HIV/AIDS

AIDS (Acquired immunodeficiency syndrome) is caused by HIV (Human immunodeficiency virus), hence the coupling, HIV/AIDS. According to WHO, classification is ICD-10 B20 B24. ORIGIN: It is believed that HIV, the virus plaguing humans, originated in wild chimpanzees, in Cameroon and was transferred to humans in the 1900s. It is also believed that HIV had evolved from Simian immunodeficiency virus (SIV) after being transferred from monkeys to humans. SYMPTOMS: Persons with aids (PWAs) are highly susceptible to a variety of unusual diseases, labeled as opportunistic diseases. For example; meningitis, Kaposi s sarcoma and Herpes simplex. Once infection with AIDS happens , the body produces antibodies in response to the viral invasion leading to symptoms resembling the flu , namely ; swollen glands , enlarged lymph nodes, night sweats , fever , rapid weight loss (unexplained), fatigue , chronic diarrhea and bruises failing to heal. TREATMENT AND CONTROL: Rigorous early treatment with powerful drugs usually retards the emergence of the full blown symptoms. Tests have been created to detect the presence of the antibodies to the AIDS virus in human blood, leading to elimination of suspicious blood in blood banks (preventative measure).AIDS have been treated with protease inhibitors , a treatment which is not universal and is very expensive .This treatment reduces the presence of HIV in the blood to almost undetectable measures N.B. Despite the use of the word treatment , to date, the virus can not be completely eradicated in PWAs. PREVENTION: To prevent the further increase in PWAs, persons and/or PWAs are advised not to 1. Limit sexual contact, sexual partners and drug use and not share needles 2. Not donate and blood, sperm, body organs or any other tissues (PWAs) 3. Refrain from sharing instruments, razors e.t.c. which could be contaminated by blood. PREVALENCE/DISTRIBUTION: Globally , Sub-Saharan Africa accounts for 68% of PWAs , then Europe and Asia with 22.5% , then North, Central and South America with 8.5% , Middle east and south Africa give 1% , Caribbean giving 1% and Oceania <1%1. Nationally, 9% of commercial sex workers and 20% to 30% gay men are PWAs. Overall, 54% PWAs in Jamaica are aged 20 to 39. SOCIECONOMIC EFFECTS: AIDS stigma exists such as ostracism and violence against PWAs.Economically, poverty and aids, especially in the under-developed countries, lead to higher mortality, and hence decrease in skilled labour force, affecting the country s economic performance.
Patton G et al (2009, 12th September), 'Global patterns of mortality in young people: a systematic analysis of population health data' The Lancet 374(9693)
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PROSTATE CANCER/UTERINE FIBROIDS

Prostate cancer is the malignant neoplasm originating in the prostate (WHO classification of C61).Uterine fibroids are benign neoplasm (non-metasizing) in the uterus(WHO classification of D25D26). SYMPTOMS: Since the prostate encircles the urethra the symptoms include, increased frequency of urination and discomfort during urinating. Uterine fibroids cause pressure against neighboring organs like the bladder, intestines and so on, hence symptoms include, constipation, vaginal bleeding, enlargement of abdomen and urinary difficulty. TREATMENT/CONTROL: After testing if malignancy is found, the gland is surgically removed when feasible, sometimes the testes are removed because male hormones increase growth of the cancer (female hormones slow it down, hence administered in some cases).Another treatment is radiation therapy. Uterine fibroids treatment vary based on size. If small, surgery may be postponed as long as tumor poses no threat to health. If large, a hysterectomy or myomectomy is done. PREVENTION: Preventing prostate cancer means preventing the things that put one at a higher risk of getting it, for example diet and lifestyle that lowers risk, chemoprevention and hormone prevention (e.g. lycopene and vitamins E and D).Preventing uterine fibroids is not possible as the disease is idiopathic in nature, however studies show that regular exercise may help. PREVALENCE: Approximately 40% males in Jamaica develop prostate cancer, with the median age of diagnosis at age 72, with 80% of cases pathologically confirmed. In Jamaica, uterine fibroids occur in about 30 %of women over 30 yrs with increasing occurrence, the older the woman gets. SOCOIECONOMIC EFFECTS: Due to prevalence of cancer world wide, society is more aware hence many take preventative measures .In terms of finance, radiation therapy is rather expensive. No data available on the socioeconomic effects of uterine fibroids

