South African healthcare workers face greater risk for TB, HIV

A large-scale survey of South African healthcare workers has revealed major gaps in workplace protection against tuberculosis, HIV and hepatitis, according to a University of British Columbia health researcher.Presenting findings today at the 2014 annual meeting of the American Association for the Advancement of Science (AAAS), Dr. Annalee Yassi says issues such as confidentiality, stigma, technological capacity and staff training need to be addressed while improving hospital resources and protocols.Preliminary results of the 2012 baseline survey of more than 1,000 healthcare workers in three hospitals show that more than 68 per cent of patient care staff had never been screened for TB; nearly 20 per cent were not vaccinated against hepatitis; and 55 per cent did not wear respiratory protection when needed. Despite South Africa’s high TB and HIV rates — 18 per cent of its adult population is HIV-positive — and risk of hepatitis transmission, recapping of used needles before disposal and washing and reusing of gloves were common, with more than 20 per cent surveyed reporting needlestick injury or unprotected exposure to bodily fluids.Yassi, who is helping South Africa implement occupational health guidelines developed by the World Health Organization (WHO), says healthcare workers in developing countries face greater health challenges while serving significantly more patients.”In addition to massive workloads, healthcare workers in developing countries are more likely to get sick from the workplace,” says Yassi, a professor in UBC’s School of Population and Public Health, noting that healthcare workers in South Africa are at three times the risk of contracting TB than other South Africans, and more than seven times more likely to be hospitalized for drug-resistant TB. A 2013 WHO estimate showed South Africans were almost 300 times more likely to contract TB than Americans.”Considerable progress is being made, including better standard operating procedures and screening,” says Yassi. “But there’s much more we can do to ensure a healthy workplace for the international health care workforce.”Story Source:The above story is based on materials provided by University of British Columbia. Note: Materials may be edited for content and length.

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Insulin differs between ethnicities, study finds

June 27, 2013 — People have differing abilities to release and react to insulin depending on ethnicity, according to a new study from researchers at Lund University in Sweden, Stanford University and Kitasato University.The results show that healthy subjects of all ethnicities were able to maintain a normal glucose level, but did so in different ways.”Africans tend to have lower insulin sensitivity. However, they appear to compensate for this by releasing larger quantities of insulin. Among those of East Asian origin, the reverse appears to be the case. They have very good insulin sensitivity, but appear to have a poorer ability to release more insulin if it is needed. Caucasians fall somewhere between the two extremes. Both insulin release and insulin sensitivity are affected,” says Damon Tojjar, a doctoral student at the Lund University Diabetes Centre (LUDC).When the researchers looked more closely at the research subjects who were at risk of developing diabetes and the subjects who had already been diagnosed, the same pattern was observed. Their results were generally worse, however, as their insulin production or insulin sensitivity had begun to fail as part of the disease.”The findings are consistent with what we see in clinical settings — East Asians are more sensitive to developing diabetes and they do so at a lower BMI. Because a lack of insulin is a condition for developing diabetes, it is not surprising that East Asians show lower insulin release and generally need to start insulin treatment at an earlier stage. The situation in Africa is still so complicated and heterogeneous that new studies are needed,” says Professor Leif Groop from LUDC.The researchers are not sure of the reasons for the physiological background to the changes, but suggest some possible explanations.”Our findings and the fantastic developments in genetic research make us optimistic that we can continue to map the important differences that cause a failure in the production of insulin and reduced insulin sensitivity, so that we can emphasise personalised treatment in the future,” concludes Damon Tojjar.About the studyIn type 2 diabetes, there are two main physiological functions that fail — the body’s ability to produce insulin and the body’s insulin sensitivity, i.e. the vast majority of cells’ ability to absorb glucose from the blood. …

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