This module is part of the WHO series The Immunological Basis for Immunization, which was initially developed in 1993 as a set of eight modules, comprising one module on general immunology and seven modules each devoted to one of the vaccines recommended for the Expanded Programme on Immunization, i....e. vaccines against diphtheria, measles, pertussis, polio, tetanus, tuberculosis and yellow fever. Since then, this series has been updated and extended to include other vaccines of international importance. The main purpose of the modules is to provide national immunization managers and vaccination professionals with an overview of the scientific basis of vaccination against a range of important infectious diseases. The modules developed since 1993 continue to be vaccine-specific, reflecting the biological differences in immune responses to the individual pathogens and the differing strategies employed to create the best possible level of protection that can be provided by vaccination. The modules also serve as a record of the immunological basis for the WHO recommendations on vaccine use, published in the WHO vaccine position papers.*
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Nearly half the population of Sierra Leone is under the age of 18 years and the impact of the Ebola crisis on their lives now and on their future opportunities has been far-reaching: no school; loss of family members and friends to the virus; and changing roles and responsibilities in the home and t...he community.
While the priority now remains meeting the goal of zero cases, the Government of Sierra Leone (GoSL) is also developing a comprehensive strategy aimed at supporting communities to recover from this crisis, to put the country back on track to meet development targets. The Ebola Recovery Strategy – currently being finalised by the GoSL – represents a potentially transformative framework to support the immediate recovery of children from the crisis and to ensure their place in the future development of Sierra Leone.
To date, there has not been a formal process for children to outline their own priorities for recovery to decision-makers. In mid-March 2015, child-centred agencies conducted a Children’s Ebola Recovery Assessment (CERA) in nine districts across Sierra Leone to create a mechanism for more than 1,100 boys and girls, to discuss issues of concern; assess the impact of the crisis on their roles, responsibilities and future opportunities; and to formulate their recommendations for recovery.
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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cance...r and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
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Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures—and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, informa...tion will be needed to support a potential campaign to promote vaccination.
Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects.
Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile.
Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies.
Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
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Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f...or developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
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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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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of... Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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For the purpose of this document, Interprofessional is defined as: Multiple health disciplines with diverse knowledge and skills who share an integrated set of goals and who utilize interdependent collaboration that involves communication, sharing of knowledge and coordination of services to provide... services to patients/clients and their care-giving systems. This best practice guideline, Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes is intended to foster healthy work environments. The focus in developing this guideline was identifying attributes of interprofessional care that will optimize quality outcomes for patients/clients, providers, teams, the organization and the system. This guideline identifies best practices to enable, enhance and sustain teamwork and interprofessional collaboration, and to enhance positive outcomes for patients/clients, systems and organizations. It is based on the best available evidence; where evidence was limited, the recommendations were based on the consensus of expert opinion.
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The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the ...move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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The Sustainable Development Goals (SDGs) aim to transform our world. They are a call to action to end poverty and inequality, protect the planet, and ensure that all people enjoy health, justice and prosperity. It is critical that no one is left behind. In 2015, all the countries in the United... Nations adopted the 2030 Agenda for Sustainable Development. It sets out 17 Goals, which include 169 targets. These wide-ranging and ambitious Goals interconnect. SDG 3 is to ensure healthy lives and promote well-being for all at all ages. It has 13 targets measured through 26 indicators. However, a person’s health and well-being are affected not only by disease and treatment, but also by social and economic factors such as housing, poverty and education. Health targets can therefore also be found across the other SDGs. This fact sheet shows how alcohol consumption undermines commitments to achieve 13 of the 17 SDGs, impacting on a range of health-related indicators, such as child health, infectious diseases and road injuries as well as much broader range of indicators related to economic and social development, environment and equality. The inclusion of a specific target on harmful use of alcohol (SDG 3.5: strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol) into the SDGs demonstrates the key role of alcohol within the global development agenda. The factsheet highlights positive examples of Member States’ experiences. It provides a short overview of the most cost-effective and feasible policy recommendations to reduce alcohol consumption and alcohol-attributable burden in the WHO European Region, in line with the European Action Plan to Reduce the Harmful Use of Alcohol. It also suggests some important resources for Member States. This factsheet was launched as part of the European Awareness Week on Alcohol Related Harm 2020.
