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Due to the particular Amazonian situation of vectorial transmission based mostly on the wild cycle of Trypanosoma cruzi with diversity of triatomine vectors involved in effective transmission, and the variety of eco-epidemiological situations that facilitate such transmission, the countries of the A
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mazon agreed that the development and strengthening of preventive actions based on comprehensive surveillance and detection of effective vectorial transmission, based on mandatory notification of acute or chronic cases, was required. In addition, it was recommended that surveillance and prevention and/or vector control actioDue to the particular Amazonian situation of vectorial transmission based mostly on the wild cycle of Trypanosoma cruzi with diversity of triatomine vectors involved in effective transmission, and the variety of eco-epidemiological situations that facilitate such transmission, the countries of the Amazon agreed that the development and strengthening of preventive actions based on comprehensive surveillance and detection of effective vectorial transmission, based on mandatory notification of acute or chronic cases, was required.
more
Policy Brief November 2021 Available in English, Spanish and Portuguese
The COVID-19 pandemic has fueled the ongoing antimicrobial resistance (AMR) global crisis due to the increase in the use of antibiotics to treat COVID-19 patients, disruptions to infection prevention and control practices in o
...
verwhelmed health systems, and diversion of human and financial resources away from monitoring and responding to AMR threats. Moreover, AMR is likely to have caused more COVID-19 deaths, as secondary bacterial infections can worsen the outcome of severe and critical COVID-19 illness. Therefore, it is more urgent than ever to prioritize efforts towards AMR containment and support countries to improve the detection, characterization and rapid response to emerging AMR.
more
Laboratory testing for the monkeypox virus
recommended
Any individual that meets the suspected case definition of monkeypox should be offered testing in appropriately equipped laboratories by staff trained in the relevant technical and safety procedures. Confirmation of monkeypox virus infection is based on nucleic acid amplification testing (NAAT), usi
...
ng real-time or conventional polymerase chain reaction (PCR), for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing. The recommended specimen type for laboratory confirmation of monkeypox is skin lesion material, including swabs of lesion surface and/or exudate, roofs from more than one lesion, or lesion crusts.
more
Pakistan is on the verge of a public health disaster as a result of the massive monsoon rainfalls and unprecedented levels of flooding that are affecting 33 million people across the country.
The risk of disease outbreaks is extremely high and malnutrition rates are rising.
WHO requires US$ 81.5 m
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illion to respond to this health crisis in flood-affected Pakistan, to ensure a coordinated delivery of essential health care services, efficient management of severe acute malnutrition, and stronger outbreak detection and control.
more
These guidelines provide updated evidence-based recommendations on the priority HCV-related topics from the 2018 WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C infection and the 2017 WHO Guidelines on hepatitis B and C testing. These priority areas are:
...
direct-acting antiviral (DAA) treatment of adolescents and children ages ≥3 years of age
simplified HCV service delivery (decentralization, integration and task sharing)
HCV diagnostics – use of point-of-care (POC) HCV ribonucleic acid (RNA) assays and reflex HCV RNA testing.
These guidelines also update existing chapters without new recommendations, such as the inclusion of new manufacturers’ protocols on the use of dried blood spot (DBS) for HCV RNA testing and new data to inform the limit of detection for HCV RNA assays as a test of cure, in addition to their use for diagnosis.
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The Global Task Force on Cholera Control (GTFCC) launched Ending Cholera: A Global
Roadmap to 2030 (Global Roadmap) (1), a strategy that aims to reduce global cholera
deaths by 90% and eliminate the disease in at least 20 countries by 2030. It is
organized according to three main axes:
• E
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nsuring early detection and response to contain outbreaks; (2)
• Adopting a multisectoral approach to prevent and control cholera in hotspots; and
• Establishing an effective coordination mechanism for technical support, resource
mobilization and partnership at local and global levels.
more
Le Groupe spécial mondial de lutte contre le choléra (GTFCC) a lancé Mettre fin au choléra : Une feuille de route mondiale pour 2030 (la Feuille de route mondiale. Cette stratégie vise à réduire de 90 % le nombre de décès dus au choléra dans le monde et à mettre fin à la maladie dans a
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u moins 20 pays d’ici 2030. Elle est organisée selon trois axes principaux :
• assurer une détection et une réponse précoces pour contenir les épidémies
• adopter une approche multisectorielle pour prévenir et contrôler le choléra dans les
points chauds
• mettre en place un mécanisme de coordination efficace de l’appui technique, la
mobilisation des ressources et des partenariats aux niveaux local et mondial.
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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
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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.
more
April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t
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he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 117: e200460, 2022
Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness
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, increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.
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This guideline for the prevention and control of chikungunya fever
(CF) is intended for use by all peripheral health workers in the Region and
is based on the strategy outlined above. This document will focus mainly
on preventing, predicting and detecting outbreaks, and after
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detection,
investigating and containing them.
