HEPATITIS B

Hepatitis B is a viral infection of the liver that can cause both acute (short term) and chronic (long term) disease. It is caused by the Hepatitis B virus (HPV). It is potentially life-threatening infection with its chronic form exposing people to the risk of death from cirrhosis and liver cancer. The likelihood that the infection becomes chronic depends on the age at which the person is infected. Children below the age of six who become infected are mostly likely to develop chronic infections. Hepatitis B is however preventable by safe, available and effective vaccines.

SYMPTOMS
Signs and symptoms of hepatitis B range from mild to severe. A lot of people do not show any symptoms when newly infected but some have acute illness with symptoms lasting several weeks. The signs and symptoms may include among others;
• yellowing of skin and eyes (jaundice),
• nausea,
• vomiting,
• extreme fatigue,
• dark urine
• fever,
• joint pain,
• abdominal pain.
A small subset of people with acute hepatitis can develop acute liver failure which can lead to death. In some; the HBV causes chronic liver infection that can later develop into cirrhosis or liver cancer.

TRANSMISSION
Hepatitis B is caused by the hepatitis B virus (HBV) which may be spread in various ways including:
• Sexual contact
The HBV can be spread through unprotected sexual intercourse with infected individuals as the virus is carried in blood, saliva, semen and vaginal secretions. Transmission of hepatitis B may occur, particularly in unvaccinated men who have sex with men and heterosexual persons with multiple sex partners or contact with sex workers.

• Sharing needles
The virus is easily spread via needles and syringes contaminated with infected blood.
• Accidental needle sticks
Hepatitis B is a concern for health care workers who may accidentally prick themselves with contaminated needles. For this reason, prospective medical professionals are encouraged to be vaccinated against the HBV. This is something to be wary of for anyone else who comes in contact with human blood.

• Mother to child
Pregnant women infected with HBV can pass the virus to their babies during childbirth. The development of chronic infection is very common in infants infected from their mothers or before the age of 5 years.

The HBV can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine

PREVENTION
The hepatitis B vaccine is the mainstay of hepatitis B prevention. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth as an effective measure to reduce transmission from mother-to-child. The hepatitis B vaccine is typically given as three or four injections over six months. It is impossible to get Hepatitis B from the vaccine.

TREATMENT
The treatment of hepatitis B depends on levels of severity. In most cases, the infection clears on its own.
No specific treatment has been developed for acute hepatitis B. Care in these cases is aimed at making one comfortable and maintaining adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhoea. It is important to avoid unnecessary medications.
Chronic hepatitis B infection can be treated with medicines, including oral antiviral agents. Treatment can slow the progression of cirrhosis, reduce incidence of liver cancer and improve long term survival. Since the treatment is not aimed at curing the infection but rather suppression of viral replication, most people who start hepatitis B treatment must continue it for life.

By: Chiyanike Nyasha Melissa (MBChB 2.2)

Most students almost quit A’level Biology because of these three words that are relatively difficult to differentiate. Why give totally different meanings to pandemic , epidemic and endemic when they clearly sound quite the same.

Typically every student gets to comprehend them the way they are taught just to get the pass mark but like most other things learnt in science……it just doesn’t make any sense!!!!
It’s as if English did not teach to similarise word meanings using their similar rhymes. In this day though, the hope for everyone with or without little science knowledge acquired is not to hate life because of failing to define these same 3 words in relation to the Covid-19 pandemic that has come upon us.

After affecting the a wide range of geographical location respecting no gender, race, ethnic group or age it has been relatively easy to call it a pandemic .

It has been seen everywhere on news headlines undeniably being called it an epidemic since it had spread so fast to infect a remarkably huge number of people in the shortest time periods.

The word I’ve only heard from the TVs and radios but not so much on the streets is that it has come and is dwelling amongst us!!! Our huge predicament is likened to knowing someone living with us and still refer to that person as an alien whenever we want talk about them. Word is, covid-19 is now endemic .

Grief has five stages, quit denial, depression, anger and bargaining to move on to the final stage that is acceptance, the highest epitome requirement in eradicating ignorance. Allowing to move on from the thought that we’ll miraculously wake up one day and it’s no more. It’s evident time has been used up and so much life progress has been hindered already.

