The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to ...sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler 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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March 2020
The number of African Union Member States reporting COVID-
19 cases is increasing and there is a likelihood of community transmission. The WHO recently modified the COVID-19 suspect case definition to include severe acute respiratory infection and advises testing of all severe acute res...piratory illness (SARI) cases.1 However, many Member States have not yet started implementing these changes, they are still focussing surveillance efforts on individuals with travel history to an area with local COVID-19 transmission. This means patients with similar symptoms, but no apparent contact, may not
be investigated.
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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Did you know that they are part of Antimicrobial Resistance?
Are you clear that we can all do something to avoid them?
Marcelo Barbato, intensive care physician and Director of the ICU at Hospital Maciel, the first public hospital in Uruguay with a long history in infection control, tells us.
Scabies is a contagious skin condition caused by the mite Sarcoptes scabiei which burrows into the skin and causes severe itching. Scabies is transmitted by direct skin-to-skin contact or indirectly by contact with contaminated material (fomites). This condition is often challenging to diagnose as m...any patients may have only subtle symptoms. However, other patients may present with the classic history of exposure, severe pruritis that is worse at night, and reference to other individuals with similar symptoms. This activity reviews the evaluation and treatment of scabies and highlights the role of the interprofessional team in managing patients with this condition.
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A major objective of this open access book is to summarize the current status of Buruli Ulcer (BU) research for the first time. It will identify gaps in our knowledge, stimulate research and support control of the disease by providing insight into approaches for surveillance, diagnosis, and treatmen...t of Buruli Ulcer. Book chapters will cover the history, epidemiology diagnosis, treatment and disease burden of BU and provide insight into the microbiology, genomics, transmission and virulence of Mycobacterium ulcerans. ; Supports further investigation by summarizing state of the art in the field of Buruli ulcer research Enriches understanding of epidemiology of Buruli ulcer in different geographic regions Reviews exhaustively the characteristics of Mycobacterium ulcerans disease
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The objectives of these WHO guidelines are to provide updated evidence- based recommendations for the treatment of persons with hepatitis C infection using, where possible, all DAA-only combinations. The guidelines also provide recommendations on the preferred regimens based on a patient’s HCV gen...otype and clinical history, and assess the appropriateness of continued use of certain medicines. This document also includes existing recommendations on screening for HCV infection and care of persons infected with HCV that were first issued in 2014
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Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia...ry education for fathers (adjusted OR (95% CI); 2.32 (1.71–3.16)) and mothers (1.85 (1.38–2.48)); area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas (2.16 (1.60–2.92)) and (2.79 (1.79–4.35)), respectively; father’s and mother’s history of asthma; children’s own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.
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This document briefly describes the macroeconomic performance before the spread of the coronavirus (COVID-19), which is mainly characterized by severe economic depression, economic and financial sanctions by the Trump administration, and tight fiscal space that constrains to undertake additional mea...sures. It estimates three economic scenarios based on different oil price assumptions for 2020. The negative effects of the quarantine on the economy are estimated using the two biggest shocks faced by Venezuela in its recent history. It emphasizes the relevance of foreign currency and external financing to mitigate the pandemic’s impact. Finally, this paper discusses the economic measures taken by the government.
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Nurses at present are facing various personal, interpersonal, professional, institutional and socio cultural challenges in their professional performance. Dealing with these issues may not be always clear. The lack of one correct approach in addressing different conte...xtual issues may lead to ethical dilemmas. Responding to this complex issues demand nurses to acquire comprehensive ethical knowledge and skills in various decision making process. Although teaching materials have a pivotal role to play in helping nurses in this endeavor, comprehensive books inclusive of all the topics in the curriculum is scarce in Ethiopia. Therefore, this lecture note is prepared to overcome the acute shortage of reference materials reflecting the national context and be used as a teaching material for nurses at various levels. The lecture note is divided in to five units. Unit one of this lecture note deals with the history of nursing, unit two about philosophy of nursing, unit three health and illness, unit four Ethico-legal aspects to nursing, and unit five communication and interpersonal relationships in nursing,
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The article "Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review" examines the financial impact associated with moderate-to-very severe COPD. The review analyzes studies published between 2006 and 2016 that discuss healthcare resource utilization (HRU), di...rect costs, and indirect costs related to COPD, with a focus on Europe and North America. It highlights that direct costs, including hospitalizations and medical treatments, increase with the severity of COPD and the frequency of exacerbations. Multivariate analyses identify key factors driving these costs, such as comorbidities and prior treatment history. The findings underscore the significant economic burden of COPD on healthcare systems and emphasize the need for improved management strategies to reduce costs and optimize patient care.
