Drug Resistance to AIDS; Tuberculosis and Malaria in the African Region

With just 10of the world population; sub-Saharan Africa has the highest burden of HIV/AIDS; tuberculosis and malaria in the world. Both access to and adequate utilization of eff ective treatment with quality-assured medicines are crucial for reducing the disease burden. However; eff orts to improve access to treatment are hampered by the development of HIV; TB and malaria drug resistance. This is a result of genetic mutations and is a major threat to control of HIV/AIDS; TB and malaria. HIV drug resistance can be minimized by good antiretroviral treatment (ART) programmes; removal of barriers to continuous access to ART and reduction of HIVtransmission. Recent surveys conducted at antenatal clinics in several countries in the African Region estimated that HIV resistance to all drug classes is less than 5. A global HIV drug resistance network established in 2001 supports countries in capacity building and guidance on standard procedures for monitoring HIV drug resistance. Multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) are principally a result of inadequate or poorly administered treatment regimens. The new WHO Stop TB Strategy launched in 2006 identifies management of MDR-TB as a core component of TB control. The magnitude of MDR-TB in the African Region is still unknown. In 2007; 27 countries notifi ed MDR-TB cases; and six reported at least one case of XDR-TB. Following widespread resistance to chloroquine and sulphadoxine-pyrimethamine all malaria-endemic countries except two in the Region have changed the treatment policy to artemisinin-based combination therapy (ACT). The main method of monitoring antimalarial drug resistance is through therapeutic efficacy testing. Todate there has been no confi rmed resistance to ACTs in the African Region. Given the emergence and spread of resistance to HIV; TB and malaria drugs; the purpose of this paper is to describe the issues and challenges and propose a way forward with regard to the prevention and control of such resistance

[Frequency of diagnosis requiring the assistance of the traumatology specialty of the Social Security: province of Valencia]. / Análisis de la frecuencia de diagnósticos demandantes de asistencia en la especialidad de Traumatología de la Seguridad Social: provincia de Valencia.

A cross sectional study lasting one week has been carried out in order the frequency of traumatological illnesses diagnose by specialists of the Social Security in Valencia province. Rheumatological diseases mean more of 50% from the total demand.

[Frequency of diagnosis of the cardiology specialty requiring the assistance of the lung and heart specialty in the social security ambulatory services: province of Valencia]. / Análisis de la frecuencia de diagnósticos de la especialidad de cardiología demandantes de asistencia en la especialidad de Pulmón y corazón en los ambulatorios de la seguridad social: provincia de Valencia.

A cross-study has been carried out of the demand for specialised medical attention, by disease process, in Heart and Lung outpatient consultations. Cardiac morbidity diagnosed in consultations carried out in the province of Valencia has been analysed. The results from the various institutions (C.I.E. Novena Revisión) fall into different age groups. They are also differentiated by first and second visits. Chronic cardiocirculatory diseases are the most frequently attended on an outpatient basis by the Heart specialist. "Other forms of chronic ischemia of the heart" is the nosological classification which is diagnosed the most in the week the sample was taken. The disorders being studied appear most during the second stage of life.