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American Journal of Public Health
(www.apha.org/news/publications/journal) (03/00) Vol. 90, No. 3,
P. 435; Marks, Suzanne M.; Taylor, Zachary; Burrows, Nilka Rios;
et al.
Researchers from the Centers for Disease Control and Prevention
investigated whether homeless patients are hospitalized for
tuberculosis (TB) more often and longer than other patients. The
study of 1,493 patients with TB showed that homeless TB patients
were more likely to be male, aged 25 to 44, and non-Hispanic
African-American. Twenty-five percent of the homeless group were
HIV-positive, compared to 12 percent of the others. Of the
homeless people, 70 percent were hospitalized at least once for
TB, and 15 percent of the patients hospitalized were homeless.
The majority of homeless TB patients were treated in public
hospitals (84 percent) compared to 56 percent of other TB
patients. Over 50 percent of the homeless had no medical
insurance and stayed a median of 18 days, six days longer than
the non-homeless. The HIV-infected homeless with TB were
hospitalized more frequently than other patients; the researchers
also note that these individuals were more likely than the other
homeless patients to have government insurance. The cost for
treating the homeless was $2,000 more than for other patients.
The findings suggest that stable housing for TB patients could
help remedy TB infection and that access to medical care could
detect TB early and treat infection properly.
Washington Post (www.washingtonpost.com) (03/21/00) P. A7;
Pianin, Eric
Reps. Sherrod Brown (D-Ohio) and Constance A. Morella (R-Md.)
introduced legislation on Monday seeking $100 million in U.S.
funding for countries with the greatest burden of tuberculosis
(TB) cases. The funds would be used to treat TB and prevent
drug-resistant strains from spreading. The lawmakers noted that
95 percent of the TB cases that are not already drug resistant
can be treated with a relatively inexpensive antibiotic regimen;
however, less than 20 percent of TB patients actually receive the
drugs.
"An Improbable Theory on AIDS Is Put to the Test"
New York Times (www.nytimes.com) (03/21/00) P. D1; Altman,
Lawrence K.
Three laboratories in the United States and Europe will start
testing soon samples of an experimental polio vaccine tested in
the Belgian Congo in the 1950s to determine if it was
accidentally made with chimpanzee tissues that could have
contained the ancestor of HIV. The Wistar Institute in
Philadelphia made the experimental vaccine and has kept drops of
it frozen since 1957. The tests follow the publication of a
theory in Edward Hooper's book, "The River," that an oral polio
vaccine in the Congo started the spread of HIV to humans;
however, scientists do not expect conclusive evidence proving or
disproving the theory. In part, this is because no one knows
whether the samples being tested are the same as the vaccine that
was actually administered in the Congo. The scientists will test
coded samples, the actual identities of which will only be known
to the independent lab and an independent committee of scientists
appointed by Wistar. The code will only be revealed after the
study is complete.
"Summers Urges World Bank Reform"
Washington Post (www.washingtonpost.com) (03/21/00) P. E3;
Burgess, John
U.S. Treasury Secretary Lawrence H. Summers stated Monday that
the World Bank should not compete with private lenders but
instead should help anti-poverty and anti-disease projects that
require financing. While he noted that no development bank "can
or should aspire to be or do everything for all countries,"
Summers also said the banks should take the lead in dealing with
matters that cross borders, including AIDS, malaria, and
environmental issues. The World Bank and the International
Monetary Fund are being pressured to change, as many in Congress
see them as too expensive, too powerful, and unaccountable. The
World Bank, under President James Wolfensohn, has decreased
bureaucracy and is now better-focused on results.
"Researchers See Potential Breakthrough With HIV Protein"
Minneapolis Star-Tribune Online (www.startribune.com) (03/21/00)
New research used Rhesus monkeys to help study a vaccine for
AIDS. The monkeys were immunized with Tat toxoid, an HIV protein
that kept the disease at lower levels in the monkeys. The
authors noted, "The test vaccine induced a strong immune response
and blocked the damaging effects on host cells from the unaltered
Tat in the virus." The report can be found in the current online
issue of the Proceedings of the National Academy of Sciences.
Reuters Health Information Services (03/20/00); Agrawal, Alka
Scientists writing in the Annals of Neurology (2000;47:186-194)
have found that Tat and gp120 proteins are present in the brains
of patients with HIV-1 encephalitis and are toxic to nerve cells
in lower concentrations when present together. Dr. Avindra Nath
of the University of Kentucky in Lexington and colleagues first
found that gp120 was present in HIV patients' brains and showed
that exposing fetal neurons to both proteins can kill the cells.
In an effort to treat HIV dementia, the researchers noted they
are studying ways to block the neurotoxic effects of the two
proteins. Memantine was able to totally block the proteins'
effects, while MIA, a sodium-proton exchange blocker could only
partially inhibit them.
Reuters Health Information Services (03/20/00)
New research from the Children's National Medical Center in
Washington, D.C., shows a high prevalence of psychiatric
disorders in a group of urban HIV-infected adolescents. The
study, which involved interviews with 34 HIV-infected young
people ranging in ages from 16 to 21, found that over half had a
previous psychiatric diagnosis and that half had a documented
history of sexual abuse. Published in the March issue of the
Archives of Pediatrics and Adolescent Medicine
(2000;154:240-244), the study revealed that the teens had a high
prevalence of major psychiatric disorders, including depression,
substance abuse, and conduct disorder. The authors suggest that
psychiatric disorders could put adolescents at greater risk for
high risk sexual behavior and substance abuse.
Miami Herald Online (www.herald.com) (03/21/00); Robinson, Andrea
Enoch Milien, a funeral director and associate pastor at a Miami
church, has started the first group effort by minority clergy in
South Florida to attack AIDS, called the Conference of Haitian
Pastors United in Christ. The group of more than 70 pastors
plans to offer AIDS education in their churches and
neighborhoods, with courses in HIV prevention care to be offered
along with standard Sunday school education. There are an
estimated 300,000 Haitian Americans in South Florida. AIDS is
striking more minorities in South Florida, with Haitians
accounting for 2,389 AIDS cases since 1981.
Reuters (03/20/00)
Western diplomats visiting a Moscow prison on Monday saw how
Russia's destitute penal system struggles to contain tuberculosis
(TB) epidemics. A tour of the Matrosskaya Tishina jail revealed
there is only one doctor for every 88 TB patients. Justice
Minister Yuri Chaika noted that one-third of the country's TB
patients are in jail, with thousands of infectious individuals
released every year. According to international experts, there
are an estimated 100,000 active TB cases in Russian prisons.