The new WHO recommendations for rabies immunization supersede the 2010 WHO position
on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for rabies. These updated
recommendations are based on new evidence and directed by public health needs that are cost-,
dose- and time-sparing..., while assuring safety and clinical effectiveness. In addition, new guidance on
prudent use of rabies immunoglobulins (RIG) is provided.
The following sections summarize the main points of the updated WHO position as endorsed by the
Strategic Advisory Group of Experts on immunization (SAGE) at its meeting in October 20171. The full
version of the WHO position on rabies vaccines and immunoglobulins will be published in the Weekly
Epidemiological Record2 in April 2018.
Rabies prevention involves two main strategies: (i) dog vaccination to interrupt virus transmission to
humans; and (ii) human vaccination as a series of vaccine administrations before or after an exposure.
Currently, rabies vaccines made from inactivated cell cultures are extremely well tolerated and have no
contraindications.
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Nosocomial or health-facility-acquired infections are a serious issue, representing one of the most significant causes of morbidity and mortality in healthcare systems and consuming many scarce resources, especially in developing countries. Although much has been done, particularly in the hospital s...etting, to reduce the risk of these infections, the problem persists and demands innovative and cost-efficient solutions.
Although the care provided in most primary health care facilities is predominantly ambulatory with few or no inpatient beds, infection prevention is still important to minimize or eliminate the risks of facility-acquired infections and assure quality patient care.
Health facilities and hospitals should have written infection control procedures and guidelines in place and should also be monitoring that these procedures are adhered to in both inpatient and ambulatory care settings.
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This study aimed to determine the drug resistance profile of Mycobacterium tuberculosis in Mozambique and concludes that M. tuberculosis resistance to antituberculosis drugs is high in Mozambique, especially in previously treated patients. The frequency of M. tuberculosis strains that were resistant... to isoniazid, rifampin, and streptomycin in combination was found to be high, particularly in samples from previously treated patients.
J Bras Pneumol. 2014;40(2):142-147
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The thirty-seventh meeting of the Programme, Budget and Administration Committee was held in Geneva from 25 to 27 January 2023 and chaired by Ms Aishath Rishmee (Maldives). The Committee adopted its agenda and agreed its programme of work. In his opening remarks, the Director-General emphasized the ...crucial work on the financial future of the Organization, most significantly implementation of the Programme budget 2022−2023 and development of the Proposed programme budget 2024−2025, which would be the first to benefit from the agreed increase in assessed contributions. He welcomed the work of the Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance with its recommendations for long-term improvements in reform, prevention of and response to sexual abuse and harassment, new web-based information portals and a new replenishment process for consideration by Member States. Efforts were also under way to improve impact at country level, and he would continue to report to Member States on progress. He was heading an agile, proactive and fast-responding WHO, committed to implementing plans approved by Member States.
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Antimicrobial resistance (AMR) is a threat to global health and development and it contributes to millions of deaths worldwide each year. Inappropriate use and overuse of antibiotics are driving an increase in AMR and have a detrimental impact on the effectiveness of these critical medicines. Throug...h the Global Action Plan on AMR, WHO is working to improve the surveillance of antimicrobial resistance and reduce inappropriate antibiotic consumption.
There is a recognized need for high-quality resources to improve antibiotic prescribing globally. To address this need, a pragmatic approach was taken by WHO to develop actionable guidance for empiric antibiotic use.
The WHO AWaRe (Access, Watch, Reserve) antibiotic book provides concise, evidence-based guidance on the choice of antibiotic, dose, route of administration, and duration of treatment for more than 30 of the most common clinical infections in children and adults in both primary health care and hospital settings. The information included in the book supports the recommendations for antibiotics listed on the WHO Model Lists of Essential Medicines and Essential Medicines Children and the WHO AWaRe classification of antibiotics.
The WHO AWaRe antibiotic book is accompanied by summary infographics for each infection for both adults and children that provide a quick-reference guide for health care workers at the point of care.
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Development finance is at a turning point, as the macroeconomic environment has changed profoundly and the financing gap for low- and middle-income countries has widened. The events that led to this new situation are the multiple crises that the global economy is facing, such as the climate crisis, ...the COVID-19 crisis and the war in Ukraine. As a
result, interest rates have risen sharply over the past year and are not expected to decline anytime soon. High interest rates further restrict low- and middle-income countries’ access to international financial markets by making borrowing more expensive. At the same time, debt
levels in several countries are rising to levels that are almost impossible to repay. Poorer countries find themselves in a trap where financing the Sustainable Development Goals (SDGs) becomes a distant goal for them.