Until we see someone we know succumbing to the Covid-19 pandemic, epidemic and endemic, it never occurs to us that a person we know can have it much more we won’t even think of ourselves. Prayers made are always directed to protect people in the faraway places forgetting we’re also not immune to something dwelling amongst us.

Just as how we have held hands in other things as a nation. May we play role in alerting that the pandemic is epidemic and now endemic. If there’s anything that can be done, there can never be a better time than now!!!

Covid-19….a pandemic, epidemic, endemic
By Christine Musiiwa (Mbchb 3-UZ)

By Vimbayi Mukarati

Being a Form 3 student at an all girls school , I really didn’t have much things on my plate. Young and adventurous as I was, I found myself joining almost every club and taking part in most of the extracurricular activities that the school offered. When the National Blood Services Zimbabwe (NBSZ) team visited my school, my friends and I just sneaked into the hall even though we knew that we were still under age. When I saw other people donating blood, I felt this urge to donate too more like #FearOfMissingOut and I just had to lie about my date of birth. That is how I became a blood donor ! I may have started donating blood because of a childish and stupid reason but now that I’m older, I now understand the importance of donating blood–the need to save people’s lives. How many of you also have a story to tell ? How many have even thought about donating blood ? Today , as we celebrate the good works that the blood donors do after every 4 months, I would also like to urge those who have never donated blood to give it a thought! I’m just about to turn 21 but I’ve donated 15 times already, that should be enough motivation for you right?

I’ve heard people saying, “Why should I donate blood when they then give it to the patient’s with a cost. You need to know that after collecting the blood from the donors, there is some purification as well as some blood tests that need to be done and this is quite expensive.  So we really can not crucify them for selling the blood can we? The need for safe blood is universal. Safe blood is critical both for treatments and urgent interventions. The blood is needed for patients suffering from life-threatening conditions in order for them to live longer and with a higher quality of life and supports compositemedical and surgical procedures. Blood is also vital for treating the wounded during emergencies of all kinds (natural disasters, accidents, armed conflicts) and has an essential, life-saving role in maternal and neonatal care.

Access to safe blood is still a privilege of the few. Most low and middle income countries struggle to make safe blood available because donations are low and equipment to test blood is scarce. Globally, 42% of blood is collected in high-income countries, which constitute only 16% of the world’s population.An adequate supply of safe blood can only be made possible through regular donations by voluntary unpaid blood donors. This is why there is aspecial day to thank blood donors and encourage more people to give blood freely. World Blood Donor Day takes place every year on 14 June. This day also serves to raise awareness about the global need for safe blood and how everyone can contribute.

This year‘s theme is ‘Safe Blood Saves Lives’ whereas the slogan is ‘Give blood and make the world a healthy place‘Do you wish to save the lives of accident victims or mothers who have complications during delivery? Do you want to make this world a healthy place? All you have to do is make a decision to be a blood donor today! This will not even cost you anything!

The day and the theme are also a call to action for governments, national health authorities and national blood transfusion services to provide adequate resources and put in place systems and infrastructures to increase the collection of blood from voluntary blood donors, to provide quality donor care, to promote and implement appropriate clinical use of blood and to set up systems for the oversight and surveillance on the whole chain of blood transfusion.

You might be asking yourself this question “Is it still safe to donate blood during this covid19 pandemic?” I also did not have the answer to this question until yesterday when I heard a guest speaker from NBSZ talking about it on Star FM. She said that currently there is no evidence that covid19 can be transmitted through blood.Blood donation agencies are committed to the highest standard of safety and infection control to keep healthy donors safe from covid19. There’s also the question of people getting tested for covid19 before they donate blood.The answer is that ,your temperature will be checked and you’ll be screened verbally for symptoms, but you will not be tested for COVID-19 when you donate blood.  You will also be asked about symptoms and signs of infection, if you have been around anyone else who may have a viral infection and if you have, you will be asked not to donate at that time.  

