In recognition of the growing problem of antimicrobial resistance (AMR), its increasing threat to human, animal and plant health, and the need for a One Health approach to address this issue, the 39th Session of the Codex Alimentarius Commission (CAC) agreed it was important for the food safety comm...unity to play its part and re-established the ad hoc Codex Intergovernmental Task Force on Antimicrobial Resistance (TFAMR) ). The objectives of the Task Force were
to revise the current Codex Code of Practice to Minimise and Contain Antimicrobial Resistance and to develop new guidance on surveillance programmes relevant to foodborne AMR.
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Schistosomiasis and soil-transmitted helminths (STH) infections are major public health problems. We aimed to study the 6-mo impact of mass drug administration with praziquantel and albendazole on urinary schistosomiasis and STH.We examined children (aged 2–15 y) from one hamlet, who provided urin...e and faeces samples at baseline (n=197), 1 mo (n=102) and 6 mo (n=92); 67 completed the protocol.At baseline, 47/67 (70.1%) children presented Schistosoma haematobium (75.8% in the baseline total sample) and 12/67 (17.9%) with STH (30.5% in the initial sample, p=0.010). Among the children, 47.3% had heavy Schistosoma haematobium infection. The most frequent STH was Trichuris trichiura in 9.0%. We also found Hymenolepis nana (13.2%) and Plasmodium falciparum (9.1%) infections and anaemia (82.1%). One mo after chemotherapy there was a significant (p=0.013) reduction of Schistosoma haematobium prevalence (23.5%) and a high egg reduction rate (86.9%). Considering the sample of 67 children, the mean egg concentration was 498 at baseline, 65 at 1 mo and 252 at 6 mo (p<0.05). We also observed a reduction in STH infections, 50% in Ascaris lumbricoides, 33.3% in T. trichiura and 50% in hookworms. At 6 mo, the prevalence of Schistosoma haematobium (76.1%) was similar to the baseline and the STH reduction was not significant.Longitudinal studies have reported many losses in these settings, but we were able to show that mass drug administration for control of schistosomiasis and STH present low effectiveness, that reinfections occur rapidly and that stand alone anthelmintic therapy is not a sustainable choice.
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The thirty-seventh meeting of the Programme, Budget and Administration Committee was held in Geneva from 25 to 27 January 2023 and chaired by Ms Aishath Rishmee (Maldives). The Committee adopted its agenda and agreed its programme of work. In his opening remarks, the Director-General emphasized the ...crucial work on the financial future of the Organization, most significantly implementation of the Programme budget 2022−2023 and development of the Proposed programme budget 2024−2025, which would be the first to benefit from the agreed increase in assessed contributions. He welcomed the work of the Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance with its recommendations for long-term improvements in reform, prevention of and response to sexual abuse and harassment, new web-based information portals and a new replenishment process for consideration by Member States. Efforts were also under way to improve impact at country level, and he would continue to report to Member States on progress. He was heading an agile, proactive and fast-responding WHO, committed to implementing plans approved by Member States.
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The World Health Organization's Regional Office for Africa webpage on diabetes provides an overview of the disease's impact in the African Region. It highlights that diabetes is a serious, chronic, and costly condition, with projections estimating cases to rise to 23.9 million by 2030. The page outl...ines risk factors such as physical inactivity, overweight and obesity, tobacco use, and diets high in unhealthy fats and calories. It also discusses the three main types of diabetes: type 1, type 2, and gestational diabetes. Recent surveys indicate that up to 15% of adults aged 25 to 64 in the region have diabetes, with many unaware of their condition. The lack of access to proper treatment and medications, especially insulin, often leads to complications like neurological, vascular, or visual disorders, heart disease, stroke, lower limb amputation, and kidney failure.
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Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma ...symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
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The scale of international migration in the WHO European Region has increased substantially in the last decade. The dynamics of large-scale migration pose specific challenges and opportunities to health systems, and responses will differ from country to country. Strengthening health system responses... is one of the priority areas in the 2016 Strategy and action plan for refugee and migrant health in the WHO European Region. Its agreed actions include the identification and mapping of practices for developing and delivering health services that respond to the needs of refugees, asylum seekers and migrants. This compendium aims to collect and present some of these practices in the form of case studies. Selected in 2016, the case studies reflect experience from different levels of administration in a variety of European countries, and during the different phases of the migration journey.
