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El objetivo de este artículo es analizar las condiciones de acceso a servicios de salud de las personas con tuberculosis en América
Latina y el Caribe (ALC), reflexionando desde la bioética sobre los aspectos de salud pública implicados. Se realizó una revisión
documental del contexto de la
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tuberculosis en ALC con base en datos epidemiológicos. Los resultados se analizaron a partir de su
relación con los determinantes sociales de la salud, los principios éticos que pautan la práctica médica y la responsabilidad social
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Describir el comportamiento epidemiológico de comorbilidades en
pacientes diagnosticados con tuberculosis de una institución prestadora de servicios
de salud (IPS) de Colombia, durante 2016 a 2019.
Epidemics of infectious diseases are occurring more often, and spreading faster and further than ever, in many different regions of the world. The background factors of this threat are biological, environmental and lifestyle changes, among others. A potentially fatal combination of newly-discovered
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diseases, and the re-emergence of many long-established ones, demands urgent responses in all countries. Planning and preparation for epidemic prevention and control are essential. The purpose of this “Managing epidemics” manual is to provide expert guidance on those responses.
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Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv
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e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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Human activities are driving fundamental changes to the biosphere and disrupting many of our planet’s natural systems. There is increasing scientific evidence that the unfolding climate crisis, global pollution, unprecedented levels of biodiversity loss, and pervasive changes in land use and cover
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threaten nearly every dimension of human health and wellbeing
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t
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o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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Health Policy and Planning, Volume 35, Issue 1, February 2020, Pages 47–57, https://doi.org/10.1093/heapol/czz122
Colombia has an underreporting of 30% of the total cases, according to World Health Organization (WHO) estimations. In 2016, successful tuberculosis (TB) treatment rate was 70%, and t
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he mortality rate ranged between 3.5% and 10%. In 2015, Colombia adopted and adapted the End TB strategy and set a target of 50% reduction in incidence and mortality by 2035 compared with 2015.
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Glob Heart . 2020 Oct 13;15(1):69. doi: 10.5334/gh.891.
India is the world’s second most polluted country. Air pollution shortens average Indian life expectancy by 5 years,
relative to what it would be if the World Health Organization (WHO) guideline fine particulate pollution (PM2.5) of 5 μg/m3 was met. Some areas of India fare much worse than avera
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ge, with air pollution shortening lives by almost 10
years in the National Capital Territory of Delhi, the most polluted city in the world.
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Virtually all (99.9 percent) of Southeast Asia’s 656.1 million people live in areas where particulate pollution exceeds the World Health Organization (WHO) guideline of 5 μg/m³. Despite the lockdowns of the pandemic, pollution continued to rise in much of Southeast Asia in 2020. This pollution c
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uts short the life expectancy of the average Southeast Asian person by 1.5 years, relative to what it would be if the WHO guideline was met. That’s a total of 959.8 million person-years lost to pollution in the eleven countries that make up this region. Some countries in the region experience greater impacts from pollution.
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In Central and West Africa, regions together comprising 27 countries and 605 million people, the average person is exposed to particulate pollution levels that are more than 4 times the World Health Organization’s (WHO) guideline of 5 μg/m³1. If these particulate pollution levels persist, averag
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e life expectancy in the regions would be 1.6 years lower, and a total of 971 million person-years would be lost, relative to if air quality met the WHO guideline. The Democratic Republic of the Congo, Rwanda and Burundi, are the top three most polluted countries in the region.
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Bangladesh is the world’s most polluted country. Air pollution shortens the average Bangladeshi’s life expectancy by 6.9 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m³ was met. Some areas of Bangladesh fare much worse than average, with air poll
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ution shortening lives by nearly 9 years in Dhaka, the country’s most polluted city.
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Pakistan is the world’s fourth most polluted country. Air pollution shortens the average Pakistani’s life expectancy by 3.8 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 Some areas of Pakistan fare much worse than average, with air pol
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lution shortening lives by almost 7 years in the country’s most polluted regions, like Lahore and Peshawar.
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Nepal is the world’s third most polluted country. Air pollution shortens average Nepalese life expectancy by 4.1 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 The highest concentrations of air pollution are observed in Nepal’s southwes
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tern districts, which share their borders with the highly-polluted Indo-Gangetic Plain of India. Here, residents stand to lose nearly 7 years of life expectancy.
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Ocean plastic pollution has reached crisis level: every minute, more than an entire garbage truck of plastic makes its way into the world’s oceans—roughly 11 million metric tons annually. While plastic waste presents an immediate threat to marine wildlife and ecosystems, this global challenge al
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so has implications for major industries such as fishing and tourism, impacting the livelihoods of millions of people. The drivers and impacts of ocean plastic pollution also contribute to global challenges in food security, human health, and climate change.
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Expanding access to quality health services through task sharing
The guideline on Drug misuse: opioid detoxification, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence-based recommendations for healthcare staff on how to work with people who misuse opioids to significantly improve their treatment a
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nd care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.
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