2017年08月24日

読書から学ぶ結核

結核について長年にわたって研究をされている森亨氏著の「現代の結核」を読んだ。

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結核と言えば、「昔の病気」と思われがちだが、実際日本は結核中蔓延国で毎年約18,000人が新たに発症しているという。
私もこの本を読むまでは、未だに結核という病気が国内外問わず多くの患者さんを苦しめている病気であるとは知らなかった。「自分には関係ないだろう」「まさか自分は罹らないだろう」と思っている人は多いと思うが、日本で平穏な日常を送っている誰にでも発症する危険性はある。そう思うと、もっと多くの人に結核を意識してもらえるよう活動する必要がある。また、結核と闘っている患者さんや医療従事者、研究者も多くいることを知ってもらいたい。
(もすが)
posted by resultsjp at 10:26| Comment(0) | 情報

ナイロビ生活vol41 "エンドライン調査の様子"

皆さん、こんにちは。
白石です。

前回のブログ"ナイロビ生活vol40"はこちら
ナイロビ生活vol40 "記事紹介A"

===

本日はCHVから送られてきた、エンドライン調査の様子をお届けします。

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ケニアオフィスでは、プロジェクトの総括として、エンドライン調査の分析を行っています。
7月10日に開始した「認知度・満足度調査」をカンゲミ住民を対象として10,000サンプルの収集を目標と掲げ、CHVsとスタッフ一丸になって、取り組んでいました。
さらに事業開始時に行ったベースラインとの比較調査のために、「カンゲミにおける結核の認識と知識、偏見」の調査を行っていました。
その後7月20日までに10,000サンプルの収集を終えて、詳細分析を行っています。

===

しらいし
posted by resultsjp at 03:17| Comment(1) | 情報

2017年08月21日

WITH 1 MILLION DYING ANNUALLY OF TB, RJ AND OTHER AGENCIES GOT REASON TO FIGHT ON STILL

By ABUTA OGETO

Tuberculosis kills over a million people each year, mostly in developing countries, where poor public health systems hamper efforts to diagnose and treat it. But NGOs are now embracing new mobile health technologies that could help fight the disease more efficiently and cost-effectively.
As one of the world’s deadliest communicable diseases, TB presents a massive public health challenge. Due to the high costs of fighting it in places with weak institutions and infrastructure, the WHO reports a $2 billion annual funding shortfall for TB prevention, diagnosis, and treatment. And as the disease festers in densely populated cities and remote areas, new antibiotic-resistant strains are gaining strength. It’s not implausible that one of these strains could morph into a superbug that causes the next big global pandemic.
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To be sure, extensive work by The Global Fund, the World Health Organization, the United States Agency for International Development (USAID), and other large organizations are making a big difference. Worldwide incidence of TB declined at a rate of 1.5% each year between 2000 and 2013, according to the WHO’s Global Tuberculosis Report in 2014.

Yet further progress will require expensive efforts in low-resource settings where administering drugs and monitoring compliance can be a logistical nightmare. Most normal cases of TB require patients to take six months of antibiotics on a daily basis. Adherence to this regimen will usually cure the patient, but missing doses or failing to complete the regimen exposes the patient to treatment failure. It also allows TB bacteria in their bodies to develop into multi-drug-resistant tuberculosis (MDR-TB), which is substantially more difficult and costly to treat.

To work around this challenge, many budget-strapped NGOs have turned to mobile tech for health worker education, field management, data collection, patient tracking, and improved diagnostics.
The Results Japan Kenya Office, a Nairobi-based NGO, has joined hands with the Kangemi TB Centre to take up a door-to-door campaign and screen slum residents to curb tuberculosis. The organisation hopes to spread awareness about TB especially the stigma associated with it.

While the plan is to reach out to slums in urban areas across the city, special attention will be paid to neighbourhoods in Kangemi. The incidence of the disease in some pockets is a cause for concern.

According to Edwin Shikanda, The head of the Kangemi Health Centre, the stigma associated with the disease prevents some people from talking about it, and at times, from seeking treatment. "There are areas where we found the incidence very high. Since this is a door-to-door screening, community and religious leaders will be part of it. These people will counsel residents about the need to be aware of the disease and seek medical attention," he said.

The NGO, which recently conducted a health survey of residents in Kangemi, has started training more volunteers who will collect sputum samples from residents, teach them basic hygiene, and conduct awareness campaigns in the slums.

