JUBA, Sept. 12 (Xinhua) -- South Sudan's Ministry of Health backed by the World Health Organization (WHO) said Monday they had kicked off a reactive measles vaccination campaign targeting 37,390 children aged between six months and 14 years.

The ministry and WHO said in a joint statement that the exercise is underway in Juba County which has a history of recurring measles outbreaks with one outbreak confirmed in 2017 and a more recent one in 2019.

The campaign aims to achieve at least 95 percent coverage to interrupt the ongoing transmission of the measles virus in the county.

Acting WHO Representative for South Sudan Fabian Ndenzako said COVID-19 has disrupted immunization programs around the world, increasing the risk of severe outbreaks.

"Vaccine remains the most cost-effective preventive measure against measles. Thanks to Gavi, the Vaccine Alliance, the ongoing reactive campaign focused on building immunity among over 37,000 children who are vulnerable to measles infections and its complications," Nadenzako said.

The vaccination activities are being conducted at health centers, schools and outreach centers to maximize access to all the vulnerable members of the community.

According to the WHO, the current outbreak started with the initial cases reported in mid-July which led to further investigation and confirmation of the outbreak. Since the beginning of the outbreak, the UN health agency said 79 measles cases with no deaths have been reported from the five affected payams in Juba county. A payam is the second-lowest administrative division below county in South Sudan.

Jamal Hassen, director general with the Ministry of Health Central Equatoria State, said that it provides routine vaccination services against vaccine-preventable diseases for the community free of charge to prevent children against measles.

Measles is one of the most contagious diseases of humans that is caused by the measles virus. Measles is preventable and can be eliminated by vaccination. - Xinhua

JUBA, Aug. 30 (Xinhua) -- South Sudan's Ministry of Health backed by the World Health Organization (WHO) said Tuesday it has trained more than 200 healthcare workers to help bolster disease surveillance and response in the country.

The healthcare workers were trained on how to use an early warning, alert and response system (EWARS) in more than 20 counties in South Sudan to optimize its use to support surveillance, alert management, outbreak response, and laboratory data and management.

John Rumunu, director-general for Preventive Health Services at the Ministry of Health, said the aim of the training was to improve real-time detection and prompt response to disease outbreaks and other health emergencies.

"Given the current humanitarian setting in the country, an effective disease surveillance system is essential to detecting disease outbreaks quickly before they spread," Rumunu said in a joint statement issued in Juba, the capital of South Sudan.

EWARS is a web-based system designed to improve disease outbreak detection in emergency settings.

The East African nation is experiencing multiple disease outbreaks and floods, thus increasing the risk of transmission of infectious diseases and other health conditions such as severe malnutrition.

Fabian Ndenzako, acting WHO representative for South Sudan, said infectious diseases can cost lives and become difficult to control if they are not detected and responded timely. "With generous World Bank funding, we are strengthening EWARS reporting by training healthcare workers countrywide," Ndenzako added.

The EWARS project was rolled out in 2017 to all 80 counties of South Sudan, with the second phase of the rollout further decentralizing data collection and alert management down to the health facility level from 2019 to early 2020.

According to WHO, before the rollout of EWARS in South Sudan, the integrated disease surveillance and response (IDSR) weekly reporting rates were as low as 30 percent, far below the target of 80 percent. Following the completion of the EWARS rollout to the health facilities, however, the reporting rates have improved and surpassed the target of 80 percent on completeness and timeliness of weekly IDSR reporting. - Xinhua

A new clinical trial researching treatment for patients with sight loss as a result of diabetes has shown a type of laser treatment to be both cost effective and non-invasive, offering the best option for patients and healthcare providers. 
There are currently several treatment options offered to people with Diabetic Macular Oedema (DMO), including two types of laser treatment and eye injections. DMO is the most common sight-threatening complication of diabetes, affecting over 27 million adults. This new research provides much-needed evidence to enable patients and healthcare professionals to be better informed on treatment options.
DMO happens when blood vessels in the retina at the back of the eye leak, causing fluid build-up at the macula, which provides central vision. The leakage occurs when high blood sugar levels damage blood vessels.
The severity of DMO is most often determined by measuring the thickness of the macula, which in-turn will determine the treatment offered. Patients with more severe DMO (with thickness of 400 microns or more) are treated with injections into the eye of drugs, known as anti-VEGFs. Patients with mild DMO (with thickness of less than 400 microns) can be treated with macular lase, which can be standard threshold laser or subthreshold micropulse laser. The former produces a burn or scar on the retina.  The latter, which is a more recent technology, works without leaving a burn or scar or any type of visible change or mark on the retina.
The research,  published in Ophthalmology, found that subthreshold micropulse laser, which does not create a burn on the retina, was effective in maintaining a patient’s vision. This also requires much less frequent visits to the clinic and is much more cost effective than treatment via eye injections, with eye injections costing almost ten times more than laser treatments.
Professor Noemi Lois, Clinical Professor of Ophthalmology at Queens University and Honorary Consultant Vitreoretinal Surgeon at the Belfast Health and Social Care Trust and lead author on the study, explains: “The absence of a scar or burn following subthreshold micropulse laser led to some healthcare professionals to doubt its effectiveness compared to the standard threshold laser.”
“However, our research addressed this by demonstrating that subthreshold micropulse laser is as good as standard threshold laser for helping people’s vision, reducing macula thickness, allowing people to meet driving standards, and maintaining their quality of life, both in general terms and for vision in particular.”
The research team set out to compare both types of available laser treatment through a large randomised clinical trial, known as DIAMONDS (DIAbetic Macular Oedema aNd Diode Subthreshold micropulse laser SML). They recruited 266 patients across 16 NHS hospitals around the UK, with half receiving standard threshold laser and the other half receiving subthreshold micropulse laser. Unique to this trial, patients were involved in selecting the outcomes, including how driving standards would be met following treatment. At the end of the two-year trial, DIAMONDS found both laser treatments to offer equivalent benefits.
The total cost of the care of patients enrolled in the trial (including the laser treatment and any other treatments required as well as the costs of the follow-up visits) over two years was similar for both patient’s groups. Over the two-year period, the cost per patient was just under £900 (£897.83) for patients in the subthreshold micropulse laser arm of the trial compared to £1125.66 for those in the standard laser arm. 
Professor Lois adds: “Some ophthalmologists advise patients with milder forms of DMO to have injections of anti-VEGFs, rather than laser, despite laser being less invasive and requiring less visits to the clinic. Laser treatment costs significantly less than eye-injections of anti-VEGFs. With an average of ten injections required over two years, the total cost of eye injections per patient amounts to approximately £8,500 for the drug alone. This is almost ten times the cost of subthreshold micopulse laser without taking into account additional costings such as staff time.
“Until we published these findings, there was no robust evidence comparing these types of laser treatments. A lack of information led some healthcare professionals to favour standard laser over subthreshold micropulse laser. We now have robust evidence to show that both laser treatments are not only effective in clearing the fluid from the retina and maintaining vision for at least two years, but both are also cost-effective.” 
“Armed with this knowledge, it’s likely that patients will opt for micropulse subthreshold laser, which doesn’t burn the retina and is comparable to standard laser. Whilst we didn’t directly compare laser treatments to treatment via eye injections of anti-VEGFs, hopefully we have shown that laser is an effective treatment, while remaining much less invasive to the patient and much less costly to the NHS.” 
The research was funded by the Health Technology Assessment (HTA) of the National Institute for Health and Care Research (NIHR).