/ 25 November 2004

Cheap drug saves the lives of HIV+ Zambian kids

An inexpensive antibiotic often used to treat lung infections could help prevent deaths in children infected with HIV, according to the Science and Development Network.

A multinational research team tested the preventative effect of the widely-available antibiotic co-trimoxazole in 540 Zambian children between the ages of one and 14 years, The antibiotic cut Aids-related deaths such as pneumonia in the HIV-infected children by almost half at 43 percent.

The children were divided into two groups, with one given the antibiotic and the other receiving a placebo. Results after 19 months were so positive that a committee monitoring the study recommended the trial should be stopped, so the children in the placebo group could receive the antibiotic treatment too.

Research recently published in the British-based peer-reviewed medical journal The Lancet says the antibiotic works even in areas with high resistance to the drug. Much of the work was done at the University Teaching Hospital in Lusaka, Zambia, with doctors V Mulenga, K Lishimpi, and F Sinyinza conducting the trials. Data managers in Zambia received specialised training to document the results accurately.

Dianne Gibb from the United Kingdom’s Medical Research Council’s clinical trials unit says it also reduced the number of children admitted to hospital with respiratory conditions by close to a quarter at 23 percent.

The team’s findings highlight the fact that research into tackling Aids-related illnesses is just as important as studies on antiretrovirals and Aids vaccines.

”Tackling HIV infection directly is just one approach,” says Diane Gibb. ”Reducing the secondary complications and infections, which can be just as fatal as HIV itself to those with weak immune systems, is also important.”

The cheap and widely available drug is used to treat respiratory infections such as pneumonia, which can be dangerous for HIV-infected people given the vulnerability of their immune systems.

The antibiotic has proved effective in preventing deaths from respiratory disease in HIV-infected people who live in areas with low bacterial resistance to the drug.

But scientists have been concerned that the drug would not work as well in countries such as Zambia, where antibiotic resistance is high. This trial shows the first promising evidence to the contrary, say the researchers.

According to the World Health Organisation, at the end of 2003, 2,1-million children under 15 were infected with HIV. Of those, 1,9-million were African.

Traditional healers seek marriage with modern medicine

Traditional healers in Zambia say their remedies should be integrated with modern medicines in the treatment of diseases such as HIV/Aids, tuberculosis and cancer.

The president of the Traditional Health Practitioners Association of Zambia, Rodwell Vongo, made the call in Lusaka at Zambia’s annual national science forum.

Vongo said traditional medicine has met resistance from policymakers and scientists in Zambia, so traditional healers have resolved to work closely with both groups in a bid to dispel myths about their practices.

”Complex diseases like Aids, cancer and tuberculosis are multisectoral issues,” said Vongo. ”Serious collaboration is needed between traditional healers, scientists and policymakers.”

The traditional healers intend to lobby policymakers about the need to integrate traditional herbal medicine into Zambia’s health care system. Meanwhile, the association will educate the country’s healers about ethical aspects of disease treatment and the need for hospital referral for cases needing modern medical attention. The association also plans to make herbal medicines available for safety testing.

Vongo said the government needs to develop a clear policy to guide the use of indigenous knowledge because current policy is unclear. He added that the legal framework on intellectual property should also be changed as it is currently too expensive to register patents.

Mwananyanda Lewanika, executive director of the National Institute for Scientific and Industrial Research, said that collaboration between scientists and traditional healers is needed to check the safety and effectiveness of herbal medicines, and to prevent people from taking medicines that are not appropriate for their treatment.

Lewanika believes that the government and society should create incentives to protect traditional knowledge and promote innovation.

Most Zambians live on less than $1 a day and cannot afford expensive Western medicines. Although traditional medicines have played a significant role in management of certain diseases, some citizens associate them with witchcraft. — SciDev.Net