Second edition. June 2022. This revised guidance recommends that access to COVID-19 testing is decentralized as far as possible and made available at health facilities, and through the use of self tests to enable access to care and the mitigation of transmission. Testing should be prioritized for hi...gh-risk and vulnerable individuals presenting with acute onset of respiratory illness so that those found to be infected can benefit from clinical care and access to COVID-19 therapeutics and vaccines
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Carlos Chagas discovered American trypanosomiasis, also named Chagas disease (CD) in his honor, just over a century ago. He described the clinical aspects of the disease, characterized by its etiological agent (Trypanosoma cruzi) and identified its insect vector. Initially, CD occurred only in Latin... America and was considered a silent and poorly visible disease. More recently, CD became a neglected worldwide disease with a high morbimortality rate and substantial social impact, emerging as a significant public health threat. In this context, it is crucial to better understand better the epidemiological scenarios of CD and its transmission dynamics, involving people infected and at risk of infection, diversity of the parasite, vector species, and T. cruzi reservoirs. Although efforts have been made by endemic and non-endemic countries to control, treat, and interrupt disease transmission, the cure or complete eradication of CD are still topics of great concern and require global attention. Considering the current scenario of CD, also affecting non-endemic places such as Canada, USA, Europe, Australia, and Japan, in this review we aim to describe the spread of CD cases worldwide since its discovery until it has become a global public health concern.
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Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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The document titled "Prevención y control del cólera" (Cholera Prevention and Control) provides essential guidance on preventing and managing cholera, a disease characterized by severe watery diarrhea and vomiting. Without prompt treatment, cholera can lead to death due to dehydration within hours.... The disease is primarily transmitted through the ingestion of food or water contaminated with the feces of an infected person.
To protect against cholera and other diarrheal diseases, the document emphasizes the importance of drinking safe water, such as bottled water with intact seals, boiled water, or water treated with chlorine products. Frequent handwashing with safe water and soap is recommended, and in the absence of soap, hands can be cleaned using ash or sand followed by rinsing with safe water. Proper sanitation practices, such as using latrines or burying feces and avoiding defecation near water sources, are crucial. The document also highlights safe food practices, including thoroughly cooking food (especially seafood), consuming it while hot, keeping it covered, and peeling fruits and vegetables. Ensuring the safe cleaning of kitchens and areas where the family bathes or washes clothes is also advised.
In case of diarrheal illness, the document stresses the immediate use of oral rehydration solution (ORS) to prevent dehydration and the importance of seeking medical attention as quickly as possible. Patients should continue ORS intake both at home and during transit to a health facility. These preventative measures and prompt treatment strategies are vital for reducing cholera transmission and mortality.
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Lymphatic filariasis (LF) is a preventable neglected tropical disease (NTD) caused by infection with the filarial parasites Wuchereria bancrofti, Brugia malayi or B. timori. Mosquitos in the genera Culex, Anopheles, Mansonia and Aedes transmit the parasites from person to person. Lymphoedema and hyd...rocoele are the visible, chronic clinical consequences of the impairment of lymphatic vessels caused by infection with these parasites. WHO established the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to stop transmission of infection by mass drug administration (MDA) of anthelminthics and to alleviate the suffering of people affected by the disease through morbidity management and disability prevention (MMDP). Since the start of GPELF, the number of infections has been reduced by 74% globally. The latest estimate is that 51.4 million people are infected.
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here need to be adjusted to the scale of transmission, co...ntext and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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Interim guidance, 6 October 2021
Direct detection of SARS-CoV-2 viral proteins (antigens) in nasal swabs and other respiratory secretions using lateral flow immunoassays (also known as rapid diagnostic tests, RDTs) offers a faster and less expensive method to test for SARS-CoV-2 than the reference ...method, nucleic acid amplification tests (NAATs). This interim guidance offers recommendations on the priority uses of antigen-detecting rapid diagnostic tests (Ag-RDTs) in specific populations and settings, including (i) for primary case detection in symptomatic individuals suspected to be infected and asymptomatic individuals at high risk of COVID-19, (ii) for contact tracing, (iii) during outbreak investigations and (iv) to monitor trends of disease incidence in communities. Ag-RDTs meeting minimum performance requirements can be used outside of clinical and laboratory settings, including in communities, by trained operators in accordance with instructions. The guidance additionally provides recommendations on implementation, product selection and storage.
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Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated th...at at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
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Rabies is a fatal viral disease, but is preventable in humans. The rabies virus is transmitted to humans through virus-laden saliva from a rabid animal, mostly dogs. The virus is shed in the saliva of an infected animal and can be introduced into another body through bites, scratches and any other ...wounds that transect the skin. Contact of the infected saliva with mucous membranes is also thought to be a possible route of infection, whereas contact of infected saliva with intact skin is not considered an exposure. Rabies is preventable through pre-exposure prophylaxis (PrEP) for individuals at high and continual risk, and post-exposure prophylaxis (PEP).
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Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmatic management of drug-resistant TB has been developed and forms part of the Five Year National Strateg...ic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols
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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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BMJ Global Health, Vol.5 No. 12Spatial subdivision of the camp (‘sectoring’) was able to ‘flatten the curve’, reducing peak infection by up to 70% and delaying peak infection by up to several months. The use of face masks coupled with the efficient isolation of infected individuals reduced t...he overall incidence of infection, and sometimes averted epidemics altogether. These interventions must be implemented quickly in order to be maximally effective. Lockdowns had only small effects on COVID-19 dynamics.