So, where can one donate blood in Zimbabwe?! For those in Harare, the NBSZ offices are located at 53 Mazowe Street North, Belgravia next to Parirenyatwa Hospital as well as at the Joina City Shopping Mall in the Second floor. For those in Bulawayo, you can find them at the United Bulawayo Hospitals Grounds as well as the Bulawayo CBD Clinic. In Gweru, they are located at the Gweru Showgrounds. In Masvingo, they are located at Corner Hayles Street/Emslie Close. Lastly , for those in Mutare, you can find them at 27 George Silundika Street.

#SafeBloodForAll#BloodConnectsUsAll#GiveBloodGiveNowGiveOften#ThankYouForSavingMyLife

By Rukudzo Nyakanda

Issues to Do with Mental Health, Depression, Sexuality and Identity as a Medical Student at the University of Zimbabwe, plus cultural differences.

Many of you don’t know me, and those who do only know me in a very limited capacity as a student. That’s the way it should be. We are colleagues after all, our personal lives shouldn’t come into the equation. Some of us might become acquitances , some of us long term friends and others friends that last a lifetime but the idea of the professional image has persisted and is increasingly creeping up. With the birth of social media, we have the fragmentation of character. Who we are with our friends is completely different to who we are with Colleagues , and is completely different to who we are with family. Social media facilitates this. It allows us to present ourselves in a certain way, that in some cases may indeed be counter to factual solid reality, which isn’t necessarily a bad thing .
In this Covid season, I’ve taken the time to rediscover myself but more than that to boost my social media, and one thing I learnt is that in most cases its not the substance of something that matters but the presentation. Queue in “Empty” by Juice Wrld
Presentation has become the mainstay of this generation. We don’t have enough time to look at each individual character and weigh it, so we make quick assumptions based on mental logarithms. We do this everyday without thought, We look at the number of followers, the ratio of following to followers , then the most recent post and then make a quick decision as to wether we should follow this person or not, even in life, we look at the persons clothing, their mannerisms and their posture and we make quick conclusions. But how is this having an effect on the mental state and are we starting to neglect real legitimate, intimate relationships for the convenience of quick , mutually beneficial interactions.
For a really long time, Ive been suffering from depression, at least three years. Living day to day in a fugue state in which I sometimes don’t know whats coming and going, but just living to survive and suffering from negative body image and self-consiousness. Who I am, has always been a question that has molded my day. And when I arrived at the UZ I was shocked by the difference in culture, and the latent peer pressure. In this hyper-sexualised society at the University, value is sometimes determined by the number of exploits you’ve had and attractability. If you’ve had none , then you’re termed a meek individual, weak and indeterminate and if you’re a female and you’ve had many, youre termed a hoe. This is complicated by the tension between the Western perspective and the African one, which is pseudo-Christian.. The African one telling you, especially for women , that its good to remain sexually immature until marriage and the western one telling you that sexuality is complicated and is something that has to be fiercely celebrated. This sort of tension , leaves people living two lives, or as I personally like to call it , two lies , in which they are neither white nor black but grey and leads to internal turmoil. That’s why we have questions like “ When does it stop being just “fun” and turn into fornication or other such questions
But this is not the only one aspect in which people are defined , it might be something minor like race, accent, likeability or even grades. But this one dimensional means of determining an individuals value sometimes leaves people feeling insufficient. As a generation , we spend so much time looking into developing the image of something , rather than the substance and on a daily basis we are bombarded with images, so we send our own, creating a vicious cycle of artificiality. Think about it, when was the last time, you did something, just for doing something and not for the image and how many times on a daily basis do you write someone off before they have even uttered a word.
Most of us probably have deep seated issues with identity, not knowing who we are or who we want to be and it leaves us hollow, feeling empty and dead inside and so we look around and see other people who we see as “lving the life” but what might shock you is that they look back at you and do the same. There is a genuine lack of the real substance, especially with the make belief values of western society that’s creeping into us through series and for mental health it does a number you, that I’ve personally experienced.
The characters that we become for the audience becomes the characters we’re locked into, and the longer we wear them, the more it becomes increasingly stifling to remain in them. Should this be celebrated or should it be stopped .
Another question is if that artificiality is creeping into our syllabus and are we still bonovide doctors or simply doctors on paper.
But that is a question for another day in general this article is about Mental Health And Depression.
Personally this Covid period affords lots of time with family, and friends or sometimes a lot of time isolated which might lead to a lot of introspection. In general, WHO recommendations for maintaining a Healthy mind in the covid time is that
1. You should settle into a habit anda fixed time table
Ive seen that doing this on a daily basis, even in the small things might afford a bit of sense of security or predictability that’s lacking at this point in time. If during pre-covid time , you talked with person A at X o’clock try to maintain that through a call
2. Find a hobby
It doesn’t have to be something big or significant , it can be just watching birds or looking outside at people, or going for a walk, or it could be chess. Anything that just takes your mind off things
3. Try and avoid news and where possible spread a little positivity
Whatsapp was initially loaded with lots of doomsayer messages, its getting better, but I’m trying to channel my focus away from the phone but when possible and when im on it I always try to gravitate towards the positive.
4. develop yourself daily and focus on earning your own respect. Everything else should follow
If you’re going through depression or any issues to do with Mental health, don’t keep it to yourself, tell someone, Somebody is bound to listen and understand

