Clinical Pharmacology: Advances and Applications, 2025:17 29–47
Le Infezioni in Medicina, n. 1, 3-10, 2019
The Rwanda Malaria Strategic Plan 2020–2024 outlines Rwanda’s national strategy to reduce malaria morbidity and mortality by at least 50% compared to 2019 levels. The vision is a malaria-free Rwanda contributing to socioeconomic development.
The plan includes strengthening prevention through lo...ng-lasting insecticide-treated nets, indoor residual spraying, and larval source management; ensuring universal access to testing and treatment; improving surveillance and data use; and enhancing program management, coordination, and financing. It also emphasizes community engagement and behavior change to ensure at least 85% of the at-risk population adopts protective practices.
The strategy builds on past lessons, involves multi-sectoral collaboration, and aligns with global malaria goals. It highlights equity, quality services, and evidence-based interventions as guiding principles, aiming to mobilize national and international resources for sustained impact.
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The document "Combating False Information on Vaccines: A Guide for Health Workers" is designed to help health workers address vaccine misinformation. It begins by defining misinformation and explaining why it spreads rapidly, often due to its emotional appeal and simplistic explanations. The guide i...dentifies common sources of vaccine misinformation, including influential individuals who profit from spreading false information. The document outlines strategies for combating misinformation, emphasizing the importance of health workers as trusted sources. It provides tips for identifying misinformation online, such as checking URLs, dates, and author credentials, and recognizing tactics like evoking strong emotions or pushing conspiracy theories. Two main approaches to fighting misinformation are discussed: prebunking and debunking. Prebunking involves warning individuals about potential misinformation before they encounter it, while debunking aims to correct false information after it has been consumed. The guide offers practical examples for both methods. Additionally, the document highlights the role of health workers in supporting peers and patients to trust immunization. It suggests being kind, nonjudgmental, and transparent when addressing concerns, and using motivational interviewing techniques to understand and respond to patients' doubts. Overall, the guide emphasizes the critical role of health workers in maintaining trust in vaccines and provides comprehensive strategies to identify, address, and prevent the spread of vaccine misinformation in clinical and community settings. The guide is a valuable resource for health workers to enhance their ability to combat vaccine misinformation, support informed decision-making, and promote trust in vaccines within their communities, and it addresses a pressing issue with practical solutions, supports trusted health workers, and ultimately aims to protect public health by promoting accurate information and trust in vaccines.
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The document "Combating False Information on Vaccines: A Guide for EPI Managers" is designed to help Expanded Program on Immunization (EPI) managers address vaccine misinformation. It begins by defining misinformation and explaining why it spreads rapidly, often due to its emotional appeal and simpl...istic explanations. The guide identifies common sources of vaccine misinformation, including influential individuals who profit from spreading false information. The document outlines strategies for combating misinformation, emphasizing the importance of EPI managers as trusted sources. It provides tips for identifying misinformation online, such as checking URLs, dates, and author credentials, and recognizing tactics like evoking strong emotions or pushing conspiracy theories. Two main approaches to fighting misinformation are discussed: prebunking and debunking. Prebunking involves warning individuals about potential misinformation before they encounter it, while debunking aims to correct false information after it has been consumed. The guide offers practical examples for both methods. Additionally, the document highlights the role of EPI managers in supporting health workers to trust immunization. It suggests being kind, nonjudgmental, and transparent when addressing concerns, and using motivational interviewing techniques to understand and respond to health workers' doubts. The guide also emphasizes the importance of creating a supportive environment for health workers, promoting pro-vaccine norms, and providing continuing education on vaccines. Overall, the guide aims to help EPI managers maintain trust in vaccines and provides comprehensive strategies to identify, address, and prevent the spread of vaccine misinformation in clinical and community settings. This document is necessary to equip EPI managers with the knowledge and tools to combat vaccine misinformation, support their teams, and promote trust in vaccines, ultimately protecting public health.
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Access to safe, effective and quality-assured health products and technologies is crucial for achieving universal health coverage and primary health care goals. The continued growth of the aging population; increasing burden of noncommunicable diseases; growing burden of mental health issues; climat...e change; shifting patterns of vector borne diseases, fungal disease and waterborne diseases; antimicrobial resistance; and new infectious hazards create an ongoing need for equitable access to safe, effective and quality-assured health products and technologies, and renewed investments in research and development for innovative health products and technologies.
The coronavirus pandemic exposed the inequalities in access to health products, highlighting the need for longer-term strategies to strengthen access to health products and technologies outside of and in emergency situations. While technological and scientific advances present an opportunity to increase access to health products and technologies, the risk of increasing inequality due to higher prices for new health products and technologies; the persisting problem of substandard and falsified medical products; a lack of skilled workforce in many low- and middle-income countries; and a lack of data for decisionmaking and for measuring progress present significant challenges.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee...ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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PLoS ONE 15(1): e0228135.