Conclusions
Agent-based models are powerful tools for forecasting the spread of disease in spatially structured and heterogeneous populations. Our findings suggest that feasible interventions can slow the spread of COVID-19 in a refugee camp setting, and provide an evidence base for camp managers planning intervention strategies. Our model can be modified to study other closed populations at risk from COVID-19 or future epidemics.
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Soil transmitted helminth (STH) infections are among the most common human infections worldwide with over 1 billion people affected. Many estimates of STH infection are often based on school-aged children (SAC). This study produced predictive risk-maps of STH on a more finite scale, estimated the nu...mber of people infected, and the amount of drug required for preventive chemotherapy (PC) in Ogun state, Nigeria. Georeferenced STH infection data obtained from a cross-sectional survey at 33 locations between July 2016 and November 2018, together with remotely-sensed environmental and socio-economic data were analyzed using Bayesian geostatistical modelling. Stepwise variable selection procedure was employed to select a parsimonious set of predictors to predict risk and spatial distribution of STH infections. The number of persons (pre-school ages children, SAC and adults) infected with STH were estimated, with the amount of tablets needed for preventive chemotherapy. An overall prevalence of 17.2% (95% CI 14.9, 19.5) was recorded for any STH infection. Ascaris lumbricoides infections was the most predominant, with an overall prevalence of 13.6% (95% CI 11.5, 15.7), while Hookworm and Trichuris trichiura had overall prevalence of 4.6% (95% CI 3.3, 5.9) and 1.7% (95% CI 0.9, 2.4), respectively. The model-based prevalence predictions ranged from 5.0 to 23.8% for Ascaris lumbricoides, from 2.0 to 14.5% for hookworms, and from 0.1 to 5.7% for Trichuris trichiura across the implementation units. The predictive maps revealed a spatial pattern of high risk in the central, western and on the border of Republic of Benin. The model identified soil pH, soil moisture and elevation as the main predictors of infection for A. lumbricoides, Hookworms and T. trichiura respectively. About 50% (10/20) of the implementation units require biannual rounds of mass drug administration. Approximately, a total of 1.1 million persons were infected and require 7.8 million doses. However, a sub-total of 375,374 SAC were estimated to be infected, requiring 2.7 million doses. Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, either for resource acquisition or identifying priority areas for delivery of interventions in Ogun State, Nigeria.
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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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Dengue Fever & What You Need to Know, including Pathophysiology, Symptoms, Diagnosis & Treatment. Dengue fever is a viral infection with potentially fatal consequences. In this lesson, we discuss how people are infected with Dengue fever, pathophysiology of the condition, along with phases of infect...ion, signs and symptoms, diagnosis, treatment, preventative methods (vaccines, mosquito repellent).
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MedPPE emphasizes the role and timing of health workers jobs and offers specific information to prevent the spread of COVID-19. The guidelines are aimed at all personnel working in health facilities, including security guards, administrative and cleaning personnel, transfer assistants, nurses, biome...dical and imaging technicians, surgeons, and physicians, among others.
MedPPE provides guidance for the use of PPE according to workers’ function, the level of care they provide, and the multiple environments of primary health care and hospitals. The tool also clarifies the type of PPE needed when performing aerosol-generating procedures and other activities related to the care of patients infected or suspected of being infected with COVID-19.
However, use of PPE alone is not enough to protect against COVID-19. Hand hygiene and proper PPE dressing and undressing procedures must also be followed, along with the proper disposal and management of waste.
MedPPE is available in Spanish, English, Portuguese and French for iOS and Android devices.
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The Global Programme to Eliminate Lymphatic Filariasis (LF) is using mass drug administration (MDA) of antifilarial medications to treat filarial infections, prevent disease and interrupt transmission. Almost 500 million people receive these medications each year. Clinical trials have recently shown... that a single dose of a triple-drug combination comprised of ivermectin, diethylcarbamazine and albendazole (IDA) is dramatically superior to widely used two-drug combinations for clearing larval filarial parasites from the blood of infected persons. A large mul-
ticenter community study showed that IDA was well-tolerated when it was provided as MDA. IDA was rapidly advanced from clinical trial to policy and implementation; it has the potential to accelerate LF elimination in many endemic countries.
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Rabies is a neglected zoonotic disease responsible for an estimated 59,000 human deaths annually. Rural populations in Africa and Asia are predominantly affected, and approximately
40% of cases occur in children under the age of 15 years. Transmitted through bites and scratches from infected animal...s, dogs are responsible for up to 99% of human rabies cases.
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Planning and preparedness are the keys to dealing effectively with threats that include infectious diseases caused by SARS and the Middle East Respiratory Syndrome or MERS, novel influenza viruses like H1N1, and Ebola. During outbreaks or epidemics of these emerging infectious diseases, healthcare f...acilities must carefully monitor the global situation as it evolves and conduct robust planning to promptly identify and safely manage a patient who may be infected and prevent further transmission. This module focuses on preparedness considerations for Ebola and how to engage a multi-disciplinary team to prepare your institution. Planning, preparedness, and practice will protect patients, visitors, and staff.
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- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to... essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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