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International World Tuberculosis Day, 24th March

24th March every year is the World Tuberculosis day designed to spread awareness about the global epidemic of tuberculosis and efforts to eliminate the disease. Today, this disease causes the deaths of about 1,6 million people each year, mostly in the third world.

The reason that it is on 24th March is because the day commemorates the day in 1882 when Dr. Robert Koch announced that he had discovered the cause of tuberculosis, the TB Bacillus. By the time of the announcement in Berlin, Europe and Americas was already being raged by the TB-virus causing the death of every one out of seven people.

In 1982, on the 100th anniversary of Robert Koch’s presentation, the International Union Against Tuberculosis and Lung Disease (IUATLD) proposed that March 24th would be proclaimed as an official World TB Day.

Signs and symptoms

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When the disease becomes active in the human body, 75% of the cases are pulmonary TB, that is, TB in the lungs. The symptoms include; chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks. Systemic symptoms include fever, chills, night sweats, appetite loss, weight loss, pallor, and fatigue. Tuberculosis also has a specific odour attached to it; this has led to trained animals being used to vet samples as a method of early detection.

In the other 25% of active cases, the infection moves from the lungs, causing other kinds of TB, collectively denoted extra pulmonary tuberculosis. This occurs more commonly in immunosuppressed persons and young children. Extra pulmonary infection sites include the pleura in tuberculosis pleurisy, the central nervous system in meningitis, the lymphatic system in scrofula of the neck, the genitourinary system in urogenital tuberculosis, and bones and joints in Pott’s disease of the spine.

Causes

The cause of TB, Mycobacterium tuberculosis (MTB), is a small aerobic non-motile bacillus. High lipid content of this pathogen accounts for many of its unique clinical characteristics. It divides every 16 to 20 hours, an extremely slow rate compared with other bacteria, which usually divide in less than an hour.

Epidemiology

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A third of the world’s population has been infected with M. tuberculosis, and new infections occur at a rate of one per second. However, not all infections with M. tuberculosis cause TB disease and many infections are asymptomatic. In 2007, an estimated 13.7 million people had active TB disease, with 9.3 million new cases and 1.8 million deaths; the annual incidence rate varied from 363 per 100,000 in Africa to 32 per 100,000 in the Americas. Tuberculosis is the world’s greatest infectious killer of women of reproductive age and the leading cause of death among people with HIV/AIDS.

In 2007, the country with the highest estimated incidence rate of TB was Swaziland, with 1200 cases per 100,000 people. India had the largest total incidence, with an estimated 2.0 million new cases. The Philippines ranks fourth in the world for the number of cases of tuberculosis and has the highest number of cases per head in Southeast Asia. Almost two thirds of Filipinos have tuberculosis, and up to an additional five million people are infected yearly. In developed countries, tuberculosis is less common and is mainly an urban disease. In the United Kingdom, the national average was 15 per 100,000 in 2007, and the highest incidence rates in Western Europe were 30 per 100,000 in Portugal and Spain. These rates compared with 98 per 100,000 in China and 48 per 100,000 in Brazil. In the United States, the overall tuberculosis case rate was 4 per 100,000 persons in 2007. In Canada tuberculosis is still endemic in some rural areas. The incidence of TB varies with age. In Africa, TB primarily affects adolescents and young adults, however, in countries where TB has gone from high to low incidence, such as the United States, it is mainly a disease of elder people, or of the immunocopromised.

What are the main causes of TB?

There are a number of known factors that make people more susceptible to TB infection such as HIV. Co-infection with HIV is a particular problem in Sub-Saharan Africa, due to the high incidence of HIV in these countries. Smoking more than 20 cigarettes a day also increases the risk of TB by two to four times. Diabetes mellitus is also an important risk factor that is growing in importance in developing countries. Other disease states that increase the risk of developing tuberculosis are Hodgkin lymphoma, end-stage renal disease, chronic lung disease, malnutrition, and alcoholism.

