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Toolboxes
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1
9 March 2022, Timely and accurate diagnostic testing for SARS-CoV-2 is an essential part of a comprehensive COVID-19 response strategy. Ag-RDTs can be performed by individuals in which they collect their own specimen, perform a simple rapid test and interpret their test result themselves at a time a
...
nd place of their choosing, termed COVID-19 self-testing. This interim guidance provides a new recommendation that COVID-19 self-testing, using SARS-CoV-2 Ag-RDTs, should be offered as part of SARS-CoV-2 testing services. It also includes implementation considerations that can guide decisions on whether, and how, to adopt self-testing in different contexts, including the populations being prioritized; the disease prevalence in that population; and the impact on accessibility of testing, health care services and result reporting.
more
The Lancet Planetary Health Volume 5, ISSUE 7, e466-e478, July 01, 2021
Transmission of many infectious diseases depends on interactions between humans, animals, and the environment. Incorporating these complex processes in transmission dynamic models can help inform policy and disease control int
...
erventions. We identified 20 diseases involving environmentally persistent pathogens (ie, pathogens that survive for more than 48 h in the environment and can cause subsequent human infections), of which indirect transmission can occur from animals to humans via the environment.
more
Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o
...
r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
more
This booklet presents key messages for action, summarized from a set of chapters on different environmental health issues, available at www.who.int/ ceh/publications/healthyenvironmentsforhealthychildren. The work is a result of an on-going partnership between WHO, UNEP and UNICEF in the area of chi
...
ldren’s environmental health, and seeks to update the 2002 joint publication “Children in the New Millennium: Environmental Impact on Health.”
more
There is a broad consensus nowadays that the Earth is warming up as a result of greenhouse gas emissions caused by anthropogenic activities. It is also clear that current trends in the fields of energy, development and population growth will lead to continuous and ever more dramatic climate change.
...
This is bound to affect the fundamental prerequisites for maintaining good health: clean air and water, sufficient food and adequate housing. The planet will warm up gradually, but the consequences of the extreme weather conditions such as frequent
storms, floods, droughts and heat-waves will have sudden onset and acute repercussions. It is widely accepted that climate change will have an impact on the spread of infectious diseases in Europe, which is likely to bring about new public health risks in the majority of cases. Transmission of infectious diseases depends on a number of factors, including climate and environmental elements. Foodborne and waterborne diseases, for instance, are associated with high temperatures. Disease-transmitting vectors (e.g. mosquitoes, sandflies and ticks) are highly sensitive to climate conditions, including temperature and humidity; their geographical distribution will widen as climate conditions change, potentially allowing them to spread into regions where they are not currently able to live.
The primary purpose of this manual on climate change and infectious diseases is to raise the awareness and the level of knowledge of health workers at national, regional and local levels in the former Yugoslav Republic of Macedonia on the health risks associated with climate change and infectious diseases. This manual was devel-
oped as part of the WHO Regional Office for Europe project, Protecting health from climate change: a seven–country initiative, implemented with financial support from the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety.
more
This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their n
...
ewborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
more
Despite its rich culture, great economic potential, high level of education and last but not least its sheer size – it is the largest state whose borders lie entirely within Europe and is 1.7 times the size of the Federal Republic of Germany – Ukraine seems far away in perception and awareness.
...
Publications on recent dramatic events, such as the Ukraine conflict or the Crimea crisis, have done little to change this. In fact, the armed conflict in the eastern Ukrainian oblasts of Donetsk and Luhansk, which has been ongoing since February 2014, is still a burdening feature of many political and economic difficulties destabilizing the country. News coverage of health issues in Ukraine has recently been dominated by highly critical reports on the handling of the Covid 19 pandemic. This pandemic exacerbated existing weaknesses in the Ukrainian health care system, but at least it did not create any new ones.
more
The objective of Health in the Americas: Overview of the Region of the Americas in the Context of the COVID-19 Pandemic is to respond to the need to address important public health issues in an increasingly timely manner, while serving as a platform with a close focus on specific issues of regional
...
importance. This 2022 edition is the second in its new format, providing an overview of the analysis, as well as an in-depth description of the key issues related to COVID-19 in the Region of the Americas. This overview is supported by the Health in the Americas+ virtual platform, which offers interactive resources for data analysis and allows for the comparison of information disaggregated by subregions and countries.
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Liberia: Demographic and Health Survey 2019-2020
Liberia Institute of Statistics and Geo-Information Services (LISGIS) Monrovia, Liberia
The DHS Program ICF
(2021)
C2
The LDHS provides an opportunity to inform policy and provide data for planning, implementation, and monitoring and evaluation of national health programs. It is designed to provide up-to-date information on health indicators including fertility levels, sexual activity, fertility preferences, awaren
...
ess and use of family
planning methods, breastfeeding practices, nutritional status of children, early childhood and maternal mortality, maternal and child health, and awareness and behaviors regarding HIV/AIDS and other sexually transmitted infections. The study also incorporated measurements of HIV, hepatitis B, and hepatitis Cprevalence along with seroprevalence of Ebola virus disease antibodies, the results of which will be included in future addendums. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s 15 counties, and the capital, Monrovia.
more
Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim
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ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in
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health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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Antimicrobial resistance (AMR) is a threat to global health and development and it contributes to millions of deaths worldwide each year. Inappropriate use and overuse of antibiotics are driving an increase in AMR and have a detrimental impact on the effectiveness of these critical medicines. Throug
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h the Global Action Plan on AMR, WHO is working to improve the surveillance of antimicrobial resistance and reduce inappropriate antibiotic consumption.
