YCLOAK

Kenya on Friday recognized World Tuberculosis Day by releasing results of a TB study by the country’s ministry of health  — the first of its kind since Kenya’s independence. TB remains high in Kenya, and experts say the country lags in the fight against the disease.

The survey represents a united front by many committed parties to determine the true burden of tuberculosis and how to best combat the fourth-leading cause of death in Kenya.

The survey is intended to provide an accurate estimate of Kenya’s TB burden, determine existing challenges in delivering TB testing and treatment, and identify people with TB not yet detected by the National TB control program. It was conducted to inform the government on how to effectively respond to TB control.

More than 63,000 people across 45 counties in Kenya were screened for the survey and, for the first time, there is accurate data on TB’s prevalence.

Dr. Enos Masini, the head of the National Tuberculosis, Leprosy and Lung disease program at the Ministry of Health, said the survey was driven by a need to know what the country was facing.

“We undertook to do this survey in the community to provide us with the exact data of the burden of the disease in Kenya, but also to go further and find out which groups of people are affected by the disease and what would be the best strategies for us to reach them,” he said.

The report states that there are more TB cases in Kenya than previously estimated, with a TB prevalence of 558 per 100,000 people.

TB was found to be higher in men between the ages of 25 and 34 years, urban dwellers, and women over the age of 65.

The majority (83 percent) of TB cases were HIV negative, suggesting that broad efforts at controlling TB in people with and without HIV are needed.

“For a long time, the estimates that we have used to accurately determine the burden of tuberculosis has been provided by the World Health Organization,” said Masini. “And this has been derived from the data we get from hospital records. We have always suspected that there could be a huge number of patients in the community that go untreated and undiagnosed and, therefore, fuel the transmission of the disease.”

Now, with the findings, he said the government and various stakeholders can deal with the disease effectively.

“Now we are not groping in the dark,” he said. “We know how much disease there is in this country. Secondly, we know that 40 percent of disease that occurs in this country remains undetected and untreated, and then we have a pretty good idea where people who are undetected, who are called missing TB cases, are.”

Masini said this information will help with planning. “We can … have strategic plans that really target people at most risk, people who are missed. And so we are able to find them and provide them with treatment.”

The United States Agency for International Development (USAID) and the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention (CDC) provided technical and scientific support to the government of Kenya in the design and implementation of the survey and $575,000 in funding to conduct it.

According to Kenya’s National Tuberculosis, Leprosy and Lung Disease Program, the major factor responsible for the large TB disease burden is the concurrent HIV epidemic.

Other contributing factors include poverty and social deprivation that have led to a mushrooming of peri-urban slums between cities and the countryside, and limited access to general health care services.

The survey findings also reveal that the current practice of screening for TB symptoms and using microscopy as the only test misses many cases. Using GeneXpert, an innovative technology for the diagnosis of TB, has led to the detection of 78 percent of TB cases among those screened, making it a more reliable and efficient test.

A statement from the Cabinet secretary of Health, Dr. Cleopa Mailu, said in part “the government was committed to making TB diagnostics accessible”  by expanding “the use of Chest X-rays to screen all persons presumed to have TB and make GeneXpert the first diagnostic test for all presumed TB cases.”

The government also said that it would increase engagement with the private sector, carry out targeted approaches through community-based action, and improve community awareness of TB symptoms in an effort to make TB everyone’s business.
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Astronauts ventured out on a spacewalk Friday to prep the International Space Station for a new parking spot.

NASA’s Shane Kimbrough and France’s Thomas Pesquet emerged early from the orbiting complex, then went their separate ways to accomplish as much as possible 250 miles up.

“We are ready to get to work,” Mission Control informed them.

Their main job involves disconnecting an old docking port. This port needs to be moved in order to make room for a docking device compatible with future commercial crew capsules, and provide more clearance. The new docking device — the second of two — will fly up late this year or early next and hook onto this port.

If all goes well, flight controllers in Houston will relocate the old docking port Sunday, using the station’s robotic arm. Then next Thursday, the crew will conduct another spacewalk to secure the unit.

SpaceX and Boeing are developing capsules capable of flying astronauts to and from the space station. Until the SpaceX Crew Dragon and Boeing Starliner come on line — possibly next year — U.S. astronauts will have to keep riding Russian rockets to orbit.

Before working on the docking port, Kimbrough replaced a computer-relay box with an upgraded version. Pesquet, meanwhile, looked for signs of a small ammonia coolant leak in outdoor plumbing. He patted and tugged at hoses, but did not spot any frozen flakes of ammonia. A GoPro camera caught his every move for playback later.

“No flakes. All good,” Pesquet reported.

