PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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1 July 2021; Report shows big COVID-19-related HIV prevention programme service disruptions, but highlights that HIV service innovations and adaptations are possible.
A synthesis report on programme disruptions and adaptations during the COVID-19 pandemic in 2020
The risk of increasing rates of acute malnutrition during the COVID-19 pandemic demonstrates the urgent need to adapt, and expand access to, acute malnutrition diagnosis and treatment services in humanitarian and fragile contexts.
Non-Communicable Diseases (NCDs) are a worldwide epidemic. Particularly, the most common diseases - Cardiovascular diseases, Chronic Obstructive Pulmonary Diseases (COPD), Chronic Kidney Diseases, Cancer, Diabetes, injuries and disabilities, EMT, oral, eye g...reatly contribute to the morbidity and mortality accounting for around 60% of all deaths worldwide. The disease pattern is also changing from infectious to chronic in Rwanda like other developing countries due to the epidemiological transition.
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En la reunión de alto nivel de las Naciones Unidas del 2018 se fijó el objetivo de tratar al menos a 40 millones de personas con tuberculosis (TB) entre el 2018 y el 2022; sin embargo, en el 2021 ese objetivo solo se había cumplido en un 66%. Las pruebas diagnósticas son fundamentales para logra...r el objetivo, pero constituyen un eslabón débil en la continuidad de la atención. Las pruebas de diagnóstico rápido recomendadas por la Organización Mundial de la Salud (PDRO) son sumamente precisas, acortan el tiempo hasta el inicio del tratamiento, influyen en resultados importantes para el paciente y son costo-eficaces. Aunque el objetivo para el año 2025 es que todos los pacientes notificados se hagan inicialmente una PDRO, en el 2021 tan solo el 38% se hizo una PDRO como prueba inicial, y se determinó que el acceso a las pruebas diagnósticas era un problema crítico. Una de las principales consecuencias del uso insuficiente de las PDRO es la gran brecha en la detección de la farmacorresistencia. La presente Norma de la OMS: Acceso universal a las pruebas de diagnóstico rápido de la tuberculosis se basa en las directrices de la OMS y en el manual operativo conexo
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At the global, national, and regional levels, there are several guidelines and guides regarding the preparedness, prevention, surveillance, and control of diseases caused by respiratory viruses; most initiatives focus on specific virus events or cases. During the coronavirus disease 2019 (COVID-19) ...pandemic, it has been found that even when there are strategies designed and planned for pandemics, it is necessary to strengthen and improve them. Planning for imminent threats, including those posed by respiratory viruses, contributes to strengthening the core capacities of the International Health Regulations (IHR [2005])
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The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach...ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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It explains the importance of faecal sludge management in urban areas in which many people rely on on-site and decentralized sanitation facilities and emphasizes the place of treatment in the overall sanitation service chain. It defines terms used throughout the book, explains why faecal sludge and ...septage treatment is important, and identifies broad treatment objectives.
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PlosOne December 10, 2014 https://doi.org/10.1371/journal.pone.0111913
Plastic pollution is ubiquitous throughout the marine environment, yet estimates of the global abundance and weight of floating plastics have lacked data, particularly from the Southern Hemisphere and remote regions. Here we re...port an estimate of the total number of plastic particles and their weight floating in the world's oceans from 24 expeditions (2007–2013) across all five sub-tropical gyres, costal Australia, Bay of Bengal and the Mediterranean Sea conducting surface net tows (N = 680) and visual survey transects of large plastic debris (N = 891). Using an oceanographic model of floating debris dispersal calibrated by our data, and correcting for wind-driven vertical mixing, we estimate a minimum of 5.25 trillion particles weighing 268,940 tons. When comparing between four size classes, two microplastic <4.75 mm and meso- and macroplastic >4.75 mm, a tremendous loss of microplastics is observed from the sea surface compared to expected rates of fragmentation, suggesting there are mechanisms at play that remove <4.75 mm plastic particles from the ocean surface.
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Encuesta Nacional de Condiciones de Vida 2014 (ENCOVI 2014)
The ICOPE guidance for person-centred assessment and pathways in primary care (ICOPE Handbook) helps community health and care workers put the recommendations outlined in the ICOPE Guidelines into practice. The Handbook assists with setting person-centred goals, screening for loss in a range of doma...ins of intrinsic capacity and assessing health and social care needs to develop a personalised care plan. The care plan may include multiple interventions to manage declines in intrinsic capacity, provide social care and support, support self-management and support caregivers. The domains of intrinsic capacity include cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss and depressive symptoms.
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The Quadripartite Organizations – the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Organisation for Animal Health (WOAH, founded as OIE), and the World Health Organization (WHO) – collaborate to drive the change and tra...nsformation required to mitigate the impact of current and future health challenges at the human–animal– plant–environment interface at global, regional and country level.
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Trastornos externalizantes
Capítulo D.3
Edición: Matías Irarrázaval & Andres Martin
Traducción: Fernanda Prieto Tagle, Sofía Hacohen Domené
Recommendations on the initiation and continuing use of nine common types of contraceptive methods are covered by the tool. In addition to looking at individual medical conditions or characteristics, users may also easily combine multiple conditions or characteristics and view the guidance on each c...ondition separately or in combination.
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To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required. This package should include management of infections such as pneumonia, diarrhoea, malaria and ear infections, as well as common opportunisti...c infections and HIV-related co-morbidities. WHO is developing a series of guidelines on each of these conditions, following the GRADE approach. The document on the management of pneumonia and diarrhoea in HIV-infected infants and children is the first of this series. The recommendations are similar to those for non infected children, but they cover specific aspects related to HIV infection.
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov...ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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'Ethical Issues in Obstetrics and Gynecology' represents the results of carefully researched and considered discussion. The guidelines are intended to provide material for consideration and debate about ethical aspects of our discipline for member organisations and their constituent membership.
Care and Support Centre (CSC) is a national initiative to provide expanded and holistic care and support services for PLHIV. The guideline focuses on the objectives, criteria for selection, required infrastructure, human resources, MIS tools, and financial guidelines for CSCs. This guideline will b...e useful to the care providers, programme managers, and all stakeholders in providing excellent care to the people living with HIV/AIDS
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