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Dengue is the fastest spreading, mosquito-borne viral infectious disease worldwide, with remarkable morbidity and mortality. In the past decades, profound contributions have been made towards understanding its epidemiology, including disease burden and distributions, risk factors, and control and pr
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evention practices. Dengue continues to disseminate to new areas, including high latitude regions, and a new serotype (dengue virus serotype 5) has been identified. Vaccine research has made new progress, in which the licensed yellow fever and dengue virus quadrivalent chimeric vaccine is now under further safety assessment. In disease surveillance, because of its operational simplicity, rapidity, capability, and utility as an indicator of disease severity, dengue virus NS1 antigen detection has great promotion and application value among primary health care institutions. Vector control progress has driven new breakthroughs in biotechnology, including Wolbachia-infected Aedes and genetically modified Aedes. Both Aedes variants have been used to block transmission of the dengue virus through population replacement and suppression. In the future, vector control should still be pursued as a key measure to prevent transmission, along with anti-viral drug and vaccine research.
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To assess national-level responses to NCDs, WHO has implemented NCD country capacity surveys periodically since 2001. This report is the latest in that series. Since the first survey round, the NCD Country Capacity Survey (NCD CCS) has been conducted a further seven times, most recently in 2021. In
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the survey, completed by the NCD focal point within each country’s ministry of health or similar agency, countries are asked to report on the following topics relating to NCDs: (i) public health infrastructure, partnerships and multisectoral collaboration; (ii) policies, strategies and action plans; (iii) health information systems and surveillance; (iv) health system capacity for detection, treatment and care; and, added for 2021, (v) the impact of the COVID-19 pandemic on NCD-related resources and activities. The questionnaire is web-based and requires supporting documentation wherever possible. In the 2021 round, data were collected from May onwards, with the last survey responses arriving in September. Validation was carried out by WHO regional offices and WHO headquarters. Country responses to previous rounds of the survey were incorporated into the analysis to assess progress since 2010. Although all 194 Member States responded to the survey, data comparisons were restricted to the 160 countries that had responded to all rounds of the survey since 2010.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog
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nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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The UNHCR Cholera Response Plan (October 2022 – March 2023) outlines efforts to combat the cholera outbreak in Lebanon, which was declared in October 2022. The plan, led by the Ministry of Public Health with support from UNHCR, WHO, UNICEF, and NGOs, focuses on prevention, response, and surveillan
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ce. Key actions include oral cholera vaccination campaigns, rapid diagnostics, strengthening healthcare facilities, and improving hygiene and sanitation in high-risk refugee settlements and collective shelters. The response also emphasizes risk communication and community engagement to raise awareness and ensure early detection. The plan targets 120,000 individuals and requires $8.5 million in funding to provide life-saving support and containment measures.
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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant
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imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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Prompt, effective antimalarial treatment, and supportive care can substantially reduce the rate of mortality from severe malaria. However, many children in malaria-endemic countries do not have access to health facilities or a qualified health care provider and do not receive the necessary care in a
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timely fashion. Without rapid detection of danger signs and access to effective treatment, including pre-referral treatment that can be administered in the community level, many of these children with severe malaria die.
In situations where there is no immediate access to a health care facility, WHO recommends the administration of a standard dose of an effective antimalarial medicine as pre-referral treatment before referral to a facility at which complete treatment can be administered.
Rectal artesunate is the WHO-recommended pre-referral intervention in situations where artesunate injection are not feasible for children under the age of 6 years with suspected severe malaria. The intervention reduces the risk of death or permanent disability by up to 50% provided the child is referred to a health facility at which complete treatment can be administered.
This field guide is aimed at supporting the effective deployment of RAS as pre-referral treatment of suspected severe malaria in line with the WHO malaria guidelines.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
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3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del
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ivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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How to Improve Awareness, Treatment, and Control of Hypertension in Africa, and How to Reduce Its Consequences: A Call to Action From the World Hypertension League
Parati, G.; Lackland, G.T.; Campbell, N.R.C. et al.
Hypertension Volume 79, Issue 9, September 2022; Pages 1949-1961
(2022)
CC
Hypertension is the leading preventable risk factor for cardiovascular diseases and disability globally. In low- and middle-income countries hypertension has a major social impact, increasing the disease burden and costs for national health systems. The present call to action aims to stimulate all A
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frican countries to adopt several solutions to achieve better hypertension management. The following 3 goals should be achieved in Africa by 2030: (1) 80% of adults with high blood pressure in Africa are diagnosed; (2) 80% of diagnosed hypertensives, that is, 64% of all hypertensives, are treated; and (3) 80% of treated hypertensive patients are controlled. To achieve these aims, we call on individuals and organizations from government, private sector, health care, and civil society in Africa and indeed on all Africans to undertake a few specific high priority actions. The aim is to improve the detection, diagnosis, management, and control of hypertension, now considered to be the leading preventable killer in Africa.
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