Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt...h raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
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Government Barriers to Condom Use by Men Who Have Sex With Men
The purpose of the toolkit is to bring together existing learning and guidance as a starting point for stakeholders to begin SRH preparedness work. Within the SRH sector the field of preparedness is relatively new and growing. More collective effort is required to further evaluate the impact of prep...aredness efforts and push the field forward. This effort is a first attempt at a draft guidance for SRH preparedness, and is intended for field testing. The toolkit recognizes the longstanding work of the field of emergency and disaster risk management, and endeavors to bridge that work with the human rights-oriented and peoplecentered field of sexual and reproductive health.
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PLoS Negl Trop Dis 13(10): e0007694. In 2005, the World Health Organization (WHO) recognized Chagas disease (CD; Trypanosoma cruzi infection) as a neglected tropical disease (NTD) [1] and included it into the global plan to combat NTDs [2]. The Target 3.3 of the United Nations Sustainable Developmen...t Goals (UN/SDG) aims at ending the epidemics of NTDs by 2030 [3]. Mother-to-child (congenital/connatal) transmission is currently the main mode of transmission of T. cruzi over blood transfusions and organ transplantations in vector-free areas within and outside Latin America (LA). Based on recent demonstrations that congenital transmission can be prevented [4–7], WHO has shifted its objective, in 2018, from control to elimination of congenital CD (cCD).
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GMS Zeitschrift für MedizinischeAusbildung 2015, Vol. 32(5),ISSN 1860-3572
Internationalizing higher education is considered to be a major goal for universities in Germany and many medical students aspire to include international experiences into their academic training. However, the exact meani...ng of “internationalizing” medical education is still poorly defined, just as is the possible pedagogic impact and effects. Against this background, this article presents the special track curriculum on global health (in German: Schwerpunktcurriculum Global Health, short: SPC) at Justus Liebig University Giessen, which was established in 2011 as a comprehensive teaching program to integrate international perspectives and activities systematically into the clinical years of the medical curriculum
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Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrom...e, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status
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These are two parallel guidelines, one for small hospitals and another one for large hospitals. In view of heavy burden of malaria and prevalence of drug resistant falciparum malaria in the South-East Asia Region, the guidelines were developed for use by medical personnel who treat severe malaria pa...tients, referred from lower-level health facilities. The guidelines were developed by the WHO Regional Office for South-East Asia and the WHO Collaborating Centre for the Clinical Management of Malaria, Faculty of Tropical Medicine, Mahidol University, Thailand. The guidelines are based on a review of current evidence, existing WHO guidelines and experience in the management of malaria in the Region.
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The design of anaesthesia equipment for use in hospitals in the developing world must take intoaccount the local conditions, particularly whether reliable supplies of compressed oxygen andelectricity are available. Designs should ensure that maintenance is feasible locally. Internationalstandards sh...ould encourage the design of suitable equipment to ensure safe anaesthesia for patientsworldwide
Anaesthesia, 2007,62(Suppl. 1), pages 54–60
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The Central African Republic has experienced
repeated sociopolitical crises since
the tragic death of its founder, Barthélémy
Boganda, the year before the county’s independence.
Today there is a general tendency
by foreign observers and analysts who are
not conversant with the history of t...his country,
to simply ignore or minimize this aspect
of the political background of the CAR. This
has resulted in poor understanding of the
diachronic and holistic causes of the identity
crises, and of the recurrent cycles of violence
this country has been experiencing through
the years.
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Journal of Cancer Education
https://doi.org/10.1007/s13187-020-01935-7
The Lancet Planetary Health, Vol.5 Issue 2, Feb. 1,2021.
Nationally determined contributions (NDCs) serve to meet the goals of the Paris Agreement of staying “well below 2°C”, which could also yield substantial health co-benefits in the process. However, existing NDC commitments are inadequa...te to achieve this goal. Placing health as a key focus of the NDCs could present an opportunity to increase ambition and realise health co-benefits. We modelled scenarios to analyse the health co-benefits of NDCs for the year 2040 for nine representative countries (ie, Brazil, China, Germany, India, Indonesia, Nigeria, South Africa, the UK, and the USA) that were selected for their contribution to global greenhouse gas emissions and their global or regional influence.
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Assessment in English on South Sudan about Education, Food and Nutrition, Drought, Epidemic and more; published on 22 Jul 2022 by IOM
Ethiopia is home to 25 million girls and women who have experienced FGM. More than half are in the regions of Oromia and Amhara. Overall, 65 per cent of girls and women aged 15 to 49 have undergone FGM. The highest prevalence is in the Somali (99 per cent) and Afar (91 per cent) regions
Dengue is a mosquito-borne viral disease that occurs mainly in the tropics and subtropics but has a high potential to spread to new areas. Dengue infections are climate sensitive, so it is important to better understand how changing climate factors affect the potential for geographic spread and futu...re dengue epidemics. Vectorial capacity (VC) describes a vector's propensity to transmit dengue taking into account human, virus, and vector interactions. VC is highly temperature dependent, but most dengue models only take mean temperature values into account. Recent evidence shows that diurnal temperature range (DTR) plays an important role in influencing the behavior of the primary dengue vector Aedes aegypti. In this study, we used relative VC to estimate dengue epidemic potential (DEP) based on the temperature and DTR dependence of the parameters of A. aegypti. We found a strong temperature dependence of DEP; it peaked at a mean temperature of 29.3°C when DTR was 0°C and at 20°C when DTR was 20°C. Increasing average temperatures up to 29°C led to an increased DEP, but temperatures above 29°C reduced DEP. In tropical areas where the mean temperatures are close to 29°C, a small DTR increased DEP while a large DTR reduced it. In cold to temperate or extremely hot climates where the mean temperatures are far from 29°C, increasing DTR was associated with increasing DEP. Incorporating these findings using historical and predicted temperature and DTR over a two hundred year period (1901-2099), we found an increasing trend of global DEP in temperate regions. Small increases in DEP were observed over the last 100 years and large increases are expected by the end of this century in temperate Northern Hemisphere regions using climate change projections. These findings illustrate the importance of including DTR when mapping DEP based on VC.
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The skin of a patient is the first and most visible structure of the body that any health-care worker encounters during the course of an examination. To the patient, it is also highly visible, and any disease that affects it is noticeable and will have an impact on personal and social well-being. Th...e skin is therefore an important entry point for both diagnosis and management. Many diseases of humans are associated with changes to the skin, ranging from symptoms such as itching to changes in colour, feel and appearance.
This training guide explains how to identify the signs and symptoms of neglected tropical diseases of the skin through their visible characteristics. It also contains information on how to diagnose and manage common skin problems that front-line health workers may encounter.
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