Cuba eliminates Mother-to-child transmission of HIV and Syphilis
Good news! Cuba eliminates Mother-to-child transmission of HIV and Syphilis
A report published today (1 July 2015) by BBC (British Broadcasting Corp) News has stated that Cuba has successfully eliminated transmission of HIV and Syphilis from mother-to-child (otherwise known as vertical transmission.
The claims have been backed by the World Health Organisation (WHO) and has been described as one of the ‘Greatest public health achievements possible’.
This hasn’t been an overnight revelation. It has taken many years of research as well as huge effort to give pregnant women early access to prenatal care, disease testing and medication to halt the transmission from mother to child.
The report states that approximately every year 1.4 million women living with HIV become pregnant (global figures). Without treatment these women have a 15-45% chance to pass HIV onto their child during pregnancy, labour, the delivery, or even through breastfeeding. This risk is significantly reduced to approximately 1% if treatment for HIV (antiretroviral medication) is given to both mother and baby.
In addition the above figures, approximately 1 million pregnant women are also infected with syphilis and the report shows that early screening and treatment can avoid problems for their unborn child.
Cuba
Latest available data shows that Cuba has reduced the infection rate of HIV from mother to child to less than 2% which is deemed the lowest possible rate with available preventative measures.
There are 22 countries that account for 90% of new HIV infections and the report states 8 of these have reduced the infection rate of HIV among children to less than 50% since 2009. Four more countries are approaching this benchmark figure.
As of 2014 over 40 countries were achieving and impressive figure of testing more than 95% of pregnant women in pre-natal care for syphilis.
In conclusion
What Cuba has achieved is impressive and all countries should strive for these results. The most important point in managing vertical transmission of HIV and syphilis is to get testing and treatment early. Of course this means that amenities have to be easy to access, readily available and affordable. But if this can be achieved we are taking a big step forward in the battle against HIV and syphilis.
If you are concerned about HIV or syphilis testing while you are pregnant or even before conception please visit any of our clinics here.
For further information on HIV testing in pregnancy check here.
((((Big Step Forward, Cuba!))))
COPYRIGHT © 2015. DR TAN & PARTNERS (SINGAPORE). ALL RIGHTS RESERVED.
SOURCES: WWW.DRTANANDPARTNERS.COM
HIV Post Exposure Prophylaxis (PEP)
HIV Post Exposure Prophylaxis (PEP)
by drtanandpartners.com
Do You Know What is PEP?
Post-Exposure Prophylaxis (PEP) involves taking anti-HIV medications as soon as possible after you may have been exposed to HIV to try to reduce the chance of becoming HIV positive. These medications keep HIV from making copies of itself and spreading through your body.
HIV PEP Post Exposure Prophylaxis - YouTube
HIV Post Exposure Prophylaxis (PEP) is a medicine given to people who are at high risk of getting HIV. They are up to 99% effective in preventing a HIV infection.
You are a potential candidate for PEP if:
- You have been exposed to potentially HIV infected body fluids
- Your exposure was less than 72 hours ago
Factors that can increase the risk of HIV infection include:
- Condom Break
- Presence of Blood (e.g. Menses)
- Presence of cuts
- Presence of Ulcers
- You are not circumcised
Notes:
These medicines have to be started within 72 hours after possible infection/exposure.
They are taken twice a day for 1 month.
The side effects vary from person to person and also depend on which medicines are used.
Our clinics use the medicines as recommended by the latest US CDC guidelines. These medicines have very limited side effects.
From my experience, more than 9 out of 10 patients do not have any side effects at all. Those that do usually only have mild nausea.
A repeat HIV test will be done once the medicines are finished (1 month). This HIV test will already be very accurate.
In my personal experience, I feel that it is 100% accurate. We will also do another HIV test at 3 months post exposure (2 months after finishing PEP) as recommended by the guidelines.If you are interested in this treatment, please visit us at our clinics.
BE SAFE. BE NICE
COPYRIGHT © 2015. DR TAN & PARTNERS (SINGAPORE). ALL RIGHTS RESERVED.
Sources: www.drtanandpartners.com
How to Prevent HIV?
What can we do to Prevent HIV? - by Dr Tan and Partners
Preventing sexual transmission
- Use of condoms, including female condoms (although condoms are not 100%, they reduce transmission rate significantly)
- Limit the number of sexual partners
- Sex education to spread awareness
- Treating other sexually transmitted infections
Preventing HIV transmission through blood
- Don’t inject drugs
- But if you do, do not share needles. Only use sterile drug injection equipment.
