This is the VOA Special English Health Report.
Premature or preterm births are defined as live births before a woman completes thirty-seven weeks of pregnancy. A new study found that about fifteen million babies were born prematurely around the world in twenty-ten. The study was the first of its kind, and shows that the problem exists in poor countries as well as in wealthy ones.
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Researchers gathered information from eighty-four countries. The researchers were from Save the Children, a nongovernmental organization. They found that more than one in ten babies are born too soon.
The research team found that fifteen countries -- including the United States and Brazil -- had two-thirds of all preterm births. Sixty percent of preterm births happen in South Asia and sub-Saharan Africa.
Problems related to premature birth are the second most common cause of death in children under five, after pneumonia. The study found that these complications of preterm birth result in more than a million deaths around the world every year.
Babies born early are more likely to develop learning disabilities and problems with their eyesight and hearing. They can also suffer cerebral palsy, a neurological condition, and a lifetime of lung disease. The risk of death in a newborn also increases sharply if babies are born after less than thirty-two weeks of pregnancy.
But eight out of ten premature babies are born between thirty-two and thirty-seven weeks. Joy Lawn of Save the Children in South Africa led the team that wrote the report for the World Health Organization. She says with the right medical care and loving attention, these newborns have a good chance of survival.
JOY LAWN: "They would survive with really basic care. So, being breastfed, being kept warm. And they are at much higher risk of infection, so treating with antibiotics."
She says only five percent of preterm babies were born at twenty-eight weeks or less. Those that survived birth required intensive hospital care.
Only three countries -- Croatia, Ecuador and Estonia -- reported a decrease in their preterm birth rates between nineteen ninety and twenty-ten.  
JOY LAWN: "Really we can't point to one solution and say this is what caused it. Just as we couldn't point to something in the U.S. and say this is what caused the very high rates in the U.S."
In the United States, twelve percent of all live births in twenty-ten were preterm.
You can find a link to the full report, along with videos about the problem of premature births, at voaspecialenglish.com.
This study would have interested Mary Ellen Avery. She was a medical researcher who made a discovery that helped save the lives of many preemies. Next week, learn about Dr. Avery and her discovery more than fifty years ago.
And that's the VOA Special English Health Report. I'm Faith Lapidus.
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Contributing: Jessica Berman and Christopher Cruise

This is the VOA Special English Health Report.

 
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We told you last week about a study which found that more than ten percent of all babies worldwide are born too early. One common problem in preterm babies is respiratory disease. The lungs are the last organs to develop. But a medicine called surfactant can save babies struggling to breathe.

The story of this lifesaving medicine begins with a discovery in nineteen fifty-nine by a researcher named Mary Ellen Avery. She told this story in two thousand five to Children's News at Children's Hospital Boston, where she was the first woman to serve as physician-in-chief.
She had been doing research at the Harvard School of Public Health. She was asked to find out more about the foam that forms in the lungs of people with a condition called pulmonary edema. At night she worked in a hospital delivery room. She saw many premature babies with hyaline membrane disease, now called respiratory distress syndrome.
She examined the lungs of babies who had died. She found there was no air in their lungs, and she discovered why. In her words, "The material that was important -- the foam -- was missing, and they were struggling to re-inflate their lungs. Nature put this foam, or surfactant, in the lung to lower surface tension. You cannot keep air spaces inflated without it."
Babies usually develop this coating while they are in the womb, but many premature babies do not.
Finally, in nineteen eighty, a Japanese pediatrician, Tetsuro Fujiwara, published a study about an artificial surfactant. It could be given to a baby and, within minutes, the baby could breathe.
The medical community had taken years to accept Dr. Avery's discovery. But she said in a Harvard Medical School interview in nineteen eighty-two that she never gave up.
MARY ELLEN AVERY: "Hanging in there is key, I think. Knowing what you want to do and not being easily discouraged is key, particularly in research. You know, you're always moving into the unknown. And you can spend months trying to prove something, only to find that you made some terrible mistakes and you have to be willing to say 'six months of my life and my hard work went down the drain,' and you have to start over -- that's terrible discouragement."
Dr. Anne Hansen in the Neonatal Intensive Care Unit at Children's Hospital Boston remembers the first time she heard about Dr. Avery. It was in nineteen ninety, when the government was in the process of approving an early surfactant called Exosurf. The attending doctor she was working with in the unit had some news for her.
ANNE HANSEN: "And the attending [doctor] who I was on with said, 'When you're on call tonight, if there's a baby who's born who's premature, you should watch very closely the natural history of that disease, because this is the last night before we're going to start giving Exosurf to all our preterm babies, so this will be your last chance ever in your life to see what a preterm baby does when they don't receive Exosurf.' And then he told me the whole story of Dr. Avery and her discoveries."
Mary Ellen Avery was eighty-four years old when she died last December fourth.
And that's the VOA Special English Health Report. I'm Jim Tedder.

