Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause of early mortality and morbidity, and it is associated with po...verty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
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Afghanistan has one of the largest populations per capita of persons with disabilities in the world. At least one in five Afghan households includes an adult or child with a serious physical, sensory, intellectual, or psychosocial disability. More than 40 years of war have left more than one million... Afghans with amputated limbs and other mobility, visual, or hearing disabilities. Many Afghans have psychosocial disabilities (mental health conditions) such as depression, anxiety, and post-traumatic stress, which are often a direct result of the protracted conflict. Other Afghans have pre-existing disabilities not directly related to the conflict, such as those caused by polio.
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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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The HIV drug resistance report 2021 summarizes findings from 38 countries that had finalized the surveys by the time of this report and shared data with WHO.
Pretreatment HIVDR to non-nucleoside reverse-transcriptase inhibitors (NNRTI) can affect more than 10% of adults starting therapy and is fo...und up to 3 times more often in people who had previous exposure to antiretroviral drugs. In addition, nearly half of infants newly diagnosed with HIV has HIVDR to NNRTI before initiating treatment.The high levels of observed NNRTI pretreatment HIVDR among emphasize the need to fast-track the transition to WHO-recommended dolutegravir-based ART.
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This manual provides practical guidelines for the management of children with severe malnutrition. It seeks to promote the best available therapy so as to reduce the risk of death, shorten the length of time spent in hospital, and facilitate rehabilitation and full recovery. Emphasis is given to the... management of severely malnourished children in hospital and health centres; the management of severely malnourished children in disaster situations and refugee camps and of severely malnourished adolescents and adults is also considered briefly.
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Effective implementation of WHO PEN, combined with other very cost effective population-wide interventions, will help even resource constrained settings to attain the global voluntary targets related to reduction of premature mortality and preventionof heart attacks and strokes.
2nd edition. The purpose of this document is to provide a generic model that can be used for risk assessment of larviciding and mollusciciding; it aims to harmonize the risk assessment of such pesticides for public health use. The assessment considers both adults and children (all age groups) as we...ll as people in the following specific categories:
those handling products and preparing/loading the spray liquid in application equipment;
those applying the spray or other formulations; and
residents who may come into contact with treated waters during washing, bathing, fishing or any other activity, or use the treated waters.
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Depression is a leading cause of non-fatal disease burden worldwide, with a lifetime prevalence of 9% among European adult men and 17% among European adult women.
The task at hand requires substantial investments in preventive mental health care, but the potential benefits can be equally rewarding.... After all, mental wellbeing is a key resource for learning, productivity, participation and inclusion. Investing in proactive care to promote, protect and sustain mental health in the population is therefore likely to offer good value for money.
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The main aim of these guidelines is to enable the central units of national TB and HIV/AIDS programmes to support districts to plan, coordinate and implement collaborative TB/HIV activities. These guidelines reinforce current medical understanding, that highly active antiretroviral treatment (HAART)... has decreased TB incidence of people living with HIV/AIDS. They are comprehensive, giving an overview of the range of activities that could be undertaken in high burden TB/HIV countries or where a rising prevalence of HIV might fuel TB. Activities highlight the need for comprehensive care, prevention and support for adults living with HIV/AIDS. Comprehensive TB and HIV care and prevention rely on full implementation of the DOTS strategy as part of a wide ranging HIV/AIDS care and prevention programme as well as collaborative TB and HIV programme activities.
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First published in 2020, this toolkit is intended for clinicians working in acute care, managing adult and paediatric patients with acute respiratory infection, including severe pneumonia, acute respiratory distress syndrome, sepsis and septic shock. The main objective is to provide key tools for us...e in the care of critically ill patients – from hospital entry to hospital discharge.
The 2022 updated version includes new tools and adapted algorithms, checklists, memory aids for COVID-19 and influenza, and the latest clinical evidence regarding clinical management of SARI. It is intended to help clinicians care for SARI patients: from epidemiology of severe acute respiratory infections, screening and triage, infection prevention and control, monitoring of patients, laboratory diagnosis, principles of oxygen therapy and different types of ventilation (invasive and non-invasive), as well as antimicrobial and immunomodulator therapies, to ethical and quality of care assessments.
