INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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This primer aims to guide health professionals on engaging with WASH-related issues. It gives an overview of WASH interventions and the status of WASH services globally and outlines key linkages with health. It provides examples of key actions that health actors can take to ensure WASH efforts effec...tively protect public health and highlights World Health Organization (WHO) activities to support those actions.
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THELANCETID-D-16-00800 S1473-3099(16)30318-8
A manual for health managers
TB remains one of the world’s deadliest infectious diseases, second only to COVID-19, and drug-resistant TB strains are still a major concern. In the fight against TB, urgent investment is critical, especially in the context of the ongoing pandemic.
The aim of this study is to research deeply on the post-traumatic stress disorder in sexually abused children. Proving the presence of forms of the disorder in children and the their treatment mode will be in the center of the study. The methods used to conduct this study will be a literature review... on the focused issue referring to reviews of articles which focus on the defined peer group. For the purpose we have selected only articles focusing on sexually abused children treated for post-traumatic stress disorder. The results of the study reveal that all forms of abuse could bring consequences on children, even more, posttraumatic stress is the language with which the victims communicate their sorrow in the most typical mode. Sexual abuse as one of the major forms of abuse, is among the most severe which cause irreversible consequences over a category of children. In conclusion we can assume that post-traumatic stress in sexually abused children might appear through the most severe forms of psychiatric and psychological symptoms and for the recovery and rehabilitation of the child in many cases the pharmacological treatment seems as the best choice for the child.
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Substance use disorders
Chapter G.3
This document is produced by the Humanitarian Country Team and the United Nations Resident
Coordinator’s Office in Mozambique, with the support of the United Nations Office for the Coordination of
Humanitarian Affairs (OCHA). The projects reflected here support the national government. It covers... the
period from November 2018 to June 2019. The Plan has been revised in March 2019 to incorporate the
immediate response to needs arising from the impact of Cyclone Idai.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest leve...ls of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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The "Cystic Fibrosis Fact Sheet" by the National Heart, Lung, and Blood Institute provides an overview of cystic fibrosis (CF), a chronic and often fatal genetic disorder affecting the respiratory and digestive systems. The document outlines the causes, genetic inheritance patterns, and symptoms of ...CF, which include thick mucus buildup, respiratory issues, and digestive problems. It also discusses diagnostic methods, such as the sweat test and genetic testing, and highlights current treatment approaches focused on symptom management, including chest therapy, medications, and potential gene therapy. The fact sheet emphasizes patient and family education to improve quality of life and support coping strategies.
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The Atlas of health and climate is a product of this unique collaboration between the meteorological and public health communities. It provides sound scientific information on the connections between weather and climate and major health challenges. These range from diseases of poverty to emergencies... arising from extreme weather events and disease outbreaks. They also include environmental degradation, the increasing prevalence of noncommunicable diseases and the universal trend of demographic ageing.
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