With the growing prevalence of type 2 diabetes, particularly in emerging countries, its management in the context of available resources should be considered. International guidelines, while comprehensive and scientifically valid, may not be appropriate for regions such as Asia, Latin America or Afr...ica, where epidemiology, patient phenotypes, cultural conditions and socioeconomic status are different from America and Europe. Although glycaemic control and reduction of micro- and macrovascular outcomes remain essential aspects of treatment, access and cost are major limiting factors; therefore, a pragmatic approach is required in restricted-resource settings. Newer agents, such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in particular, are relatively expensive, with limited availability despite potentially being valuable for patients with insulin resistance and cardiovascular complications. This review makes a case for the role of more accessible second-line treatments with long-established efficacy and affordability, such as sulfonylureas, in the management of type 2 diabetes, particularly in developing or restricted-resource countries.
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Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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Development of cardiovascular disease (CVD) is influenced by risk factors such as:
tobacco use, an unhealthy diet, physical inactivity, obesity (which can result from
a combination of unhealthy diet, physical inactivity, and other factors), elevated
blood pressure (hypertension), abnormal blood l...ipids (dyslipidaemia) and elevated blood glucose (diabetes mellitus). Continuing exposure to these risk factors leads
to further progression of atherosclerosis, resulting in clinical manifestations of these diseases, including angina pectoris, myocardial infarction, heart failure and stroke. Total CVD risk depends on the individual’s overall risk-factor profile.
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In areas of Mexico, Central America, and South America, where the Trypanosoma cruzi parasite is present in triatomine bugs, improved housing and spraying insecticide inside housing to eliminate the bugs has significantly decreased the spread of Chagas disease. Screening of blood donations for Chagas... is another important public health tool to help prevent spreading the disease through blood transfusions. Early detection and treatment of new cases, including mother-to-baby (congenital) cases, will also help reduce the burden of disease.
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الكوليرا هي عدوى إسهالية حادة تنتج عن تناول طعام أو ماء ملوث. توفر هذه الدورة مقدمة عامة عن الكوليرا وتستهدف الأفراد المسئولين عن الاستجابة لفاشيات المرض في حالات ا...طوارئ المعقدة أو في البيئات التي تعرضت فيها البنية التحتية البيئية الأساسية للتلف أو الدمار.
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Психические расстройства имеют общие черты с другими неинфекционными заболеваниями, в том числе многие основные причины и общие последствия, высокую степень взаи...мозависимости и склонность развиваться одновременно, а также то, что их наиболее эффективное лечению связано с использованием интегрированных подходов. Схемы более интегрированного планирования и программирования включают: вмешательства популяционного уровня, направленные на повышение осведомленности о факторах риска НИЗ и психических расстройств и их снижение (посредством изменения законодательства, регулирования и повышения информированости); внедрение программ, осуществляемых в школах, на рабочих местах и в сообществах в целях укрепления психического и физического благополучия; предоставление более индивидуальных услуг здравоохранения, и предоставление более координированной помощи людям с (часто коморбидными) психическими и соматическими заболеваниями.
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Despite recommendations on the marketing of commercial baby and toddler foods, two new reports from WHO find widespread evidence of inappropriate promotion and poor nutritional quality of foods for infants and young children across the WHO European Region. To address these issues and help countries ...implement nutrition recommendations, a nutrient profile model is proposed to guide decisions on promotion and nutrition quality of baby foods.
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The report and an accompanying series of studies show the global uptake of the World Health Organization (WHO) Surgical Safety Checklist in its first ten years since its launch and recommend ways the Checklist can be more effectively used to improve surgical safety for millions at risk.
The report ...found that uptake has been remarkably positive: the Checklist has been adopted in almost 90% of operating rooms in countries with a high Human Development Index (HDI), a country-level measure of health, education, and standard of living. It was referenced by at least 139 (70%) of the world's countries and is included as a national standard by the health ministries of at least 20 countries. The Checklist has also had beneficial qualitative impact, introducing a culture of safety and improved communication within surgical teams, increasing patient trust, and improving job satisfaction.