Plus normalize doing things at your own pace. Life has no formula.
Queue in “ Something About You” by Shasha
Thanks

By Vimbai Heather Mukarati

HOW TO DEAL WITH DEPRESSION DURING THIS LOCKDOWN

Being constantly bombarded with negative news can at times feel overwhelming and sometimes we need to give ourselves a break from trying to know every statistic because they rarely come with a calming contextual explanation. The Covid19 pandemic has brought a lot of theories that bring with it untold panic to many. The first thing is to learn to scrutinise everything you come across on social media and try to take only the sensible things . If possibly, I would advise everyone to onlytake the information that comes from the World HealthOrganization(WHO). It is really important to stay away from conspiracy theories and some views that may seem far fetched. I realized the anxiety that can come with such a pandemic and the impact “limited knowledge on what information to trust and what not to trust” can have and l really hope that this article will be helpful during this lockdown.

It is very important to stay close to your normal routine. Try to maintain some semblance of structure from the pre-quarantine days. If you normally did your laundry on Sundays, then keep doing that. If your original time table required you to study for 5 hours a day the continue doing just that.Not only will sticking to your normal routine keep you active and less likely to spiral, it will be easier to readjust to the outside world when it’s time to get back to your usual life.Ensure that you’re in a well ventilated room and following basic self care, healthy eating,  enough sleep, lots of hydration and try to keep a routine.

Avoid obsessing over endless Covid19 coverage. During the first days of this lockdown,  I joined many whatsapp groups in which people would send Covid19 updates. I would also watch BBC and CNN news religiously . Not that it is bad to keep up to date with the current situation,  but too much information will only lead to depression. I started thinking about things like “ifthis situation continues,  how will people even feed themselves” , “when are schools even opening, my degree program has a duration of 5,5 years and I don’t want more years added” . Literally, this was all I could think of and if I had continued at that rate, I would have fallen into depression. This actually disturbed my progress when it came to the studying aspect. Ever gotten into a situation whereby you keep procrastinating on doing something just because your mind is convinced that you still have all the “time” in the world? That was me during the first days of this quarantine but as soon as I stopped running after all the covid19 updates, my life went back on track. Also cut down on social media because there, you will see posts on the very topics that will eventually depress you.

Start a new quarantine ritual! With this newfound time, why not do something special during these quarantine days? You can start a daily journal to jot down thoughts and feelings to reflect on later. Exercising also helps, you can take a walk everyday at a specific time. I always get motivated by people who have “book-reading goals “ I love reading ! I actually prefer novels to movies . Many people think it’s weird but well, that’s how it is. You can make it your goal to read one or 2 books a week. I know a group of people who have bible study sessions every day at 8pm and I’m sure they are actually using this quarantine time to grow spiritually.  Having something special during this time will help you look forward to each new day.