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Section 3, Management of Men's Reproductive Health Problems, provides information to clinicians and other service providers in diagnosing and managing reproductive health disorders in men. Topics include disorders of the male reproductive system, including infertility and sexually transmitted i...nfections; sexual and reproductive history assessment; and step-by-step instructions for performing a genital examination.
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The Mediclinic article on silicosis provides an overview of this occupational lung disease caused by inhaling silica dust. It explains that inhaled silica particles lead to lung scarring and nodule formation, progressively impairing breathing. The article outlines symptoms such as shortness of breat...h, severe cough, fatigue, loss of appetite, chest pains, and fever. Diagnosis involves a medical examination, detailed occupational history, lung function tests, and imaging like chest X-rays or CT scans to detect lung scarring and nodules. While silicosis is irreversible with no specific cure, management focuses on preventing further silica exposure and treating complications. Preventive measures include maintaining high occupational health standards to control silica dust exposure.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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As slight hints of recovery begin to surface in West Africa, UNICEF is looking at the impact of Ebola on children and the response and work of the affected communities in the report, Ebola: Getting to zero – for communities, for children for the future. The document traces some of the outbreak’s... history along with the stories of survivors, health care workers and those working to make things better on the ground. The report also helps map out the actions that urgently must continue to help build resiliency and resuscitate basic services and systems decimated by Ebola.
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The whole book has 50.3 MB!!!!
To download chapter by chapter:
http://www.uib.no/cih/en/resources/neurology-in-africa
Africa is a vast continent and neurological disorders are a common cause of disability and death. This practical neurology textbook is specifically written for Sub-Saharan Africa.... The aim of this book is for students to gain an understanding of neurology, learn the necessary clinical skills and obtain sufficient knowledge to care for patients presenting with neurological disorders. Diagnosis in neurology is based on accurate history and physical examination and this book emphasizes these principles
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Zika and dengue viruses remain significant public health threats. These viruses share the same Aedes (Stegomyia) mosquito vectors and geographic distributions but infections cannot be readily distinguished clinically and need to be differentiated from each other, and from other circulating arboviral... and non-arboviral pathogens, using laboratory tests. This document provides guidance on current testing strategies for Zika and dengue virus infections with updates to the previous interim guidance for laboratory testing for ZIKV, addressing pregnant and non-pregnant patients respectively, and incorporates current guidance for dengue virus diagnostic testing. The choice of laboratory assays and interpretation of test results require careful consideration of epidemiology, patient history, and limitations of existing diagnostic tests.
This interim guidance is for use by staff of laboratories testing for Zika and dengue virus infections and for clinical practitioners and public health professionals providing clinical management or surveillance.
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The report showed commitments made three decades ago to protect the rights of children remain unfulfilled for millions. Violence still affects countless children. Discrimination based on age, gender, disability, sexual orientation and religion harms children worldwide.
The UN Convention on the Ri...ghts of the Child is the most widely ratified international human rights treaty in history. It has prompted substantial investment in children’s health, education and safety and the adoption of laws and policies that recognise the rights of children, particularly in areas where they are vulnerable, including labour exploitation, corporal punishment, alternative care and forced and early marriage.
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In December 2019 a novel coronavirus (2019-nCoV) was identified as the causative agent of a severe acute respiratory illness among people exposed in a seafood market in Wuhan, China; • Human-to-human transmission has been documented, including in healthcare workers, and aerosol-generating procedur...es (AGP)† may play a role in the spread of the disease; • There are uncertainties in the natural history of the 2019-nCoV, including source(s), transmissibility mechanisms, viral shedding, and persistence of the virus in the environment and on fomites; • As of 6 February 2020, the following precautions are recommended for the care of patients with suspected or confirmed cases of 2019-nCoV: o For any suspected or confirmed cases of 2019-nCoV: standard + contact + droplet precautions o For any suspected or confirmed cases of 2019-nCoV and AGP: standard + contact + airborne precautions • The use of personal protective equipment (PPE) by healthcare workers requires an evaluation of the risk related to healthcare-related activities;
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