orientaciones provisionales, 23 de abril de 2020
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.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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The WHO Toolkit for the care and support of people affected by complications associated with Zika virus has been developed to serve as a model guide, with the goal of enhancing country preparedness for Zika virus outbreaks. The toolkit is intended to provide a systems approach involving public heal...th planners and managers so that the necessary infrastructure and resources can be identified and incorporated as needed, as well as technical and practical guidance for health care professionals and community workers.
The toolkit includes three manuals to provide countries with tools to effectively recognize people affected by Zika virus and deliver comprehensive care and support:
Manual for public health planners and managers
Manual for health care professionals
Manual for community workers
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The document provides a detailed overview of cholera, including its clinical features, diagnosis, treatment, and prevention. It explains the causes of cholera, its symptoms such as severe diarrhea and dehydration, and the importance of rehydration therapy (oral or intravenous) to reduce mortality. T...he document also emphasizes public health measures, including access to clean water, proper sanitation, and vaccination, as essential strategies to control and prevent cholera outbreaks. It serves as a comprehensive resource for healthcare professionals managing cholera cases and outbreaks.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha...llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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Interim Assessement Report
The EMA review was started by the Agency’s Committee for Medicinal Products for Human Use (CHMP) to support decision-making by health authorities. This first interim report includes information on seven experimental medicines intended for the treatment of people infecte...d with the Ebola virus:
BCX4430 (Biocryst);
Brincidofovir (Chimerix);
Favipiravir (Fujifilm Corporation/Toyama);
TKM-100802 (Tekmira);
AVI-7537 (Sarepta);
ZMapp (Leafbio Inc.);
Anti-Ebola F(ab’)2 (Fab’entech).
The amount of information available for the seven treatments is highly variable. For some compounds there is no data from use in human subjects available. A small number of treatments have been administered to patients in the current Ebola outbreak as compassionate use. Finally, there are also medicines included in this review that have already been studied in humans, albeit for the treatment of other viral diseases.
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Tools and practical guidance for achieving high uptake
La prise en charge de la tuberculose représente un véritable défi en milieu carcéral et l’organisation de la continuité des soins à la sortie un enjeu majeur. Comme tout être humain, les détenus ont le droit de jouir du meilleur état de santé physique et mental possible. Ce droit est gar...anti par l’article 25 de la Déclaration universelle des droits de l’homme adoptée par l’Organisation des Nations Unies, et par l’article 12 du Pacte international relatif aux droits économiques, sociaux et culturels. Ce travail fait un état des lieux sur la prise en charge de la tuberculose en milieu carcéral au Sénégal, depuis les stratégies de dépistage jusqu’à la continuité des soins après la sortie de prison.
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Vol 5 No 27 | ISSN 2039-2117 (online) | ISSN 2039-9340 (print) | The rate of sexual victimization of mentally retarded children is alarming and it goes unnoticed because the perpetrators could be parents, step- parents, relatives, well-respected individuals by family members, neighbours and educator...s. Drawing from labelling theory that the mentally retarded have low IQ, majority of perpetrators tend not to get arrested because of lack of evidence. Research indicates that educators struggle to identify the psychological, behavioural and physical symptoms of sexual abuse owing to their limited training. Having employed systematic review as methodology, this research study found that mentally retarded children are prone to HIV/AIDS, PTSD and feelings of helplessness owing to uninvolvement of parents, dysfunctional communities, poverty and their inability to differentiate between abuse and affection. Based on the findings, the recommendations are that: (1) extensive training for professionals, families and community members be executed to protect children with intellectual disability. Furthermore, the rights of the mentally retarded children must be respected in the court of law when reporting sexual abuse.
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La evolución de los acontecimientos y el esfuerzo conjunto de la comunidad científica mundial, hangeneradogran cantidad de información que se modificarápidamente con nuevas evidencias. Este documento pretende hacer unresumen analítico de la evidencia científica dispo...niblehasta el momento en torno a la epidemiología, características microbiológicas y clínicas del COVID-19.En esta actualización se añaden los hallazgos acerca de la transmisiónen periodo asintomático y a partir de aerosoles y superficies inanimadas, así como las características de los principales grupos de riesgo. Para información relativa a medicamentos relacionados con COVID-19 se puede consultar la web de la Agencia Española del Medicamento y ProductosSanitarios: https://www.aemps.gob.es/
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Infection prevention and control (IPC) practices are of critical importance in protecting the function of healthcare services at all levels and mitigating the impact on vulnerable populations. Although the management of possible COVID-19 cases is usually guided by national policies for specific heal...thcare facilities, community transmission is currently widespread in most EU/EEA countries and the UK, therefore primary healthcare providers in the community such as GPs, dentists and pharmacists are at risk of being exposed to COVID-19.
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Lancet Glob Health 2020Published OnlineNovember 27, 2020 https://doi.org/10.1016/S2214-109X(20)30449-6
Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid di...agnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
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2nd edition. WHO's recommendation has not changed: the standard WHO susceptibility tests should remain a primary method by which resistance is detected. However, it was considered necessary to update the existing resistance-monitoring procedures to also highlight the need for operationally meaningfu...l data.
Two new assays were included in this expanded version: an intensity assay and a synergist assay.
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With this World Health Day, WHO is drawing attention to a group of diseases that are spread by insects and other vectors, the heavy health and economic burdens they impose, and what needs to be done to reduce these burdens. Many of these diseases have been historically confined to distinct geographi...cal areas, but this situation has become more fluid due to a host of ills, including climate change, intensive farming, dams, irrigation, deforestation, population movements, rapid unplanned urbanization, and phenomenal increases in international travel and trade. The control of vector-borne diseases can make a major contribution to poverty reduction, as it precisely targets the poor
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SARS-CoV-2 infections among children and adolescents cause less severe illness and fewer deaths compared to adults. While a less severe course of infection is a positive outcome, there are concerns that mild symptoms may have led to less testing, resulting in fewer identified cases of COVID-19 in ch...ildren. If children with mild or no symptoms transmit the disease, they may act as drivers of transmission within their communities. Understanding symptoms, infectivity and patterns of SARS-CoV-2 transmission in children and adolescents is essential for developing, adapting and improving control measures for COVID-19 across all ages. This is a summary of the current knowledge around SARS-CoV-2 infection acquisition and transmission and COVID-19 disease symptoms in children and adolescents. It aims to inform decisions, based on local contexts, on how to best keep schools, kindergarten and day-care facilities open and what advice to apply to intergenerational mixing.
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