Category Archives: Health

Detecting deadly foodborne pathogens on the spot

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Researchers from Saudi Arabia and Jordan have invented a cheap sensor that can detect foodborne pathogens within minutes and which can be used by anyone.

The sensor can detect, among other pathogens, Listeria monocytogenes, a notoriously harmful pathogen that has caused numerous infections worldwide and whose inspection and detection efforts exhaust billions of dollars every year, says a new study published in Biosensors & Bioelectronics.

The sensor itself is made of magnetic nanoparticles. It can detect minute traces or serial dilutions of Listeria in milk and meat, as the study demonstrates. “The sensor’s performance is superior in terms of its simplicity, cost and speed,” says researcher Mohammed Zourob, the study’s corresponding author.

Zourob adds that the sensor can be used by non-skilled personnel to check the food contamination; food manufacturers, stores, distributors and even laypersons can use it.

The biosensor changes color from black to yellow in less a minute time when it detects Listeria. Zourob’s team has also developed sensors that can detect other food pathogens such as Escherichia  coli, Salmonella, Shigella flexnerii and Staphylococcus aureus.

The Throes of AIDS

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As scientists, press, leaders and activists meet at the 21st International AIDS conference in Durban, the Middle East and North Africa region remains embroiled in its own fight against HIV/AIDS.

The odds are stacked against this region, solidly among those groups where infections are increasing – an issue that the conference at Durban is expected to mount concerns about, among others. In addition to discussing the state of the epidemic worldwide, and in high-risk areas, the conference will address the fact that HIV/AIDS is plateauing or peaking in several countries, plus the level of jeopardy this entails.

In this region, 80% of people living with HIV/AIDS are not aware they’re carrying the virus, 85% of those in progressive stages of infection are not receiving treatments and deaths due to AIDS have increased 176%, according to reports from UNAIDS and WHO. There are not enough national strategic plans to tackle the problem and access to life-saving medications remains limited.

Stigma is partly to blame, according to Navid Madani, senior scientist in the Department of Cancer Immunology and Virology at Dana-Farber Cancer Institute and the Department of Global Health and Social Medicine at Harvard Medical School.

Globally, growing resistance to the antiretroviral drugs used against HIV is the most serious issue facing plans to end the endemic, according to the WHO’s opening statement to Durban’s conference this morning.

Finding preventive measures and a vaccine-antiviral combination that might bring us closer to a cure are underway. In fact only this week, a new study in Science provides insights into the workings of new HIV drugs and into how the virus becomes resistant. Scientists can use these to scrutinize structures insides irregular viruses like HIV to understand the molecular underpinnings of the virus in order to come up with new drug designs.

But finding new drugs is an expensive affair, as meanwhile funding for HIV has been dropping.

Back in the Middle East and North Africa, the extent of the HIV epidemic is undeniable, and governments – some reluctantly and others readily – are beginning to understand there’s a problem in need of curbing.

Just as pivotal to halting the spread is the culture of HIV-related practices, the shame surrounding the virus, the inequality cited by many in terms of medication access and the outdated fears about the prognosis for those infected. The burden falls on scientists, policymakers, healthcare workers and even at-risk communities to try and change the status quo.

One step closer to a diabetes cure?

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Zewail City scientist Sameh Ali has joined a league of Egyptian researchers engaged in pre-clinical trials that use stem cells to explore a viable type 2 diabetes treatment by transforming mesenchymal stem cells (MS cells) – adult bone marrow stem cells – into insulin-producing cells (IPCs).

Mesenchymal stem cells are multipotentent, a feature that enables them to differentiate into different cell types including IPCs. MS cells are also a rich source of autologous stem cells that are derived from a patient’s own body, eliminating the risk of rejection.

In his latest, soon to be published, study, Ali is focusing on the aftermath of deriving IPCs from MS cells originating from diabetic patients; how the ‘modified’ cells (referred to in the study as ‘diabetic IPCs’) respond to increasing glucose stimulation compared to cells from healthy individuals.

