PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data collection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in ...all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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The new WHO guidelines provide recommended steps for safe phlebotomy and reiterate accepted principles for drawing, collecting blood and transporting blood to laboratories/blood banks.
This publication articulates the WHO Botswana Country Office’s focus and investment needs for the biennium 2022–2023, building on achievements, networks, and partnerships fostered in 2020-2021.
As the leading health authority within the United Nations system in Botswana, the WHO Country Offi...ce has been at the forefront of supporting the government to improve health since 1996. The WHO Country Office supports the Ministry of Health in realizing the health goals the Government of Botswana defines. Acknowledging that as an upper middle-income country, Botswana provides the bulk of its resources for implementing health programmes, the WHO directly brings technical expertise to the table by collaborating with relevant partners. Where the country office has limitations in terms of human resources with the requisite expertise to answer the country’s needs, the regional level and headquarters of the WHO will be mobilized to provide the necessary support.
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The international community sits at the tipping pointof a post-‐antibiotic era, where common bacterial infections are no longer treatable with the antibiotic armamentarium that exists. In South Africa, t...he identification of the first case of pan-‐resistant Klebsiella pneumoniae(Brink et al, J Clin Microbiol. 2013;51(1):369-‐72) marks a watershed moment and highlights ourtip of the antibiotic resistance ‘iceberg’ in this country. Multi-‐drug resistant (MDR)-‐bacterial infections, predominantly in Gram-‐negative bacteria such as Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosaand Acinetobacter baumanniiare now commonplace in South African hospitals. Whilst a number of expensive new antibiotics for Gram-‐positive bacterial infections have been manufactured recently (some of which are licenced for usein South Africa), no new antibiotics active against Gram-‐negative infections are expected in the next 10-‐15years. Hence what we have now, needs conserving
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To provide supply & equipment to collect, test and transfuse 50 blood bags.
The new Collection testing and transfusion kit 2021 is specially designed for emergency settings where blood transfusion is crucial. It contains all the necessary supply & equipment needed to collect blood, test it agains...t HIV, Malaria, Hep B and C, and syphilis, make sure of the blood grouping, and ensure transfusion.
The equipment such as blood bags, IV transfusion set and vacutainer blood collection tubes are from BD or Fresenius Kabi, also available as single item in the WHO catalogue.
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The Ministry of Health conducted STEPS surveys on adult risk factors surveillance in Myanmar in 2003, 2009 and 2014. Amongst these three surveys, the 2014 one is the most comprehensive, providing an analysis of all States and Regions within Myanmar through not only questionnaires and physical measur...ements – STEPs 1 and 2 of the survey – but also with data obtained through biochemical measurements (STEP 3).
The STEPS survey was initiated by the Ministry of Health in December 2014 with the technical support of WHO Headquarters, regional and country offices.
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communicable Disease Toolkit
Plan Benin used the Integrated Management for Child Illnesses (IMCI) framework in creating the project "Collaborative Approach to Community based Malaria Prevention.” The project targeted 20 pilot villages in the communes of Aplahoué and Djakotomey, with the goal of reducing maternal and infant m...ortality related to malaria in the Couffo district. In order to assess the effects of the project on the beneficiary communities, the evaluation was initiated to measure the progress and the perfomance outcomes achieved at the end of the pilot stage. The evaluation was conducted from March to April 2009.
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A manual for impact assessments. The SCH Practical and Precision Assessment (SPPA) strategy is an evidence-based approach for conducting impact assessments for SCH. The SPPA was identified by programme managers and SCH experts from the African region as a feasible and sufficiently accurate approach ...after reviewing and discussing the results of a multi-country study. This manual describes the resulting Practical and Precision Assessments approach and includes a discussion of the underlying concepts, factors to consider when determining what approach is appropriate, and how to interpret the collected data. The manual also includes annexes with standard operating procedures for conducting the stool and urine analyses.
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East and West Hararghe zones are located within Oromia region, one of the largest and most populated regions of Ethiopia. Like many parts of Oromia and the country, over 80% of the people in East and West Hararghe rely on agricultural livelihoods. This baseline survey target districts are Babile, an...d Kersa in East Hararghe, and Mieso woreda in West Hararghe zone. Babile woreda has a population of 117,682 residing in 22 kebeles. The woreda hosts 14, 545 displaced households from neighboring region Somali. Kersa woreda bordered on the south by Bedeno, on the west by Meta, on the north by Dire Dawa, on the northeast by Haro Maya, and on the southeast by Kurfa Chele. The woreda has a population of 243,544 peoples residing in 38 kebeles and it has hosted 874 household IDPs displaced from Somali region. Mieso woreda is bordered on the south by Guba Koricha, on the west by the Afar Region, on the north by the Somali Region, on the east by Doba and on the southeast by Chiro. It has a total population of 130,709.
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An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone. J Basic Clin Pharma 2015;6:109-14.