Tag: public health

Categories : Diet and Nutrition General InterestTags :

Health Experts Call for a Sugar Tax Increase to 20%

On By ModernMedia

In advance of Finance Minister Tito Mboweni’s annual budget presentation on 24 February, health specialists have been calling for an increase in the health promotion levy from 11% to 20%. 

The health promotion levy (or ‘sugar tax’) was put into effect in April 2018, and imposes an 11% tax on sugar sweetened beverages. Specialists called for an increase in this tax on Tuesday at a webinar rub by the Healthy Living Alliance (Heala), saying that this was a prudent time to do it because the health sector is currently battling the COVID pandemic.

Most people hospitalised with COVID in SA have comorbidities such as diabetes and hypertension, said Karen Hofman, director of the Wits Centre for Health Economics and Decision Science (Priceless SA). Sugar, especially in liquid form, is a risk factor for obesity, diabetes, hypertension, cardiovascular disease, a number of common cancers and dental decay. She added that had those comorbidities had been prevented, the country could have been in a much better position.

Hofman said that people think they have “control over what [they] are eating and drinking”, but in fact don’t, having been heavily influenced by their environment from an early age. For the tax to have any effect, it should be increased to 20%, based on the World Health Organization and other health experts’ recommendations.

Heala head, Lawrence Mbalati, said the sugar tax had created R5.4-billion for the government within its first two years. This would have been enough to finance South Africa’s downpayment for COVID vaccines from the Covax facility almost 20 times over, in spite of its minimal contribution to the overall budget. 

A doubling of the sugar tax would net an additional R2 billion to help fight COVID, Mbalati said.

“This is a watershed moment for the country,” Mbalati continued. “Government revenues are under immense pressure and funding the fight against Covid-19, including vaccines, remains critical.”

Hofman said that research in other countries with a sugar tax had shown a fall in volume of taxable beverages by 51%, and a 29% reduction in sugar intake.

“SA must address commercially driven epidemics with taxes, mandatory food labelling and mandatory comprehensive marketing bans,” Hofman said.

Source: Mail & Guardian

Categories : COVID Medical IndustryTags :

Over Half of SA Has Had COVID, Says Discovery CEO

On By ModernMedia

From the number of excess deaths in South Africa, it appears that over half of South Africa has been infected with COVID at least once.

The CEO and founder of the Discovery Group, Adrian Gore, has said in an interview on 702’s The Money Show that he believes over half of the South African population has had COVID. He believes that there is “absolutely no ambiguity” that the “sky high” excess death rates recorded in SA are attributable to COVID. He said that the excess deaths point to over 50% of the SA population having been infected with COVID so far.

The latest data released by the South African Medical Research Council (SAMRC) puts the number of excess deaths in SA over the course of the pandemic at 137 731 – nearly triple the official death toll from COVID. Nearly 5000 Discovery members and 12 staff members have died. 
Last week, SA National Blood Service released a study showing that 32% of people in the Northern Cape up to 63% of people in the Eastern Cape had contracted COVID. Gore said that this high infection rate would hopefully reduce the impact of the third wave predicted to arrive in the colder winter months.

“We are hoping that a third wave may take longer and might be less because we think the infection rate has been high.” He said, adding that if the first and second phases of vaccination targetting healthcare workers and vulnerable individuals was completed by mid-year, a third wave might be completely avoided.

He said that young, healthy people who can afford a vaccine should not be able to get one before those who were older and more vulnerable. “Not following this process would mean low-risk people get vaccinated before the clinically vulnerable, resulting in unnecessary illness and death. This cannot and should not happen,” he said in a Linkedin post.

He also refuted the rumour that Discovery was not paying contributions towards non-members’ vaccinations. In fact, he said on The Money Show, that medical aid schemes have extra cash to pay for this since members had been going for fewer treatments during the pandemic. This amounts to some R24 billion in surplus, as revealed by regulatory filings, which would be right in the middle of cost estimates for SA’s entire vaccination programme as opposed to the 30% amount that medical aid companies were being expected to contribute.

