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1
The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to
...
sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
more
Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in failure to provide adequate, accessible and quality m
...
aternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
more
South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing
...
and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
more
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
...
3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
more
Fact Sheet
Diabetes is a major public health problem. The rising incidence of Diabetes Type 2 is related to the effects of urbanization and unhealthy lifestyles. Research studies show that healthy eating and regular physical activity can prevent or delay the onset of Diabetes Type 2, even in high-risk individu
...
als.
more
Diabetes in pregnancy
National Institute for Health and Care Excellence (NICE)
National Institute for Health and Care Excellence (NICE)
(2016)
CC2
The document "Diabetes in Pregnancy" by NICE (National Institute for Health and Care Excellence) outlines quality standards for managing diabetes in women during pregnancy, with a focus on five key areas. First, it emphasizes the importance of preconception planning for women of childbearing age wit
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h diabetes. These women should receive guidance on optimizing their health before pregnancy, including achieving target HbA1c levels and taking high-dose folic acid to minimize risks. Second, joint diabetes and antenatal care is recommended for pregnant women with pre-existing diabetes, who should be seen early in pregnancy (ideally by 10 weeks gestation) by a combined diabetes and antenatal team to ensure optimal care throughout their pregnancy.
The third focus area is continuous glucose monitoring (CGM), which should be offered to pregnant women with type 1 diabetes. This includes either real-time CGM or flash monitoring to help improve blood glucose control and reduce complications during pregnancy. Fourth, postnatal testing and referral are essential for women diagnosed with gestational diabetes, who should receive glucose testing after birth to detect any persistent diabetes. Those eligible are referred to the National Diabetes Prevention Programme to lower their risk of developing type 2 diabetes. Lastly, the document recommends annual HbA1c testing for women with a history of gestational diabetes to monitor for type 2 diabetes development.
These standards aim to improve pregnancy outcomes for women with diabetes by providing individualized, accessible, and culturally appropriate care.
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Diabetes in children and young people
National Institute for Health and Care Excellence (NICE)
National Institute for Health and Care Excellence (NICE)
(2022)
CC2
The document "Diabetes in Children and Young People" by NICE (National Institute for Health and Care Excellence) provides quality standards for the diagnosis, management, and support of diabetes in children and adolescents.
The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the
provision of basic health services in rural and urban communities with the participation of people who live there.
Historically, Community Health has significantly contributed to im
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provements in Malawi’s health outcomes in particular
attainment of MDG4. However, the community health system faces resource constraints and inconsistencies around quality
of service – which negatively affect health outcomes.
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This module covers common Non-Communicable Diseases such as Hypertension, Diabetes and three common cancers (Cervical,
Breast and Oral cancer). The focus of this module is on building the knowledge and skills of the Multi-Purpose Workers (MPW) in
undertaking Population Based Screening, identifi ca
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tion of cases for referral, follow up, recognition of complications, prevention
and health promotion. This module can be used by the female
or male MPW. However, while the content of the overall module
is the same for both some tasks will be different, particularly
those related to screening which the female MPW will have to
undertake. It is expected that the ANM/MPW will work closely
with the ASHA in her area. Together they form a front line worker
team to serve the needs of the community. The content of this
module will be covered in three days.
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The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T
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he Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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When someone is having an asthma attack, their airways go into spasm which causes tightness of the chest; the linings of the airways become inflamed and phlegm is produced further obstructing the airways and leading to severe difficulty in breathing (Fig. 1). Asthma does lead to fatalities and shoul
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d always be taken seriously.
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This articel summarises the evidence base underpinning supported self-management for asthma. It provides clinicians with a practical approach to providing supported self-management for asthma and suggests an appropriate strategy for implementing supported self-management.
To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer screening services in Malawi with regard to accessibility, uptake, acceptability and effectiveness.
Systematic review of published scientific evidence. A search of six bibliographic databases and gre
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y literature was executed to identify relevant studies conducted in Malawi in the English language, with no time or study design restrictions. Data extraction was conducted in Excel and evidence synthesis followed a thematic analysis approach to identify and compare emerging themes.
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Malawi is a landlocked country with a surface area of 118,484 km2. Administratively, the country is divided into three regions, namely the Northern, Central and Southern regions. The country has 28 districts, which are further divided into traditional authorities (TA) ruled by chiefs. The TAs are su
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b-divided into villages, which form the smallest administrative units. The Village Development Committees (VDCs) under the TAs are responsible for development activities. Politically, each district is divided into constituencies that are represented by Members of Parliament (MPs) in the National Assembly for purposes of legislations. Constituencies are further divided into wards which are represented by a ward councillor at district assembly.
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Hum Resour Health 20, 37 (2022). https://doi.org/10.1186/s12960-022-00735-y.
For countries to achieve universal health coverage, they need to have well-functioning and resilient health systems. Achieving this requires a sufficient number of qualified health workers and this necessitates the importa
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nce of investments in producing and regulating health workers. It is projected that by 2030, Africa would need additional 6.1 million doctors, nurses, and midwives. However, based on the current trajectory, only 3.1 million would be trained and ready for service delivery. To reduce current shortages of the health workforce, Africa needs to educate and train 3.0 million additional health workers by 2030. This study was conducted to describe the distribution and ownership of the health training institutions, production of health workers, and the availability of accreditation mechanisms for training programmes in the WHO African Region.
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Tsetse traps and targets (insecticide-impregnated screens) function by attracting the flies to a device that collects and/or kills them. Traps can be used for entomological surveillance, and also for control. Targets are simpler than traps, but are not used for surveillance. They are impregnated wit
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h biodegradable insecticides in order to kill any flies that alight on them. Traps can also be impregnated with insecticides. Traps and targets can both be used to eliminate a fraction of the tsetse population.
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This malaria case management training manual was developed by the Federal Ministry of Health (FMOH) of Ethiopia, in collaboration with several national and international partners. Primarily based on WHO guidelines and training materials, as well as the 2022 national malaria guidelines and various te
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chnical documents, it aims to provide a standardised, simplified resource for clinical health workers in both the public and private sectors in Ethiopia. The manual aims to provide clinical health workers in both the public and private sectors in Ethiopia with a standardised, simplified resource.
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The Manual for Parasitological Surveillance in Prevention of Reintroduction or Re-establishment of Malaria in Sri Lanka (2019) provides guidelines to health professionals on how to conduct effective malaria surveillance to prevent the reintroduction of the disease in Sri Lanka, which was certified m
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alaria-free in 2016.
The manual outlines strategies for active and passive case detection, laboratory diagnosis, case investigation, foci investigation, and follow-up measures. It emphasizes targeted screening of high-risk populations, including travelers and migrant workers, and explains the importance of prompt reporting, accurate parasitological confirmation, and coordination between healthcare levels. The overall goal is to maintain Sri Lanka’s malaria-free status by ensuring early detection and rapid response to any imported or locally suspected malaria cases.
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The overall objective of this approach is to accelerate efforts toward malaria elimination by increasing
access to early diagnosis and treatment. The specific objectives are to: Minimize the barriers that the population faces in accessing timely, quality diagnosis and treatment. Reduce the time bet
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ween diagnosis and the start of treatment. Reduce the parasite reservoir in symptomatic infected persons through early treatment. Maximize the transmission-blocking strategy by taking early action on gametocytes. Decrease the incidence of P. vivax relapses.Ultimately, disrupt malaria transmission and prevent mortalit.
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