Wastewater in India
India is not only one of the most populated countries in the world, but it is also one of the poorest. In addition to poverty, India is grappling with a lack of access to clean water and increasing pollution. This not only takes a toll on households but also affects industrial and agricultural demands. Urban runoff is an issue when domestic waste and untreated water go into storm drains, polluting lakes and rivers. Approximately only 30 percent of the wastewater in India is cleaned and filtered.

The U.S. Agency for International Development teamed up with a nongovernmental organization, Agra Municipal Corporation, to formulate a treatment plan to clean the wastewater in India.

What is Being Done?

North of the Taj Mahal runs the Yamuna River, one of the most polluted waterways in India. Agra, the city through which the river runs, is a slum community. As of 2009, this community has had no access to sanitation facilities, disposal systems or waste collection. At least 85 percent of the residents in Agra have resorted to open defecation that ultimately pollutes the Yamuna River, where residents collect drinking water. This lack of sanitation has left the community vulnerable to diseases such as cholera, dysentery, typhoid and polio.

USAID-supported NGO Center for Urban and Regional Excellence decided to reverse the state of Agra and come up with a treatment plan. In 2011, they built a wastewater treatment plant to clean the water, leading to healthier community members. Instead of chemicals, the treatment plant uses natural methods to sanitize the water. Moreover, they designed the plant to be low-maintenance, thus keeping it cost-efficient. After filtering and sanitizing the water, it flows back into the community for residents to collect.

As of 2017, the Agra Municipal Corporation, who initially teamed up with USAID, took over operating the plant. And they made it their mission to continue working to improve the lives of the residents.

The Progress

The Center for Urban and Regional Excellence’s transformation of Agra influenced the government to also act. As a result, the government planned to cleanse the entire country by the end of 2019. On Oct. 2, 2014, the Prime Minister of India declared the Swachh Bharat Mission. At the time, only 38.7 percent of the country was clean—less than half. As of 2019, India’s government reported 98.9 percent of the country is now clean. Since the mission began, they built 9,023,034,753 household toilets and established

  • 5,054,745 open defecation-free villages,
  • 4,468 open defecation-free villages in Namami Gange,
  • 613 open defecation-free districts, and
  • 29 open defecation-free states.

Less than 2 percent away from meeting their goal, India has made big improvements to better the lives of its citizens by providing clean water for domestic and industrial purposes.

Lari’onna Green
Photo: Flickr

Treatments for TuberculosisTuberculosis is the leading infectious cause of death worldwide. However, the full extent of childhood tuberculosis is poorly understood. According to 2015 World Health Organization estimates, TB infected more than one million children and killed more than 200,000. Given the difficulty of diagnosis in children, the true burden of this disease is likely even greater than reported.

Tuberculosis most commonly affects the lungs and is spread by infected airborne particles, released by patients with the active disease. Because transmission is augmented in overcrowded, poorly ventilated areas, people living in poverty are disproportionately affected. More than 95 percent of TB-related deaths occur in low and middle-income countries.

Active tuberculosis is often asymptomatic or causes vague symptoms such as general malaise, anorexia, and weight loss. A cough is the most common symptom and often becomes progressively productive. Diagnosis is based on the results of sputum samples.

Treatment regimens consist of multiple medications taken for extended periods of time. To ensure adequate therapy, patients must take a certain number of doses. If too many doses are missed, treatment must be restarted. Problems with patient non-adherence have led to the rise of directly-observed therapy (DOT) in which a public health worker witnesses the patient’s medication consumption.

In addition to the extensiveness of the drug regimen, the bitter taste of the medications can be a significant barrier to adherence, especially for children. TB Alliance has already helped to develop liquid formulations for first-line antituberculosis drugs, but with the rise of drug-resistance, alternative therapies must also be made more kid-friendly. PepsiCo has stepped up to partner with TB Alliance in developing tastier treatments for tuberculosis.

As a highly successful beverage company, heavily invested in research and development, PepsiCo is a logical collaborator in this endeavor to develop tastier treatments for tuberculosis. Since 2011, PepsiCo has increased investment in research and development by 35 percent. The emphasis on innovation has undoubtedly contributed to the company’s success. In addition, as a global brand, PepsiCo garners insights from countries most heavily affected by tuberculosis. The company has R&D facilities in India and China, two of the six countries that account for more than 60 percent of tuberculosis cases.

Rebecca Yu

Photo: Flickr

Capsid Pores
HIV remains one of the major issues in global health today. According to the CDC, 36.9 million people have HIV. Additionally, 66 percent of new HIV infections are occurring in Sub-Saharan Africa, so improving ways to combat HIV would benefit development goals in that region as well. However, researchers have recently discovered the existence of capsid pores in the HIV virus that may lead to new treatments.