- Screening blood products (most countries are already doing this)
- Prevent needle-stick injuries
Preventing mother to child transmission
- Testing mother for HIV and offering treatment if tested positive
Preventing transmission of HIV from HIV positive individuals
Appropriate treatment for HIV positive patients plays an important role in preventing HIV transmission. With early treatment and good compliance to HIV medicine, HIV level becomes so low that it is undetectable in the blood. This not only save lives, it also reduces the risk of spreading HIV to their sexual partners.
PrEP (Pre-Exposure Prophylaxis)
HIV medicine can also be used to prevent HIV transmission in other situations. People who are at increased risk of HIV infection can take a HIV pill called Truvada as a daily dose to reduce the risk of being infected with HIV. This is also known as Pre-exposure prophylaxis (PrEP).
Click here to read more on PrEP
PEP
HIV treatment known as post-exposure prophylaxis or PEP, is a combination of anti-retroviral medications that can be taken after a potential exposure to HIV. If taken within 72 hours post-exposure, they can reduce the chances of being infected with HIV significantly.
Click here to see video on PEP
HIV Testing
When it comes to treatment and prevention of HIV, the most important thing that one can do is to get an HIV test. Rapid HIV testing is available these days. In Singapore we have anonymous HIV testing. The U.S. Centers for Disease Control and Prevention recommends at least a yearly HIV screening for people considered at high risk for infection. This is especially important for young people from ages 13 to 24, because more than half in that age group who tested positive for HIV did not know that they had been infected.
Some people are afraid of getting tested because they fear the possibility of being HIV positive. Some feel embarrassed about it. HIV stigma and discrimination that still exist in our community have perpetuated this problem. The truth is, the earlier HIV is diagnosed and treated, the better the outcome. Therefore, do not be afraid of getting tested. This not only protects yourself, it also protects your family, your sexual partners and your loved ones.
HIV treatment works, but prevention is the key. If you wish to know more, visit us and speak to our doctors. All our doctors are fully certified and trained to conduct counselling, consultation and testing for HIV.
PrEP and PEP treatment are available in all 4 of our clinics.
Copyrighted Material: Not for Reproduction or Distribution (www.DrTanandPartners.com)
*1:Be Safe
HIV Transmission and Prevention
HIV Prevention - Transmissions by Dr Tan and Partners
Human Immunodeficiency Virus (HIV) is a virus that destroys your immune system, causing life-threatening infections and cancers, therefore leading to Acquired Immune Deficiency Syndrome (AIDS).
It has been about 30 years since HIV was discovered as the cause of AIDS. Back in the days when HIV/AIDS was first discovered, it was a total mystery. No one knew how it happened and no treatment was available. It was basically a death sentence, and people died within weeks or months after being diagnosed.
We have come a long way since then. People who have been diagnosed with HIV today can live a normal healthy life like anyone else. By taking a combination of anti-reviral medicationsand close monitoring by HIV physicians, the number of HIV patients who develop AIDS have been reduced significantly. HIV infection can also be prevented now by taking medications (they are called PrEP and PEP). Because of this, some people may take it for granted. Some may not take it seriously, and think that there is little need to be concerned. They fail to realise that there are more than 1 million people in the world who are infected with HIV, and more than 50,000 people become newly infected each year!
Yes, treatment works. But even with our advanced technology and knowledge in medicine, there is still no cure to HIV. No vaccines have been successfully developed against HIV yet, even after 30 years. Therefore, it all comes down to prevention.
Before we talk about prevention, let us again look at how HIV is transmitted. By understanding how it is transmitted, we can work out ways to prevent transmission. HIV passes from one person to another through body fluids such as blood, semen and vaginal fluids.
- Sexual intercourse, the most common route of HIV transmission
- Sharing of needles and injection drug use
- Blood transfusion
- Needle-stick injury
- HIV transmission from infected mother to newborn
Here's a video on the Signs and Symtoms of HIV
((((Be Healthy. Be Safe))))
Copyrighted Material: Not for Reproduction or Distribution (Dr Tan and Partners.com)
All you need to know about Contraception.
[Part One] of Everythings on Women Contraception: What you need to know about contraception! by Dr Tan and Partners
In the coming weeks, we will be posting several blogs on various aspects of this rather complicated subject.