The introduction of “Treat All” (TA) has been promoted to increase the effectiveness of HIV/AIDS treatment by having patients initiate antiretroviral therapy at an earlier stage of their illness. The impact of introducing TA on the unit cost of treatment has been less ...clear. The following study evaluated how costs changed after Namibia’s introduction of TA in April 2017.
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Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis. Web Annex G Abstract
WHO convened the fifth stakeholders meeting on the elimination of HAT due to infection with Trypanosoma brucei gambiense (g-HAT) and Trypanosoma brucei rhodesiense (r-HAT) in Geneva, Switzerland, on 7–9 June 2023. The meeting was held again in person after the coronavirus disease (COVID-19) pandem...ic and jointly for both forms of the disease. The previous meetings on g-HAT held in 2014, 2016 and 2018, as well as on r-HAT in 2015, 2017 and 2019, and jointly for g-HAT and r-HAT in 2021 (8) reinforced the partnership and commitment for HAT elimination and structured the mechanisms of collaboration within the WHO network for HAT elimination. The network includes NSSCPs, groups developing new tools, international and nongovernmental organizations involved in disease control, and donors.
Fewer than 1000 cases of HAT annually have been reported over the past 5 years, which is a historic achievement. The area at risk has been substantially reduced. The elimination of HAT as a public health problem at the global level has been achieved.
The new road map for neglected tropical diseases (NTDs) 2021−2030 (“the road map”) with the target to interrupt the transmission of g-HAT requires the strengthened and sustained efforts of all stakeholders, national authorities and partners, under WHO coordination. It will take disproportionally high efforts and innovative strategies to find the last cases of g-HAT and neutralize its transmission. Given the limited resources and other competing public health priorities, this is a challenge that requires our joint commitment.
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Human strongyloidiasis is a chronic parasitic disease caused by infection with Strongyloides stercoralis, a soil-transmitted helminth that is estimated to infect 300–600 million people worldwide. This neglected tropical disease (NTD) is endemic globally, predominately in the South-East Asia, Afric...an and Western Pacific regions, and in South and Central America. Strongyloidiasis has a wide range of clinical presentations, including subclinical disease, symptomatic disease (often with diarrhoea, abdominal pain and urticaria) and a rare but deadly complication of hyperinfection with disseminated disease. The feared complication of disseminated strongyloidiasis can occur in the setting of immunocompromising conditions (e.g. human T-cell lymphotropic virus type 1 infection and malignancies) or immunosuppressive medications (e.g. steroids) and has an estimated case-fatality rate exceeding 60%. The standard treatment for chronic S. stercoralis infection is oral medication with ivermectin.
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What is high blood pressure in pregnancy?
Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps blood. High blood pressure, or hypertension, is when this force against your artery walls is too high. There are different types of high blood pressure ...in pregnancy:
Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. It sometimes can be severe, which may lead to low birth weight or preterm birth. Some women with gestational hypertension do go on to develop preeclampsia.
Chronic hypertension is high blood pressure that started before the 20th week of pregnancy or before you became pregnant. Some women may have had it long before becoming pregnant but didn't know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. In rare cases, symptoms may not start until after delivery. This is called postpartum preeclampsia. Preeclampsia also includes signs of damage to some of your organs, such as your liver or kidney. The signs may include protein in the urine and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.
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Peripheral artery disease is similar to coronary artery disease (CAD).
Peripheral artery disease is a narrowing of the peripheral arteries that carry blood away from the heart to other parts of the body. The most common type is lower-extremity PAD, in which blood flow is reduced to the legs and fee...t. Upper-extremity PAD (arms, hands and fingers) is less common but affects about 10% of the population.
Both PAD and coronary artery disease are caused by atherosclerosis, the buildup of fatty plaque in the arteries that narrows and blocks them throughout the body, including in the heart, brain, arms, legs, pelvis and kidneys.
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760 WEEKLY EPIDEMIOLOGICAL RECORD, NOS. 51/52, 20 DECEMBER 2024, pp.760-769. In French and English
Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns... of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
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This guide can be used to train medical officers to ensure BP is measured for all adults visiting the OPD, treat all patients with high BP, initiate treatment as per protocol, counsel patients for follow-up, refer patients to local care, and report data.
Factors to take into account when choosing, reviewing and changing medicines.
Rescue therapy:
For symptomatic hyperglycaemia, consider insulin or a sulfonylurea and review when blood glucose control has been achieved.
Diet and lifestyle advice:
At each point reinforce advice about diet and life...style.
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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What is blood pressure?
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is a...t rest, between beats, your blood pressure falls. This is called diastolic pressure.
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