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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Neurological, Psychiatric, and Developmental Disorders: Meeting the Challenge in the Developing World
Institute of Medicine (US) Committee on Nervous System Disorders in Developing Countries.
Washington (DC): National Academies Press (US); 2001.
This document provides up-to-date guidance on laboratory studies as well as smallscale (semi-field) and large-scale field trials to assess the efficacy and determine field application rates of new molluscicide products for control of schistosomiasis.
Psychoactive substance use affects the functioning of the brain and leads to impaired driving
India | The ‘Standard Operating Procedures for Care, Protection and Rehabilitation of Children in Street Situations’, is a unique endeavour to streamline the processes and interventions regarding Children in Street Situations, based on the prevailing legal and policy framework.
WHO has issued a new recommendation on the length of bladder catheterization following surgical repair of a simple obstetric urinary fistula. Currently the length of catheterization is not standard and ranges from 5 to 42 days. The new guidance recommends a 7–10 day period of bladder catheterizati...on to allow complete healing. Longer periods of catheterization can be inconvenient for the woman, her family and care providers as it is associated with more discomfort and inconvenience. It also increases the risk of infection and erosion related to catheterization; requires more intensive nursing care and costs more per patient.
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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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Este informe proporciona una explicación descriptiva sobre los hallazgos de las actividades de monitoreo de protección llevadas a cabo por el ACNUR y sus socios de enero a junio de 2019. La estructura de este informe refleja la secuencia de las preguntas formuladas a las personas participantes. Es...te informe no pretende ser una evaluación de protección ni reemplaza ninguna política u orientación legal del ACNUR. Como esta es una actividad continua, posterior a este informe se realizarán actualizaciones semestrales.
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This technical brief presents the current options for safe storage and point of use water treatment. It is intended to help field staff working in a variety of locations to decide upon the most appropriate course of action for providing safe water for the communities in which they work. The effectiv...eness of household water treatment options now and in the future rely to a huge extent on user compliance; it is critical that users are involved in the decision making process, and are aware of the purpose, how to use, maintain and manage their household water options. The brief therefore details relevant hygiene promotion steps for the different treatment options.
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