Try to focus on positive things, knowing that effort is being made globally to bring this situation to an end, but it will take time. Distract yourself so that you will not over think as this will only lead to depression.Stay active!

Talk to someone ! Some of you guys are medical students and you have the privilege of having mentors who are health-care professionals. Talk to them whenever you feel anxious. You can even talk to your peers whenever you feel too lonely. If you bottle emotions up,it usually doesn’t end well, so its always advised to let it all out. I am sure that our parents would be more than willing to listen to our problems.You can try and get professional help before things escalate. Many organizations are there for support with grief, anxiety, or general mental well being. You can call or text these organizations and you can access therapy online with a trained therapist.

Look after key relationships. It may be your friends or family. Try to look out for them , always communicate with them because this will give you inner comfort and you will also worry less.

I always say that music is therapeutic! Try listening to music whenever you feel lonely or any feelings that might lead to depression . Whenever I feel like I’m at my lowest point in life, I try to listen to gospel music because it literally lifts my soul if there’s anything like that . But the point here is that , music will distract you from thinking too much . They say that an idle mind is the devil’s workshop, don’t they ?

Lastly , if you’re someone who is spiritual, reading the bible will always renew your mind . You could try and download the you–version app bible. This online bible has bible reading plans on every aspect of life including depression and anxiety! These reading plans are really helpful and I really think they are worth the try.

After all this is said and done, Remember to: Stay Home, Wash And Disinfect Your Hands, Cover Your Mouth When Coughing Or Sneezing, And Please , Be Safe!

By Laura Maisvoreva

Tuesday 31 December, 2019. The start of what has now been declared by the World Health Organization a “global health emergency”.

A sixty one year old man in Wuhan, China visited a local hospital presenting with pneumonia. This seemingly common problem only lead to the unraveling of a more sinister illness that has taken the lives of 170 and infected more than 7000 others (data as at Friday 31 January 1300 hours). This virus has received much attention from its rapid spread to 18 other countries, with cases in France and the USA, according to the World Health Organization.  So, what is there to know about this new epidemic?

Coronavirus, named for its crown-like appearance, is part of a group of viruses that affects mammals and birds. SARS (Severe Acute Respiratory Syndrome) is a member of this group. Interestingly, contrary to physiological understanding of viruses, this group of viruses is considered both living and non-living. Speculations that this new strain of coronavirus, 2019-nCOV, arose by zoonosis from bats or snakes remain to be proven. Other theories suggest seafood in China may have been a main contributor to the spread of this virus.  

Transmission involves inhalation of an infected person’s respiratory secretions or physical contact with infected individuals or surfaces. Dr Isaac Bogoch, an Infectious Diseases Specialist at the University Health Network claims “the ease of transmission is still unknown”. The most concerning thing about the coronavirus is its symptoms. Mimicking symptoms similar to a common cold can cause infection with the virus to be overlooked and mistaken for an influenza virus, especially in countries in the flu season. Early reports demonstrate that people sixty years and above have higher fatality rates and experience harsher symptoms, including pneumonia and sometimes kidney failure. This can be attributed to the fact that this age group is generally immunocompromised.

The graphs below, courtesy of SkyNews, illustrate the severity of this epidemic and how quickly it is spreading.

Source: SkyNews

The only treatment available involves supportive care – fluids, rest and pain medication. Unfortunately, an antidote has not yet been made, neither has a vaccine been manufactured. Disease control measures have been taken in countries with suspected or confirmed cases, and involve isolation and close monitoring.

A simple, daily practice can assist in prevention of infection – washing hands. It is of utmost importance to practice good hygiene and not undermine any flu-like symptoms.

The coronavirus has certainly gone viral, but there is nothing to fear. The healthcare industry is fully aware of the manifestations of this virus and how quickly it is spreading. Control measures are being taken, and at an individual level, it is imperative to ensure any suspicious symptoms are reported to health officials.

By Primrose Mashavave

For a while now our greater population has been ignorant to the existence of climate change and even more, the dire effects it entails. Many of us do not realise the magnitude of this problem we have on our hands.

Climate change is evident in the warmer winters, the heat waves, floods and droughts just to mention a few.

