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Biomedical subjects

H Veeken

Publications and source records attributed to H Veeken.

At least 19 recordsLinked to original sources
PubMed2001

Comparison of generic and proprietary sodium stibogluconate for the treatment of visceral leishmaniasis in Kenya.

OBJECTIVE: To compare the use of generic and proprietary sodium stibogluconate for the treatment of visceral leishmaniasis (kala-azar). METHODS: A total of 102 patients with confirmed kala-azar were treated in a mission hospital in West Pokot region, Kenya, with sodium stibogluconate (20 mg/kg/day for 30 days)--either as Pentostam (PSM) or generic sodium stibogluconate (SSG); 51 patients were allocated alternately to each treatment group. FINDINGS: There were no significant differences in baseline demographic characteristics or disease severity, or in events during treatment. There were 3 deaths in the PSM group and 1 in the SSG group; 2 patients defaulted in each group. Only 1 out of 80 test-of-cure splenic aspirates was positive for Leishmania spp.; this patient was in the SSG group. Follow-up after > or = 6 months showed that 6 out of 58 patients had relapsed, 5 in the SSG group and 1 in the PSM group. No outcome variable was significantly different between the two groups. CONCLUSION: The availability of cheaper generic sodium stibogluconate, subject to rigid quality controls, now makes it possible for the health authorities in kala-azar endemic areas to provide treatment to many more patients in Africa.

Adolescent↗
PubMed2000

[AIDS: the world's future is in 'their' hands, but comes from 'our' pockets; an impression from the World AIDS Conference in South Africa].

The HIV-Aids epidemic is a global disaster with vast social, economic, psychological and medical implications. With 34 million persons infected and 19 million cumulative deaths since the start of the epidemic, its impact surpasses all other diseases. The end of the epidemic is not in sight and we will see an increase of HIV cases during the next decennia before the epidemic levels off. This warrants a global solution. Small, nongovernmental projects can never curb this epidemic. The world has to establish a 'global fund', which allocates the resources on a nationwide scale. We should think in billions of dollars and not millions. Political commitment and a nationwide approach are the keys to success. Stigma is still the most important issue that hinders prevention. Offering care to the people will make it worthwhile for them to be tested. Anti-retroviral treatment is, with current price settings, unaffordable for patients in developing countries. Selective use of these expensive drugs could, however, play a part to put Aids on a national agenda. Prices of anti-retroviral drugs will have to come down. The current situation with the North having all the drugs but relatively few patients, and the South many patients and no drugs, is ethically unacceptable.

Acquired Immunodeficiency Syndrome↗
PubMed2000

[Drugs for 'neglected diseases': a bitter pill].

Neglected diseases are diseases restricted to poor areas; diseases for which there exist no commercial incentives to invest in the development of new treatments. Patients suffering from these diseases often have no access to essential drugs; this can be a matter of life and death. Lack of research and patent protection play a crucial role. Both are cost driven; greed in the West curtails the availability of life-saving drugs for all. Treatment options for trypanosomiasis and visceral leishmaniasis are lacking. It is recommended that drugs for the treatment of 'neglected diseases' be developed via a centralised, public approach that is not based on profit, rather than leaving it to free enterprise.

Africa↗
PubMed2000

A randomized comparison of branded sodium stibogluconate and generic sodium stibogluconate for the treatment of visceral leishmaniasis under field conditions in Sudan.

OBJECTIVE: To compare the outcome of treatment of Sudanese kala-azar patients treated under field conditions with either branded sodium stibogluconate (SSG) (Pentostam GlaxoWellcome) or generic SSG (Albert David Ltd, Calcutta, supplied by International Dispensary Association, Amsterdam). METHOD: Randomised comparison. 271 patients were treated with Pentostam and 245 with generic SSG. RESULTS: No statistically significant differences in cure rate or mortality were detected between Pentostam and generic SSG. No differences in side-effects between the two drugs were noted. The initial cure rate at the time of discharge was 93.7 and 97.6%, respectively; the death rate during treatment 5.9 and 2.4%. Six months follow up was achieved in 88.5% of the discharged patients. Two patients had died in the Pentostam group and two had died in the generic SSG group, giving a final death rate of 7.5 and 3.7%. The number of relapses in the Pentostam and generic SSG groups were 3 and 1, respectively. The final cure rates, calculated at 6 months after discharge, were 91.3% and 95.9%. CONCLUSION: No difference was observed in the performance of generic SSG compared to Pentostam for the treatment of visceral leishmaniasis in Sudan. Generic SSG can be routinely and safely used for the treatment of kala-azar. Generic SSG costs only 1/14 of the price of Pentostam. The use of generic SSG may make treatment of kala-azar affordable for national governments in Africa.

Adult↗
PubMed1998

[Sudan, through the back door].

South Sudan has five million inhabitants and has been fighting a war of independence with North Sudan since 1959. The hostilities have totally disrupted society and the country is the most inaccessible of Africa. International non-government organizations co-operate in relief activities in the 'Operation Life Line'. Semi-nomadic pastoral tribes populate South Sudan. Doctors Without Borders assisted in fighting a major epidemic of kala azar in the late eighties which cost some 200,000 lives; the organization still provides medical aid in the country.

Adolescent↗
PubMed1998

[Russia: sex, drugs, AIDS and the Doctors Without Borders].

Russia faces a serious crisis and finds it difficult to look after all its citizens. Alcoholics, homeless and elderly fight to survive. A recent problem is the rapid increase in the number of injecting drug users. In Moscow an estimated 100,000 users form an important core group for HIV transmission. With the health system collapsed and sexually transmitted diseases on the rise, all ingredients for a HIV epidemic are present. By the turn of the century the Ministry of Health forecasts 800,000 HIV positives. Médecins sans Frontières in co-operation with the government started a HIV prevention campaign.

Disease Outbreaks↗
PubMed1998

Priority during a meningitis epidemic: vaccination or treatment?

From November 1995 to May 1996, a meningitis epidemic occurred in northern Nigeria. More than 75,000 cases and 8440 deaths (case fatality rate (CFR), 11%) were recorded. Médecins sans Frontières, in cooperation with the Nigerian government, carried out an assistance programme (support to case management, surveillance and mass vaccination) in three states (Bauchi, Kano, Katsina) where 75% of cases occurred. Cost analysis of this assistance in Katsina State reveals that case management and mass vaccination were efficient: US$ 35 per case treated and US$ 0.64 per vaccination. There was, however, a remarkable difference in cost-effectiveness between the two strategies. The cost per death averted by improved case treatment was estimated to be US$ 396, while the cost per death averted by vaccination was estimated to be US$ 6000. In large part this difference is attributed to the late start of vaccination: more than 6 weeks after the epidemic threshold had been passed. During meningitis epidemics in countries where surveillance systems are inadequate, such as in most of sub-Saharan Africa, curative programmes should have priority.

Anti-Bacterial Agents↗
PubMed1997

[Rwanda, a retrospective to aid rendered following the 1994 genocide].

Some 700,000 Tutsi were killed in Rwanda in 1994, and 1.2 million Hutu fled to neighbouring countries. The United Nations and the non-governmental organizations recently issued a document assessing the aid given. Several matters could have been better. Security in the camps, for instance, was a crucial problem and relief workers and armed forces were unprepared for the involuntary cooperation. Also, estimates of numbers of refugees were inadequate and such estimates were manipulated for political purposes. Relief organizations resorted too quickly to import of goods that were available locally, thereby making the aid unnecessarily expensive. The refugees themselves were involved too little in establishing relief priorities. Life of the original population round the camps was disrupted, a fact that received hardly any attention.

Disasters↗