Ali is collaborating with a team from the Urology and Nephrology Center (UNC) in Mansoura, led by urologist Mohamed Ghoneim who has previously used stem cell technology to cure a diabetic rodent; the scientists presented their promising results two years earlier and are still hoping they can replicate said results for humans.

“The new study is hoping to expand the potential of the clinical applicability of this research for humans,” Ali comments.

Ali’s study highlights the effect of type 2 diabetes on insulin secretion, mitochondrial function in addition to metabolic changes in MS cells before and after they differentiate into IPCs.

Ali explained in a Library of Alexandria lecture, partly sponsored by Nature Middle East and Nature Arabic Edition, that the main goal of the collaboration was to understand how can scientists control metabolism to control how MS cells differentiate into IPCs.

In their research, the scientists also observe the impact of the transplanted IPC clusters used to treat diabetes on mitochondria, which, in addition to being a powerhouse of the cell, play a crucial part in coordinating cellular signaling pathways implicated in insulin synthesis and secretion.

So far, the scientists found that, unlike in healthy subjects, IPCs derived from diabetic donors produce significantly higher levels of insulin in response to glucose stimulation, exhausting their metabolic machinery and essentially self-destructing on the long run. “During differentiation, cells start to rely more on mitochondria for fulfilling their bio-energetic demands. It appears that in stem cells derived from diabetic patients, this metabolic switch is somewhat defective,” explains Ali.

The study draws several conclusions about IPCs derived from previously defective MS cells, including highlighting a few adaptations in response to impaired glucose metabolism. Among these adaptations, for instance, are: ‘overcompensation’ in levels in molecules critical to insulin secretory function and an over-expression of genes related to insulin secretion augmentation.

These adaptations produce, among other symptoms, dysfunctional mitochondria and metabolically stressed differentiated cells.

Ali says that enhancing the process of differentiation is key to understanding how metabolism works; utilizing this understanding will enable them to expand the research to humans.

World Diabetes Day: The silent killer endures

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On World Diabetes Day, a new report by International Diabetes Federation (IDF) bears bad news to the Arab world, already boasting the highest prevalence of diabetes worldwide and reeling from its different side effects. According to the report, 35.4 million adults aged 20-79 of the Middle East and North Africa region are living with diabetes – over 40.6% of these are undiagnosed.

In 2015, over 340,000 people died due to diabetes, and projections for 2040 expects the number of people with diabetes to almost double, rising to 72.1 million.

Moreover, the silent killer is depleting resources in the region, with overall health expenditure eating up 15% of the region’s healthcare budget and it’s not enough. Although expenditure is also expected to double by 2040, the IDF says it will “likely not be enough to adequately treat all people with the disease.”

The wide infrastructure development, rapid urbanization, increased life expectancy and reduced infant morality also translated into lifestyle changes that included soaring rates of diabetes across most countries in the region, especially the Gulf states.

This time last year Nature Middle East ran a detailed infograph tracing the effects of the soaring epidemic. And nothing has changed much since then, except for the certainty that diabetes is still killing more than 10% of all adults in the region, and nearly half of these under 60, the cost to society and development due to the disease and other metabolic syndromes is high and rapidly growing.

The disease is worse in some countries than others. For instance, a report by our writer Louise Sarant earlier this year cited a study by King Fahad Medical City in Riyadh, predicting that over the next ten years, one in four Saudis will be at risk of having a fatal heart attack.

Of the 4,900 urban-dwelling Saudis monitored by the study, 26% were at high risk of having a heart attack in the next decade. Those in the cohort did not have a history of cardiovascular diseases (CVD), and were between the ages of 20 and 40.

Of those studied, the research found out that 25% had diabetes, 34% hypertension, 25% were smokers, 27% were obese, 86% were not involved in any physical activity and 19% had dyslipidemia, an abnormal level of lipids in the blood.

Another report published a year earlier, also by Sarant, warns of a sharp hike in type 1 diabetes cases. More alarmingly, the incidence among infants of this type was reported to be growing with children developing the disease as early as six months, rather than the established peak ages of around seven and at puberty, when hormones antagonize the action of insulin.