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Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and
reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist
yet sadly approximately only 3.2 million children with SAM have access to treatme...nt each year2. Thus, there
is a need to scale up interventions to improve coverage and access across high burden countries. While efforts
are currently underway to expand services in many countries, obstacles remain.
One critical barrier to expanding SAM treatment services is the acceptance, accessibility and utilisation of
ready-to-use therapeutic food (RUTF). In some countries and contexts, RUTF is still not fully accepted by
community members; while other countries face problems with procurement, storage and supply chain
management which impact on availability and use3. Reports from Ghana and Zambia highlighted that stock-
outs and logistical challenges are often noted as key contributors to high default rates in outpatient treatment
centres4.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions... (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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The article "Under- and over-diagnosis of COPD: a global perspective" reviews the worldwide variation in the prevalence of chronic obstructive pulmonary disease (COPD) and issues related to its misdiagnosis. It highlights that COPD is under-diagnosed due to factors such as limited access to spiromet...ry and variable diagnostic criteria, especially in low- and middle-income countries. Conversely, over-diagnosis often results from reliance on non-standard criteria or inadequate spirometry use. The article discusses key risk factors, including age, gender, exposure to pollutants, and comorbidities, and emphasizes the need for standardized diagnostic practices to better address and manage COPD globally.
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The aim of the SATG was to produce a triage scale for use throughout South Africa. The group was multi-disciplinary and comprised doctors, nurses and paramedics. The result of the SATG’s activities is the South African Triage Scale (SATS), a physiology and symptom based scale which prioritises int...o one of four colours and can be used in hospital Emergency Centres as well as in the pre-hospital setting. The SATS has been validated in the public, private health care setting as well as pre-hospital.
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The number of confirmed COVID-19 cases detected and reported in each country is influenced by
many factors including limited access and/or utilization of healthcare and COVID-19 testing, limited
surveillance, lack of knowledge amongst the population about when to seek testing, an asymptomatic pres...entation, and other unknown issues. This is true in all countries of the world, and not Africa specific, however there are factors unique to Africa which may also affect the way the virus behaves there. COVID-19 prevalence data are critical for planning effective mitigation strategies and understandingthe true impact of the disease and relevant intervention measures in Africa, which might be quite different from regions with a different population age distribution or risk factor profile.
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This catalogue serves the purpose of connecting stakeholders from the
energy and health sectors with solutions providers, to help meet the
energy needs of healthcare facilities in response to COVID-19 and
beyond. The solutions provided herein represent a sample of a larger
group of solution prov...iders who can contribute to addressing this
challenge
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The Panorama Perspectives: Conversations on Planetary Health report series aims to inspire new thinking, conversations, and engagement with planetary health and other integrated concepts. Collaboration and open knowledge sharing across sectors are necessary to solve the complex global health and dev...elopment problems of today. These reports are intended as practical tools, presenting actionable opportunities to advance planetary health.Each report expands on knowledge gathered from many sources, including analysis of publicly available reports and data; forums and events; group discussions; and individual conversations
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The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising... poverty contributed to girls’ increased risk of female genital mutilation (FGM). School closures limited the monitoring and reporting of cases of FGM. Rising household monetary poverty may have contributed to families adopting negative coping mechanisms, including having girls undergo FGM as a precursor to marriage to reduce household costs. A report from the United Nations Population Fund (UNFPA) estimates 2 million additional cases of FGM by 2030 due to the pandemic.
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Ethiopia is one of the most vulnerable countries to climate change in East Africa. The future climate change projections suggest that temperature will rise and rainfall variability will increase with high unpredictability. Agriculture is extremely vulnerable to these
changes, with concerns that the... yields of the main cereal crops will be adversely affected.
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Yaws is targeted for eradication by 2030, using a strategy based on mass drug administration (MDA) with azithromycin. New diagnostics are needed to aid eradication. Serology is currently the mainstay for yaws diagnosis; however, inaccuracies associated with current serological tests makes it difficu...lt to fully assess the need for and impact of eradication campaigns using these tools. Under the recommendation of the WHO Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases(NTDs), a working group was assembled and tasked with agreeing on priority use cases for developing target product profiles (TPPs) for new diagnostics tools.
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ECDC launched the HEPSA (Health Emergency Preparedness Self-Assessment) tool, in order to support countries in improving their level of public health emergency preparedness. The tool is worksheet-based and is targeted at professionals in public health organisations responsible for emergency planning... and event management. It consists of seven domains that define the process of public health emergency preparedness and response: 1) Pre-event preparations and governance; 2) Resources: Trained workforce; 3) Support capacity: Surveillance; 4) Support capacity: Risk assessment; 5) Event response management; 6) Post-event review; 7) Implementation of lessons learned.
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BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) r...eleased evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
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Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidance for the CO...VID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges.
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