Source: Business Insider

Categories : COVIDTags :

Real-world Results for Pfizer Vaccine Match Trials

On By ModernMedia

Encouraging results have been reported from Israel, where the real-world efficacy of the Pfizer vaccine closely matches that seen in clinical trials.

Israel has engaged in the world’s most aggressive COVID immunisation schedule, with some 30% of its population vaccinated by late January with at least one dose.

Israeli health fund Clalit matched 600 000 vaccinated individuals to an equal number of unvaccinated individuals. Those who were vaccinated experienced a similar rate of positive COVID tests as was observed in clinical trial data, equating to a 94% effectiveness. Crucially, almost no severe cases of COVID were observed in vaccinated individuals. This pattern was also seen in the over-70s age group, which is generally underrepresented in trials.

Public health doctor Prof Hagai Levine said that high vaccination coverage of the most susceptible groups was key. However, he said that he could not give an answer as to what number needed to be vaccinated before containment measures could be eased. 

“We still don’t know what the impact is on transmission,” he said. But he added that “the vaccine is useful for personal protection”.

The greatest drop in cases was seen in the over 60s age group, and in areas which had been vaccinated, indicating that this was not the result of lockdown. However, many people still remain unvaccinated, resulting in tens of thousands of cases. Prof Segal noted that the fall in cases was not as rapid as had been hoped, due to the B.1.1.7 or UK strain becoming dominant in Israel.

“We still have to exit our lockdown very cautiously,” he warned, or else hospitalisations would spike again.

The fact that the same rate was observed in clinical trials is important news for other countries, which are watching to see the effects of Israel’s vaccination programme.

Source: BBC News

Categories : COVIDTags :

Research Shows ‘UK Variant’ is up to 70% Deadlier

On By ModernMedia

A review of research on the COVID variant B.1.1.7, also known as ‘the UK variant’, has shown it to be 30% to 70% more deadly than the original wild-type COVID strain.

Concerns over the deadliness of B.1.1.7 were raised in January, when the UK government’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) presented initial findings suggesting that B.1.1.7 cases were deadlier than non-variant cases. After this, they released an updated report which is available online. The report makes the cases that the earlier linked community testing and mortality data were all based on the same datasets, and so had the same biases. However, the group explained that the new analysis was more valid.

“More recent analyses have added a wider range of data sets and been able to control for additional confounders, increasing confidence in the association of the [variant of concern] with increased disease severity,” the group wrote.  

London School of Hygiene & Tropical Medicine found a relative hazard of mortality within 28 days was 1.58 for variant-infected individuals, while Imperial College London used a case-control weighting method to find a case fatality ratio of 1.36 for variant cases. Public Health England  found a “death risk ratio” of 1.65 in matched cohort analysis for variant cases versus non-variant cases.

A number of other studies investigated the variant’s impact on hospitalisation. Public Health Scotland used S-gene target failure as a proxy for variant case detection. They found that S-gene target failure cases had a higher risk for hospitalisation than the S-gene positive cases.
Some studies did not support the higher fatality risk, such as the UK’s Office for National Statistics (ONS), which said that “the number of deaths are too low for reliable inference.”

A number of limitations were reported in the study, including potential bias in case ascertainment, representativeness, unmeasured confounders and secular trends. They also tried to control for nursing home status in hospital reports, but not all of these could be excluded.

“There are potential limitations in all datasets used but together these analyses indicate that it is likely that … B.1.1.7 is associated with an increased risk of [hospitalisation] and death compared to infection with non-[B.1.1.7] viruses,” the group concluded.

In mid-January, modelling by the CDC indicated that the UK variant would become the dominant strain in the United States by March. At the end of January, President Joe Biden had pledged to increase vaccinations to 1.5 million per day, a target which would still not be able to contain the spread of the variant.

