BY POLHN editorial team Published on: 24 May, 2019

Hypertension is a chronic medical condition in which the blood pressure in arteries is persistently higher than what normally it should be.Each year on May 17^th, World Hypertension Day is observed to acknowledge the disease’s burden on health of a significant population of the world. The uncontrolled high blood pressure is associated with number of concomitant health problems like coronary artery disease, stroke, chronic kidney disease, cardiac hypertrophies and even heart attack.

Prevalence of disease

According to World Health Organisation (WHO), hypertension affects 1.13 billion people and causes an estimated 7.5 million deaths worldwide. Across the WHO regions, the prevalence of raised blood pressure was highest in Africa, i.e. 46%. In Western Pacific Region, approximately 37% of the population is affected by hypertension. Among them, the prevalence of disease is more in men then in women.

% raised blood pressure in population of WHO regions of the world

Signs and symptoms

A person with hypertension may not experience any sign or symptom. For this very same reason this disease is infamously known as “silent killer” as well. In spite of being asymptomatic and undetected, uncontrolled high blood pressure can adversely affect the internal organs of a patient. Patients occasionally complain about headache, sleep disturbance, restlessness or nosebleed where their blood pressure is high.

Risk factors for Hypertenison

The risk factors for hypertension include the following:

• Age
• Race
• Family history
• Smoking and use of tobacco
• Physical inactivity
• Obesity
• High sodium intake (as sodium chloride salt)
• Stress
• Concomitant disease state

Life style modification

Hypertension is among those diseases that can be managed through life style modifications as first line of therapy. Few changes in the way of living can help people live a better and healthier life. Enlisted below are some modifications that can be adapted:

• Reducing weight if obese
• Quitting smoking
• Eating a healthy diet,
• Following  the DASH (dietary approach to stop hypertension) diet protocols
• Reducing the amount of sodium intake to less than 1,500 mg a day
• Getting regular exercise such as brisk walking at least 30 minutes a day, several days a week
• Limiting alcohol consumptions

POLHN-Helping people improving lives

In Pacific Region, very limited resources are available that can help in educating people about their as well as others well-being. In this regard, Pacific Open Learning Health Net (POLHN) provides free online learning opportunities to health workers in the Pacific and strives to make continuousprofessional development freely accessible to all health workers using relevant, effective and quality e-learning.

With respect to hypertension and associated life style modifications, POLHN has detailed courses which precisely focus on each of the risk factor of the disease as well as how to manage it. It provides a wide array of information to help health care givers to update their knowledge and implement it for the well-being of patients.

Hypertension focused courses offered by POLHN are:

Live courses:

• Obesity and Overweight- helps in enhancing understanding of overweight and obesity, statistical insights, causative factors, broad-term health implications, preventive strategies and management of lifestyle problems. 
• Training for Primary Care Providers - Brief Tobacco Interventions- provides a basic introduction to tobacco interventions. It will particularly assist healthcare providers to improve their skills and confidence to assist tobacco users in quitting its use.
• Alcohol Reduction-explains how alcohol adversely affects both the individual and society. Participants will also learn about effective health interventions and policy options for preventing harmful use of alcohol.
• Salt Reduction- explains the physiology behind sodium's effect on the body, followed by an explanation of excessive sodium use and its consequences. It enlists the best ways to implement salt reduction strategies.
• Physical Activity- in this course, importance of physical activity is focused. It also covers different age-related guidelines and provides information on intensity of the physical activity training for different age brackets.

Upcoming courses:

• Healthy Diet - The Macronutrients- it has been designed to highlight the significance of healthy diet in promoting and maintaining a healthy lifestyle, and to bring the dietary trends more in line with the Healthy Islands Vision. 
• Healthy Diet - The Micronutrients: It is the continuation of healthy diet- the macronutrients, and helps to understand a healthy diet, and develops the knowledge about the dietary components that constitute the micronutrients.

Health life makes living worth it. Register for these free online courses and help improve your life and someone else as well.

BY POLHN editorial team Published on: 23 May, 2019

Acquired immunodeficiency syndrome (AIDS-) is –a life-changing yet incurable ailment caused by Human immunodeficiency virus (HIV). Affecting multiple organs, AIDS is the most advanced stage of HIV infection (stage 3). It is defined by the occurrence of any of more than 20 opportunistic infections or HIV-related cancers World Health Organisation (WHO). Presently, the only treatment for HIV patients involves antiretroviral therapy (ART) and lifestyle modification.

