Demographic and epidemiological transitions are changing the age structure of the population and the most common diseases. Non-communicable respiratory diseases are an increasing problem at both ends of the age range in low-income and middle-income countries. In children, who represent a large propo...rtion of the total population, the increasing problem of asthma is a strain on health services. Improved survival of the older population is increasing the proportion of morbidity and mortality attributable to chronic lung diseases. Health services in low-resource countries are poorly adapted to treating chronic diseases. Designed to respond episodically to acute disease, almost all historical investment has focused on infectious diseases. Crucial to the successful management of chronic diseases is an infrastructure designed to support pro-active management, providing not only an accurate diagnosis, but also a secure supply of cost effective drugs at an affordable price. The absence of such an infrastructure in many countries and the market failure that makes drugs generally more expensive in low-resource regions means that many people with chronic non-communicable lung diseases are not given effective treatment. This has damaging economic consequences. The common causes of poor lung health in lowincome countries are not the same as those in richer countries, and there is a need to study why they are so common and how best to manage them.
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Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi. CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical criteria. CHD presents with a myriad of clinical man...ifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%-60%), followed by heart failure (25%-30%) and stroke (10%-15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
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As of 14 December 2021, a total of 19 laboratory-confirmed human rabies cases has been reported in South Africa for 2021. The cases are from Eastern Cape, KwaZuluNatal and Limpopo provinces. In addition, four probable rabies cases were reported from KwaZulu-Natal and the Eastern Cape provinces. A pr...obable case of rabies is defined as a person who has had a history of contact with a suspected or confirmed rabid animal and has developed an acute encephalitis with hyperactivity and paralytic signs and symptoms that progressed and resulted in death, usually by cardiac or respiratory failure, typically within ten days.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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Indian markets caused a stir across the country.1
According to the Centre for Science and the Environment (CSE), a respected New Delhi-based NGO, most honey brands
sold in India contained varying amounts of antibiotics. Their consumption over time could induce resistance to antibiotics,
putting p...eople at risk of treatment failure in case of severe infections.
For the study, 12 samples were picked in Delhi, all well-known brands, including one each from Australia and Switzerland.
Antibiotics found included Chloramphenicol and various broad-spectrum drugs such as Ciprofloxacin and Erythromycin.
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The World Health Organization's fact sheet on diabetes provides an overview of the disease, highlighting its increasing prevalence, particularly in low- and middle-income countries. It outlines the main types of diabetes—Type 1, Type 2, and gestational diabetes—detailing their characteristics an...d risk factors. The document emphasizes the importance of early diagnosis and management to prevent complications such as heart disease, kidney failure, and vision loss. Preventive measures include maintaining a healthy diet, regular physical activity, and avoiding tobacco use. The fact sheet also discusses WHO's initiatives aimed at monitoring, preventing, and controlling diabetes globally.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Heart & Circulatory Diseases (Cardiovascular Disease; CVD)
Heart and circulatory diseases is an umbrella term for all diseases of the heart and circulation. It includes everything from conditions that are inherited or that a person is born with, to those that develop later, such as coronary heart d...isease, atrial fibrillation, heart failure, stroke and vascular dementia.
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The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors ...(cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).
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Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly exi...sting as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil’s disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.
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The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital ...heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
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Emergency assistance needs are anticipated to be atypically high through 2019/20 lean season.
The 2018/19 rainy season was marked by a delayed start of season, below average rainfall, early cessation of rains, and heavy late season rainfall and flooding associated with Tropical Cyclones Desmond, I...dai, and Kenneth.
In most of the south, rainfall was delayed and erratic resulting in a reduction of area planted as well as poor germination, crop establishment, and multiple planting attempts. Additionally, mid-season dryness resulted in poor cropping conditions along with permanent wilting and crop failure in localized areas.
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Our awareness necessity of cystic fibrosis (CF) significantly predates our ability to comprehend the molecular factors that underpin its cause and affect prognosis. The dire warning “Woe to that child which when kissed on the forehead tastes salty. He is bewitched and soon must die” has been cir...culating since the 1800s. CF patients taste salty when kissed because an elevated level of sweat chloride is a hallmark of the disease. If untreated, they rarely make it past their first birthday. Typical presentation also includes failure to thrive caused by pancreatic insufficiency and chronic recurrent chest infections.
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The devastating impacts of the 2015–16 El Niño will be felt well into 2017. This crisis was predicted, yet overall, the response has been too little too late. The looming La Niña event may further hit communities that are already deeply vulnerable. To end this cycle of failure, there is an urgen...t need for humanitarian action where the situation is already dire, to prepare for La Niña later this year, to commit to comprehensive new measures to build communities’ resilience, and to mobilize global action to address climate change which is creating a ‘new normal’ of higher temperatures, drought and unpredictable growing seasons.
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Textes du Codex concernant la résistance aux antimicrobiens d’origine alimentaire
Textos del Codex sobre la resistencia a los antimicrobianos transmitida por los alimentos
Antimicrobial resistance (AMR) is a major global public health concern and a food safety issue. When pathogens become r...esistant to antimicrobial agents they can pose a greater human health risk as a result of potential treatment failure, loss of treatment options and increased likelihood and severity of disease
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Interim Guidance, published 11 January 2021.
The cold chain is necessary to prevent damage to vaccines caused by heat exposure. However, improper use of cold chain equipment may cause damage to freeze-sensitive vaccines (i.e. those vaccines containing alum adjuvant or oil-emulsion adjuvant). Studie...s conducted in several countries with hot and cold climates show frequent occurrences of sub-zero temperatures in the cold chain. The most common cause of exposure to freezing temperature is the failure to correctly condition ice packs prior to transport. Vaccines that are inadvertently frozen lose potency, increase wastage rates and increase the risk of adverse events following immunization (AEFI). Vaccine carriers protect vaccine potency during immunization sessions and transport to outreach sites. This guidance document is intended to help inform which type of vaccine carrier to select based on local context, to maintain vaccine quality, especially at service delivery points.
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The World Health Organization's fact sheet on diabetes provides an overview of the disease, highlighting its increasing prevalence, particularly in low- and middle-income countries. It outlines the main types of diabetes—Type 1, Type 2, and gestational diabetes—detailing their characteristics an...d risk factors. The document emphasizes the importance of early diagnosis and management to prevent complications such as heart disease, kidney failure, and vision loss. Preventive measures include maintaining a healthy diet, regular physical activity, and avoiding tobacco use. The fact sheet also discusses WHO's initiatives aimed at monitoring, preventing, and controlling diabetes globally.
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The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.
The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014.
Diabetes prevalence has been rising more rapidly in middle- and low-income countries.
Dia...betes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
In 2012, an estimated 1.5 million deaths were directly caused by diabetes and another 2.2 million deaths were attributable to high blood glucose.
Almost half of all deaths attributable to high blood glucose occur before the age of 70 years.
WHO projects that diabetes will be the 7th leading cause of death in 2030
Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.
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Development of cardiovascular disease (CVD) is influenced by risk factors such as:
tobacco use, an unhealthy diet, physical inactivity, obesity (which can result from
a combination of unhealthy diet, physical inactivity, and other factors), elevated
blood pressure (hypertension), abnormal blood l...ipids (dyslipidaemia) and elevated blood glucose (diabetes mellitus). Continuing exposure to these risk factors leads
to further progression of atherosclerosis, resulting in clinical manifestations of these diseases, including angina pectoris, myocardial infarction, heart failure and stroke. Total CVD risk depends on the individual’s overall risk-factor profile.
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The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital ...heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
more