Diet may also modulate risk. For example, among immigrants in London from the Indian subcontinent, vegetarian Hindu Asians were found to have an 8.5 fold increased risk of tuberculosis, compared to Muslims who ate meat and fish daily. Although a causal link is not proved by this data, this increased risk could be caused by micronutrient deficiencies: possibly iron, vitamin B12 or vitamin D. Further studies have provided more evidence of a link between vitamin D deficiency and an increased risk of contracting tuberculosis. Globally, the severe malnutrition common in parts of the developing world causes a large increase in the risk of developing active tuberculosis, due to its damaging effects on the immune system. Along with overcrowding, poor nutrition may contribute to the strong link observed between tuberculosis and poverty.

Prisoners, especially in poor countries, are particularly vulnerable to infectious diseases such as HIV/AIDS and TB. Prisons provide conditions that allow TB to spread rapidly, due to overcrowding, poor nutrition and a lack of health services. Since the early 1990s, TB outbreaks have been reported in prisons in many countries in Eastern Europe. The prevalence of TB in prisons is much higher than among the general population, in some countries as much as 40 times higher.

Robert Koch

Heinrich Hermann Robert Koch (11 December 1843 – 27 May 1910) was a Prussian physician. He became famous for isolating Bacillus anthracis (1877), the Tuberculosis bacillus (1882) and the Vibrio cholerae (1883) and for his development of Koch’s postulates. He was awarded the Nobel Prize in Physiology or Medicine for his tuberculosis findings in 1905 and considered one of the founders of microbiology,

Heinrich Hermann Robert Koch was born in Clausthal, Prussia one of the German states as the son of a mining official. He studied medicine under Friedrich Gustav Jakob Henle at the University of Göttingen and graduated in 1866. He then served in the Franco-Prussian War and later became district medical officer, Wollstein (Wolsztyn), Prussian Poland. Working with very limited resources, he became one of the founders of bacteriology, the other major figure being Louis Pasteur. After Casimir Davaine showed the direct transmission of the anthrax bacillus between cows, Koch studied anthrax more closely. He invented methods to purify the bacillus from blood samples and grow pure cultures. He found that, while it could not survive outside a host for long, anthrax built persisting endospores that could last a long time. These endospores, embedded in soil, were the cause of unexplained “spontaneous” outbreaks of anthrax. Koch published his findings in 1876, and was rewarded with a job at the Imperial Health Office in Berlin in 1880. In 1881, he urged the sterilization of surgical instruments using heat.

In Berlin, he improved the methods he used in Wollstein, including staining and purification techniques, and bacterial growth media, including agar plates (thanks to the advice of Angelina and Walther Hesse) and the Petri dish, named after its inventor, his assistant Julius Richard Petri and these devices are still used today. With these techniques, he was able to discover the bacterium causing tuberculosis (Mycobacterium tuberculosis) in 1882 (he announced the discovery on 24 March). Tuberculosis was the cause of one in seven deaths in the mid-19th century.

In 1885, he became professor of hygiene at the University of Berlin, then in 1891 he was made Honorary Professor of the medical faculty and Director of the new Prussian Institute for Infectious Diseases (eventually renamed as the Robert Koch Institute), a position from which he resigned in 1904. He started traveling around the world, studying diseases in South Africa, India, and Java. He visited what is now called the Indian Veterinary Research Institute (IVRI), Mukteshwar on request of the then Government of India to investigate on cattle plague. The microscope used by him during that period was kept in the museum maintained by IVRI. Probably as important as his work on tuberculosis, for which he was awarded a Nobel Prize (1905), are Koch’s postulates, which say that to establish that an organism is the cause of a disease, it must be:

  • found in all cases of the disease examined
  • prepared and maintained in a pure culture
  • capable of producing the original infection, even after several generations in culture
  • Retrievable from an inoculated animal and cultured again.

Koch’s pupils found the organisms responsible for diphtheria, typhoid, pneumonia, gonorrhoea, cerebrospinal meningitis, leprosy, bubonic plague, tetanus, and syphilis, among others, by using his methods.

