Tis burning

Cystitis – tis a nasty inflammation

When you pee, tis a burning sensation

Please do not desist, to the Chemist forthwith!

But if the pain persists

Despite medical reliefs

To the GP, begone!

Your pee tested, anon

Warrant further investigation

A prescription, henceforth

For antibiotic intervention

Behold!

Tis a urinary tract infection.

 

Sources:

Not another UTI…
Redmond, P et al
Age and Ageing 2012, Vol. 41(4) pp.569-570

Recurrent UTI and Urinary E. coli in a Randomized Controlled Trial of Cranberry Juice

Stapleton, Ann E. ; Dziura, James ; Hooton, Thomas M. ; Cox, Marsha E. ; Yarova-Yarovaya, Yuliya ; Chen, Shu ; Gupta, Kalpana
Mayo Clinic Proceedings

Evaluation of the Prevalence of Urinary Tract Infection in Rural Panamanian Women (Prevalence of UTI in Rural Panamanian Women)

August, Suzanne L ; De Rosa, Michael JVermund, Sten H. (Editor) PLoS One
2012, Vol.7(10), p.e47752

Antibiotics for URTI and UTI: Prescribing in Malaysian primary care settings

Teng, C.L. ; Tong, S.F. ; Khoo, E.M. ; Lee, V. ; Zailinawati, A.H. ; Mimi, O. ; Chen, W.S. ; Nordin, S.
Australian Family Physician, May 2011, Vol.40(5), pp.325-329

Detection of Intracellular Bacterial Communities in Human Urinary Tract Infection (Intracellular Niche during UTI Pathogenesis) Rosen, David A ; Hooton, Thomas M ; Stamm, Walter E ; Humphrey, Peter A ; Hultgren, Scott JOpal, Steven M (Academic Editor)  PLoS Medicine, 2007, Vol.4(12), p.e329

Bacteriophage in genito-urinary tract infections by McCarthy, Joseph F et al (1933)

Oxford handbook of genitourinary medicine, HIV, and sexual Health by Pattman, Richard (2010)

Testing facilities for STD/RTI and quality assurance in private pathology centers in Dhaka City by Islam, Z et al (1997)

The Early diagnosis of Urinary Tract Infection by Asscher, A.W (1970)

Wallace/Maxcy-Rosenau – Last public health & preventive medicine (2008)

World Breastfeeding Week: The Cost of Not Breastfeeding Infographic

World Breastfeeding Week is celebrated every year from 1 to 7 August to encourage breastfeeding and improve the health of babies around the world.

Breastfeeding promotes better health for mothers and children alike. Global economic costs of not breastfeeding are around US £341 billion annually and globally inadequate breastfeeding leads to preventable deaths, obesity and cognitive losses. WHO recommends exclusive breastfeeding starting within one hour after birth until a baby is 6 months old.

Health Policy and Planning have published a new study on the cost of not breastfeeding (See Walters et al. 2019. The cost of not breastfeeding: global results from a new toolwhich connects the dots between publicly available big data in a simple tool, (the Alive & Thrive Cost of Not Breastfeeding Tool), drawing a larger picture of global impact. While the data is not new, for the first time it is now available at country-level for over 100 countries around the world.

The below infographic is interactive and links through to this new tool. Click here for a PDF version of the infographic and here for the recent blog from Dr Dylan Walters.

INFOGRAPHIC

Funding statement: This research was supported by Alive & Thrive, a global nutrition initiative funded by the Bill & Melinda Gates Foundation.

Image credit: Giacomo Pirozzi

The School in 1929

During July the Archives Service has been celebrating the 90th anniversary of the Keppel Street building with a display on the history of the building, and regular tweets and blog posts. For our final blog post, we thought that we’d concentrate on the staff and students who were at the School in 1929.

Sir Andrew Balfour

The Director of the School in 1929 was Sir Andrew Balfour, he was a physician who became interested in tropical medicine through his friendship with Sir Patrick Manson and he studied at the School in 1902. He was then appointed Director of the Wellcome Tropical Research Laboratory at Khartoum and Medical Officer of Health to that city. In 1913, he returned to England and founded and directed the Wellcome Bureau of Scientific Research and organised what was to become the Wellcome Museum of Medical Science. He undertook a number of roles during World War One and worked in Mesopotamia, East Africa and Egypt. He was appointed Director of the School in 1923 and became the first Director of the new London School of Hygiene & Tropical Medicine when it received its Royal Charter in 1924. He was knighted in 1930 but unfortunately died on 1 January 1931.

 

In 1929, the divisions and departments of the School and key staff were as follows:

  • Public Health, Professor Jameson
  • Bacteriology and Immunology, Professor Topley
  • Bio-Chemistry and Chemistry as Applied to Hygiene, Professor Raistrick
  • Epidemiology and Vital Statistics, Professor Greenwood
  • Tropical Medicine and Hygiene
    • Medical Zoology, Professor Leiper
    • Helminthology, Professor Leiper
    • Protozoology, J G Thomson
    • Entomology, P A Buxton
    • Institute of Agricultural Parasitology, Professor Leiper

Class of March to July 1929

There were 166 students who added the School during 1929 who took the following courses:

  • Tropical Medicine and Hygiene (ordinary course): 147
  • Tropical Medicine and Hygiene (special courses) : 2
  • Bacteriology and Immunology (advanced course): 5
  • Epidemiology and Vital Statistics (ordinary course): 10
  • Epidemiology and Vital Statistics (special courses: 2

102 students passed the School examination in Tropical Medicine and Hygiene out of 110 competing, of this number 13 gained distinction.