There is a recognized need for high-quality resources to improve antibiotic prescribing globally. To address this need, a pragmatic approach was taken by WHO to develop actionable guidance for empiric antibiotic use.
The WHO AWaRe (Access, Watch, Reserve) antibiotic book provides concise, evidence-based guidance on the choice of antibiotic, dose, route of administration, and duration of treatment for more than 30 of the most common clinical infections in children and adults in both primary health care and hospital settings. The information included in the book supports the recommendations for antibiotics listed on the WHO Model Lists of Essential Medicines and Essential Medicines Children and the WHO AWaRe classification of antibiotics.
The WHO AWaRe antibiotic book is accompanied by summary infographics for each infection for both adults and children that provide a quick-reference guide for health care workers at the point of care.
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Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes.
This is photomicrograph
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of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
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Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be a
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dded the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
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Arsenical monotherapies were previously very successful for treating human African trypanosomiasis (HAT).
Melarsoprol resistance emerged as early as the 1970s and was widespread by the late 1990s.
Melarsoprol resistance represents the only example of widespread drug resistance in HAT patients wher
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e the genetic mechanism has been established.
The current goal of elimination of HAT as a public health problem by 2020 may be undermined by the emergence and spread of resistance to current or new drugs.
Insights into potential resistance mechanisms for current and new drugs will facilitate predictions of the likelihood of resistance and will also facilitate rational approaches to minimizing, monitoring, and tackling the future emergence of resistance.
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Schistosomiasis is a public health problem in tropical and subtropical regions of Africa, Asia, the Caribbean and South America. It is one of the neglected tropical diseases (NTDs) - a group of diseases and conditions that affect particularly low-income populations, worldwide.
Last year, WHO laun
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ched a new road map for 2021-2030 that aims to end the suffering from NTDs by 2030, in line with the Sustainable Development Goals. The road map specifically targets the elimination of schistosomiasis as a public health problem, globally.
This guideline provides evidence-based recommendations in the following areas: prevalence thresholds, target age groups and frequency of PC, establishment of WASH and snail control activities to support control and elimination of schistosomiasis, diagnostic tests for the assessment of schistosomiasis infection in animal reservoirs, in snail hosts, and in humans.
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Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT
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control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
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The social context of schistosomiasis and its control: an introduction and annotated bibliography
Bruun, B.; Aagaard-Hansen, J.; Watts, S.
World Health Organization WHO; Institutional Repository for Information Sharing iris
(2008)
C_WHO
Schistosomiasis is widely recognized as a disease that is socially determined. An
understanding of the social and behavioural factors linked to disease transmission and
control should play a vital role in designing policies and strategies for schistosomiasis
prevention and control. To this must b
...
e added the awareness that schistosomiasis is
also a disease of poverty. It still survives in poverty-stricken, remote areas where there
is little or no safe water or sanitation, and health care is scarce or non-existent. For
a variety of complex reasons, many of which are addressed in this book, the disease
is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural
China. This concern for human behaviour in an environment of poverty echoes the
concerns of the new research priority for “diseases of poverty” identified by the
Special Programme for Research & Training in Tropical Diseases.
more
Regional implementation framework for elimination of cervical cancer as a public health problem: 2021–2030
recommended
Cervical cancer continues to be a significant public health problem and a major cause of premature mortality among women, disproportionately affecting the socioeconomically disadvantaged population in low- and middle-income countries (LMICs). In the absence of implementing the known evidence-based,
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cost-effective interventions, the number of deaths per year is projected to reach approximately 416 000 globally in 2035. It was estimated in 2020 that 32% of incident cervical cancer cases and 34% of cervical cancer deaths in the world occurred in the 11 Member States of the WHO South-East Asia (SEA) Region. In 2020, 190 874 new cases and 116 015 deaths were estimated due to cervical cancer, which is the third commonest cancer in the Region
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Violence against women and girls is widespread in the Region of the Americas, resulting in enormous consequences for the health and wellbeing of women and girls, their families and communities. These costs are unacceptable and they can be prevented through evidence-based action, including the health
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sector through its policies and protocols, as well as in collaboration with other sectors. This report remains the first of its kind and is a major milestone for the Region. It is specifically informed by the commitments of Member States in the regional Strategy and Plan of Action on Strengthening the Health System to Address Violence against Women. The report provides an analysis of efforts to advance the prevention of violence against women through health policies, clinical protocols, multisectoral plans and related approaches across the Americas. Attention to this topic is timely, as the COVID-19 pandemic has created new visibility for this area of work. This report offers critical information on efforts in the Region that can be learned from and used to build upon in the future to prevent and respond to violence against all women and girls everywhere.
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