WHO TRS N°1012.
Key updates include: (i) surveillance strategies, including cross-sectoral linking of systems and suitable diagnostics; (ii) the latest recommendations on human and animal immunization; (iii) palliative care in lowresource settings; (iv) risk assessment to guide management of bite... victims; and (v) a proposed process for validation and verification of countries reaching zero human deaths from rabies.
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Module 1
Clinical
July 2017
Module 1: Clinical. This module is for clinicians, including physicians, nurses and clinical officers. It gives an overview of how to provide PrEP safely and effectively, including: screening for substantial risk of HIV; performing appropriate testing before initi...ating someone on PrEP and while the person is taking PrEP; and how to follow up PrEP users and offer counselling on issues such as adherence.
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The WHO health advisory provides guidance to countries on adapting all existing preparedness and response plans and procedures for natural hazards such as cyclones, tropical storms, tornadoes, floods, earthquakes and potential outbreaks of other diseases to their existing COVID-19 strategic prepared...ness and response plans. It advises countries to sustain all established public health and social measures to prevent and control COVID-19 while simultaneously preparing for responding to and effectively manage other disaster risks and events. It highlights WHO’s call for local, national, regional and global solidarity to support countries and communities with high levels of vulnerability to natural hazards during the COVID-19 pandemic.
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea...lth and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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Background: The World Health Organization (WHO) published a clinical case definition of post COVID-19
condition, by a Delphi consensus, on 6 October 2021. That process concluded that a separate definition
may be applicable for children. It is important to understand the frequency, characteristics ...and risk factors
that lead to post COVID-19 condition, along with its impact on everyday functioning and development of
children and adolescents. Long-term outcomes of the condition are currently unknown and need to be
studied. For these reasons, a globally standardized clinical case definition is needed.
Aim: To develop a globally relevant standardized clinical case definition for children and adolescents by
building on the WHO clinical case definition for post COVID-19 condition in adults.
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The technical note by the Global Task Force on Cholera Control (GTFCC) discusses the use of Oral Cholera Vaccines (OCVs) for international workers and travelers in cholera-affected areas. It reviews the effectiveness of WHO-prequalified vaccines (Dukoral®, Shanchol™, and Euvichol®), emphasizing ...their role in preventing infection and reducing transmission risks.
The document highlights concerns about travelers contracting cholera in endemic regions and potentially spreading the disease upon returning home. While the overall risk is considered low, certain groups, such as humanitarian workers and travelers to high-risk areas like South Asia, face a higher exposure.
Recommendations include vaccination for emergency and relief workers who may come into direct contact with cholera patients or contaminated environments. However, routine vaccination for general travelers is not widely recommended. The note also calls for better surveillance and studies to assess the potential of vaccines in preventing international transmission.
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This document is a situation report (#6) from October 2, 2017, describing the cholera outbreak in Yemen. By October 1, 2017, there were 777,229 suspected cholera cases and 2,134 deaths across 22 of Yemen's 23 governorates. The response involves WASH partners providing hygiene supplies and water trea...tment, health cluster partners operating treatment centers, and communication campaigns reaching over 16 million people. Major challenges include limited supplies, security risks hindering access to affected communities, a weakened health system with over 55% of facilities closed or partially functional, and difficulties importing medicines and medical supplies. Children under 18 represent 60% of cases, while people over 60 report the highest death rates.
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The main objective of this mission was to assess the level of preparedness of Guinea-Bissau in respect of the WHO consolidated checklist. The checklist helps countries to assess and test their level of readiness it is being used to identify concrete action to be taken and where countries will requir...e support from partners. It lists 10 key components and tasks for both countries and the international community that should be completed within 30, 60 and 90 days from the date of issue of the list, with minimal requirements for equipment, material and human resources.
The components include: overall coordination; rapid response teams; public awareness and community engagement; infection prevention and control; epidemiological and laboratory surveillance; contact tracing; points of entry; laboratory; social mobilization and risk communication; budget.
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Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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All malaria-endemic countries in the Region of the Americas have taken on the challenge of eliminating malaria and have focused their health programs and strategies on that goal. The risk of emergence of artemisinin resistance in the Americas, the characteristics of P. falciparum parasite, and the e...pidemiological evidence of subnational territories experiencing reintroduction of P. falciparum urge for a call to push for P. falciparum elimination as an intermediate goal of the elimination of all malaria human species. Derived from the elimination of P. falciparum, other important results are expected, such as the empowerment of different actors and entities for the elimination of malaria inspired by the achievements of the elimination of P. falciparum, using early victories as a catalyst. This technical note provides guidance on actions to accelerate P. falciparum elimination in areas close to achieving this goal without compromising unified malaria elimination efforts (P. vivax - P. falciparum), while contributing to the country's ultimate goal of eliminating malaria overall. The acceleration of P. falciparum elimination has several goals: mitigating the risk that resistance to artemisinin and associated drugs will emerge and spread; accelerating the reduction in the total number of malaria cases in areas with a significant proportion of P. falciparum; accelerating malaria elimination (both P. vivax and P. falciparum), considering that P. falciparum is one of the triggers of P. vivax relapses; developing capacities in interventions to accelerate malaria elimination by building on the experience of P. falciparum elimination; and empowering different actors, including high-level authorities, donors, municipalities, and other entities involved in malaria elimination, by inspiring them with the achievements of P. falciparum elimination.