This is the VOA Special English Agriculture Report.
Researchers estimate that more than two billion people a year get diseases spread by animals. More than two million of them die.

 
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Delia Grace is a veterinary epidemiologist -- an expert in the spread of diseases involving animals. She is also a food safety expert. She  works at the International Livestock Research Institute in Nairobi, Kenya. She explains that diseases transmitted between animals and people are called zoonoses.
DELIA GRACE: "A majority of human diseases are actually zoonotic. More than sixty percent of human diseases are transmitted from other vertebrate animals. Some of these diseases are pretty common. Some of the food-borne diseases and also diseases such as tuberculosis, leptospirosis are not uncommon. Others are quite rare."
Delia Grace says there are many different infection pathways for a person. Probably the most common one is for people to get sick from food. Other transmission pathways include direct contact with animals. And some diseases can be transmitted through water or through the air.
DELIA GRACE: "Diseases like avian influenza or mad cow disease have actually killed very few people. But they are of interest because some of them have the potential to kill a lot of people -- diseases like the Spanish flu after the First World War or HIV/AIDS, both of which were originally zoonoses."
Delia Grace is the lead author of a new report called "Mapping of Poverty and Likely Zoonoses Hotspots." She points out that poverty and disease are closely linked, so preventing the transmission of animal diseases could help reduce poverty.
The report, for Britain's Department for International Development, lists places where the diseases are most common. The report lists places where a disease has existed for a long time, a so-called endemic zoonosis, as well as places with new threats.
DELIA GRACE: "So in terms of the hotspots of the zoonosis which are there all the time -- not the new zoonosis, but what we call the endemic zoonosis -- we identified three countries which bear the greatest burden of these diseases. And those are India, Ethiopia and Nigeria. But in terms of the new diseases -- the diseases which haven't been there, but are emerging -- the hotspots are very different. They appear to be western United States and western Europe."
Delia Grace says things could get worse in the coming years as meat production increases to feed a growing world population. High production farms often raise animals close together. Crowding can allow diseases to spread quickly. Another concern is the use of antibiotics in food animals, not only to prevent and treat diseases but to increase growth.
The report says an "incentive-based" system to encourage safer methods of raising animals could be more effective than increasing food inspections. For example, small farmers could receive training and other help that would lead to official certification that their products are safe.
And that's the VOA Special English Agriculture Report. I'm Jim Tedder.
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Contributing: Joe De Capua