Also on the spacewalkers’ to-do list Friday: Replace a pair of Japanese cameras and grease latching mechanisms on the end of the big robot arm.

NASA wants to cram in two and possibly three spacewalks before Kimbrough, the station’s commander, returns to Earth on April 10.

Before a third spacewalk can be conducted, however, Orbital ATK needs to launch a cargo ship to the space station with replacement parts. That shipment was supposed to be there by now, but repeatedly has been delayed because of rocket concerns. It’s unclear when the Atlas V rocket will be ready to soar from Cape Canaveral, Florida.

NASA has been contracting out cargo deliveries since the end of the space shuttle program in 2011. The space agency is counting on private companies to do the same with astronauts.
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Friday marks World Tuberculosis Day, aimed at raising awareness of a disease that kills an estimated 1.8 million people every year. Six countries account for nearly two-thirds of the cases: India, Indonesia, China, Nigeria, Pakistan and South Africa. As Henry Ridgwell reports, resistant forms of TB bacteria are undermining efforts to roll out new treatments.
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President Donald Trump told House Republicans the time for negotiations on a crucial health care vote had ended. After a chaotic day of dealmaking, the vote that could shape the future of the Republican Party was scheduled for Friday. VOA’s congressional reporter Katherine Gypson has more from Capitol Hill.
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A new vaccine against rotavirus, a diarrheal disease that kills about 600 children a day, has been shown to have almost 67 percent efficacy in preventing the illness.

“This efficacy of about 70 percent is higher than any other vaccine in similar settings,” said Dr. Emmanuel Baron, director of Epicentre, the research arm of Doctors Without Borders, which conducted the trial.

A clinical trial of 3,500 infants in the African country of Niger showed the efficacy of the new vaccine, known as BRV-PV, to be 66.7 percent. Thirty-one cases of rotavirus were reported among children who got the vaccine, compared with 87 cases among those who received a placebo.

Details of the study and the vaccine’s effectiveness were published in the New England Journal of Medicine.

“We saw actually three things,” Baron said. “The first is that this vaccine is efficient. The second is that this vaccine is safe. And we also saw a good acceptability by the care providers and the families.”

An estimated 450,000 young children and babies die each year of diarrheal diseases. One of them is rotavirus, which causes a severe infection of the gastrointestinal tract. 

Experts say rotavirus is responsible for about 37 percent of deaths among children younger than 5 who succumb to diarrheal diseases each year, or about 215,000 deaths annually.

There are two existing vaccines, but Baron said they are not widely used, as they are relatively expensive and must be refrigerated. Refrigeration is an obstacle in many African countries where rotavirus is most pronounced because electricity there is unreliable.

Even when children are immunized with the older vaccines, Baron says, hundreds die each day around the world.

The new vaccine does not need refrigeration for up to six months, because it is mixed or reconstituted with liquid before it is given to children in a three-dose schedule, at 6, 10 and 14 weeks of age. 

Initially, the BRV-PV is expected to cost $6 dollars for the three shots, a price that is expected to drop as the vaccine gains traction.

Baron said clinicians in countries where rotavirus is a serious health threat are waiting for the green light from the World Health Organization to begin immunizing children with the new vaccine.
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On Tuesday, the rusty patched bumblebee became the first wild bee in the continental United States to be placed on the U.S. endangered species list. Veronica Balderas Iglesias reports, scientists hope the designation will help safeguard one of the small insects that play a big role in American agriculture and the environment.
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In advance of World TB day (March 24), the World Health Organization is warning the battle to wipe out the global tuberculosis epidemic will not be won unless stigma, discrimination and marginalization of TB patients is brought to an end. VOA was in Geneva at the launch of new WHO ethics guidance for the treatment of people with tuberculosis.

Progress is being made toward achieving the U.N. Sustainable Development Goal of ending the global TB epidemic by 2030.  The World Health Organization reports 49 million lives have been saved since 2000.

But, much remains to be done. 

Data from 2015 show more than 10.4 million people fell ill and 1.8 million died of tuberculosis, with most cases and fatalities occurring in developing countries.

The World Health Organization says stigma and discrimination against TB patients hamper efforts to wipe out this deadly disease. 

WHO Global TB Program medical officer Ernesto Jaramillo says vulnerable people, such as migrants, prisoners, ethnic minorities, marginalized women and children are most likely to suffer abuse, neglect and rejection.

He says this prevents them from seeking treatment for tuberculosis.

“Having new tools for diagnosis, and treatment of TB is not sufficient if there are not clear standards to ensure that vulnerable people can have access in a matter of priority to these tools in a way that the end TB strategy can really serve the interest not only of individuals, but also the interests of public health in general ,” said Jaramillo.

