Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric...t and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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Large-Scale UN Response Needed to Address Health and Food Crises
This report is based on interviews with more than 150 health care professionals, Venezuelans seeking or in need of medical care who recently arrived in Colombia and Brazil, representatives from international and nongovernmental humani...tarian organizations. In addition, researchers analyzed data on the situation inside Venezuela from official sources, hospitals, international and national organizations, and civil society organizations.
We found a health system in utter collapse with increased levels of maternal and infant mortality; the spread of vaccine-preventable diseases, such as measles and diphtheria; and increases in numbers of infectious diseases such as malaria and tuberculosis (TB). Although the government stopped publishing official data on nutrition in 2007, research by Venezuelan organizations and universities documents high levels of food insecurity and child malnutrition, and available data shows high hospital admissions of malnourished children.
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Since 2000, concerted efforts by national programmes, supported by public–private partnerships, nongovernmental organizations, donors and academia under the auspices and coordination of the World Health Organization (WHO), have produced important achievements in the control of human African trypan...osomiasis (HAT). As a consequence, the disease was targeted for elimination as a public health problem by 2020. The Sixty-sixth World Health Assembly endorsed this goal in resolution WHA66.12 on neglected tropical diseases, adopted in 2013.
National sleeping sickness control programmes (NSSCPs) are core to progressing control of the disease and in adapting to the different epidemiological situations. The involvement of different partners, as well as the support and trust of long-term donors, has been crucial for the achievements.
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A global hunger crisis -- fuelled by conflict, economic turbulence and climate-related shocks -- has been exacerbated by the COVID-19 pandemic. The number of people experiencing food insecurity and hunger has risen since the onset of the pandemic. The IRC estimates that the economic downturn alone w...ill drive the number of hungry people up by an additional 35 million in 2021. Without drastic action, the economic downturn caused by COVID-19 will suspend global progress towards ending hunger by at least five years.
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Sudan has a long history of hosting refugees and asylum seekers with 991,787 individuals, 51 per cent female and 53 per cent children, expected to live in Sudan by the end of 2020.
Annual Household Survey 2015/16 is the forth survey of its kind. These annual surveys are conducted to provide estimations of some major socio-economic indicators on annual basis which would not be possible with other periodic surveys like Nepal Labour Force Surveys (NLSS) and Nepal Living Standard ...Surveys (NLSS) which are undertaken at longer intervals. The survey basically aims to provide estimates of consumption by sex, urban-rural area and by consumption quintiles/deciles. Although the major thrust of Annual Household Survey is on consumption and employment situations, other sectors like education, housing and housing facilities and demographic characteristics are also included. As this year NLSS survey is conducted so, this survey does not contain information on employment situation as in previous annual household surveys.
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Long-lasting insecticidal nets (LNs) constitute a core vector control intervention against malaria. A number of new LN products are under development and will require assessment of risks to humans. This document provides an updated generic model that can be used for the risk assessment of exposure t...o insecticides of individuals sleeping under LNs and during the washing of nets.
In an Annex, exposures and health risks are described for the conventional treatment or retreatment of nets (ITNs) with an insecticide considering that such practices may still be used in evaluation of ITNs and their use. The generic model does not include the risks associated with the manufacturing of LNs in a factory environment.
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Climate change presents the single biggest threat to human development, and its widespread impacts disproportionately burden the poorest and most vulnerable households in fragile and rural developing contexts – particularly women and children.
According to the Intergovernmental Panel on Climate C...hange’s (IPCC) latest report, ‘between 2010 and 2020, droughts, floods and storms killed 15 times as many people in highly vulnerable countries, particularly in Africa — which is responsible for less than 3 percent of global emissions – than in the wealthiest countries’.
Recognising environmental degradation and climate change are key accelerators of extreme child vulnerability, World Vision (WV) approved the Environmental Stewardship Management Policy (‘the Policy’) and Guidelines (‘the Guidelines’) in 2021.
To support the implementation of the Policy and Guidelines, WV has developed this Environmental Stewardship and Climate Action Handbook (‘the Handbook’) to help offices across the WV Partnership implement best practice environmental management strategies both in the field and in our operations and facilities.
Integrating environmental stewardship and climate action into all our work – whether that be in our Area Programmes, grant projects, responses to disasters or advocacy – is critical to achieving WV’s strategy.
As a Christian organisation we are compelled to follow the ways of Jesus Christ, calling us to care for the ‘least of these’ (Matthew 25:40) – the vulnerable children who are disproportionately impacted by climate change. Our response to the degradation of the environment is not motivated by political expediency or funding – but because we are called to steward God’s creation (Genesis 1:28).
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India is experiencing rapid demographic and epidemiological transitions with NCDs causing significant disability, morbidity and mortality both in urban and rural populations and across all socioeconomic strata. According to the ICMR State Level Disease Burden Initiative, in 2016, NCDs accounted to a...n estimated 6.0 million deaths, constituting 62% of the total mortality of that year.
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Since the last situation report on the multi-country outbreak of cholera was published on 6 July 2023 (covering data reported until 15 of June), and as of 15 July 2023, one new outbreak of cholera was reported from India on 15 May 2023. In total, 25 countries have reported cases since the beginning ...of 2023. The WHO African Region remains the most affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high.
