microbicides that women can use themselves and a gender-specific vaccine program
that takes into account the different immune responses between women and men."
Also needed, he says, are cultural programs for reshaping gender roles, such as educating more women about safe-sex
practices, use of condoms, lessons on negotiating safe sex, and awareness campaigns about where to seek testing and
treatment.
"Women are different when it comes to HIV infection," says Quinn. "If medical progress is to continue on how best to prevent
and treat the disease, then developing specific strategies that empower women will be key to its success."
For more information or to schedule an interview with Quinn, please contact David March at 410-955-1534, or dmarch1jhmi.edu.
Johns Hopkins Medical Institutions
hopkinsmedicine
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