Source: MedPage Today

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Categories : Diet and Nutrition PaediatricsTags :

Study Reveals More Sugar in Breakfast Products Aimed at Children

On By ModernMedia

Breakfast products that are aimed at children contain significantly more sugar than those aimed at adults, a Spanish study has revealed.

The researchers analysed a 355 advertisements from 117 different products from 2015 to 2019, and found that the average amount of sugar in the breakfast products analysed and advertised for adults was 10.25%, while for children it was 36.20%.

“Although much of the adult population still adhere to the Mediterranean diet, it is a practice that is waning among children and young people, who are increasingly opting to eat processed industrial products with a high sugar content for breakfast,” explained Mireia Montaña, UOC Faculty of Information and Communication Sciences professor and researcher.

Mònika Jiménez, professor of Advertising and Public Relations at Pompeu Fabra University (UPF) and co-author of another study on breakfast food advertising involving Prof Montaña, warned of persuasive advertising for foods with little nutritional value.

She said, “The less closely a product correlates to that which would be deemed healthy nutritional parameters, the greater the tendency for the advertising discourse to focus on hedonism or happiness and tend towards persuasion.” As Jiménez explained, when such discourse alludes to positive feelings, it stimulates certain areas of the brain that lead us to consume, a strategy which “is especially harmful in relation to certain audiences, such as minors, because they are very susceptible to these kinds of stimuli.”

Profs Montaña and Jiménez found that low nutritional quality breakfast foods were advertised mostly through television (39%), followed by radio (28%), the internet (18%), newspapers (6%), magazines (5%), outdoor advertising (2%) and cinema (0.56%). “TV is the most effective medium when it comes to persuading children. And when is it that children are going to the supermarket with their parents and end up imposing their preferences with regard to what goes into the shopping trolley? Precisely when they are younger, up until preadolescence,” Prof Jiménez pointed out.

Though there are regulations in Spain preventing advertisers from targeting children directly, there are no such restrictions for products which can be aimed at any age group, such as hot chocolate. Advertising aimed at children to use ‘pester power’ on their parents results in food being bought which is then consumed by the entire family. 

Their recommendations included more stringent regulatory frameworks, better nutritional education aimed at parents and children, and added taxes on certain products such as soft drinks.

Source: News-Medical.Net

Journal information: Blasco, M.M., et al. (2021) Breakfast Food Advertisements in Mediterranean Countries: Products’ Sugar Content in the Adverts from 2015 to 2019. Children. doi.org/10.3390/children8010014.

Categories : COVIDTags :

SA to Expedite 80 000 Doses of J&J Vaccine

On By ModernMedia

South Africa will accelerate the rollout of the Johnson & Johnson vaccine, it has been reported.

SA has secured orders for 9 million doses of the vaccine, of which the first 80 000 are expected to arrive in the country next week. Since immunity with the Johnson & Johnson vaccine is achieved with a single dose, this will be enough for 9 million people in South Africa, barring some inevitable wastage. Results from clinical trials in South Africa show that the vaccine has an effectiveness of 57%, 28 days after vaccination.

Professor Linda-Gail Bekker at the Desmond Tutu HIV Centre, University of Cape Town, who was involved in a South African trial last year, explained that there is a delay between the results of a clinical trial and the licence being granted for commercial use. She has urged the need for rapid vaccine rollout, and had also tested positive for COVID herself along with her family during the festive season. As a stopgap measure, an interim vaccination plan with 80 000 doses will be put into action at 32 locations around the country.

Explaining the programme, Prof Bekker said: “Can we together bring this expedited plan forward so that we can make sure we, as quickly as possible, rollout phase one recipients – mainly healthcare workers – into a kind of emergency programme.”

Prof Bekker describes the expedited rollout as being different to a clinical trial.

She continued, “This is not clinical research in the clinical trial concept; it really is programme evaluation, and many eyes are on it at the moment to make sure that we have covered all aspects – ethical, safety and scientific. We will not move without those approvals.”