A miscarriage is the natural loss of a baby before the twentieth week of pregnancy. Experts say many pregnancies end before a woman even knows she was pregnant. Up to twenty percent of known pregnancies end in a miscarriage.
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Miscarriages are generally caused by genetic problems with the baby that prevent it from developing. But whatever the cause, the loss of a pregnancy can be heartbreaking. And sometimes the advice that women receive after a miscarriage can also be heartbreaking.
Some women are told to wait before they try to get pregnant again. A two thousand five report from the World Health Organization advised waiting at least six months. Some doctors advise women to wait even longer.
But a Scottish study published in twenty-ten found no need to delay. Researchers from the University of Aberdeen examined the medical records of thirty thousand women. The women visited Scottish hospitals between nineteen eighty-one and two thousand. They had miscarriages in their first known pregnancies and became pregnant again.
The study found that eighty-five percent of women who waited less than six months to get pregnant had live births. That compared to seventy-three percent of women who waited more than two years.
Those who quickly became pregnant again were less likely to have a dangerous pregnancy form in their fallopian tubes. They were less likely to lose their fetus after twenty weeks, known as a stillbirth. They were also less likely to give birth by caesarean section. And they had fewer preterm births and fewer babies with low birth weight.
The study found that about forty percent of women became pregnant again within six months. Twenty-five percent got pregnant within six to twelve months.
The women who quickly became pregnant again after a miscarriage were more likely to be older. Older women might be less likely to delay because they know there are more risks with pregnancy the older they get.
The twenty-ten report appeared in the BMJ, the British Medical Journal. The researchers pointed out that their results were limited to Scottish records and could not be generalized to all women. For example, women in developing countries start having children at an earlier age than females in Western countries.
And that's the VOA Special English Health Report. Find us online at voaspecialenglish.com. I’m Faith Lapidus.

This is the VOA Special English Health Report.
There is new medical evidence for the expression "better late than never." Researchers have found that smokers reduce their risk of dying from tobacco even if they stop smoking after the age of sixty.
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Smoking is a known risk for many diseases, including many forms of cancer as well as heart disease. But most studies on the health effects of smoking involve middle-aged people.
The latest analysis by German researchers examined the findings of seventeen studies carried out in the United States, China, Australia, Japan, England, Spain and France.
Smokers sixty and older had an eighty-three percent increased risk of dying from all causes compared to people who had never smoked. Smokers also had a thirty-four percent higher risk of death compared to former smokers.
T.H. Lam is professor in the school of public health at the University of Hong Kong. He says people who continue to smoke as seniors have at least a fifty percent chance of dying from their smoking habit.
T.H. LAM: "And if they stop smoking, then they can reduce about one-quarter of their excess risk. So this is good news that older people should not continue to smoke."
What about smokers who start at a young age and stop when they are in their thirties? Dr. Lam says they can reduce their risk of dying from a smoking-related illness to almost the same level as someone who never smoked. Even people who never smoke can still die from breathing other people's secondhand smoke.    
An article on smoking among older individuals, with a commentary by T.H. Lam, appeared in the Archives of Internal Medicine.
In other news, the World Health Organization now says diesel fuel exhaust causes cancer. Since nineteen eighty-eight the WHO had rated exhaust from diesel engines as "probably carcinogenic" to humans. Now, it compares the risk to that of secondhand cigarette smoke.
This month's announcement came after international experts spent a week reviewing new research findings. Those included a long-term study of more than twelve thousand miners who were heavily exposed to diesel exhaust.
The diesel industry pointed out that the mining study lacked exact data on exposure levels during its early years. Also, diesel engine makers point to their new designs that produce far less emissions than older truck and bus engines.
The WHO says stronger standards are needed to limit diesel emissions into the air.
The United States Environmental Protection Agency continues to rate diesel as only a "likely" cause of cancer.
And that's the VOA Special English Health Report. I'm Jim Tedder.