Regional experts have told Nature Middle East that changes in policy, and better research into diabetes, is needed. But it seems that few are listening.

In short, the region has a ‘fat’ diabetes problem, and it’s not waning. And the Middle East and North Africa, like the rest of the world, are no closer to a cure.

 

The Middle East experiences a sharp rise in antibiotic use

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PhotoDisc/Getty Images

The region, especially countries like Saudi Arabia and Egypt, has increased its reliance on antibiotics, and the rise in numbers is dramatic, according to a new report that is hailed as the most comprehensive yet, worldwide.

The Center for Disease Dynamics, Economics and Policy (CDDEP), a non-profit think tank based in Washington DC, used national data and regional surveillance systems to calculate how antibiotic drugs are used globally. The center mapped out their use for 12 types of bacteria, over the period of ten years – and regionally, Saudi Arabia and Egypt are revealed to be the highest in terms of use, with numbers steadily growing every year.

The center measured antibiotic consumption in standard units, defined as the equivalent of one pill, capsule or ampoule. They divided reported numbers of standard units use by estimates of countries’ population, obtained from the World Bank, to get their data. To allow for easier comparison across countries, their graphics count standard units per 1,000 population (1000/pop).

CDDEP

CDDEP

In Saudi Arabia, for instance, all antibiotics use amounted to 25,171 standard units per 1000/pop in 2000. By 2010, this number rose to 32,272. The interactive maps, classified by country, can simultaneously track the use for several types of antibiotics, including broad and narrow spectrum penicillins, among others.

In Egypt, antibiotic drug intake experienced a similar hike, the figures climbed from 16,654 standard units per 1000/pop in 2000 to 24,734 by 2010.

Information regarding resistance to the drugs, however, is absent for this region, perhaps because of restricted access to data. Daniel Sahm, chief scientific officer at International Health Management Associates in Schaumburg, Illinois, tells Nature magazine that the new analysis “might contain holes: an argument for more-aggressive surveillance,” noting that it is difficult to gather data in developing countries.

 

Hepatitis C: The case of Egypt

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In the Arab world, and worldwide, one of the most affected countries when it comes to hepatitis C virus (HCV) is Egypt – in fact, it’s estimated that 14.7% of the North African country’s population is carrying the virus and up to 100,000 new infections occur each year.

Seven months before the world celebrates World Hepatitis Day today, Tuesday, a new study revealed that between 3,000 an 5,000 Egyptian children could be infected by the virus through mother-to-child transmission, probably during pregnancy, childbirth or somewhere in the postpartum period. The transmission could contribute to up to 50% of new cases in children under five.

A feature story published by Nature Middle East in October last year explored the possible causes of one of the most widely spread epidemics in Egypt, and it turns out, medical care – or the lack thereof – is responsible, with most transmissions happening due to healthcare hygiene breaches. Hospitals and clinics are by far the largest suppliers of the virus. Wahid Doss, the head of the Egyptian National Committee for the Control of Viral Hepatitis and dean of the Ministry of Health’s affiliated Liver Institute, told our writer Louise Sarant that “[around] 60% of patients who undergo kidney dialysis will have contracted HCV within the year, because the machines are not sterilized properly. Same goes for blood transfusions, which are very risky.”

In 2011, Nature Middle East’s chief editor Mohammed Yahia wrote that “not only is the Egyptian HCV problem one of size, but the genotype of the virus in circulation is one that is not commonly found in the rest of the world. If it is not controlled, there’s no guarantee that it will be confined to Egypt.”

Egypt — and the Middle East more generally — is a stronghold for genotype 4. The prolonged 72-weeks treatment available for hepatitis C – which involves a weekly injection and a daily capsule dose – only has a 60-65% success rate for this genotype. While the preferred treatment regimen – a costly 48-week course of interferon and the antiviral drug ribavirin – is usually only effective in 30-50% of cases.

By contrast, about 75% of HCV infections in Europe and the United States are of genotype 1. Naturally, most prominent research in the West targeted the latter, and not the former.