"We have seen that people who have been diagnosed with TB, abandon treatment midway for a variety of reasons. The idea is to encourage them to continue the treatment," Lilian Njoroge, the head of the CHVs said.

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RESULTS Japan Volunteers first collect sputum samples from people and send them for microscopic analysis. People whose samples show TB positive, will be asked to take up treatment. Those whose samples yield a negative result will be encouraged to get an XRay done. The NGO help desks at government area hospital will provide assistance required to other patients as well.

Over the last one year, the NGO has renovated the facility, trained hundreds of locals on how to act on TB, and facilitated free treatment of TB patients.
posted by resultsjp at 23:36| Comment(1) | 情報

らぽーる事業にて、クラウドファンディング挑戦開始!

クラウドファンディング挑戦開始!ご支援のほど、よろしくお願いいたします。

親の離婚に悩む子どもたちが支え合える場を作りたい!
https://readyfor.jp/projects/oyako-support

★★★
1年間で、未成年の子供がいる夫婦が離婚した件数は12万3190件(2015年度法務省)、そして、現在、片親家庭である数は120万世帯以上だと考えられます。

しかし、現実はまだまだ子どもを第一に考えて離婚できる夫婦は少ないようです。離婚する際、養育費の分担や親子の面会交流について取り決めたケースは約6割に留まり、さらに、実際、離婚後に養育費を支払うのは約2割、面会交流の実施をするのは約3割になります。

取り決めやその履行ができていない夫婦の中には、夫婦間の対立が激しく、お互いに言い争いが続き、調停や裁判となる夫婦もいます。そうした両親の争いの間で、子ども達は父母どちらに付くべきか迷ったり、自分の想いを押し殺してしまったりします。また、「人に知られて同情されたくない。負い目を感じたくない」「自分の家庭はフツウじゃないんだ。それを知られたくない」と感じる子も多くいます。中には、同居親から別居親の悪口など否定的な言動を見聞きし、それを鵜呑みにしてしまい、長い間、別居親と会えないでいる子どももいます。 そして、子ども達は、その気持ちを誰にも打ち明けられずに苦しむことが多々あります。

家族の葛藤や争いは、簡単に他人に話せるものではありません。しかし、親の離婚を乗り越えるきっかけとして、一人で抱え込まずに誰かに打ち明けたり、特に同じような家庭環境にある友人と出会うことで、自分の気持ちが「楽になった」・「救われた」と進展することもあります。

ただ現状は、これだけ多くの子どもが親の離婚を経験し、特有の悩みを抱えているにも関わらず、同じ経験をした子ども達がお互いに話せる場所はまだほとんどありません。両親の争いに巻き込まれた子どもは、親に自分の意見を言うことは難しく感じ、また片親家庭になっても同居親との密接な関係に束縛を感じることもあり、家庭以外の自分をさらけ出せる場所が大切です。

そのために、同じような家庭環境にある仲間と出会い、一人じゃないと分かって心強く思ったり、気持ちを吐き出すことができてこころが軽くなったと思えるような場所を作りたいです。

そのために、クラウドファンディングを通してサポーターを募集します。

目標金額は21万円。
本日8月21日(月)〜9月15日(金)23時までの募集です。
※もし、目標金額100%に達しなければ、全額返金となってしまう仕組みです。

支援のリターンとして、らぽーるが作成したオリジナルの冊子や、ペンやマグカップ、離婚相談などをお選びしていただけます。

詳しくは、こちらからご覧ください。
https://readyfor.jp/projects/oyako-support
検索サイトで、『レディフォー・らぽーる・子ども』で検索しますと、上位に表示されます。

どうかご支援、ご協力のほどお願いいたします!

★★★
お知り合いの方に、こんなプロジェクトがあるとお伝えいただけたら、とても嬉しいです!
最後までお読みいただきまして、ありがとうございます。
posted by resultsjp at 14:58| Comment(3) | らぽーる

A sorry tale to tell in Results Japan’s fight against TB in Kenya slums.

BY ABUTA OGETO

KAROI − The long journey travelled by 42-year-old Sylvia Mudoka in the fight against tuberculosis is a typical case that calls for the scaling up of the fight against the disease from the Kenyan Government. Were it not for NGOs work, the deaths could be in tens of thousands.

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Her sorry tale highlights the importance of awareness among TB patients and the community at large.
Soon after she was diagnosed, Mudoka discovered that she was about to travel a long journey to defeat the scourge.