71 students gained the DTM&H (Eng) out of 116 competing.

The image below shows which services the students belonged to and the destination of the students.

Extract from 1929 Annual Report

Flicking through the annual report for 1929, I was fascinated to see that under the Department of Entomology report there is a list of gifts to the department which include:

  • Living larvae and pupae of Halticid beetle used as arrow poison
  • Fleas, 39 species new to collection
  • Mosquitoes, 34 species new to collection

For more information on the history of the School, please contact the Archives Service at

Artwork in Keppel Street

During our regular tours of the building, we point out the various artworks which are on display around the Keppel Street building. In 2000, the School established a contemporary art programme. The initial idea was to commission or purchase some sculptures and pictures, but the building has relatively few suitable spaces for placing or hanging art. So instead the emphasis shifted towards commissioning works that fitted, both in terms of the themes of the school and the architecture of the building. There are now various major pieces installed in the main building.

Bad air by Susan Brind

In ‘bad air’ [mal´aria], Susan Brind entwines language and architecture in a complex work touching on the history of LSHTM, the disease of malaria itself and the doctor and patients who wrote about it and suffered from it. It is an installation inscribed in gold leaf lettering on the terrazzo surfaces around the quadrant of the Keppel Street building. The texts are drawn from a number of sources, ranging from the classical period to the twentieth century. They draw upon beliefs that prevailed in Britain until the Victorian era, when ideas about miasma (noxious vapours and foreboding atmospheres) were replaced by scientific knowledge about bacteria, the causes of diseases and forms of pollution. The texts draw particularly on the 19th C accounts of malaria induced delirium and recovery, described by the explorer Sir Richard Burton. This artwork can be seen on the ground floor of the building.

Ramifications by Martina Kramer

Ramifications by Martina Kramer is inspired by the School’s beautiful Bloomsbury building and the School’s research. Kramer selected a space of movement and transit for her work: the stairwell in the main part of the building is its site and inspiration. Ramifications is the title of two complementary series of drawings that continue through the floors. At first an organic or crystalline growth is suggested by the paintings, which draw on fractal geometry, an irregular whole built up from regular and symmetric basic forms. Kramer recognises this as a pattern that many researchers at the LSHTM may be familiar with but she has also conceived this work to reflect, both literally and metaphorically, the vertical movement of the people using the stairs.

Untitled by Grenville Davey

Untitled by Grenville Davey was conceived to reflect the maritime origins of tropical medicine, and the School’s early history, which was inextricably linked with seafaring. In the papers and correspondence which passed between the architect and the client at the time the original building was constructed, there are numerous references to maritime architecture and plenty of nautical touches to be found in the original building design. The artist’s aim is to reflect this theme in the wave wall, using oak veneer for both the wall and the ceiling. The artist,  Grenville Davey won the Turner Prize in 1992 for his artwork entitled HAL.

18 – 24 July 2019

Peter Piot issues a statement in response to the Ebola outbreak in DRC being declared a Public Health Emergency of International Concern (PHEIC). Peter said: “The response to the ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC) is at a critical juncture. With more than 2,500 cases, over 1,600 deaths, and the recent case of a pastor with Ebola who travelled from Butembo to the border city of Goma, it shows no sign of coming under control. That is why I welcome the World Health Organization’s (WHO) decision to declare a Public Health Emergency of International Concern. I hope that today’s decision serves as a wake-up call to drive high-level political action, improved coordination, and greater funding to support DRC in their efforts to stop this devastating epidemic.”

Peter’s comments were covered by the Financial Times, Reuters, Telegraph, Scientist and BMJ.

Bloomberg publish an in-depth piece on the Ebola outbreak looking at the role that the second experimental vaccine could play. The piece was republished by Straits Times.

This week DRC’s Health Minister, who had been against rolling out the second experimental Ebola vaccine, resigned. Al Jazeera and Science cover the news and quote Peter.

Colin Sutherland provides expert comment to BBC News about a new Lancet study which found that resistant malaria has spread across South East Asia. Colin said: “While the drug-resistant parasite has undoubtedly spread, it is not necessarily a global threat. The implications are not as severe as we might think.”

The Guardian cover the findings of a report co-authored by Heather Wardle and commissioned by GambleAware, which finds that problem gamblers are significantly more likely to attempt suicide. The report calls for the government to do more to tackle the dangers of gambling. Heather said: “The harms from gambling are profound and can be devastating for individuals, families and communities. These results show how people with gambling problems are a higher risk group for suicidality.”

‘Friendship Bench’ founder Dixon Chibanda is featured in the New York Times (£) as the initiative is rolled out in New York City. Dixon said: “The clinic where the programme started had no room inside and wouldn’t lend its very busy nurses. That was a blessing in disguise. It made the program cheap and easy to spread.”

