Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea...lth and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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The chapter Fostering Health Systems’ Monitoring to Better Serve Older Populations is part of the publication series entitled Decade of Healthy Aging: Situation and Challenges. The publications are designed to favor the prioritization of effective actions at the local level as well as the monitori...ng of data and public health policies, and providing evidence-based information. Along with the objective of presenting the available updated knowledge about the situation of health and aging at the beginning of the Decade of Healthy Aging in the Americas, this publication gives information about health systems’ monitoring to better serve the needs of older adults and emphasizes the need for societies and health systems to better adapt to an aging population. It introduces the 360-tool as a guide to adapt health systems through monitoring tracers/indicators and highlighting the data and information that is readily available, disaggregated by age. This information can aid in decision-making and resource allocation to support older adults’ needs. Concerning the 360-tool development, a consensus has been reached on seven tracer indicators with high relevance to informing policy, and case studies in selected countries have assessed the feasibility of this approach. The list of indicators and the process related to the development of the tool are presented in this publication. The Decade of Healthy Aging 2021-2030 is a period to guide action towards the transformation of societies by fostering the inclusion of older people in every decision. This publication intends to contribute to this strategy and highlight the upcoming challenges and opportunities on healthy aging.
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Indoor residual spraying (IRS) involves applying residual insecticide to potential vector resting sites on the interior surfaces of human dwellings or other buildings. The main aim of IRS is to kill vectors before they are able to transmit pathogens to humans. When carried out correctly, IRS has his...torically been shown to be a powerful intervention to reduce adult vector density and longevity for mosquitoes, sand flies and triatomine bugs and can reduce the transmission of vector-borne diseases.
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A healthcare worker manual. 2nd edition
The development of this National Manual for the Management of HIV-related Opportunistic Infections and Conditions for use by health care workers at the frontline of our fight against HIV/AIDS is intended to improve their understanding of the causes, preventio...n and appropriate management of opportunistic infections and conditions in adults and adolescents (OIs in children is covered effectively in the Integrated Management of Childhood Illnesses – IMCI – materials). It is also intended to be a practical guide at the clinic level, so as to improve quality of life, treatment outcomes and survival of PLHA. Crucially, this manual uses a “symptom-based” approach to support health care workers at the most basic primary level to be able to effectively initiate the care of PLHA with OIs and refer patients as appropriate (effective triage of patients at the primary care level). The result of this will be to move the management of OIs closer to the patient while ensuring that referral links with higher-level facilities and care is cultivated.
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Namibia is estimated to be at 94-97-93 as defined by the UNAIDS 95-95-95 treatment cascade, one of the first high burden countries to approach epidemic control. COP22 is about sustaining the impact of years of investment and partnership with the Namibian government and other stakeholders by employin...g targeted and innovative approaches to prevent new infections, reduce mortality rates, and strengthen the health system to endure the impact of unexpected external shocks, while still providing person-centered health services.
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This manual is designed to provide comprehensive malaria case management training for health workers at all levels, including clinical, nursing, dispensing, laboratory and records staff. The training covers the use of malaria rapid diagnostic tests (RDTs) and the treatment of severe malaria. The fiv...e-day training programme includes interactive modules supported by job aids. The ideal group size is 20–30 participants, supported by a team of three trainers. Trainers should thoroughly review the manual, including the 'Adult Learning Techniques' module, and follow the 'Facilitator's Guide', while participants should use the 'Simplified Participant's Guide'. The training includes pre- and post-tests to assess knowledge improvement. Continuing Medical Education (CME) is encouraged after the training, and resources are provided in the appendix.
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This document was developed by the Ministry of Health in Malawi in collaboration with national and international partners. It introduces a Social and Behaviour Change (SBC) malaria message guide that is aligned with the National Malaria Communication Strategy (NMCS) for the period 2023–2030. The g...uide aims to facilitate effective communication and behavioural change in order to reduce malaria-related morbidity and mortality. It provides a reference framework for messaging and communication tools tailored to target groups, supporting the broader goals of the Health Sector Strategic Plan III. This guide was developed with technical and financial support from key partners, including USAID, PMI through Breakthrough ACTION, and other stakeholders. The guide reflects Malawi’s ongoing commitment to evidence-based SBC interventions, community engagement, and the national fight against malaria.
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The WHO Global Health Estimates show that nearly half a million deaths (493 471) occurred in the WHO European Region due to violence and injuries in 2016. This represents a decline of 29% from 2000. Injuries account for 5.3% of all deaths and 9.6 of all years of life lost. They are a leading cause o...f death in people aged 15–29 years and the second leading cause of death for young people aged 5–14. The three leading causes of injury deaths are self-directed violence (141 089), falls (83 325) and road-traffic injuries (78 198). Inequalities in injury deaths exist in the Region, with mortality rates 2.4 times higher in males than in females and 1.5 times higher in middle-income compared to high-income countries.