Robert Koch died on 27 May 1910 from a heart-attack in Baden-Baden, aged 66.

Source info; Wikipedia

Overview of the violence against women around the world

The situation of women and girls, facts and figures all over the world*


Gender and HIV/AIDS:

  • Nearly a third of all adults living with HIV/AIDS are under the age of 25 and 2/3 of them are women.
  • In Sub-Saharan Africa, girls are getting infected faster and earlier than boys. In the group from 15 to age 24, two girls are infected for every boy. According to surveys that indicate women who have some post primary schooling compared to women with no education are 5 times more likely to lack basic information about HIV/AIDS.
  • In 2002, an estimated 800,000 children under the age of 15 were infected with HIV as a result of parent-to-infant transmission.

Gender and girls education:

  • Over 110 million of the world’s children, 2/3 of them being girls are not attending school.
  • Of the world’s 875 million illiterate adults, 2/3 is women.
  • Half of the girls who live in developing countries (excluding China) will be married before their 20th birthday. Increasing girl’s time in school is one of the best ways for the girls to get married in an older age.

Gender and violence against women and girls and child protection issues:

  • One in every 3 women is a survivor of some form of gender based violence, most often by someone in her family. Between 15 and 76% of women are targeted for physical and/or sexual violence in their lifetime.
  • Girls between 13 and 18 years constitutes the largest group in the sex industry and it is estimated that around 500,000 girls below the age of 18 are victims of trafficking each year.
  • Female Genital Mutilation (FGM) affects around 130 million girls and women globally and places 2 million at risk but the last decades this problem has improved.
  • In some cultures, the preference for boys results in pre-natal sex selection and death of many girls. In India for example; there are 933 Indian women for every 1000 men resulting in 40 million missing women.

Gender and the Maternal Mortality Rate (MMR) and other health issues:

  • 1,400 women die every day from pregnancy-related causes, 99% of them in developing countries.
  • In Sub-Saharan Africa, a woman has 1 in 3 chance of dying in child birth. In industrialized countries the risks are 1 in 4,085.
  • Direct obstetric deaths account for about 75% of all maternal deaths in developing countries.

Emergencies

  • More than 80% of the world’s 35 million refugees and displaced people are women and children.
  • Emergencies put women at risk of extreme sexual violence and abuse. In Rwanda, 2,000 women and many of them are being survivors of rape tested positive for HIV during the 5 years following the 1994 genocide.

Femicide

  • In Guatemala, two women are killed every day.
  • In India, 8,093 cases of dowry-related death were reported in 2007 and unknown number of murders of women and young girls were labeled as “suicides” or “accidents”.
  • Between 40 and 70% of female murder victims were killed by their intimate partners in Australia, Canada, Israel, South Africa and the United States.
  • In Chihuahua, Mexico, 66% of murders of women were committed by husbands, boyfriends or other family members.

Violence and young women

  • Up to 50% of sexual assaults worldwide are committed against girls under the age of 16.
  • An estimated 150 million girls under the age of 18 suffered some form of sexual violence in 2002.
  • The first sexual experience of some 30% women was forced and the percentage is even higher among those who were under 15 at the time of their sexual initiation.

Harmful practices

  • Approximately 100 to 140 million girls and women worldwide have experienced female genital mutilation leaving more than 3 million girls in Africa annually at risk of the practice.
  • Over 60 million girls worldwide are child brides and married before the age of 18. The numbers are divided as; South Asia-31, 3 million and Sub-Saharan Africa-14, 1 million. Violence and abuse characterize married life for many of these girls. Women who marry early are more likely to be beaten or threatened, and more likely to believe that a husband might sometimes be justified in beating his wife.
  • Trafficking
  • 80% from the estimated number of 800,000 people being trafficked across the national borders is women and girls.
  • One study in Europe found that 60% of trafficked women had experienced physical and/or sexual violence before being trafficked, pointing to gender-based violence as a push factor in the trafficking of women.