WHO Global TB program director Mario Raviglione tells VOA no country, rich or poor, is immune from getting tuberculosis.  He warns marginalizing patients with TB is dangerous.

“You cannot eliminate a disease like TB thinking that you build walls or you isolate your country,” said Raviglione. “TB is an airborne disease.  It travels by air.  So, you have a Boeing 747 that leaves Malawi tonight and it comes to Switzerland tomorrow morning and there you go.  So, it has to be faced from a global perspective.”

New WHO ethical guidance includes actions to overcome barriers of stigma, discrimination and marginalization of people with tuberculosis.  The agency says protecting the human rights of all those affected will save many lives and will make it possible to end this global scourge. 
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Curious toddlers find the drugs in a mother’s purse or accidentally dropped on the floor. Sometimes a parent fails to secure the child-resistant cap on a bottle of painkillers.

 

No matter how it happens, if a 35-pound toddler grabs just one opioid pill, chews it and releases the full concentration of a time-released adult drug into their small bodies, death can come swiftly.

 

These are some of the youngest victims of the nation’s opioid epidemic — children under age 5 who die after swallowing opioids. The number of children’s deaths is still small relative to the overall toll from opioids, but toddler fatalities have climbed steadily over the last 10 years.

 

In 2000, 14 children in the U.S. under age 5 died after ingesting opioids. By 2015, that number climbed to 51, according to the Centers for Disease Control and Prevention. In Milwaukee County, Wisconsin, alone, four children died last year of accidental overdoses. Another 2-year-old perished in January.

 

Each family who loses a toddler to opioids confronts a death that probably could have been prevented. Here are a few of their stories:

 

An energetic birthday girl, a methadone mystery

 

Cataleya Tamekia-Damiah Wimberly couldn’t sit still. She spent most of her first birthday party in Milwaukee dancing and diving into the cake. But her first birthday party was also her last. Nearly three weeks later, she was found dead of a cause her mother never suspected — a methadone overdose.

 

Helen Jackson, 24, was styling her older daughter’s hair when she got a call from Cataleya’s father, who shared custody of the little girl. He sobbed on the phone as he explained how he found their daughter unresponsive the morning of Feb. 16, 2016.

 

“I screamed so hard and so loud,” Jackson said. “The screams that came out of me took all my strength, all my wind. It was just terrible.”

 

Police were puzzled. They looked into whether the toddler was smothered while co-sleeping with her father and his girlfriend. They also investigated carbon monoxide poisoning because of a gas smell. Toxicology tests eventually revealed the methadone in her system.

 

Jackson said her daughter, while in the care of her father, was at a relative’s house when she swallowed the methadone that took her life.

 

Police are still investigating how Cataleya got the methadone. The case could be referred to the Milwaukee County District Attorney’s Office for consideration of criminal charges, said Sgt. Timothy Gauerke.

 

Since Cataleya’s death, friends and family have commented on what they perceive as Jackson’s strength in dealing with her loss. In reality, she said, she feels fragile and weak.

 

“I don’t know when I’m going to fall apart,” she said. “I don’t know when I’m going to explode. It’s all still in there.”

Mother’s prescription proves fatal for daughter

 

At just 2 years old, Londyn Raine Robinson Sack was protective of her baby brother, Liam.

 

“She thought she was his mother,” said Londyn’s grandmother, Shauna Etheredge. “She liked to be the boss of her little brother.”

 

Londyn’s own mother was convicted of second-degree manslaughter and risk of injury to a child in connection with the Oct. 19, 2014, death of her daughter, who ingested an opioid known as Suboxone that was packaged in the form of a dissolving strip.

 

Prosecutors in New Britain, Connecticut, said the drug was obtained illegally by her mother and was dispensed in a box, not a child-resistant container.

 

Rebekah Robinson entered a plea in which she did not accept or deny responsibility for the charges but agreed to accept punishment. In June 2016, she was sentenced to 10 years in prison and 10 years of probation.

 

Robinson apparently knew Londyn had ingested the opioid but did not call for medical help, according to prosecutors. It was an older sibling who called 911 to say her little sister was not breathing.

 

The Connecticut Department of Children and Families was cited in a 2015 report for failing to adequately identify risks to Londyn and Robinson’s three other children, given her history of mental health, substance abuse and child-welfare complaints.

 

Besides her protective nature, Londyn loved making people laugh, Etheredge said.

 

“She would put underwear on her head and act goofy and silly,” her grandmother said. “She loved to explore.”

 

Etheredge, of Indian Trail, North Carolina, said one of her lasting memories of her grandchild was a visit to the local park.

 

“The last time I saw her, she was running around and trying to catch up with the birds,” she said.