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May 9, 2022.Since the onset of the COVID-19 pandemic, a large number of clinical trials have been planned and developed to assess the effectiveness and safety of various interventions that could prevent hospitalizations and progression to severe disease in people infected with SARS-CoV-2. Currently,... the WHO and the PAHO recommend the use of corticosteroids, tocilizumab, baricitinib, and casirivimab e imdevimab (the latter in seronegative COVID-19 patients) and propose the use of sotrovimab, casirivimab/imdevimab, and molnupiravir in patients with non-severe illness who are at high risk for complications
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This second edition of the Infection prevention and control in the context of coronavirus disease (COVID-19): A living guideline provides the most up to date technical guidance on mask use in community settings in the context of COVID-19.
In this edition, new information includes updated mask re...commendations for children in community settings including updated age specific recommendations, statements for children with disabilities and those at high risk for complications related to COVID-19 infection. Updated implementation considerations for mask use in school settings are also included.
This living guideline is being published using the MAGICApp online publishing platform https://app.magicapp.org/#/guideline/Lr2a8L , as well as in PDF copy on the WHO website.
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Onchocerciasis used to be an important public health problem in Africa, with over 37 million people infected and millions suffering from debilitating skin disease, terrible itching, impaired vision and
blindness. But the epidemiological situation has improved dramatically over the last two decades.... Community directed treatment with ivermectin has effectively brought the disease under control in most endemic areas where onchocerciasis is no longer a public health risk.
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This technical report presents the results of a cross-sectional survey conducted in Sarajevo, the Federation of Bosnia and Herzegovina, Bosnia and Herzegovina, between June and August 2017, as part of the FEEDcities Project (Food Environment Description in cities – eastern Europe and central Asia).... The aim of the report is to describe the city’s local street food and takeaway food environment, exploring the characteristics of food vending sites, the industrially produced and homemade foods they typically offer, and the nutritional composition of these foods. Finally, the report provides guidance on how to address its findings through policy action.
The study was conducted through a bilateral partnership between the World Health Organization (WHO) and the Institute of Public Health of the University of Porto, in collaboration with the Faculty of Medicine, the Faculty of Nutrition and Food Sciences, the Faculty of Pharmacy of the University of Porto (WHO registration 2015/591370 and 2017/698514) and the Institute of Public Health of the Federation of Bosnia and Herzegovina. The study was funded through a voluntary contribution of the Ministry of Health of the Russian Federation, and through a contribution made by the Swiss Agency for Development and Cooperation (SDC)/Swiss Government to a joint WHO/SDC project, “Reducing Health Risk Factors in Bosnia and Herzegovina: Developing and Advancing Modern and Sustainable Public Health Strategies, Capacities and Services to Improve Population Health”, implemented in Bosnia and Herzegovina.
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This report reviews the current situation in relation to national capacity to address NCDs and the progress made at country level over the past decade. It highlights that, while progress is being made, there is still much work to be done to create the infrastructure, policies, surveillance and healt...h systems response that will allow NCDs and their contributing risk factors to be successfully contained and reversed.
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The "Global NCD action plan" provides a road map and a menu of policy options for countries to take in order to attain the 9 voluntary global targets, including that of a 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2...025. The main focus of this action plan is on 4 types of NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes) which make the largest contribution to morbidity and mortality due to NCDs, and on 4 shared behavioural risk factors (tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol).
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This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N...CD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.All ministries of health need to set national NCD targets and lead the development and implementation of policies and interventions to attain them. There is no single pathway to attain NCD targets that fits all countries, as they are at different points in their progress in the prevention and control of NCDs and at different levels of socioeconomic development. However all countries can benefit from the comprehensive response to attaining the voluntary global targets presented in this report.
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It has been over a year since Kenya identified the first case of COVID-19 in the country. The Government formed the National COVID-19 task force, which supported the country's response through multi-sectoral technical working groups on testing, case management, risk communication and community engag...ement among others. An earlier version of the COVID case management guideline was released in April 2020 and capacity building of health care workers on diagnosis and treatment of COVID-19 was quickly carried out, even as counties prepared themselves by setting up isolation centres and supplies
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Diabetes is a major public health problem in the Americas and worldwide, demanding special attention and integrated response. It is estimated that more than 62 million adults are living with diabetes in the Americas. The projections show that diabetes prevalence will continue to increase to at least... 2025. Its steady rise has been mainly due to the high prevalence of risk factors, especially overweight/obesity and physical inactivity. Diabetes also is one of the leading causes of mortality and disability worldwide and across our Region.
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Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis...ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
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