Source: Eyewitness News

Categories : COVIDTags :

Reckless to Discard AstraZeneca Vaccines, Says Prof Madhi

On By ModernMedia

Professor Shabir Madhi of Wits University says that it would be reckless to simply abandon South Africa’s stock of AstraZeneca vaccine doses, even after a small trial showed it to have minimal effect against the local variant.

One million doses of AstraZeneca vaccine had been scheduled for rollout, but that plan has been put on hold after preliminary results showed that it conferred minimal effectiveness against mild-to-moderate infections by the dominant 501Y.V2 strain in South Africa. 

Madhi said that scientists needed more time to go through the data, said Madhi.

“I think it would be highly reckless for us to discard the vaccine. We paid a high price for it and so the vaccines do have a role in protecting from severe disease. I think an important feature in all the vaccines is that generally, vaccines work much better in preventing severe disease.”

There is already a closing window of opportunity, since it was recently discovered that the first batch of one million doses received from the Serum Institute of India would be expiring in April.

Madhi said that there were other options to put the vaccine to good use.
“If we’re strategic in terms of the rollout, we might still be able to get the vaccine used, not two doses per individual but at least a single dose and we could possibly follow it up then with another vaccine and a few vaccines that might come online in the next two or three months.”

In an interview with the BBC, he said that the disappointing results of the trial had not been able to show the effectiveness against severe COVID, as the sample size was too small and too young, with an average age of 31, but that it might still have a protective effect in different age groups. “There’s still some hope that the AstraZeneca vaccine might well perform as well as the Johnson & Johnson vaccine in a different age group demographic that I address of severe disease,” he said.

Source: Eyewitness News

Categories : HIVTags :

Revolutionary HIV Prophylaxis Pill Rollout in SA

On By ModernMedia

Amidst the COVID pandemic and concerns about vaccines, the South African government is rolling out a gaming-changing pill that protects against contracting HIV.

Due to delays including COVID-19, the revolutionary HIV pre-exposure prophylaxis (PrEP) pill is currently only available at 36% of public healthcare facilities – but the impact as it is rolled it will be significant.

Yogan Pillay, Deputy Director for Communicable and Non-Communicable  Diseases, Prevention, Treatment and Rehabilitation at the National Department of Health, says the PrEP pill will be available at all public healthcare providers by the end of September this year.

The pill combines two antiretrovirals, tenofovir disoproxil fumarate and emtricitabine (TDF/FTC), and gives nearly complete protection against contracting HIV. Over the past 4 years, over 50 000 people received the pill during trials. Young women and adolescent girls aged 15 to 24 are at four times higher risk of contracting HIV than males the same age, and since they may not be in a position to negotiate condom use, PrEP allows them to reduce the risk of contracting HIV through sexual activity. The TDF/FTC pill takes seven days to achieve full protection, and should be continued to be taken 28 days after the last HIV exposure. Periodic HIV and kidney function tests will be administered after the first month.

“The PrEP targets in the National Strategic Plan (NSP) for HIV, TB and STIs 2017-2022 is 85 000,” said Pillay. “We do however estimate based on the uptake trend at the current PrEP sites that approximately 10.5% of HIV negative persons offered PrEP will take up PrEP.”

The TDF/FTC pill can be taken at any point of the day, with alcohol, and is compatible with the use of birth control pills and other contraceptives. The pill will be made available through the public sector to any HIV negative person with healthy kidneys willing to take it daily. The TDF/FTC pill can only be prescribed by NIMART (Nurse Initiated Management of Antiretroviral Therapy) trained nurses, not other nurses or clinical associates at this time.

Source: Spotlight

Categories : COVIDTags :

Six Key Takeaways of SA’s Vaccination Programme

On By ModernMedia

From a webinar held by the Department of Health late Wednesday night, there are six key points that were learned about the government’s vaccination programme.