Due to warmer winters, disease carrying insects which normally die during the cold season survive throughout the season thereby also providing a larger base for reproduction during the next hot season. Occurrence and spread of the Zika virus, malaria, Lyme disease, dengue fever is therefore increased rapidly. Exposure to extreme heat can also lead to heat stroke and dehydration. Extreme heat may also cause an increase in skin infections, inflammatory skin diseases, and traumatic skin disorders.

Longer warm seasons translate to more pollen being produced. Pollen is known to trigger asthma and allergies hence an increase in pollen will also mean an increase in asthma cases.

Climate change is also known to cause higher concentrations of air pollutants in our atmosphere. Changing environmental conditions, including rising temperatures, are expected to increase concentrations of ground-level ozone. Air pollution increases respiratory diseases, doing devastating damage to our lungs and airway passages. The eyes are also vulnerable to the effects of air pollution.

Change in climate also means the agricultural sector is stunted resulting in heavy cost on the nation and malnutrition in a large fraction of the country.

Natural disasters for example floods result in loss of proper sanitation, medication, proper health facilities, safe water, and may also result in mental illnesses and spread of diseases. Natural disasters put a heavy burden on the nation financially hence limited funds for our health sector to properly flourish.

Certain people are more vulnerable to climate change than others these include children, older people and less privileged people.

We should all hold hands to combat this venomous creature called ‘climate change’ before it kills us all. Methods of adaptation should also be put in place to reduce the impacts of climate change on our health.

By Laura Maisvoreva

What is the big deal with tuberculosis anyway?

The figures observed demonstrate how this disease is ravaging through our country and an appreciation of how tuberculosis manifests and can be avoided will assist greatly in reducing its transmission. The purpose of this article is to investigate tuberculosis, from its pathophysiology to how it can be treated.

Pathophysiology

Mycobacterium tuberculosis, commonly shortened to tuberculosis, is caused by rod-shaped bacteria. The bacterium is resistant to weak disinfectants due to the production of mycolic acid which assists in its survival for extended periods of time, especially on dry surfaces. Most infected individuals are oblivious to infection because they may possess the latent type of tuberculosis. This type of tuberculosis can be debilitated by AIDS or old age to the active type of tuberculosis.

Once transmitted, the bacterium is engulfed by alveolar macrophages. Once phagocytosed, it produces a substance that prevents lysosomal fusion and ultimately prevents its digestion and destruction by lysosomal hydrolytic enzymes. It is therefore able to proliferate and spread to infect other cells.

Drug-resistant strains of this bacterium have been observed, particularly the multiple drug resistant TB (MDR-TB) strain and the extreme drug resistant TB(XDR-TB) strain.

Transmission

Tuberculosis is transmitted via droplets in the air expelled in cough spells and contracted via inhalation.

Clinical Presentation

Flu-like symptoms are classically displayed in primary tuberculosis. Most people at this stage are asymptomatic, however, in immunocompromised individuals the tuberculosis can spread to the lungs and cause bronchopneumonia. The infection can also spread to the vascular system where it manifests as systemic miliary tuberculosis: –

Signs and symptoms

Common signs and symptoms include coughing, weight loss, fever and night sweats

Diagnostics and Testing

Testing is commonly done using a purified protein derivative (PPD) intradermal skin test also known as a tuberculin test, Mantoux test or tuberculosis test. An immune reaction can be observed on the skin surrounding the area of injection within 48 to 72 hours if the individual is infected with tuberculosis. A more specific test for TB which shows evidence of tuberculosis proteins in blood is the interferon gamma release assay (IGRA). A positive test for tuberculosis will then further require a chest x-ray.

Treatment

The latent type of tuberculosis can be treated using a single antibiotic – isoniazid for 9 months. The active type requires a combination of antibiotics for successful treatment. With a rise in antibiotic resistance, it is imperative to, for effective treatment, ensure drugs are specific to a particular strain of the bacteria. Additionally, multiple drugs should be used simultaneously and for the full course of therapy.

Other useful drugs include rifampin, pyrazinamide and streptomycin.

