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Global Update

Indian Pediatrics 2007; 44:397

News in Brief


20-minute Oral Swab Test for HIV

The conquest of HIV is about the conquest of fear. About a quarter of Americans who are infected with the HIV virus never get themselves tested and about 30% of people who get tested for HIV using the conventional blood test never go back to collect their report. Which means, a big pool of potential patients who need treatment and who can further spread the disease are being missed. To overcome some of the problems a new oral swab test has been developed which gives a report in 20 minutes. This test was recently studied in Indian patients in the Mahatma Gandhi Institute of Medical Sciences, Sevagram. The test involves rubbing the swab all along the upper and then the lower jaw. The swab is then placed in a vial containing the developing solution for 20 minutes. If the test is positive 2 lines appear and if it is negative one line appears. Saliva, blood and plasma all can be tested with the equipment. In the US it costs somewhere between, $8 to $20.

The study in Sevagram was conducted in 450 patients and had a 99.7% specificity. In literature as well, the accuracy is well over 99% and the test has been approved for use by the US FDA. The test detects antibodies against HIV I and II and hence can pick up infections after about 6 weeks of exposure. The advantages of the test are its rapid result and lack of need for blood which reduces risk of needlestick injuries. It also does away with need for complicated equipment and specialized laboratory technicians. It is useful when we need rapid results such as if a woman comes in labour and has not been previously tested. When health professionals are exposed to blood, it can be used to quickly determine whether the blood was infected (The Times of India 14 April 2007, http://www.emedicinehealth.com/rapid_oral_hiv_test.htm ).

The God of Small Drops

Health officials in Bihar have come up with a creative way to improve the immunization drive in the state. They have trained hundreds of temple priests to give polio drops to children in place of traditional prasad and flowers. Last year Bihar reported 650 cases of polio and in this year already 11 cases have been registered. People have welcomed the move. The idea to use the common mans faith in religious leaders to promote positive health messages needs more exploration (Science news, Scientific American 17 April 2007).

Is the rota virus vaccine cost effective

The US approved a new oral rota virus vaccine for routine immunization of all children in 2006. A recent study by the Centres for Disease Control has tried to see whether overall this has saved the Government any dollars. Widowson et al made a hypothetical group of 4 million children. The researchers compared the projected outcome of unvaccinated children with those vaccinated at 2, 4 and 6 months. The analysis indicated that with vaccination, 13 deaths, 44,000 hospitalizations and 137,000 emergency department visits would be avoided. Vaccination would cost $138 per case prevented, $3,024 per serious case prevented and $197,190 per year of life saved. This would cost the healthcare system $515 million and society $216 million. So though the vaccine prevents 80% of serious rota viral diarrhea, as a national policy it may not be cost effective ( Science news, Scientific American, 17 April 2007).

Gouri Rao Passi,
Consultant,
Department of Pediatrics,
Choithram Hospital & Research Center,
Indore, Madhya Pradesh, India.
E-mail: [email protected]

 

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