Susannah Mayhew, Samuel Boland and Gillian McKay are co-authors on a letter published in The Guardian, which says that in the wake of the Ebola outbreak being declared a PHEIC, frontline responders must be allowed to play a greater role in response efforts. The authors write: “Allowing local people to lead the response does not mean there is no role for the international humanitarian community. On the contrary, technical advice, response coordination and an emphasis on human rights remain important contributions the international response can offer.”

Sally Bloomfield speaks to the Daily Mail about bathroom hygiene after a study found a men’s bathroom door had six times more bacteria than the ladies. Sally said: “We know from our research that women tend to practise better hygiene and more often wash their hands after using the bathroom. Hand hygiene is important after touching bathroom doors touched by other people. So keeping a hand sanitiser in the drawer and using it when you return to your desk could be a solution to men not washing their hands after using the bathroom.”

Brendan Wren provides expert comment to the Daily Mail on plane hygiene after Naomi Campbell spoke about her concerns around hygiene while travelling on planes. Brendan said: “This is not necessary, simply wash your hands with soap and water before you leave. Plane toilets no different to public toilets.”

On social media

This week’s social media highlight comes from the LSHTM Twitter page, sharing publication of the CMO’s Annual Report. In the report, the CMO recognised LSHTM’s role and contribution to improving global health.

What do people buy to eat out-of-home in Britain and where do they buy it?

This summary of our recent published study was written by 12-year old Sophie who was visiting LSHTM for a work experience. We at PHI|Lab think she has done a fantastic job cutting through an academic paper and pulling out the key messages!

Our diets largely influence our health. Diets that contain a high intake of sugars, salts and saturated fats, combined with not much fruit, vegetable and fibre increase the risk of obesity and other diseases.

A recent paper which was published in Social Science & Medicine looked for a correlation between ‘out-of-home’ food expenditure and socio-economic patterning. Kantar Worldpanel (a panel that represents Britain as a nation) records household expenditures at product-level, including food and beverage purchased to be eaten out-of-home. 9,703 respondents, from 8,326 households took part in a 2 and ½ year course where they recorded purchases made. The options of the outlet classification were four groups – cafes & restaurants, takeaway & fast-food outlets, supermarkets & convenience stores and ‘other’ outlets. The food group classification was the option of eight different categories – main meals, quick meals, cold non-alcoholic beverages, hot beverages, sweet snacks, savoury snacks, fruit & veg and ‘other’.

One of the key aspects of this project was to see if there was any correlation between SES (socio-economic status) and the ‘out-of-home’ food they bought. The SES of a household was determined by what jobs they had. This indicates how much pay they had as well as what sort of education they have had. The results were as follows:

  • All SES households spent the highest percentage of their expenditure in cafés & restaurant
  • Low-SES households spent the highest percentage of their expenditure in fast-food & takeaway outlets
  • All SES households spent the lowest percentage of their expenditure in supermarkets & convenience stores.

Age groups also seemed to make a difference to the food group they bought from. For example, compared to 19-29 year olds, 12-18 year olds had a lower expenditure share on meals and hot beverages, but a higher share on non-alcoholic beverages (including soft drinks) as well as both sweet and savoury snacks. The main expenditure on meals eaten ‘out-of-home’ in terms of food groups was main meals, coming in at 42-43% of expenditures. Quick meals and hot beverages came in at 17-19% each. This was then followed by cold non-alcoholic beverages (10-12%) and sweet snacks (8-9%). Surprisingly, savoury snacks, fruit & veg and ‘other’ accounted for a minute amount of expenditure shares (<1% each).

 

Cornelsen, L., Berger, N., Cummins, S., Smith, R., 2019. Socio-economic patterning of expenditures on ‘out-of-home’food and non-alcoholic beverages by product and place of purchase in Britain. Soc. Sci. Med. https://doi.org/10.1016/j.socscimed.2019.112361

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Results from three pilots assessing feasibility and acceptability of recency testing (July 2019)

The MeSH Consortium has completed three pilots in different routine service-provisions context Kenya and Zimbabwe. These pilots were conducted in partnership with KEMRI, EDARP, CeSHHAR, UCSF and the ALPHA network.

Information on new infections contributes to tracking the incidence of new infections over time, thereby helping us to assess whether control measures are working and understand better where prevention efforts should be targeted. In recognition of this, the MeSH Consortium, working closely with in-country partners, conducted three pilots of HIV recency testing in a variety of routine service-provision contexts in Kenya and Zimbabwe. At a time when all PEPFAR-supported countries are being strongly encouraged to include recency testing in their national HIV testing strategies, the MeSH Consortium present the results from these three pilots in a joint report. In addition to presenting HIV and recency testing yields, in the report we also assess the feasibility of conducting recency testing in routine settings, present an analysis of the acceptability and utility of recency testing among healthcare workers and participants, present estimates of HIV incidence using a number of methods, and explore potential biases in incidence estimates when using women attending ANC as the surveillance population.

The full report can be found here

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