Bearing a child is a really wonderful thing. I know, I have 2 (so far). Conversely, struggling to get pregnant is a very worrying and frustrating experience. I also know. My second child did not come easy.
So you are probably here reading this because you are planning to start a family or you have been trying but have been facing some challenges. Hopefully we can help you shed some light on this.
Let us also bear in mind that fertility and conception are extremely complicated bodily processes and until now, even with all our advances in modern medicine, much of it still remains shrouded in mystery.
This means there is only so much we can do and the rest is in the hands of God (or fate or luck depending on your belief system).
This also means that there is a lot of pseudo-science out there and unscrupulous people capitalizing on your worries to sell fake or semi-proven cures. Please do not fall victim to this.
Right, let’s get to it. So you have been trying to get pregnant for a while now with not much success. You really do not want to see a doctor because there is really no reason you cannot get pregnant right? You also don’t want to be on any hormonal medicines and certainly not IVF! Maybe it’s the stress, maybe both of you are traveling too much. Which really leads us to the first question: When does it become a problem?
By definition, if you have been having regular unprotected sex for 1 year and have yet to get pregnant, it’s a problem. This duration is shaved down to 6 months for women above the age of 35 simply because for these ladies, we don’t have a lot of time to waste. Conversely, for women younger than 30 years, we sometimes wait 2 years.
OK scary thought that you may actually need to see a doctor. But take heart that you are not alone. In the latest MOH published guideline on infertility, 1 in 7 couples are affected by Infertility. Shocking but true.
In fact, the average monthly probability of getting pregnant is only about 15%. The cumulative probability is 60% in 6 months, 85% in 1 year and 95% in 2 years. Fertility peaks at age 20 to 24 and more or less maintains that way till 30 to 32 then declines till 40 years than really drops after that.
So what is usually the problem?
Well guys, time to man up and take some responsibility. Male factors make up 30% to 40% as the cause of not being able to conceive. 20% are due to a problem with ovulation. 35% are due to a problem with the tubes. And to back up my earlier statement of this shrouded in mystery, 5% to 10% of cases in infertility are unexplained.
What can you do about it?
Before we get into the really complicated stuff of tests and medicines and assisted reproduction, let’s first look at some of the simple things we can do to maximize our chances.
Have sex every 2 to 3 days.
This was published in the latest guidelines with Level 4 evidence (very poor quality evidence). This is frustrating because they are always changing this recommendation. The advice used to be ‘Have sex daily because this increases sperm quality’. Now it’s ‘Have sex every 2 to 3 days because timing sex to coincide with ovulation is too stressful’. My view: time the ovulation and the days leading up to and after ovulation, have sex every day.
Don’t drink.
This applies to men and women. Limit yourself to less than 2 drinks per day. In fact, less than 1 if you can help it. This is Level 2++ evidence folks. Take it seriously.
Don’t smoke.
Anybody who still believes smoking has no effect on fertility is either living in la-la land or is legal counsel for a tobacco company. Women who smoke are significantly more likely to be infertile. Level 1+ evidence. Yup, just about as definitive as you can get.
Don’t be too fat, Don’t be too thin.
BMI of between 19 and 29 is optimal. Level 1+ evidence.
Don’t take recreational drug.
Really??!! We need a guideline to tell us this?
Check with your doctor about your long term medicines and possible occupational exposure to chemicals.
Certain long terms medicines can affect fertility. In men, Cimetidine, Sulphasalazine, certain antibiotics and testosterone can affect sperm quality. Medicines used for high blood pressure and depression can cause erectile dysfunction.
Immunosuppressive drugs and anti-inflammatories can affect conception. Of course, chemotherapy can cause the ovaries to stop producing eggs.
Occupational exposures to solvents used in dry cleaning and printing, heavy metals, pesticides, lead and industrial microwaves have all been documented to be hazardous to conception.
((((Take Care))))
Copyrighted Material: Not for Reproduction or Distribution (Dr Tan and Partners.com)
MERS: Middle East Respiratory Syndrome
MERS: Middle East Respiratory Syndrome [By Dr Tan and Partners]
Most of us would have known by now that a deadly viral disease called MERS have affected the South Korea recently.
Yesterday, Thursaday, Thailand confirmed her first case of MERS. It took four days to confirm first MERS case. A time lag likely to raise fears of a further spread of the deadly virus in Asia.