Sexual harassment

  • Between 40 and 50% of women in European Union countries experience unwanted sexual advances, physical contact or other forms of sexual harassment at work.
  • Across Asia, studies in Japan, Malaysia, the Philippines and South Korea show that 30 to 40% of women suffer workplace sexual harassment.
  • In Nairobi, 20% of women have been sexually harassed at work or school.
  • In the United States, 83% of girls aged 12 to 16 experienced some form of sexual harassment in public schools.

Rape in the context of conflict

  • Estimates suggest that 20,000 to 50,000 women were raped during the 1992-1995 war in Bosnia and Herzegovina, while approximately 250,000 to 500,000 women and girls were targeted in the 1994 Rwandan genocide.
  • Between 50,000 and 64,000 women in camps for internally displaced people in Sierra Leone were sexually assaulted by combatants between 1991 and 2001.
  • In eastern Democratic Republic of Congo, at least 200,000 cases of sexual violence, mostly involving women and girls, have been documented since 1996: the actual numbers are believed to be far higher.

Conservative

  • The following figures are some of the facts of violence done on women compiled by Amnesty International and Feminist.com from various researches done by individuals and/or organizations all over the world;
  • An estimated 50,000 women and children are trafficked into the United States annually for sexual exploitation or labor (US Central Intelligence Agency, 2000).
  • One in five women will be a victim of rape or attempted rape in her lifetime (WHO 1997).
  • In USA a woman is raped every 90 seconds (US Department of Justice, 2000).
  • Somewhere in America a woman is battered, usually by her intimate partner, every 15 seconds (UN Study on the Status of Women, Year 2000).
  • Up to 70% of female murder victims are killed by their male partners (WHO 2008).
  • In Kenya more than one woman a week was reportedly killed by her male partner while in Zambia, five women a week were murdered by a male partner or family member (Joni Seager, 2003).
  • In the Russian Federation 36,000 women are beaten on a daily basis by their husband or partner, according to Russian non-governmental organizations (OMTC, 2003).
  • More than 135 million girls and women have undergone female genital mutilation and an additional 2 million girls and women are at risk each year (6,000 everyday) (UN, 2002).
  • 82 million girls who are now aged 10 to 17 will be married before their 18th birthday (UNFP).
  • In India there are close to 15,000 dowry deaths estimated per year. Mostly they are kitchen knives designed to look like accidents (Injustice Studies, Vol. 1, November 1997).
  • 4 million women and girls are trafficked annually.
  • An estimated one million children, mostly girls, enter the sex trade each year (UNICEF).
  • A study in Zaria, Nigeria found out that 16 per cent of hospital patients treated for sexually transmitted infections were younger than five (UNFPA).

Population and families

  • The world’s population tripled between 1950 and 2010 to reach almost 7 billion.
  • There are approximately 57 million more men than women in the world, but in most countries there are more women than men.
  • There is a “gender spiral” with more boys and men in younger age groups and more women in the older age groups.
  • Fertility is steadily declining in all regions of the world but still remains high in some regions of Africa.
  • Life expectancy is steadily rising as women lives longer than men.
  • International migration is increasing and there are more and more women migrants and in certain areas they outnumber men.

Health

  • Women live longer than men in all regions.
  • 2 out of every 5 deaths of both women and men in Africa are still caused by infectious and parasitic diseases.
  • Women are more likely than men to die from cardiovascular diseases, especially in Europe.
  • Breast cancer among women and lung cancer among men tops the list of new cancer cases globally.
  • Women stand for the majority of HIV positive adults in Sub-Saharan Africa, North Africa and the Middle East.
  • The majority of over half a million maternal deaths in 2005 occurred in developing countries.

Education

  • 2/3 of the 774 million adult illiterates worldwide are women.
  • The global youth literacy rate has increased to 89%.
  • 72 million children of primary school age are not attending school out of which over 39 million (54%) are girls.
  • Women in tertiary education are significantly underrepresented in the fields of science and engineering but remain predominant in education, health and welfare, social sciences, humanities and arts.
  • Worldwide, women account for slightly more than a quarter of all scientific researches that is an increase compared to previous decades.
  • Use of and access to the Internet grew in the past decade as it narrowed the gender digital divide, however, women still don’t have the same level of access as men in most countries whether it is more developed or not.