Factors that increase susceptibility to tuberculosis

Certain factors increase the risk of contracting this disease:

Preventative measures

People living with infected individuals are encouraged to wear N-95 masks to prevent transmission.

Key Organizations that assist in TB research and treatment programmes

There is still so much to know about tuberculosis and it would be worthwhile. For further information to read these recommended articles referenced below.

Tuberculosis treatment delays and associated factors within theZimbabwe national tuberculosis programme Takarinda et al. BMC Public Health (2015) 15:29

DOI 10.1186/s12889-015-1437-7

Comparison of two active case-finding strategies forcommunity-based diagnosis of symptomatic smear-positive tuberculosis and control of infectious tuberculosis in Harare, Zimbabwe (DETECTB): a cluster-randomised trial Lancet 2010; 376: 1244–53 Published Online October 4, 2010DOI:10.1016/S0140- 6736(10)61425-0

By Vimbai Heather Mukarati

Diabetes and cancer are common disorders with tremendous impact on health worldwide. Epidemiological evidence suggests that people with diabetes are at a significantly higher risk of developing  many forms of cancer. Type 2 diabetes show many of these risk factors but the potential biologic link is not known . I know I’ve got many of you wondering “What is diabetes two? ” , “How many types of diabetes are there?” Well I’ll help ease the confusion . Diabetes is divided into 2 ; type 1 diabetes, which is caused by insulin deficiency and type 2, which is caused by insulin resistance. Type 1 diabetes can be treated by insulin injections. Although there’s no cure for type 2 diabetes, studies show it’s possible for some people to reverse it . Through diet changes and weight loss, you may be able to reach and maintain normal blood sugar levels without medication. This doesn’t mean you’re completely cured. Type 2 diabetes is an ongoing disease.

As I mentioned before , type 2 diabetes is the one which brings about a higher risk for cancer.Evidence from various observational studies suggests that some medications used to treat hyperglycemia are associated with an increased risk of cancer. Cancer cells may be particularly affected by hyperinsulinemia because of an increased concentration of insulin receptors, often in a form that is particularly mitogenic.Type 2 diabetes is characterized by chronic low-grade inflammation, which increases production of free radicals that can disrupt insulin signaling and damage DNA often leading to various forms of cancer. In simpler terms,  DNA sustains more damage and gets fixed less often when blood sugar levels are high compared to when blood sugar is at a normal, healthy level, thereby increasing one’s cancer risk. Exposure to high glucose levels leads to DNA damage and the suppression of DNA repair, which in combination could cause genome instability and cancer.

It has also been suggested that the elevated cancer risk for diabetics arises from hormonal dysregulation. Insulin resistance causes the pancreas to keep producing more and more insulin leading to hyperinsulinemia.The hormone insulin can stimulate cell growth, possibly leading to cancer.Also, most people with type 2 diabetes are overweight, and their excess fat tissue produces higher levels of adipokines than those at a healthy weight. These hormones promote chronic inflammation, which is linked to cancer. Type 2 diabetes is associated with increased risks for several cancers, including colon, breast ,pancreatic, liver. However type 2 diabetes is also linked to a modest decrease in the risk for prostate cancer!! Im sure most of youmight be thinking “Ohh, so at least it has one advantage.” Type 1 diabetes can increase the risk of stomach cancer and cervical cancer.

Generally, diabetic people have a higher risk of developing cancer, particularly diabetic women.They appear 7% likelier to develop cancer, as compared to healthy women. By contrast, men with diabetes are 19% more likely to develop cancer than healthy men.And, women with diabetes are 6% likelier than men with the same diagnosis to develop a type of cancer. It should also be noted that there are forms of chemotherapy that induce insulin resistance, bringing on symptoms of diabetes.

So, you’re all being encouraged to go for diabetes testing because 2% of the people in our population are living with diabetes unknowingly. If this diabetes is not treated properly,  this may increase the risk for cancer development.