South Korea on this Wednesday announced its 20th death from the MERS virus. Criticism grew of efforts to contain the outbreak.
Since it has been on the news daily, there is no doubt that it has created fear and anxiety among us, especially for those who have to travel frequently.
For the past weeks, Doctors in all our 4 clinics have been getting a number of enquiries about this disease. Some asked if we have a vaccine against this virus. Some wanted to know if it is safe to travel to South Korea’s neighbouring countries.
Some asked if they had been infected with the virus after coming back from Japan, although they are not showing any symptoms at all.
Our doctors from Dr Tan and Partners feel that it is important for everyone to understand the disease and to learn how this virus is transmitted from one to another. This way, instead of spreading fear and uncertainty, every member of the community will learn to take necessary precautions, educate one another and protect themselves and their loved ones.
What is MERS?
MERS stands for Middle East Respiratory Syndrome. It is a disease caused by a novel coronavirus (MERS‐CoV) that was first identified in Saudi Arabia in 2012. This disease primarily affects the respiratory system (lungs and airway).
What are the symptoms of MERS?
MERS symptoms range from no symptoms to severe acute respiratory disease and death. Typically, victim presents with cough, fever and breathlessness. These symptoms can be similar to common cold. Sometimes, one can present with diarrhoea and vomiting. In severe cases, victim can have severe breathing difficulties and may require mechanical breathing support in the hospital.
Who gets it?
MERS can affect people of all ages. However, it causes more severe disease in the elderly, and people with weakened immune system (cancer, diabetes, undergoing chemotherapy etc).
Is it dangerous?
It is. Mortality is high among the report cases. Approximately 36% of reported patients with MERS-CoV have died.
How is it transmitted?
MERS-CoV can be transmitted in 2 ways.
Non-human to human transmission:
Till date, this is still not fully understood by scientists yet. Strains of MERS-CoV identical to human strains have been identified in camels in countries such as Saudi Arabia and Egypt. Therefore, it is believed that camels can transmit this virus to humans through contact.
Human to human transmission:
MERS-CoV, like other coronaviruses, is thought to spread from an infected person’s respiratory secretions, such as coughing. The exact ways the virus spreads are not currently well understood.
Statistically, in comparison to viruses such as SARS, this virus does not appear to pass easily from person to person. It can be transmitted from one person to another through close contact. The majority of cases occur in healthcare settings, where family members and healthcare workers provide care to an infected patient without appropriate hygiene measures.
So, is it contagious?
Yes, it is, but only to a certain extent. Looking at the statistics and the behaviour of the virus for the past few months, it appears that this virus does not pass from one person to another easily. Human‐to‐human transmission appears to be more efficient in a healthcare setting, especially when infection prevention and control practices are inadequate.
What can I do to prevent this illness?
There is no vaccine available for this virus currently. There is also no cure for this disease. However, there are things we can do to reduce the chances of transmission.
General hygiene measures are important. Anyone who have come in contact with people with cough and cold symptoms should practise regular hand washing. If you are visiting someone in the hospital, make sure you clean your hands properly before and after visiting.
Anyone visiting farms or markets where camels or other animals are present should practise good hygiene measures as well. Wash your hands regularly before and after touching animals. Do avoid contact with sick animals.
Do not consume raw or undercooked animal products because they carry a risk of infection.
People with diabetes, lung disease, kidney disease and impaired immune system should avoid contact with camels, drinking raw camel milk or camel urine, or eating raw or undercooked meat.
Who is at increased risk for MERS?
People recently in a healthcare facility in the Republic of Korea
Recent traveller from the Arabian Peninsula
Close contact with a sick traveller from the Arabian Peninsula
Close contact with a confirmed case of MERS
"Currently, there is no restrictions (by the government) for travelling to the affected countries. However, it is best to avoid travelling to these areas for the time being, unless it is absolutely necessary, in which case necessary precautions must be taken.
Let us all work together to spread the awareness, and to prevent this virus from spreading further."
No cases of MERS have been detected in Singapore so far. However, the possibility of an imported case here cannot be ruled out given today’s globalised travel patterns.
((((Be Healthy. Be Safe))))
Click here to read more about Health Advice for Hajj and Umrah in Saudi Arabia
Copyrighted Material: Not for Reproduction or Distribution (Dr Tan and Partners.com)
