Four successive cases of human fasciolosis in Japan.

Fasciolosis is a food-borne parasitic disease, caused by the large liver fluke, Fasciola. Humans acquire infection by ingesting fresh or undercooked water plants, on which infective metacercaria encyst. In spite of the rarity of the disease in Japan, we encountered four successive fasciolosis patients within a short period, who were all living in the same area. The patients were 70-82 years old, three females and the husband of one of the female patients. They started complaining of non-specific symptoms, such as fever, general fatigue, appetite loss, and abdominal pain, almost at the same time. All patients showed prominent peripheral blood eosinophilia, and the medical imaging indicated multiple hepatic lesions. No parasite eggs or worms were detected in any of the patients. Diagnosis was made serologically and they were treated with praziquantel and/or triclabendazole. No cattle or sheep were farmed in the area, but the wild sika deer, Cervus nippon, inhabited adjacent to the residential area. The intermediate host snail, Austropeplea ollula, were found near the residence of the patients, and one of the collected snails was positive for F. hepatica/gigantica hybrid type rediae. Our report should alarm the medical professionals for this rare and unfamiliar parasitic disease.

Burden of alcohol use and inclusion of alcohol use disorder medications in the essential medicine lists across 132 countries: An observational study.

Harmful use of alcohol effects the health of the population. The treatment coverage of alcohol use disorders (AUD) varies among countries. The study aimed to determine the inclusion of AUD medicines in various national Essential Medicine Lists (EMLs) and its association with alcohol consumption. It was a secondary data analysis of alcohol consumptions and AUD related medicines in EML. Data were extracted from the WHO Global Essential Medicines database and the WHO Global Status Report on Alcohol and Health 2018. Data were extracted for 194 countries. Only 132 of 194 countries (68.0%) had EML, and among the 132 countries only 27.3% had included AUD medicines in their EML. Only 36 countries had included any of the AUD medicines in their EML. Disulfiram was included by 23 countries, while Acamprosate and Naltrexone was included by only four and 19 countries, respectively. Among the countries, 36.1% were from upper-middle income countries and 16.65 from low-income countries. The inclusion of AUD medicines in national EML was neither associated with alcohol consumption parameters nor the alcohol consumption related policy parameters. Considering the high prevalence of AUD and its complications, there is an urgent need to focus on including AUD medicines in national EML for making AUD treatment available and accessible across the world.

The Availability of Essential Antimicrobials in Public and Private Sector Facilities: A Cross-Sectional Survey in a District of North India.

(1) Background: There is a need to assess the availability of essential antimicrobials, as the availability of an antimicrobial is a critical element of its rational use. We aimed to assess the availability of antimicrobials listed in the National List of Essential Medicines 2015, India (primary list), and a selected (secondary) list comprised of agents indicated for commonly encountered infectious illnesses in various healthcare settings and to identify the reasons for their non-availability. (2) Methods: A cross-sectional survey of 25 public, private, and other sector pharmacies was carried out in Rohtak, a district of the North Indian state of Haryana, from April to June 2022. (3) Results: Most of the antimicrobials surveyed were optimally available in various sector pharmacies with the exception of benzathine benzylpenicillin, benzylpenicillin, cloxacillin, cefazolin, cefuroxime, cefadroxil, amphotericin B, and antimalarials. The most frequent reasons for limited availability were low demand, no prescriptions, and the non-listing of drugs in the state's essential medicine list. (4) Conclusions: Enough evidence needs to be generated with respect to the status of availability of essential antimicrobials from different regions of India as well as other lower-middle-income countries to devise measures for ascertaining better availability of these agents, especially antibiotics at regional, national, and global scales.

Evaluation of alignment of the reimbursement medicines list for children in Albania with the WHO essential medicines list for children.