The way the HIV virus operates is that it infects cells with copies of its own genetic material. The genetic material then incorporates itself into the cell’s DNA and causes the cell to spawn more of the virus. Currently, there is no hard cure for HIV.

Capsid is a protein shell that surrounds the HIV virus. It protects the virus from threats, such as the human immune system. Meanwhile, the HIV capsid pores are able to open up to allow the virus to take in nucleotides, which are the material it uses to make copies of its own genetic material to infect cells with.

The researchers who discovered the pores went on to hexacarboxybenzene, which is known as an inhibitor molecule in that it can block the capsid pores. HIV viruses that had their pores blocked were unable to copy their genetic material.

Unfortunately, the hexacarboxybenzene molecule is unable to pass through human cell membranes, so they cannot target HIV viruses that have already infected human cells. However, now that researchers are aware of the capsid pores, they can work on designing new drugs that can traverse into human cells and still inhibit the pores.

Additionally, the findings on HIV capsid pores could also improve existing treatments. One of the foremost drugs used in suppressing HIV belongs to a family known as reverse transcriptase inhibitors (RTI).

Reverse transcriptase is an enzyme that HIV viruses use in the process of replicating their genetic material, and RTIs inhibit this enzyme. Now, researchers realize that the RTIs must have to traverse the capsid pores in order to be effective, so reevaluating their mode of operation could yield more effective RTIs or lead to the development of other drugs.

The recent discovery of HIV capsid pores is promising in its potential for future breakthroughs.

Edmond Kim

Photo: Flickr

Child Malnutrition
Child malnutrition is the leading cause of death in children under five years old. Some 2.7 million children die annually due to undernourishment. However, promising research coming from the Washington University School of Medicine in St. Louis is raising hopes to change that.

Two studies led by Jeffrey I. Gordon, MD and Dr. Robert J. Glaser demonstrate potentially life-saving progress in the treatment of child malnutrition.

Gordon and Glaser have been studying the connection between gut microbes and the development of children. Child malnutrition is often diagnosed in children with stunted growth and they have found that the gut microbes in these malnourished children resemble microbes of a much younger child.

These findings suggest that the microbes themselves have become stunted. Healthy gut microbes are extremely important to the development of a child’s health. Such microbes contribute to the child’s ability to properly extract the necessary nourishment from their food. Without them, this inability means that even children who have received treatment for malnutrition can continue to have problems in the future.

The first study published in Science and carried out by Laura V. Blanton found that “that malnourished children have defects in this developmental scenario, leaving them with gut microbial communities that look younger than what would be expected based on their chronological ages.”

Blanton took samples from healthy and malnourished children from Malawi and implanted them in germ free mice. Knowing that mice eat each others feces, Blanton hoped that when caged together the healthy microbes would transfer to the mice implanted with the microbes from the malnourished children. She found just that, meaning that a process for implanting healthy microbes into malnourished children could be in the works.

The second study, done by graduate student Mark R. Charbonneau and published in Cell, targeted the effects of the mother’s breast milk on child malnutrition. Research shows that these mothers breast milk often contain low levels sialic acid, which is linked to healthy brain development.

Charbonneau, again using germ free mice, implanted healthy and malnourished microbes with differing levels of sialic acid. He found that the mice that received sialic acid at comparable levels to healthy mothers breast milk, grew much larger then the mice without it, even though each group of mice received the same diet.

Mice in both studies experienced “improvements in skeletal development and a better metabolic profile in the blood, brain and liver.” The researchers were also able to reproduce these results in germ free piglets, which more accurately reflect the metabolism of a human.

While the conditions of the two studies may not exactly represent natural conditions, microbial interventions in combination with more research could lead to improved treatments and perhaps even a cure. With millions of children and families relieved from the stress of finding their next meal, the globe moves one step closer to eliminating poverty.

Michael Clark

Sources: The New York Times, The Source, The Washington Post

Hamlin Fistula EthiopiaHamlin Fistula Ethiopia is a charitable organization in Ethiopia dedicated to treating and preventing a specific childbirth injury known as obstetric fistula.

An obstetric fistula is a hole between “the vagina and rectum or bladder that is caused by prolonged obstructed labor, leaving a woman unable to control her urine or feces.”

According to Hamlin Fistula, “more than 75 percent of women with obstetric fistula have endured labor that lasted three days or more.”

The organization has built the world’s first fistula hospital and also has five regional centers in Ethiopia, providing healthcare to rural women.