The first edition is availbel in Ukrainian and Russian
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The Lancet Planetary Health Volume 4, ISSUE 12, e566-e576, December 01, 2020. Exposure to temperature variability has been associated with increased risk of mortality and morbidity. We aimed to evaluate whether the association between short-term temperature variability and hospitalisation was affect...ed by local socioeconomic level in Brazil.
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This guideline provides evidence-informed guidance on the use of non-sugar sweeteners to reduce the risk of unhealthy weight gain and diet-related noncommunicable diseases in adults and children. The guidance in this guideline is not based on toxicological assessments of the safety of individual no...n-sugar sweeteners and is therefore not intended to update or replace guidance on safe or maximal levels of intake established by the Joint Food and Agriculture Organization of the United Nations (FAO)/WHO Expert Committee on Food Additives (JECFA) or other authoritative bodies.
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Antibiotic resistant bacteria are spreading at an alarming rate and some bacterial infections may once again be untreatable. Antibiotic resistance (ABR), conservatively calculated, causes more than 500 000 deaths every year. This number is projected to rise dramatically if radical actions are not ta...ken. Lack of effective antibiotics, diagnostics and vaccines threatens the health of millions and hampers fulfilment of several of the Sustainable Development Goals. Access to effective antibiotics should be part of every adult and child’s right to health.
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Following review of the latest evidence, WHO recommends that TB-LAMP can be used as a replacement for microscopy for the diagnosis of pulmonary TB in adults with signs and symptoms of TB. It can also be considered as a follow-on test to microscopy in adults with signs and symptoms of pulmonary TB, e...specially when further testing of sputum smear-negative specimens is necessary.
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Disease Control Priorities, 3rdEdition: Volume 4.
Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-beingof individuals, families, and societies is large..., growing, and underestimated
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Antibiotic resistant bacteria are spreading at an alarming rate and some bacterial infections may once again be untreatable. Antibiotic resistance (ABR), conservatively calculated, causes more than 500 000 deaths every year. This number is projected to rise dramatically if radical actions are not ta...ken. Lack of effective antibiotics, diagnostics and vaccines threatens the health of millions and hampers fulfilment of several of the Sustainable Devel- opment Goals. Access to effective antibiotics should be part of every adult and child’s right to health.
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Reporting period: January 2014 – December 2014
The human immunodeficiency virus (HIV) epidemic in Myanmar is concentrated among men who have sex with men (MSM), people who inject drugs (PWID) and female sex workers (FSW). HIV prevalence in the adult population aged 15 years and older was esti...mated at 0.54% in 2014. But data from HIV Sentinel Sero-Surveillance (HSS) indicates higher prevalence in 2014 among key populations: FSW 6.3%, MSM 6.6% and PWID 23.1%. Compared to 2012 data, the prevalence has declined from 7.1% in FSW and 8.9% in MSM, but has increased from 18% in PWID.
Epidemiological modelling suggests that in 2014 there were around 212,000 people living with HIV (PLHIV) in Myanmar, 34% of whom were females. Nearly 11,000 people died of HIV-related illnesses, compared to approximately 15,000 in 2011. An estimated 9,000 new infections occurred in 2014.
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At the threshold of Sustainable Development Goals (SDG) era, this document captures the remarkable achievements by Member States towards achieving MDGs 4 and 5. It acknowledges new opportunities in the post-2015 phase shaped by the SDGs and the Global Strategy for women’s, children’s and adoles...cents’ health and presents an advanced state of preparedness in the Region. This also highlights the region’s renewed commitment for a more inclusive and more dynamic flagship action for ending preventable maternal, newborn and child mortality as well as to improve women’s, children’s and adolescents’ health and wellbeing in the South-East Asia Region.
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Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions, data estimates show a major increase in cancer mo...rtality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
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The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis ...B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
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