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Mental health is critical to personal well-being, interpersonal relationships, and successful contributions to society. Mental health conditions consequently impose a high burden not only on individuals, families and society, but also on economies. In Jamaica, mental health conditions are highly pre...valent and major contributors to morbidity, disability, and premature mortality.
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This report aims to improve the assessment of mental health needs in the Americas by providing an updated and nuanced picture of: (a) the disability resulting from mental, substance use, and specific neurological disorders, plus self-harm, alone and in combination with premature mortality; (b) the i...mbalance between mental health spending and its related disease burden; and (c) the inadequate allocation of the meager mental health spending by countries of the Region
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PLoSONE 14(9):e0223104.https://doi.org/10.1371/journal.pone.0223104.
The survey centering on reasons behind community resistance was conducted in Butembo in November during a time of Ebola transmission. A researcher from Catholic University of Graben in Butembo and collaborators at the University o...f Alberta in Edmonton published their findings on Sep 26 in PLOS One.
To spark focus group discussions, the researchers used an 18-item questionnaire based on similar ones used during West Africa's outbreak in Guinea, where community resistance and episodes of violence also complicated the outbreak response.
Participants were a convenience sample of 670 adults from the region who were recruited by medical students at Catholic University of Graben. Those surveyed included clinicians, community members, and displaced persons.
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UNICEF analysis indicates that:
- Investments that increase access to high-impact health and nutrition interventions by poor groups have saved almost twice as many lives as equivalent investments in non-poor groups.
- Access to high-impact health and nutrition interventions has improved ra...pidly among poor groups in recent years, leading to substantial improvements in equity.
- During the period studied, absolute reductions in under-five mortality rates associated with improvements in intervention coverage were three times faster among poor groups than non-poor groups.
- Because birth rates were higher among the poor, the reduction in the under-five mortality rate translated into 4.2 times more lives saved for every 1 million people. Indeed, of the 1.1 million lives saved across the 51 countries during the final year studied for each country, nearly 85 per cent were among the poor.
- Intensified focus on equity-enhancing policies and investments can help countries achieve the Sustainable Development Goal newborn and child mortality targets (SDG3.2).
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Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an...d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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Pneumonia kills more children than any other illness – more than AIDS, malaria and measles combined. Over 2 million children die from pneumonia each year, accounting for almost 1 in 5 under five deaths worldwide. Yet, little attention is paid to this disease. This joint UNICEF/WHO report examines ...the epidemiological evidence on the burden and distribution of pneumonia and assesses current levels of treatment and prevention. It is a call to action to reduce pneumonia mortality, a key step towards the achievement of the millennium development goal on child mortality.
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Procédures de gestion clinique standard.
La maladie à virus Ebola (MVE) est une maladie multisystémique potentiellement mortelle qui entraîne souvent une hypovolémie, une acidose métabolique, une hypoglycémie et une défaillance multi-viscérale. L'épidémie prolongée de MVE en Afrique de... l'Ouest en 2013-2016 a permis une évolution dans le domaine des soins telle qu'à la fin de l'épidémie, de nombreux patients ont pu recevoir des soins de support individualisés et optimisés, dont la réanimation hydro-électrolytique, le contrôle des symptômes, la surveillance biologique en laboratoire et au chevet de la glycémie et des électrolytes, la prise en charge des défaillances d’organe, ainsi que la détection et le traitement rapides des co-infections, contribuant ainsi à une réduction de la mortalité.
Toutefois, le niveau des soins varie considérablement d'un centre de traitement Ebola (CTE) à l'autre, au cours de la même épidémie, ainsi que d’une épidémie à l’autre
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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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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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Int. J. Environ. Res. Public Health 2021, 18(24), 13339; https://doi.org/10.3390/ijerph182413339
The climate crisis threatens to exacerbate numerous climate-sensitive health risks, including heatwave mortality, malnutrition from reduced crop yields, water- and vector-borne infectious diseases, and... respiratory illness from smog, ozone, allergenic pollen, and wildfires. Recent reports from the Intergovernmental Panel on Climate Change stress the urgent need for action to mitigate climate change, underscoring the need for more scientific assessment of the benefits of climate action for health and wellbeing.
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5 Nov. 2020
The policy brief provides a concise summary of information and considerations to ensure optimal management of influenza during the COVID-19 pandemic. It includes a list of technical guidance and other resources to assist policy makers with monitoring the situation, preventing seasonal i...nfluenza, reducing severe complications and mortality, protecting specific populations and communicating to and engaging with the public.
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