WHAT IS HIV?

Human immunodeficiency viruses are members of the retrovirus family, originating from the simian immunodeficiency viruses (SIVs) of primates. HIV-1 in humans is derived from SIV of chimpanzees; HIV-2 in humans is derived from SIV of Sooty mangabey monkeys. Unlike other viral invasions, unfortunately, complete removal of HIV is impossible and once it has invaded, it remains in patients’ body forever. But with the availability of antiretroviral therapy, disease progression into AIDS can be significantly slowed down thus improving patient’s quality of life.

ILLNESS PROGRESSION: 

HIV attacks the immunity of the body and weakens its immune system with the passage of time. In particular, the virus attacks CD4 T-lymphocytes cells which help the body in fighting off infections. As a result of lowered immunity, opportunistic infections and HIV-related cancers can take up roots and make a person multi-dimensionally ill, signalling the progression into AIDS. The most common opportunistic infections encountered by HIV+ patients are TB, meningitis, gastrointestinal infections, influenza, skin infections and fungal infections. The disease is classified into three stages: (1) Acute HIV infection, (2) Clinical latency and (3) AIDS.

Acute HIV infection: generally develops within 2 – 4 weeks of encountering the virus and is characterised by flu-like symptoms. Patients suffer from fever, swollen glands, sore throat, rash, muscle and joint pains, and headache. This is known as the acute retroviral stage.

Clinical latency: during this period, the virus is reproducing in the body but is not causing any symptoms. Without ART, this stage may last for an average of 10 years in HIV+ patients.

Acquired immunodeficiency syndrome: When the patient’s CD4 count falls below 200 cells per cubic millimetre of blood (200 cells/mm³), the disease is considered to have progressed to AIDS. This means that the immune system has become damaged beyond repair and the person is now highly vulnerable to opportunistic infections. The patient is also considered to have progressed if he/she develops an opportunistic infection regardless of their CD4 count. Life expectancy of AIDS patients is 1 year without treatment and 3 years with ART.

MODES OF TRANSMISSION:

HIV virus can be transmitted via:

• Unprotected sexual activity with an infected partner;
• Sharing of contaminated needles;
• Transfusion of infected blood or mixing of infected blood through open wounds;
• From infected mother to child during pregnancy or vaginal birth; and
• Breastfeeding a child.

AIDS IN THE PACIFIC:

Unfortunately, the prevalence of AIDS is increasing in Asia and the Pacific at an amplified rate. According to the World Health Organisation, 1.2 million people were recorded to have HIV in the region in 2017. For this reason, both government and non-government organisations in the area are becoming increasingly focused on spreading awareness of HIV/AIDS. This primarily involves training of health workers.

WHAT IS POLHN DOING?

Pacific Open Learning Health Net (POLHN) is working in collaboration with WHO to train health workers, specifically, nurses, to provide medical attention to those affected by HIV/AIDS.

In Pacific, nurses are often the first ones to encounter patients suffering from HIV/AIDS. So, POLHN has chosen to focus on these nurses to make sure they are trained to give up-to-date and accurate information, primarily through the free online HIV/AIDS course, which includes a section on community standards.

PROMINENT FEATURES OF OUR FREE ONLINE HIV COURSE:

The POLHN HIV/AIDS course focus on teaching students to:

• Manage to build a proper treatment for TB and HIV/AIDS
• Strengthen the immune system of patients suffering from AIDS
• Diagnosis and prevention of AIDS
• Identify the causes and risk factors of AIDS
• Increase public awareness of AIDS

Sign up to our free online health courses today to improve your competencies and knowledge, without investing a single penny.

BY POLHN editorial team Published on: 23 May, 2019

This year,World Immunisation Week is celebrated from 24-30 April and the theme is Protected Together: Vaccines Work! In light of this, POLHN is putting the spotlight on the importance of infant immunisation to demonstrate the value of vaccines for children, communities and the world.

According to the World Health Organization (WHO)  immunisation is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease.

Mechanism of action

A vaccine is made of a dead or weakened infectious organism or part of an organism (antigen) that causes the disease in question. When patients are exposed to a disease in vaccine form, their immune system is able to build up antibodies. These antibodies protect them from contracting the disease if and when they are exposed to the actual disease.

What is infant immunisation?