But perhaps things are changing; already scientists in the region are starting to pay some attention to the virus and its possible new treatments.

Last year, two Egyptian scientists sent sample crystals of two proteins of the hepatitis C virus to space for analysis, in their search for possible cure. The proteins are HCV genome 4, and the researchers, working at the German Aerospace Center (DLR), said they were hoping to understand the behavior of this specific type located heavily in Egypt.

Separately, researchers in Qatar collaborated with Harvard Medical School to develop a therapeutic cocktail that combines antiviral agents and cholestrol-lowering drugs, commonly known as statin, to ease the burden of hepatitis C complications. This statin therapy, announced in April, can complement treatment by slowing the progress of liver fibrosis and reducing the risks of liver cancer in virus-infected patients.

Research aside, in a chronic case like Egypt, prevention remains the saving factor in this affair. And it’s not an easy feat; it involves an overhaul of hospital practices, measures like proper sterilization across health facilities, more investment in awareness and educational programmes aimed at curbing the virus’ spread, in addition to easing access to treatments, especially in rural areas.

Hepatitis C: Training for journalists

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Hepatitis viruses under an electron microscope

Hepatitis viruses under an electron microscope{credit}Image courtesy of U.S. Centers for Disease Control and Prevention{/credit}

Nearly 2.5% of people in the world is estimated to be infected with Hepatitis C – that’s a whopping 150 million people. And it’s more than most other infectious diseases, yet many people know little to nothing about the disease.

In addition to limited awareness of a disease that kills millions yearly, Hepatitis C receives narrow media coverage.

But for reporters to be able to cover the disease, properly, journalists need to know more about the virus and the disease. What are the different genotypes? Which new medications are there? Why is the disease burden so high around the world?

To mark World Hepatitis Day, the World Federation of Science Journalists (WFSJ) is launching a new online portal to educate and support journalists who are covering viral hepatitis all over the world. The portal should give reporters the appropriate tools, data sets and education to accurately cover the killer virus.

To produce this education plan, a steering committee of science journalists from around the world came together with experts, researchers, clinicians and patient advocacy groups representatives to identify the most important topics to cover; ranging from the global disease burden and its risks to health policy and the rapidly evolving hepatitis treatment landscape. I was part of this committee which met twice, then worked together online, to build the training programme.

The material is packaged into modules made available freely online, with each covering hepatitis C from a specific angle. Together they offer journalists different ways to tell the hepatitis C story.

Hepatitis C has been around for so long that it suffers from the same predicament that a condition like HIV/AIDS does: people feel it’s an old story that they don’t know how to keep telling.

But there is so much happening in the hepatitis C landscape to make the story both very fresh and very important. Through this portal, journalists will find tips on how to address said story, in a way that suits their community.

The portal’s steering committee worked on coming up with fresh angles and the portal is expected, still, to help journalists tie loose threads; for example, reporters on the virus should be able to explore questions related to drug policy, commercial use of hepatitis C drugs, accessibility and reach.

The portal also offers a database of experts, policymakers, researchers, clinicians and patient advocacy groups from around the world, with contact information readily available to all visitors of the portal. The experts speak different languages to suit the needs of journalists globally.

The second part of the programme will see the WFSJ use the material online to host face-to-face workshops for journalists on the ground in countries and regions where hepatitis C is most prevalent, such as Egypt and Pakistan.

The workshops will be held in several regions and in different languages to make sure that as many people as possible can benefit from them. In addition to field workshops, the portal will offer a series of online webinars by award-winning science journalists.

Health situation in Yemen more desperate than ever

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The World Health Organisation’s Margaret Chan published a statement this week decrying the health situation in Yemen, in which conflict killed almost 2,000 people, and injured 8,000, according to the latest death and casualty tolls.

Around 8.6 million are in need of urgent medical help, the statement said, adding that although WHO has delivered around 48 tonnes of medicine during a recent ceasefire, this is “vastly insufficient.” The aid can only serve some 400,000 people, and more continue to suffer, “not only from war-related injuries, but from inability to get basic treatment for the most common health conditions, or get obstetric care during childbirth.”