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Diabetic foot ulcers are a complication affecting approximately 15% of the total population with diabetes mellitus. There are three and half million diabetic patients in Saudi Arabia alone. Aim: to determine capacity building for nurses’ knowledge and practice regarding prevention of diabetic foot... complications. Research Questions: 1. Does the nurse’s knowledge prevent diabetic foot ulcer and other foot complications? 2. Does the high practice of the nurses during foot screening can prevent diabetic foot ulcer in primary health care centers in Saudi Arabia? Design: Descriptive, research designs have been utilized. Setting: Chronic disease clinic in primary health care centers in Jeddah city. Subjects: a purposive sample of 30 nurses and convenience sample of 30 patients. Tools: A. Diabetic foot ulcer Structured interview questionnaire to assess nurse’s knowledge regarding diabetes mellitus and diabetic foot. B. Health status assessment questionnaire to assess health history status of diabetic client. C. An observational checklist to assess the nurse practice once during diabetic foot screening. Results: Significant increase in nurse's knowledge had been observed, while the majority of them had poor practice in relation to foot screening. Whereas complicated diabetic patients represent 35.7% of diabetic patients have neuropathy. Moreover, only 7.1% have neuropathy and diabetic ketoacidosis. Also there was a significant moderate positive correlation between the overall score of nurse’s knowledge and the overall score of the practice regarding diabetic foot complications. Conclusions: Proper foot care, early recognition and management of risk factors prevent foot ulcer. Recommendations: Developing a structured training educational program for nurses dealing patients with diabetic foot disorders.
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History has shown that governments tend to deprioritize environmental commitments during times of financial and public crises as they work to mitigate immediate needs—and the age of COVID-19 has been no different. Even though human interaction with wildlife is believed to be the cause of the pande...mic, the focus on COVID’s fallout has deprioritized the importance of reversing the damage humans have done to the planet.
COVID has had a multifaceted and detrimental effect on environmental conservation. Not only has funding been diverted to deal with the pandemic, conservation-oriented organizations are operating with minimal staff or have closed entirely. People whose daily work it is to advance environmental science and protect the land and water have become ill or have been forced to stay home because of travel restrictions. Plastic use is at an all-time high.
The good news is that there is an unprecedented opportunity for philanthropy to recharge the effort to protect the planet. This Giving Smarter Guide examines the state of environmental philanthropy, and provides an overview of potential strategic starting points for philanthropy and impact capital to play a role in saving the planet. In addition to offering recommendations specific to the COVID-19 response, the Center for Strategic Philanthropy also asks the questions that philanthropists should consider at the start of their journey into the field of conservation philanthropy.
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Q5.SCOPING QUESTION: In individuals with psychotic disorders (including schizophrenia) who require long-term antipsychotic treatment, what is the safety and role of depot antipsychotic medication?
Malgré les progrès récents vers la mise au point d’un traitement hautement efficace et abordable contre le virus de l’hépatite C, beaucoup de personnes infectées par ce virus ne connaissent pas leur statut. L’Organisation mondiale de la Santé (OMS) estime qu’en 2019, 58 millions ...de personnes à travers le monde étaient atteintes d’une infection chronique par le virus de l’hépatite C, et qu’à peine 21 % d’entre elles avaient été diagnostiquées. Le défaut de sensibilisation, l’accès limité aux services de dépistage et de traitement, la stigmatisation, la discrimination et d’autres obstacles structurels contribuent au faible taux d’utilisation des services de dépistage du virus de l’hépatite C.
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Almost all populations are consuming too much sodium. The global mean intake of adults is 4310 mg/day sodium (equivalent to 10.78 g/day salt). This is more than double the World Health Organization recommendation for adults of less than 2000 mg/day sodium (equivalent to < 5 g/day salt).
- The prima...ry health effect associated with diets high in sodium is raised blood pressure, increasing the risk of cardiovascular diseases, gastric cancer, obesity, osteoporosis, Meniere’s disease, and kidney disease.
- An estimated 1.89 million deaths each year are associated with consuming too much sodium
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Это временное руководство было разработано на основе рекомендаций Стратегической консультативной группы экспер-тов (СКГЭ) по иммунизации на ее внеочередном засе...ании 15 марта 2021 г. (
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