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The third edition, released in 2018, has grown to include a total of 18 chapters, contributed by 20 experts and authors from many countries. The goal remains the same: to educate primary care providers on the best practices in TB diagnosis, treatment and follow-up. All articles are richly illustrate...d, and most include quizzes and CME questions for self learning. The 3rd edition includes new chapters on MDR-TB, adverse effects of TB drugs, adherence monitoring strategies, and nutritional support. There is also content on how to manage children with TB, care for patients co-infected with TB and HIV, how to read and interpret chest x-rays, and how to avoid common pitfalls in TB management.
To download book chapters or the whole book go to the website: http://www.letstalktb.org/download/
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May 9, 2022.Since the onset of the COVID-19 pandemic, a large number of clinical trials have been planned and developed to assess the effectiveness and safety of various interventions that could prevent hospitalizations and progression to severe disease in people infected with SARS-CoV-2. Currently,... the WHO and the PAHO recommend the use of corticosteroids, tocilizumab, baricitinib, and casirivimab e imdevimab (the latter in seronegative COVID-19 patients) and propose the use of sotrovimab, casirivimab/imdevimab, and molnupiravir in patients with non-severe illness who are at high risk for complications
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Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response remain woefully inadequate. We know by now that the ...world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as
the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. The result is that the world remains scarily vulnerable.
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PEPFAR Malawi’s Country Operational Plan 2022 (COP22) embodies joint priorities from national and subnational dialogues building on the 2020-2025 National Strategic Plan for HIV/AIDS. The interagency team has developed a person-centered, district-tailored and Malawi Population-Based HIV Impact Ass...essment (MPHIA)-informed strategy through extensive engagement with Government of Malawi (GoM) and Civil Society Organizations (CSOs) to sustain HIV epidemic control. At the end of COP21, PEPFAR Malawi was commended for contributing to reaching epidemic control in strong collaboration with GoM and stakeholders including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). This includes enrollment of 88% of recipients of care on three or more months of antiretroviral treatment (ART), better outcomes for Malawian children through remarkable efforts in Orphans and Vulnerable Children (OVC) programming and progress made towards reaching men with more intentional and focused programming.
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Senegal’s substantial and sustained progress against malaria is an inspiring public health success story, and a source of potential lessons for other countries on the path to elimination. This case study describes three major success factors—(1) outstanding leadership and partner engagement, (2)... the achievement and maintenance of high intervention coverage levels, and (3) a thriving data culture—and explores several exciting new opportunities to consolidate and expand upon Senegal’s two decades of impact.
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The major neglected tropical diseases, Taenia solium taeniosis/cysticercosis and schistosomiasis caused by Schistosoma mansoni or S. haematobium are presumed to be widely distributed in Africa. Taenia solium taeniosis/ cysticercosis has been reported as an emerging disease in different regions of Af...rica [1, 2], but currently the exact distribution remains unclear. Reported prevalences of T. solium taeniosis and cysticercosis in African countries are not extensive and are further complicated by the lack of ‘gold standard’ tests for diagnosis.
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On 19 August 2016, the former UN Secretary-General announced a new approach to cholera in Haiti, consisting of two tracks. Track 1 focuses on reducing cholera transmission, improving access to care, and addressing water, sanitation, and health system issues. Track 2 aims to provide material assistan...ce to those most affected by cholera. The Secretary-General urged Member States to show solidarity with Haiti by increasing contributions. The UN General Assembly, in resolution 71/161, recognized the UN's moral responsibility to cholera victims and called for support to eliminate cholera and address its victims' suffering. The Secretary-General was requested to provide an update on the progress of this approach.
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Combination file of all the documents related to the national guidelines for accreditation, supervision and regulation of ART clinics in India. Documents included:
National Guidelines for Accreditation, Supervision & Regulation of ART Clinics in India | Preliminary Pages | Corrigendum | Chapter 1 ...- Introduction, Brief history of ART and Requirement of ART Clinics | Chapter 2 - Screening of Patients for ART - Selection Criteria and Possible Complications | Chapter 3 - Code of Practice, Ethical Considerations and Legal Issues | Chapter 4 - Sample Consent Forms | Chapter 5 - Training | Chapter 6 - Future Research Prospects | Chapter 7 - Providing ART Services to the Economically Weaker Sections of the Society | Chapter 8 - Establishing a National Database for Human Infertility | Chapter 9 - Composition of the National Accreditation Committee | Bibliography
| Members of the Expert Group for Formulating the National Guidelines for Accredation, Supervision and Regulation of ART Clinics
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Climate change (CC) impacts on health outcomes, both direct and indirect, are sufficient to jeopardize achieving the World Bank Group’s visions and agendas in poverty reduction, population resilience, and health, nutrition and population (HNP). In the last 5 years, the number of voices calling for... stronger international action on climate change and health has increased, as have the scale and depth of activities. But current global efforts in climate and health are inadequately integrated. As a result, actions to address climate change, including World Bank Group (WBG) investment and lending, are missing opportunities to simultaneously promote better health outcomes and more resilient populations and health sectors. Accordingly, with the financial support of the Nordic Development Fund (NDF), the World Bank Group set out to develop an approach and a 4-year action plan, outlined in this paper, to integrate health-related climate considerations into selected WBG sector plans and investments.
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