The statement reiterates that lives are lost not just in conflict, but in the throes of an ailing health system, a reality that Nature Middle East‘s correspondent Sophie Cousins has explored in an earlier report on May 4.

Ahmed Shadoul, WHO representative for Yemen, had told Cousins that health facilities are coping with “critical shortages of life-saving medicines, trauma care, and surgical and medical supplies, as well as medical staff to cope with the growing influx of patients.” At the time, the Yemeni ministry of public health and population had predicted that major hospitals will be unable to provide services, perform operations or provide intensive care to patients.

And indeed, WHO’s latest statement reported that hospitals around the country are already closing down their emergency operations rooms and intensive care units due to shortages in staff and fuel for generators. Medicines for diabetes, hypertension and cancer are no longer available, as per the WHO. The National Tuberculosis Programme has shut down in some areas, and infectious diseases such as malaria and dengue fever are spreading.

Outbreaks of polio and measles are also serious risks.

The statement in full can be read here.

Hepatitis C may increase cancer rates

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Infection with hepatitis C virus has long been linked to an increase in the rate of liver cancer, but new research suggests that it may also increase the risk of other types of cancer as well.

Hepatitis C is associated with non-Hodgkin’s lymphoma, renal, prostate and liver cancer. But the researchers also looked at other types of cancer, such as head and neck, esophagus, stomach, colon, pancreas and lung. The retrospective study looked at a group of patients in the US with our without hepatitis C and compared the incidence of cancers between the two groups. Overall, the study included 145,210 patient years in the HCV cohort, and 13,948,826 patient years were included in the non-HCV cohort.

The patients with hepatitis C were more likely to develop cancers during their lifetime – with the rate being 2.5 times higher than the group without the virus. Even when liver cancer was excluded, the rate was almost 2 times higher in the patients with HCV.

“These findings certainly point to the suggestion that hepatitis C may be associated with an increased risk of cancer. However, the findings must be interpreted with caution, as the study also showed that confounding factors such as alcohol abuse, tobacco, obesity, and diabetes modified the results,”  said Lisa Nyberg from Kaiser Permanente, Southern California, who is the senior author of the study.

Laurent Castera, Vice-Secretary, European Association for the Study of the Liver, commented: “This data adds to the evidence bank linking hepatitis C with an increased risk of cancer, and highlights that there is still a long way to go in order to fully understand this complex and devastating disease.”

Hepatitis C is endemic in several states in the Middle East, with Egypt home to the largest percentage in the world at ~13%. The disease is also prevalent in Morocco, Qatar, United Arab Emirates and Jordan. In many states it is driven by poor infection control in the healthcare system, but in the richer Gulf states the virus is more widespread among the immigrant worker communities.

Date syrup inhibits bacterial growth

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New research shows that date syrup – a delicacy popular in the Middle East and a culinary essential in countries like Iraq – can inhibit the growth of bacteria faster than manuka honey.

The syrup has antibacterial activity against a number of disease-causing bacteria, says the research presented yesterday at the Society for General Microbiology’s Annual Conference in Birmingham, and undertaken by Hajer Taleb, a research student from Cardiff Metropolitan University.

Talib studied date syrup produced traditionally in Basra, Southern Iraq, and her in vitro results reveal that the date syrup is as effective as manuka honey, in similar amounts, but works more quickly, inhibiting bacterial growth after only six hours of treatment.

The antibacterial properties – that work against a host of diseases including Staphylococcus aureus, Escherichia coli, Enterococcus spp. and Pseudomonas aeruginosa – are present thanks to phenolic compounds that form naturally in dates as they mature.

Date syrup has already been consumed for its health benefits in the region, however, Talib wanted to test the perception and consecutively pinpoint, perhaps for the first time, the mechanisms underlying said health benefits.

While the research is still in the laboratory stage, the researchers believe that the syrup could have a clinical value as a topical antibacterial treatment for wound infection, but Ara Kanekanian of Cardiff Metropolitan University, who leads this research, cautions against using the syrup to treat wounds, pending further research.