Improving access to water is one of the most important goals of development programmes in rural Africa. In the part of Ethiopia where this research was done, many women spend three hours every day walking to fetch water, which they carry home in clay pots. In those villages where tapped water has been supplied, the time spent getting water has gone down to about 15 minutes. Programmes that achieve such a result are generally hailed as a success but it is unusual for their wider impact on the population to be studied.
The research involved nearly 2000 households in both villages with and without access to improved water supply. The death rate of children in the villages where tapped water had been introduced was found to be much lower than it was in the other villages. However, the birth rate was much higher in the villages with tapped water than it was in the other villages.
It has been argued that when development improves living conditions and health, there will be a reduction in birth rate. This has happened in many countries but, in rural Africa, birth rates remain high and the population is growing rapidly. Ethiopia is an example; the rising population and the slow growth in the economy have led to repeated humanitarian crises.
A further finding in the study was surprising: the nutritional status of children fell in the villages which had taps, even though their risk of dying was lower.
Gibson and Mace say their study is the first to show a link between the introduction of a 'technological intervention' and an increase in birth rate. They suggest that development programmes should be 'multisectoral', instead of focussing on just one issue (in this case, water supply). In particular, programmes should routinely include improved access to contraceptives.
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Citation: Gibson MA, Mace R (2006) An energy-saving development initiative increases birth rate and childhood malnutrition in rural Ethiopia. PLoS Med 3(4): e87.
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RNA interference to treat viral encephalitis
A mechanism, first described in plants, can be used in mice to suppress lethal infection of the brain (encephalitis) caused by two viruses, Japanese encephalitis virus and West Nile Virus, report researchers from Harvard University in a paper published today in the open access medical journal, PLoS Medicine.
The mechanism, known as RNA interference (RNAi), is a process by which short double-stranded RNA inhibits gene expression in a gene-specific way. This process was first discovered in plant cells and is believed to have developed as a way for plants to combat viruses. Manjunath Swamy and colleagues showed that this technique has a therapeutic potential in treating viral encephalitis, both virus-specific and across species. They induced RNAi in mice to either a species-specific sequence of the viral outer (envelope) protein or to a sequence common to both Japanese encephalitis and West Nile viruses. They showed that a single treatment to induce RNAi before or just after infection with these viruses may be sufficient for protection against fatal encephalitis. This work is promising and a similar approach to treat an eye disease in humans is already in a clinical trial. However, more work needs to be done to find out how safe and effective the method is in humans, and what is the optimal way of giving the treatment.
Japanese encephalitis and West Nile fever are caused by flaviviruses carried by mosquitoes. Japanese encephalitis is prevalent in Southeast Asia and causes around 50,000 cases of encephalitis world wide annually with 30% mortality and permanent neurological disabilities in 50% of survivors. West Nile Virus, once confined to Africa and the Middle East, was introduced into the Americas in 1999, and since then has spread throughout the continental US. Currently there are no effective drugs to treat flaviviral infections.
Citation: Kumar P, Lee SK, Shankar P, Swamy MN (2006) A single siRNA suppresses fatal encephalitis induced by two different flaviviruses. PLoS Med 3(4): e96.
PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.doi.org/10.1371/journal.pmed.0030096
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Caption: Section from JVE infected mouse brain obtained after treatment with control or JEV-specific siRNA
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PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org
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