1: To receive a vaccine, people will need an internet connection, cellphone and an ID. The internet connection is needed for self-enrolment on the Electronic Vaccine Data System (EVDS), and the cellphone is needed to receive an SMS detailing the time and place for vaccination. An ID book is required for identification. After the second vaccination (if a two-dose vaccine), an “electronic vaccination certificate” can be accessed from the EVDS. No mention was made of alternatives for those without ID books or internet access to the EVDS.

2: Private doctors and nurses will be paid R50 to R60 per shot administered. However, the government would prefer to use public healthcare facilities wherever possible.

3: Medical aids will pay double or triple for the vaccine doses. As reported in early January, medical aid schemes will pay for some of the costs of achieving herd immunity. The single exit price (SEP) of vaccines will be higher. Whether medical aids cover the number of additional doses for uninsured people at 1:1 or 2:1 is yet to be determined.

4: Mines have significant vaccination capacity – assuming they have enough doses on hand. The head of health for the Minerals Council, Thuthula Balfour, explained: “We’ve actually worked out that the industry can administer about 60 000 to 80 000 vaccines a day, so within two months we could vaccinate between 2.5 million to 3 million people.” This would equate to some five extra people per mineworker.

5: Rural clinics without generators will not receive vaccines. The distribution will use a hub-and-spoke model with hubs that are able to guarantee security and available electricity receiving vaccine stocks.

6: The auditor-general is already involved, to forestall corruption. Health Minister Zweli Mkhize said that “all the approaches that we’re taking to make sure that at the end of it they can give us a sense of checks and balances they are going to suggest as we deal with the risks associated with this process.”

Source: Business Insider

Categories : Allergies PaediatricsTags :

Black American Children Have Higher Rates of Shellfish and Fish Allergies

On By ModernMedia

A study from Rush University Medical Center in the US has shown that black children in that country are more likely to have allergies to fish and shellfish than white children.

Some 8% of children in the US suffer from food allergies, which can result in signs and symptoms such as hives, breathing and digestive problems or anaphylaxis, sometimes severe enough to be life-threatening.

Lead author Dr Mahboobeh Mahdavinia at Rush University Medical Center, explained: “Food allergy is a common condition in the U.S., and we know from our previous research that there are important differences between African-American and white children with food allergy, but there is so much we need to know to be able to help our patients from minority groups.”

The study found that the black children were more likely to have an allergy to shellfish and fin fish, and also higher odds of having a wheat allergy, compared to the white children. The researchers believe the reason for this is environmental and socioeconomic: in the US, black children are more likely to be exposed to cockroaches than white children due to the increased probability of living in more socioeconomically deprived areas.

Tropomyosin, a protein found in two common household allergens, dust mite and cockroaches, share 80% of amino acid sequencing with shellfish. Some 72-98% of individuals allergic to prawns have an immunoglobin E response to tropomyosin. It has also been found in fin fish. Although the exact mechanism by which the allergy is established is not known, it provides evidence as to the importance of reducing the exposure of black children to cockroaches.

The study also showed that shellfish allergy was associated with increased asthma risk in black children. “This information can help us care for not only a child’s food allergy, but all of their allergic diseases, including asthma, allergic rhinitis and atopic dermatitis,” said co-author Susan Fox, PA-C, MMS, an allergy and immunology physician assistant at Rush University Medical Center.

The increased risk of asthma combined with food allergies can prove a lethal combination for children. “A major concern is that there is a higher prevalence of asthma in African-American children with food allergies when compared with white children with food allergies. Approximately 70% of fatal food anaphylaxis is accompanied by asthma. African-American children are at a two- to threefold risk of fatal anaphylaxis compared to white children,” Dr Mahdavinia said. “By knowing this information, it can identify [our] most at risk patients.

“We need to conduct further research to identify food allergies and food sensitivities among all races and ethnicities so we can develop culturally-sensitive and effective educational programs to improve food allergy outcomes for all children,” Dr Mahdavinia concluded.

Source: News-Medical.Net