Precocious “lil’ Reg” dies, uncle stands accused

Curious and energetic, Reginald Kendall Harris Jr. would hold conversations beyond those of a typical toddler.

 

“If he was talking to his mom, you would think he was five or six years old,” said his great-uncle Calvin Harris, of Portland, Oregon. “If you would talk to him, you would engage in a full conversation. It was hilarious for his age,” Harris said.

 

The boy died on Oct. 10, 2016, after swallowing methadone. Portland police soon issued a warning, saying the case was a reminder to keep all prescription drugs away from children.

 

Reginald’s uncle, Willie Lee Harris Jr., is behind bars, accused of leaving methadone in a place accessible to his nephew. He has pleaded not guilty to second-degree manslaughter.

 

Harris’ mother, Pamela Harris, of Vancouver, Washington, said her grandson got hold of the drug while riding in her son’s car.

 

“Lil’ Reg was so touchy and curious,” she recalled. The methadone was in a cup.

 

The boy whose family affectionately called him “Lil’ Reg” would “say some crazy stuff sometimes, somethings you wouldn’t expect a 2-year-old to say,” great-grandmother Lucy Lee Harris recalled. “He would answer the door: ‘What up, dawg?'”

 

Instead of the way he died, Pamela Harris chooses to remember how her grandson lived, such as his joy when the family made plans to visit his favorite hangout, a Chuck E. Cheese restaurant with a kid-friendly menu and games.

 

Harris said his death was almost too much to bear after losing her home in Hurricane Katrina and receiving a breast cancer diagnosis.

 

“Now I’ve got a grandson that’s not here and a son that’s being charged,” Harris said. “I couldn’t breathe. It was like I was being smothered.”

 
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A photo published on social media reveals Elon Musk’s SpaceX Corporation is close to fielding a rocket robot.

According to Florida Today newspaper, Stephen Marr got a good view of the bot sitting on top of a SpaceX drone ship at Port Canaveral, Florida.

“I knew there was something different there,” Marr, 34, told the paper.

Marr posted the photo on Reddit where it was widely agreed to be a robot, and users on the site nicknamed it “Optimus Prime,” after a character from the movie Transformers.

The robot is expected to work on the drone ships, securing the first stage of SpaceX’s Falcon 9 rockets, which will land on the drone ships, Florida Today reports. The robot is expected to save the company money and increase safety.

Ricky Lim, of SpaceX, told Florida Today that the robot is in a “testing phase” as a “future capability.”

“I don’t think it’s very far away” from being used, Lim told the paper. “But it’s new.”

He added that the robot has not been officially named.

SpaceX has recovered eight first stages of Falcon 9 rockets, starting in 2015. Three of those stages landed on pads at Cape Canaveral Air Force Station, and five times on drone ships at sea.

SpaceX is expecting to launch another rocket from Kennedy Space Center in coming months. That mission is expected to be the first use of a used or “flight tested” Falcon 9 rocket.
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Amputees with prosthetic limbs may soon have much a better sense of touch, temperature and texture, thanks to the energy-saving power of the sun, British researchers said on Thursday.

While prosthetics are usually fully powered using batteries, a new prototype from University of Glasgow researchers opens up the possibility for so-called “solar-powered skin,” which would include better sense capabilities than current technology.

“If an entity is going out in a sunny day, then they won’t need any battery” to activate their senses, said Ravinder Dahiya, a research fellow at the university and a leader of the study. “They can feel, without worrying about battery.”

The technology involves installing a thin layer of pure carbon around a prosthetic arm, hand or leg. This allows light to pass through it and be easily used as solar energy, the researchers said in a research paper.

The sun can provide up to 15 times more energy than is usually needed to power a prosthetic limb, Dahiya said.

This extra — and renewable — energy can be used to power sensors that increase sense and feeling in a limb, so much so that the prosthetic can feel pressure, temperature and texture like natural skin, the paper said.

“The skin is sensitive to touch and pressure, so when you touch the skin there you will know what point you are contacting and how much force you are applying,” Dahiya said, describing the prototype.

The scientists are the first to develop a model for solar-powered prosthetic skin, he told the Thomson Reuters Foundation.

The technology could also increase the functionality of robots, allowing them to have a better understanding of what they touch and interact with, according to Dahiya.

If robots had limbs that are sensitive to touch and pressure they would be less likely to make errors or injure humans, he said.

The researchers hope to further develop the prototype in the next two years, Dahiya said. Eventually, he hopes to power the limb’s motors with the renewable energy as well – rather than just the skin.

“Because we are saving a lot of energy, our vision is that … if we store this energy in some way we will be able to also power the motors with the energy,” he said.

“The prosthetic will be fully energy autonomous.”
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