Having the Hamlin Fistula Clinic in Ethiopia is vital because it is one the fastest growing economies in Africa. Unfortunately, the country has less than 7,000 trained midwives making the ratio of midwives to women having children very low.

According to the organization, “the childbearing population ratio is approximately 1:14,000, well below the World Health Organization’s recommendation of 1:5,000.”

This lack of services and health professionals has a direct impact on Ethiopian women. Approximately 9,000 women die in obstructed labor each year. Another 9,000 survive but with an obstetric fistula.

Hamlin Fistula Ethiopia provides a world class center of excellence for treating obstetric fistulas and training doctors to specialize in this surgery. Also, “the hospital also has the Hamlin College of Midwives and the Desta Mender – a farm and training center for long term patients.”

In addition, Hamlin Fistula offers rehabilitation services such as physical therapy, psychotherapy and job training. This helps patients rebuild their self-esteem, find meaningful employment and reintegrate into their village life.

“Over 700 Ethiopians are employed across Hamlin Fistula Ethiopia and only two of the staff are from overseas. Dr. Catherine Hamlin and Mr. Martin Andrews, the CEO.” It is with the generosity of donors that the Hamlin Fistula Ethiopia continues its work in treating and preventing obstetric fistulas.

“Mourning the stillbirth of their only child, incontinent of urine, ashamed of their offensiveness, often spurned by their husband, homeless, unemployable, except in the field, women with obstetric fistula endured, existed, without friends and without hope.”

However, thanks to Hamlin Fistula Ethiopia, Ethiopian women have the hope of receiving good, quality healthcare during childbirth. These women will be able to integrate themselves back into their families, communities and society at large, after delivery of their children.

Vanessa Awanyo

Sources: World Health Organization, Hamlin Fistula Ethiopia, Fistula Foundation
Photo: Flickr

Researchers are working on a new nasal spray that could save thousands of people from severe snakebites in India. The nasal spray is the first attempt of its kind to save victims from one of the most unrecognized killers in the world.

Snakebites kill up to 84,000 people worldwide every year. They are most prevalent in South and Southeast Asia and sub-Saharan Africa. However, India has the highest number of venomous bites and deaths, with more than 75 percent of snakebite victims dying before they can reach a hospital.

Currently, the most popular treatment for snakebites is an injection of antivenom, but this method has proved to be unreliable. Antivenom can vary in effectiveness depending on the snake species, the snake’s diet, geographical location and the time of year.

The nasal spray is an attempt to standardize treatment for snakebites. If administered soon after the attack, the spray — which is extremely cheap compared to antivenom — could prevent paralysis that is caused by the bite. It is easy to use and can be self-administered, unlike the injection of antivenom.

The two researchers leading the development have high hopes for the nasal spray. Matthew Lewin from the California Academy of Sciences and Stephen Samuel from Trinity College Dublin, Ireland have worked tirelessly to test the spray on mice. The mice were injected with fatal doses of Indian cobra venom, and then some were treated with the spray while others were not. The study proved that mice given the spray outlived the control group. In many cases, they survived.

“It would be one ingredient primarily directed against rapid onset paralysis — one of the causes of fast death following snakebite,” Lewin explained. “It is inexpensive and available everywhere in the world.”

In general, snakebites are often an ignored health problem around the world. The numbers, however, indicate that some research should be going toward developing a treatment. If the nasal spray proves to be an effective treatment, then people around the world will have a much higher chance of surviving these attacks.

– Hannah Cleveland

Sources: The Guardian, Science Development
Photo: The Guardian

hiv children treatment where you live botswana study efavirenz nevirapine medicine
There are over 3 million children that are HIV-positive, with more than 90% of them living in Sub-Saharan Africa. The World Health Organization (WHO) recommends both efavirenz and nevirapine for first-line pediatric use in resource-limited settings such as sub-Saharan Africa. A recent study compared the first-line treatments for HIV-positive children and was conducted by the Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, along with colleagues at the Botswana-Baylor Children’s Clinical Centre of Excellence. The study found that initial treatment with efavirenz was more effective than nevirapine in suppressing the virus in children ages 3 to 16, and that nevirapine is less effective than efavirenz. Nevirapine, the less effective drug, is used much more often in countries with a high prevalence of HIV.

The study notes that nevirapine costs less than efavirenz and is more widely available in pediatric formulations, which may explain this disturbing fact. Studies that focused on adult treatment also found efavirenz to be more effective than nevirapine. Conclusively, the study states, “Given this evidence, it is very reasonable to adjust pediatric HIV treatment guidelines…more work should be done to make efavirenz a more financially viable option for children on anti-retroviral therapy in these resource-limited settings.”

– Essee Oruma

Source: allAfrica
Photo: Science Daily