Background: The WHO Essential Medicine List for Children was released on the 30th anniversary of the general Essential Medicine List in 2007, to recognise special needs for medicines in children, and to promote the inclusion of paediatric medicines in national procurement programmes. This study aimed to investigate the alignment of the medicines included in the Albanian reimbursement medicines list of the Mandatory Healthcare Insurance Fund (AMHIF) and the Essential Medicine List for Children. Methods: A quantitative evaluation was performed to compare the paediatric medicines included in the 2022 list of the AMHIF and the 2021 WHO Essential Medicine List for Children. In addition, vaccines in the Albanian vaccination programmes for children were compared to the ones listed on the WHO Essential Medicine List for Children. Results: Both lists had a total of 284 active ingredients in common, whereas 14 of 24 vaccines were found to be in common in the Essential Medicine List for Children list and the Albanian vaccination programmes. Conclusions: This is the first study in Albania to investigate the alignment of the WHO EMLc and AMHIF list. In case of the same active ingredient there were many deviations in terms of dosage form, strength and indication.

Factors affecting the essential medicine prescribing behavior among general practitioners in Beijing, China: a cross-sectional study with structural equation model.

BACKGROUND: The aim of this study is to explore the influence of GPs'information, motivation and behavior skills on EM prescribing behavior in urban and suburban districts. METHOD: A cross-sectional study was conducted from June to November 2022 cross 3 urban districts and 4 suburban districts in Beijing. The structural equation model was used to analyze the factors influencing the essential medicine prescription behavior among general practitioners in urban and suburban districts. RESULTS: A total of 511 valid questionnaires were collected. There was a statistically significant difference in mean scores for personal motivation and behavioral skills between urban GPs and suburban GPs. For urban GPs, the path analysis revealed that the social motivation had a direct effect on the essential medicine prescribing behavior (ß = 0.225, p < 0.05). In contrast, for suburban GPs, both social motivation and personal motivation had a direct effect on the essential medicine prescribing behavior, respectively (ß = 0.175, p < 0.05; ß = 0.193, p < 0.01). CONCLUSION: Social motivation of urban GPs were positively and significantly associated with essential medicine prescribing behavior. Social motivation and personal motivation of suburban GPs were positively and significantly associated with essential medicine prescribing behavior. Therefore, various corresponding policies and measures should be developed to promote the National Essential Medicines Policy in China.

Judicialização e acesso a medicamentos: a essencialidade na saúde e no direito / Litigation and access to medicine: the concept of essentiality in the fields of health and law

RESUMO A jurisprudência referente ao fornecimento de medicamentos pelo Poder Público importa diretamente para a gestão da assistência farmacêutica. O presente artigo teve como objetivo apresentar a jurisprudência do Tribunal de Justiça do Estado do Rio de Janeiro sobre a aplicação do termo 'essencial' nas ações judiciais com pedidos de medicamentos, e analisar o uso deste conceito no Poder Judiciário, vis a vis sua compreensão na Saúde Pública. Foi realizado estudo qualitativo das decisões judiciais proferidas na segunda instância do Tribunal São observados aspectos correlacionados ao direito à saúde e ao exercício do acesso à Justiça, os quais permitem identificar ideias centrais sobre essencialidade do medicamento para a vida e a soberania absoluta da prescrição médica como respaldo médico-científico para a decisão judicial.

ABSTRACT The jurisprudence conceming the supply of medicine is an important issue for the management of pharmaceutical services in Brazil. This paper aimed at presenting the jurisprudence from the Court of Justice of the State of Rio de Janeiro, focusing on the term 'essential' as included on lawsuits demanding access to medicines. It also examined the utilization of this concept by public health and by the Judicial System by means of a qualitative analysis of final judicial sentences of the appellate courts. Aspects related to the right to health and to the practice of accessing Justice were observed. Main components of these sentences and the main issues that they present on the essentiality of medicines for the maintenance of life and on the absolute sovereignty of the medical prescription as the sole scientific basis for the judicial decision were scrutinized.