Rand

• More than a quarter of all reported disease in Gaza is caused by poor water quality and access.
• The main source of Gaza’s water, its aquifer, is being depleted and its quality diminished by seawater intrusion, wastewater seepage, and agricultural runoff.

MSF

An open letter from MSF clinical psychiatrist Dr Alessandro Barberio, Moria camp, Lesbos, Greece:  “……The vast majority of people I see are presenting with psychotic symptoms, suicidal thoughts – even attempts at suicide – and are confused. Many are unable to meet or perform even their most basic everyday functions, such as sleeping, eating well, maintaining personal hygiene, and communicating...….”

WHO

World leaders meeting today at the United Nations (UN) General Assembly have committed to ensure that 40 million people with tuberculosis (TB) receive the care they need by end 2022. They also agreed to provide 30 million people with preventive treatment to protect them from developing TB.

“Today is a landmark in the long war on TB,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “These are bold promises – to keep them partnership is vital. WHO is committed to working with every country, every partner and every community to get the job done.”

Heads of state and government attending this first-ever UN High-level meeting on TB agreed to mobilize US$ 13 billion a year by 2022 to implement TB prevention and care, and US$ 2 billion for research. They committed to take firm action against drug-resistant forms of the disease; build accountability and to prioritize human rights issues such as the stigma that still prevails around TB in many parts of the world.

They acknowledged that the current rate of progress was endangering prospects of meeting global targets to end TB. Today, TB remains the world’s deadliest infectious disease: it killed 1.6 million people in 2017, including 300 000 people with HIV. In the same year, 10 million people fell ill with TB.

“The political declaration proposed for this meeting sets a roadmap for accelerated action to end TB in line with the vision and targets for 2030,” said H.E. Ms Maria Fernanda Espinosa Garcés, President of the 73rd Session of the UN General Assembly. “We have before us the opportunity for a clear win – a chance to save the lives of millions, to preserve billions in resources, to demonstrate the success of the Sustainable Development Goals, and to reaffirm the utility, efficacy and necessity of multilateralism and the UN System. Let us not miss this opportunity.”

The political declaration is the culmination of recent leadership commitments at global and regional level – including the 2017 Moscow Declaration to End TB – to drive universal access, sufficient and sustainable financing, intensified research and innovation, and accountability across all sectors.

Unprotected, Unsupported, Uncertain :  Document

• “……Currently, more than 8,500 people are crammed into a site which only has the capacity to host 3,100.
• 84 people are expected to share one shower.
• 72 people are expected to share one toilet.
• People must rise at four in the morning to stand in line to get food and water, which is distributed at eight.
• The sewage system is so overwhelmed, that raw sewage has been known to reach the mattresses where children sleep, and flows untreated into open drains and sewers……..”

CIDRAP

“…..According to the WHO, 39 patients during this outbreak have been treated with experimental Ebola therapies, including mAb 114, remdesivir, and Zmapp. Of these 39 patients, 12 have died.

The DRC said that since immunization campaigns began on Aug 8, 11,563 people have been vaccinated….”

Sep 25 WHO media briefing:

NBC

“……Virginia is suspending a newly introduced policy that would have barred women who visit inmates at state prisons from wearing tampons or menstrual cups……..The abrupt about-face comes a day after widespread media coverage of state prison officials’ plan to ban tampons starting next month as a way to prevent contraband from being smuggled into prisons……”

NEJM

Document:  Diarrhea

“Diarrheal diseases are the third leading cause of disease and death in children younger than 5 years of age in Africa and were responsible for an estimated 30 million cases of severe diarrhea (95% credible interval, 27 million to 33 million) and 330,000 deaths (95% credible interval, 270,000 to 380,000) in 2015…….”

NYT

“…..In 2016 the disease, which is caused by a parasite and transmitted by mosquitoes, infected 194 million people in Africa and caused 445,000 deaths.

But biologists now have developed a way of manipulating mosquito genetics that forces whole populations of the insect to self-destruct. The technique has proved so successful in laboratory tests that its authors envisage malaria could be eliminated from large regions of Africa within two decades…..”

Nature

The malaria parasite life cycle involves two hosts. During a blood meal, a malaria-infected female Anopheles mosquito inoculates sporozoites into the human host . Sporozoites infect liver cells and mature into schizonts, which rupture and release merozoites . (Of note, in P. vivax and P. ovale a dormant stage [hypnozoites] can persist in the liver and cause relapses by invading the bloodstream weeks, or even years later.) After this initial replication in the liver (exo-erythrocytic schizogony ), the parasites undergo asexual multiplication in the erythrocytes (erythrocytic schizogony ). Merozoites infect red blood cells . The ring stage trophozoites mature into schizonts, which rupture releasing merozoites . Some parasites differentiate into sexual erythrocytic stages (gametocytes) . Blood stage parasites are responsible for the clinical manifestations of the disease. The gametocytes, male (microgametocytes) and female (macrogametocytes), are ingested by an Anopheles mosquito during a blood meal . The parasites’ multiplication in the mosquito is known as the sporogonic cycle . While in the mosquito’s stomach, the microgametes penetrate the macrogametes generating zygotes . The zygotes in turn become motile and elongated (ookinetes) which invade the midgut wall of the mosquito where they develop into oocysts . The oocysts grow, rupture, and release sporozoites, which make their way to the mosquito’s salivary glands. Inoculation of the sporozoites into a new human host perpetuates the malaria life cycle.