Work

  • Women are predominantly and increasingly employed in the services sector.
  • Vulnerable employment – own-account work and contributing family work – is prevalent in many countries in Africa and Asia, especially among women.
  • The informal sector is an important source of employment for both women and men in the less developed regions but more so for women.
  • Occupational segregation and gender wage gaps continue to persist in all regions.
  • Part-time employment is common for women in most of the more developed regions and some less developed regions, and it is increasing almost everywhere for both women and men.
  • Women spend at least twice as much time as men on domestic work, and when all work – paid and unpaid – is considered, women work longer hours than men do.
  • Half of the countries worldwide meet the new international standard for minimum duration of maternity leave – and two out of five meet the minimum standard for cash benefits – but there is a gap between law and practice, and many groups of women are not covered by legislation.

Violence against women

  • Women are subjected to different forms of violence – physical, sexual, psychological and economic, both within and outside their homes.
  • Rates of women experiencing physical violence at least once in their lifetime vary from several per cent to over 59% depending on where they live.
  • Current statistical measurements of violence against women provide a limited source of information, and statistical definitions and classifications require more work and harmonization at the international level.
  • Female genital mutilation is the most harmful mass perpetuation of violence against women shows a slight decline.
  • In many regions of the world longstanding customs put considerable pressure on women to accept abuse.

Environment

  • More than half of rural households and about a quarter of urban households in sub-Saharan Africa lack easy access to sources of drinking water, and most of the burden of water collection falls on women.
  • The majority of households in sub-Saharan Africa and South-Eastern Asia use solid fuels for cooking on open fires or traditional stoves with no chimney or hood, disproportionately affecting the health of women.
  • Fewer women than men participate in high-level decision-making related to the environment.

Poverty

  • Households of single mothers with young children are more likely to be poor than households of single fathers with young children.
  • Women are more likely to be poor than men when living in one-person households in many countries from both the more developed and less developed regions.
  • Women are overrepresented among the older poor in the more developed regions.
  • Existing statutory and customary laws limit women’s access to land and other types of property in most countries in Africa and about half the countries in Asia.
  • Fewer women than men have cash income in the less developed regions, and a significant proportion of married women have no say in how their cash earnings are spent.
  • Married women from the less developed regions do not fully participate in intrahousehold decision-making on spending, particularly in African countries and in poorer households.

Harmful tradition practices include;

  • Forced marriage
  • Child marriage
  • Female Genital Mutilation
  • Honour killings
  • Dowry related violence
  • Female infanticide
  • Trafficking of women and girls

Afghanistan at a glance*

  • Only about 15% of births are attended by trained health workers while more than 90% of the births take place at home. According to UNICEF, the maternal mortality rate in Afghanistan is the second highest in the world with an estimated 15,000 women dying each year from pregnancy related causes.
  • The infant mortality rate is 165 per 1,000 and less than 5 mortality rate is 257 per 1,000 with 1 in 4 children in Afghanistan dying before the age of 5 from preventable diseases.
  • Only 23% of the population has access to safe water, and only 12% have access to adequate sanitation which increases the incidents of diseases. 15,000 Afghans die of tuberculosis every year and of this 64% are women.
  • Malnutrition of women which affects pregnancies negatively is caused by the food scarcity linked to the war and drought.
  • The poor health situation has been aggravated by the lack of basic health services and resources, especially in rural areas because of the small number of trained female doctors, nurses and midwifes that remained in the country after the rise of Taliban.
  • 23 years of war have destroyed the infrastructure of the educational system and increased the illiteracy rate in Afghanistan. Only 10% of women are able to read and write.
  • 54% of girls under the age of 18 are married. Families of girls and young women were forced to marriage for several reasons and often for the purpose of dowry for the family’s survival.
  • *Source; Report of the Secretary-General on Discrimination against women and girls in Afghanistan (E/CN.6/2002/5)

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