Infants are extremely vulnerable to infections; that is why it is so important to protect them via immunisation. Infant immunisation is a process to build active immunity in infants and toddlers against disease for a better chance of survival. It is also an important indicator used to predict the likelihood of a child having a healthy life. Moreover, if a mother has been immunised, then her baby might get some protection from specific diseases due to passive immunity (the transfer of antibodies from mother to infant born to her) as well. However, this level of protection can be low and wears off quickly, putting the newborn at risk of getting infections.

Targeted diseases for infant immunisation

The Center for Disease Control recommends the following vaccines in children age 0 to 6 years.

• Hepatitis (A and B)
• BCG (TB vaccine)
• Rotavirus
• Diphtheria
• Tetanus
• Pertussis (whooping cough)
• Bacterial meningitis (Hib)
• Polio
• Pneumococcal infections
• Influenza (flu)
• Measles
• Mumps
• Rubella
• Chickenpox

WHO's work

WHO is working worldwide with several organisations to provide universal immunisation. According to WHO, 116.2 million infants worldwide received a vaccine of diphtheria-tetanus-pertussis (DTP3) in 2017. 123 countries had covered 90% of their infant populations with diphtheria-tetanus-pertussis at this time, thus protecting them from a fatal infection causing severe disability.

The recommended schedule of vaccinations for children is briefed in table that has been updated in December 2018.

Pacific Open Learning Health Net (POLHN) is working in collaboration with WHO to provide a free online immunisation course for healthcare professionals and train them for monitoring, effective planning and management of immunisation programmes on an extensive scale.

They offer free online immunisation courses with certificates to encourage health workers in order to learn the managerial and demographical strategies of immunisation plans.

This course not only helps health workers to learn more but also assists everyone to better serve humanity. POLHN’s free online health training courses are recognised worldwide. People who enrol gain a significant scope of knowledge that is widely applicable in the medical field. POLHN targets the Pacific island region to deliver optimum medical facilities and enhance health standards in the area.

The purpose of this course is to spread public health awareness and decrease the death rates related to lack of immunisation in underdeveloped parts of the Pacific and elsewhere. POLHN’s free self-paced programmes help train health workers and increase their knowledge and skills through eLearning.

Significant features of the course:

The purpose of this course is to enable students able to understand:

• Principles of immunity and immunisation;
• Management and supervision of immunisation programmes;
• Evaluation of positive vaccination coverage and interpretation of inference;
• Strategies used for immunisation programmes; and
• Comprehensive knowledge of the targeted disease.

For further information visit the POLHN site and sign up to the course for free.

BY POLHN editorial team Published on: 22 May, 2019

World Malaria Day is celebrated on 25 April, with the aim of highlighting the need for continued commitment toward malaria prevention, control, and elimination. This year’s theme is “Zero malaria starts with me”.

Malaria is a preventable and treatable disease. After more than 10 years of significant headway in the fight against malaria, progress has halted. An estimated 435,000 people died of malaria in 2017 according to the World Health Organization (WHO); this represents virtually the same number as the year before. The number of malaria cases globally was 219 million.

Now, urgent action is needed to bring the global malaria response back on track. That is why this year’s campaign of “Zero malaria starts with me” is highlighting the importance of country ownership and community empowerment when it comes to malaria prevention and care. This grassroots campaign aims to ensure that malaria remains high on the political agenda, mobilise resources and empower communities to take responsibility for the prevention and care of malaria.

Progress in the Western Pacific

There has been a 47% increase in malaria cases and a 43% increase in malaria deaths in the WHO Western Pacific region between 2015 and 2017. Considering malaria is preventable and treatable, these numbers represent the urgency for more political and grassroots focus on the disease.

The increased instances of malaria in the region are largely due to outbreaks in the Solomon Islands, Papua New Guinea, and Cambodia, jointly accounting for 92% of the disease burden. Conversely, significant progress was made in some parts of the region since then; for example, Cambodia has reported zero deaths from malaria in 2018.

With the aim of further progress in this domain, WHO has implemented the Regional Action Framework for Malaria Control and Elimination in the Western Pacific 2016-2020. This emphasises the need to increase progress via the deployment of interventions based on strengthened surveillance systems.

Engaging with all levels of society

This year’s “Zero malaria starts with me” campaign aims to get the ball rolling again on the fight against malaria, which means involving all members of society. This could be private companies that stand to benefit from a malaria-free workforce, politicians that have power in government policies and decision-making, healthcare providers actively working to prevent and treat malaria, and most importantly affected communities. In particular, urgent action is needed in the highest burden countries that are most affected by malaria.

The time to take action on malaria is now. "Zero malaria starts with me" and ends with everyone.