Uterine fibroids

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SICKLE CELL DISEASE

Sickle cell is a disorder of the blood caused by inherited abnormal haemoglobin. The abnormal hemoglobin causes distorted (sickled) red blood cells, leading to aneamia, due to rupture of cells. (Under WHO classification D57). ORGIN: Sickle cell occurred as a natural mutation that evolution had planned as a protection for people in regions where malaria was a rampant (Africa and Mediterranean, hence accounting for the large number of black people with the disease) SYMPTOMS: Since circulation ids highly affected, symptoms like: fatigue, pain crises, leg ulcers, eye damage, tachycardia, priapism, jaundice and delayed puberty occur. TREATMENT/CONTROL: Treatments that may be beneficial during a sickle cell crisis include blood transfusions for severe cases, fluid therapy given by mouth or through a vein, hydroxyurea (a drug that promotes formation of a different type of hemoglobin) and pain medication. Treatment for complications of the disease entail ;antibiotics to prevent infection, blood transfusions, folic acid supplementation to assist in red blood cell production and vaccines to prevent infection. PREVENTION : Genetic counseling may prevent birth of a sickler. PREVALENCE/DISTRIBUTION: Globally, three-quarters of sickle cell cases occur in Africa, followed by the Caribbean, then Middle East, South America and then North America. Survival figures for sicklers in Jamaica published in 2001 suggested 53 years for men and 58.5 years for women. In Jamaica, the greatest mortality occurs between 6 and 12 months old when 10% of patients die despite considerable experience in the diagnosis and therapy of the condition and absence of malaria.2

SOCIOECONMIC EFFECTS: Cost of treatment is high , and since it is mainly in Africa and Caribbean ( poor countries ) it poses a very large problem for public health care.

According to statistics published by World health organization.

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DENGUE FEVER (DENGUE HEMORRHAGIC FEVER)

Dengue is a infection carried by mosquitoes that causes a severe flu-like illness, and sometimes a potentially lethal complication called dengue hemorrhagic fever. (WHO classification of A90-91). Dengue is spread by the bite of an Aedes mosquito.

SYMPTOMS: While the symptoms are hard to tell the difference from flu-like symptoms pain behind the eyes was a distinguishing symptom of dengue fever. Dengue fever sufferers experience headache, joint or bone pain, muscle pain, skin rash and nausea. Symptoms of dengue haemorrhagic fever include the usual dengue fever symptoms, along with skin bruising; bleeding from the nose, mouth or gums; severe stomach pains; pale, cold and clammy skin; difficulty breathing; fainting and frequent vomiting.

TREATMENT: There is no specific treatment for dengue, but appropriate medical care frequently saves the lives of patients with the more serious dengue haemorrhagic fever. A transfusion of fresh blood or platelets can correct bleeding problems and oxygen therapy may be needed to treat abnormally low blood oxygen. PREVENTION: Persons may be exposed to dengue fever up to four times because of the four different virus strains, types one to four. The only way to prevent dengue virus transmission is to combat the disease-carrying mosquitoes. Vector (mosquito) control is employed. Public education is used as well to decrease vulnerability.

PREVALENCE/DISTRIBUTION: All types of Dengue virus are re-emerging worldwide and causing larger and more frequent epidemics, especially in cities in the tropics. Dengue is endemic in more than 110 countries. It infects 50 to 100 million people worldwide a year, leading to half a million hospitalizations, and approximately 12,500 25,000 deaths. Since disease prevails in areas of poverty, in Jamaica 40% of the population is at high risk (updated 2009) of contractioni.

CAREC. 1997. Epinote: An update of dengue fever in the Caribbean. Caribbean Epidemiological Centre Trinidad, West Indies

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