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En este documento se ofrece, en un formato de fácil consulta, el panorama general de las cuestiones relativas a la salud y los derechos sexuales y reproductivos que pueden afectar a los derechos humanos, la salud y el bienestar de los adolescentes (de edades comprendidas entre los 10 y los 19 años...) y las directrices pertinentes de la Organización Mundial de la Salud (OMS) para abordar dichas cuestiones. Este documento permite acceder al amplio conjunto de directrices de la OMS al respecto y constituye un útil recurso para la labor de promoción, formulación de políticas, investigación y diseño de programas y proyectos. Tiene por finalidad apoyar la aplicación de la Estrategia Mundial para la Salud de la Mujer, el Niño y el Adolescente 2016-2030 (1) y está armonizado con las medidas mundiales aceleradas en favor de la salud de los adolescentes (AA HA!) de la OMS y el marco operativo de la OMS sobre salud sexual y su relación con la salud reproductiva (2, 3).
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N Engl J Med 2019;380:2429-39.DOI: 10.1056/NEJMoa1901113
Le choléra est une infection diarrhéique aiguë causée par l'ingestion d'eau ou d'aliments contaminés. Ce cours offre une introduction générale au choléra et s'adresse au personnel qui intervient en cas d'apparition de la maladie dans des situations d'urgence complexes ou dans des environneme...nts où les infrastructures environnementales de base ont été endommagées ou détruites. Ce cours comprend des documents accessibles en anglais et en arabe. Nous espérons que ce cours vous aidera à vous rappeler de ce que vous savez déjà et à exécuter les bons principes de gestion du choléra.
Objectif d'apprentissage : A la fin de ce cours, les participants devront être en mesure de :
décrire la définition du cas et les alertes pour le choléra ;
décrire les principales voies de transmission ;
identifier les principales actions préventives ; et
expliquer comment le contrôle du choléra est multisectoriel.
Durée du cours : Environ 1 heure.
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En este manual hemos recopilado información sobre las caracteristicas socioculturales de inmigrantes de distintas procedencias y os presentamos las dudas más comunes que nos han planteado respecto al VIH y al sida. No obstante debemos subrayar que se trata de información orientativa y no debe lug...ar a prejuicios sino ayudarnos a entender otras maneras de ver la realidad.
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Очень часто дети это уязвимая под-группа внутри уже уязвимых групп населения. Поэтому необходимо, чтобы политики, гражданское общество и медицинские работники без...отлагательно обратили свое внимание на проблему борьбы с детским туберкулезом. Дети являются источником развития заболеваний в будущем, а продолжающееся бездействие приводит к потере многих человеческих жизней.
Accessed on 19.07. 2019
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Guide des éléments essentiels pour une bonne pratique - Première édition 2019
Ce guide a été conçu afin d’apporter les informations nécessaires à une prise en charge pratique et exhaustive des personnes atteintes de diabète et de tuberculose. Il s’appuie sur les résultats d’étude...s publiées, sur l’opinion d’experts ainsi que sur l’expérience pratique.
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Position Statement
Diabetes Care2018;42(Suppl. 1):S1–S194.
Childhood obesity is a major public health problem globally, which could undermine progress towards achieving the Sustainable Development Goals. Prevention is recognized as the most efficient means of curbing the epidemic; however, given the scale of the problem and the many children who need profes...sional support due to the severity of the disease and/or obesity-related complications, health systems all over Europe must take steps to develop obesity management systems. The aim of this project was to assess the response of health care delivery systems in 19 countries in the WHO European Region to the childhood obesity epidemic.
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Este documento ha sido concebido para proporcionar un marco que respalde los estudios de prevalencia de las ITS en los niveles local y nacional. El propósito de estos estudios es conocer la carga de las infecciones por NG y CT, dos ITS prioritarias que dan lugar a resultados obstétricos y perinata...les adversos.
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