A moment like this doesn’t come around often. In London today, global health leaders — the CEOs of major pharmaceutical companies, Bill Gates, WHO Director General Margaret Chan, senior government officials from endemic and donor countries, and others — announced an unprecedented commitment to control or eliminate 10 diseases by the end of this decade.
We have a unique opportunity to meet the World Health Organization’s 2020 targets for NTD control and elimination. Success would represent one of the most cost-effective means to lift 1 billion people out of poverty and prevent needless suffering among future generations.
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om the World Health Organization (WHO) concluded that a woman living in a developing country is practically always on the verge of iron deficiency anemia either because of pregnancy, which requires the transfer of 300 mg of iron to the fetus during the third trimester and an additional 500 mg of iron to accommodate an increase in red blood cell mass, or lactation, in which each episode transfers 0.75 mg of iron from mother to child. Moreover, even before she becomes pregnant, a woman of childbearing age suffers substantial iron losses from menstruation. Anemia, defined as a reduction in hemoglobin to <11 g/dl in the first and third trimester and <10.5 g/dl in the second trimester, creates a dangerous state of health for both mother and child . It is estimated that 20% of maternal deaths in Africa are attributed to anemia, while simultaneously anemia represents a key risk factor for poor pregnancy outcome and low birth weight. It now appears that human hookworm infection, one of the most common NTDs affecting 576–740 million people in developing countries, considerably adds to the iron loss and anemia that occurs during pregnancy. An estimated 44 million pregnant women are infected with hookworm at any one time, including up to one-third of all pregnant women in sub-Saharan Africa. In Africa and Latin America, hookworm is a major contributor to anemia in pregnancy, while in Nepal and presumably elsewhere in Asia hookworm is responsible for 54% of cases of moderate to severe anemia during pregnancy. Not surprisingly, deworming during pregnancy has major beneficial effects in terms of reduced maternal morbidity and mortality, as well as improved perinatal outcome, and most likely leads to a reduction in maternal anemia. Such studies have led to calls for including deworming in antenatal packages in hookworm-endemic areas in developing countries.
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Hookworm infection is among the major causes of anaemia in poor communities, but its importance in causing maternal anaemia is poorly understood, and this has hampered effective lobbying for the inclusion of anthelmintic treatment in maternal health packages. We sought to review existing evidence on the role of hookworm as a risk factor for anaemia among pregnant women. We also estimate the number of hookworm infections in pregnant women in sub-Saharan Africa (SSA).
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