Mid to late 90s Zimbabwe was at its peak of HIV infection with a quarter of the adult population recorded to be infected. Knowledge was very minimal and the people were caught unaware by the dreaded virus, the main cause then being heterosexual intercourse. In the late 90s to early 2000s a very large naïve but HIV infected new generation was born. Not their fault of course but just unlucky, now they have to live with the consequences of others’ actions for the rest of their lives. Since then there have been major strides in preventing mother to child transmission with a vision to eliminate it by 2021 which is applaudable but then year after year infant related new HIV infections are recorded although on a significant decrease.

These are the recent statistics of the distribution of HIV in Zimbabwe. My focus will mainly be on the significant number of children and adolescents infected by HIV and this a fight against stigma directed towards this fragile group. Adolescence is a very crucial stage in development. It is the stage in which the individuals will be trying to find their feet in the world, get to be self-conscious of oneself to be able to propel one’s life in the desired direction. It is the stage at which one gets it right or gets completely lost and gaining confidence and social support are some of the things expected of the adolescent as he/she is weaned into adulthood.

The HIV positive youth is very vulnerable at this stage. The stigma around being HIV positive in society is something unbearable to this naïve adolescent. HIV is still something demonized to the extent that if the agemates find out about the child’s status they can virtually stop sharing material with the infected, they will stop associating with him/her at virtually all levels and its something unbearable to the infected but naïve youth. Taking particular cognizance to those born infected, imagine the tormenting thoughts everywhere they go. Most of them are reported to stop going to school, some even confess to having suicidal thoughts multiple times and most of them find problems expressing themselves but remain encapsulated in this shell so difficult to break free of. Each and everyday the fear of being exposed haunts them and it is very difficult for them to navigate their way up the rungs of society. All this points towards a perennial poor mental state and this is the boundary we ought to work to break into and even out the odds for this unfortunate social group at this volatile stage of their life.

The problems faced by the HIV infected youth are way so overwhelming. It is the 21st century, people claim to be educated but then the infection is still demonized at most levels of society. They think they will get infected as well by handshakes, sharing a cup or playing in the same football team as an infected person. The church is supposed to be a pillar of strength to this fragile group but more often than not the men of the cloth associate HIV with promiscuity and immoral sexual activities in their preachings. Imagine those born with the virus, imagine those infected via blood transfusion or even those who got it via sexual transmission do not deserve to be marginalized but they need all the support they can get. After all HIV is just another infection, with proper medication one can live a very normal life so what is special about it.

The efforts of Africaid through its Zvandiri programme is a brilliant initiative in giving support to the HIV infected adolescent between 6 and 24 years and so is the contribution of UNICEF through its Community Adolescent Treatment Supporters (CATS). Indeed, these infected people need all the support they can get from all angles possible to make sure they make the most out of their lives. Recently the IMUNZI Project with its Comprehensive Sexuality Program was launched. These are tools to help the subject group to counteract the stigma around them but why not fight to do away with that stigma before they are even exposed to it?

I believe it is high time we all step up and fight HIV related stigma right at the grassroots. Recently sexual education has been introduced at ECD level, which is a good initiative and l believe we can do much more to neutralize the stigma right from this stage. These young innocent fellows have to be made aware of this disease at this early stage and taught to embrace the infected. They ought to be taught that mere interaction with them will not get them infected as well. It is funny to think of how malleable the brains of children are at these early stages and they can be made to believe whatever the elder ones deem necessary, look at Hitler and the Nazi regime and how they manipulated the education system into making the children believe in him. It is just that in this instance we will be using this phenomenon to the benefit of everyone. This may seem like a very long-term initiative but believe you me it is worth it. If successful we would then have managed to create an HIV stigma free generation. The HIV infected individuals will then be able to freely express themselves and their mental health would be sound.

This initiative will not only be able to eliminate HIV related stigma but will also go a very long way in reducing the number of new infections every year as there will be much more awareness on the issues to do with HIV. Its has been quite a long time now since HIV started tormenting the nation. The societal point of view has not been any kind to the infected individuals and they have been marginalized for way too long. It is high time we make a collective approach to fight it off together with the stigma that comes with it. Yes, Nelson Mandela was correct…indeed education is the most powerful weapon we can use to change the world.