This is the VOA Special English Health Report.
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Each year an estimated one hundred six million people get infected with gonorrhea. This sexually transmitted disease is getting harder and harder to treat.
The World Health Organization says gonorrhea is increasingly resistant to antibiotics. The WHO warns that there are few treatment options available, and that the world is running out of ways to cure it.
Manjula Lusti-Narasimhan is a scientist in the Department of Sexually Transmitted Diseases at the WHO. She explains what could happen if this bacterial disease becomes untreatable.
MANJULA LUSTI-NARASIMHAN: "For men and women of reproductive age, they could become infertile. For women who are pregnant, they could have ectopic pregnancies or spontaneous abortions that could increase maternal deaths. And for infants born to these women with untreated gonorrhea, we already know that over half of them develop severe eye infections and many of these could lead to blindness."
Gonorrhea is one of four major sexually transmitted infections that can be cured. The other three are chlamydial infection, syphilis and chancroid.
But the organism that causes gonococcal infections has developed resistance to almost every class of antibiotic that exists. Resistance is caused by the overuse of antibiotics and the use of poor quality antibiotics. It also results from natural genetic changes, or mutations, within disease organisms.
The WHO says it does not know the extent of the resistance worldwide. This is because of a lack of good information in many countries and a lack of research. But it says cases of resistance to treatment are already being reported in several countries. These include Australia, France, Japan, Norway, Sweden and Britain.
The WHO is calling for smarter use of antibiotics and more research into new ways to treat the infections. Dr. Lusti-Marasimhan says there is no current research into new drug treatments for gonorrhea. 
MANJULA LUSTI-NARASIMHAN: "We have no plan B right now. There has been this general complacency that has set in because so far, you pop a pill, you get cured, end of story. And, we are no longer there.  We are in a state right now where in so many places this organism is rapidly developing resistance. So we do need to start looking into the research."
The World Health Organization is part of the United Nations. The WHO is calling for urgent action to prevent the spread of untreatable gonorrhea. A new global action plan calls for increased monitoring and reporting of resistant strains of the disease. The plan also calls for better efforts to prevent, diagnose and control the infections.
And that's the VOA Special English Health Report. You can find links to more information about gonorrhea at voaspecialenglish.com. I'm Faith Lapidus.
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Contributing: Lisa Schlein

This is the VOA Special English Health Report.
A study has raised questions about a widely held belief involving cholesterol. The belief is that high levels of so-called good cholesterol in the blood can reduce the risk of a heart attack.
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The medical name for "good" cholesterol is high-density lipoprotein, or HDL. Doctors commonly believe it reduces the risk of heart attack by removing fatty deposits that can block the flow of blood in the arteries of the heart.
But Dr. Sekar Kathiresan at Massachusetts General Hospital in Boston says the effects of high HDL have never been proven. He says the new study that he and other researchers did suggests that HDL cholesterol does not affect the risk of heart attack.
SEKAR KATHIRESAN: "This has been the major assumption over the last thirty years, that if you raise HDL cholesterol, the risk for heart disease will be lowered. And I think we have now broken that assumption, broken that link using this gene variant."
The researchers say about four percent of people have a genetic change that gives them a naturally high level of HDL. The study found that those who were genetically "programmed" to have higher HDL levels were just as likely to suffer heart attacks as those who were not.
A second analysis looked at fourteen gene variants that increase good cholesterol. Dr. Kathiresan says people with the most variants had no more protection against heart attacks than anyone else.
But he says there is no dispute about low-density lipoprotein, or LDL. LDL, the so-called bad cholesterol, causes a buildup of fatty substances inside arteries and increases the risk of heart attack.
Dr. Kathiresan and his colleagues published their findings in the Lancet medical journal.
Another widely held medical belief has also come into question recently. For years, men over the age of forty have been told to get a simple blood test to see if they have prostate cancer. Now, experts on a government committee are advising them not to. Dr. Virginia Moyer heads the United States Preventive Services Task Force
VIRGINIA MOYER: "Close to two-thirds of older men have prostate cancer and yet the huge majority of them never have a problem from it in their lifetime."
The task force examined two large studies before deciding that treating the cancer found by the PSA test can do more harm than good. Effects of the treatment can include a loss of sexual ability and bladder control, as well as other problems including heart attacks.
Some doctors support the findings of the task force, but others disagree. Urologist Deepak Kapoor says in about twenty years of PSA testing, death rates for prostate cancer have dropped by thirty-eight percent.
And that's the VOA Special English Health Report. I'm Steve Ember.
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Contributing: Jessica Berman and Carol Pearson

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This is the VOA Special English Health Report.

Severe bleeding, also called hemorrhage, causes one-third of pregnancy-related deaths in Asia and Africa.

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This is the VOA Special English Health Report.

"Sleep-disordered breathing" is a term for a group of conditions that can interfere with normal breathing while people sleep. These include snoring, mouth-breathing and sleep apnea. Sleep-disordered breathing can do more than just leave people feeling tired the next day. It can also affect people's health. In children the effects can include behavioral and emotional problems.