She had nowhere to stay, after her brother evicted her from their family home.
Although her electrifying smile greets any visitor in Nairobi’s oldest high-density slum suburb of Kibera, the battle she went through in the last seven years is still fresh in her mind.

A single mother of two children, aged eight and 11, Mudoka has somehow managed to overcome the social outcast jacket she wore for several years and also the disease.

“It all started in early October 2010 when I developed cold fever,” she recalled.
“I went to the hospital and was given amoxicillin drugs. The doctor recommended that I must have my sputum tested.”

It took some time before Mudoka could get results and the feedback that she was to undergo TB treatment.

All hell broke loose as she could no longer afford to fend for herself because of the burden brought by the disease.

“I had to move to our family house, but my brother, Stephen, could not accept me,” Mudoka says.
Her neighbour, Ambuya Jennifer Mapanga, says Mudoka was a social outcast after her brother evicted her.

“We were touched by Mudoka’s plight after eviction. She was a social outcast,” she said.

Without anyone to turn to for solace and shelter, Mudoka went to Mbagathi General Hospital, where officials understood her plight and accommodated her.

“For six months, my brother never visited me, but I used to get regular visits from other friends,” she says. “But eventually, I fought through and won the battle with the help of strangers.”

Mudoka’s plight aptly explains how TB should be treated as a cause of concern by both the government and co-operating partners.

HIV and Aids advocate Moses Mukamuri notes that TB patients face more pronounced stigma, compared to other patients, making it a barrier to accessing treatment and adherence.

“Stigma must be fought from all angles, starting at family level, health care givers and the community at large. Awareness must be included with easy-to-read materials in vernacular,” Mukamuri says.

“Political commitment and will must be reflected in costing it through the health budgets allocation. As long as the health budget continues to be as it is, we may make as much noise as possible, but we may not achieve any tangible results”-Results Japan Kenya

The Global TB Report 2016 lists Kenya as among the 30 high burdened countries, with a triple burden of TB, TB-HIV and MDR-TB.

The other countries on the list are Angola, Bangladesh, Cambodia, Central African Republic, China, Congo, the Democratic People’s Republic of Korea, the Democratic Republic of Congo, Ethiopia, India, Indonesia, Lesotho, Liberia, Mozambique, Myanmar, Namibia, Nigeria, Pakistan, Papua New Guinea, Philippines, Russian Federation, Sierra Leone, South Africa, Thailand, Tanzania, Vietnam and Zambia.

“The 30 high TB burden countries accounted for 87% of all estimated incident cases worldwide,” the report reads in part.

“The six countries that stood out as having the largest number of incident cases in 2015 were (in descending order) India, Indonesia, China, Nigeria, Pakistan and South Africa (combined, 60% of the global total).
“Of these, China, India and Indonesia alone accounted for 45% of global cases in 2015. The annual number of incident TB cases relative to population size (the incidence rate) varied widely among countries in 2015, from under 10 per 100 000 population in most high-income countries to 150–300 in most of the 30 high TB burden countries.”

TB has attracted the attention of Parliament. The Parliamentary Portfolio Committee on Health in February 2016 produced a report painting a gloomy situation with regards to the disease.
While TB treatment for six to nine months costs $31, it was discovered that MDR-TB treatment for 20 to 24 months goes for $2 571.

The situation is worse for another TB strain called Extensively Drug Resistant-TB costing $31 000 to treat for 24 to 36 months.

“In this regard, with the economic strains facing the country, prevention and control of the disease becomes key to TB management in the country,” the legislators noted in their report.
They recommended government moves swiftly and reduces the exorbitant costs of the second line TB treatment.

Riku Shiraishi, The Director of RJ Kenya says TB campaign, especially in Kangemi is now a success story through community involvement.

“The programme on TB has been very successfully because we have rapidly decentralised diagnosis, care and treatment to the house/home level and successfully adopted a community based approach,” he says.

Kenya Minister for Health, Dr. Cleopa Maillu says they are working with the National TB Control Programme to strengthen TB control in Kenya in the next nine years.

“Current interventions include enhancing access to quality patient centered care for TB, TB/HIV and MDR-TB services; prevention of transmission and disease progression through active case finding; and strengthening TB platforms including political commitment to end TB,” he says, adding that although funding is always not enough, financial challenges always hinder the provision of adequate services, the government has, however, helped in lessening the financial burden in the TB programme.

Mudoka, free from the disease, had to go through what she termed “hell”, especially after her rejection by relatives because she had contracted the disease.

posted by resultsjp at 02:34| Comment(3) | 情報