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The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of n...ucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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At the moment, 83 elderly people are receiving care in six round-the-clock care facilities, 17 of them are from the Stepanakert nursing home, 50 are single. As of September 24, 10 children, 5 girls and 5 boys, aged 1 to 17, living in Stepanakert boarding house were also transferred to a round-the-cl...ock care facility on September 25. All children have biological parents.
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Health ministries currently lack effective tools for monitoring and evaluation of schistosomiasis control programmes. Egg detection can be used, but the cost, challenges of obtaining samples, and the need for trained personnel and equipment limit the frequency of monitoring. The purpose of this TPP ...is to guide the development of new diagnostic tools to reliably measure when prevalence is above or below a cut-off of 10% in school-aged children. Communities remaining above 10% require annual MDA, while communities below 10% can reduce MDA frequency as long as < 10% prevalence can be maintained. However, the lack of a reliable test has hindered the development of maintenance strategies. The test is also needed to track changes of prevalence > 10% to ensure that annual MDA is reducing overall prevalence.
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High salt consumption is an important determinant of high blood pressure and reducing it would improve health outcomes by lowering cardiovascular disease and therefore death rates. Reducing salt intake has been identified as one of the most effective public health measures and is one of the leading ...targets at global, regional and national levels to reduce the burden of noncommunicable diseases. The purpose of the Dietary Salt Intake Survey in the Republic of Moldova was to establish current baseline average consumption of salt (sodium), potassium and iodine through 24-hour urinary excretion testing among a random sample of the adult population (aged 18–69 years), and to assess the knowledge, attitudes, practices and behaviour around dietary salt in order to enable more efficient planning and the implementation of an effective salt-reduction strategy in the Republic of Moldova.
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Nutrition training of health and agriculture workers can help to reduce child undernutrition. Specifically, trained health extension workers cancontribute through frequent nutrition counselling of caregivers. Evidence from systematic reviews has showed that providing nutrition training targeting hea...lth workers can improve feeding frequency, energy intake, and dietary diversity of children aged six months to two years. Scaling up of nutrition training for health and agriculture workers presents a potential entry point to improve nutrition status among childrenFood insecurity and nutrition deficiency are a common phenomenon in Ethiopia.
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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The STEPS survey of noncommunicable disease (NCD) risk factors in Zambia was carried out from July to September 2017. Zambia carried out Step 1, Step 2 and Step 3. Socio demographic and behavioural information was collected in Step 1. Physical measurements such as height, weight and blood pressure w...ere collected in Step 2. Biochemical measurements were collected to assess blood glucose and cholesterol levels in Step 3. The survey was a population-based survey of adults aged 18-69. A multi-stage cluster sample design was used to produce representative data for that age range in Zambia. A total of 4,302 adults participated in the survey. The overall response rate was 74% for Step 1 and 2 and 65% for Step 3. A repeat survey is planned for 2022 if funds permit.
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Soil-transmitted helminths (STH) affect 1.45 billion people worldwide, and high intensity infections are associated with anemia, undernutrition and impaired cognition, particularly among children. Mathematical models suggest it may be possible to interrupt the transmission of STH in a community by e...xpanding mass drug administration (MDA) from targeted high-risk groups (primarily school-aged children and women of child-bearing age) to all community members with high coverage. The DeWorm3 Project will test the feasibility of this approach to interrupting the transmission of STH using a series of cluster randomized trials in Benin, India and Malawi. Each study area (population 80,000) will be divided into 40 clusters and randomized to community-wide or standard-of-care targeted MDA for three years. Two years following the final round of MDA, prevalence of STH will be compared between arms and transmission interruption assessed in each cluster. The DeWorm3 trials will provide stakeholders with information regarding the potential to switch from STH control to a more ambitious and sustainable strategy.
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La Politique de protection de l’enfance de CBM s’appuie sur la Convention des Nations unies relatives aux droits de l’enfant de 1989 (et sur ses protocoles facultatifs), sur la législation allemande en matière de protection de l’enfance, sur les législations nationales des pays dans lesqu...els CBM mène ses actions ainsi que sur les normes proposées par la coalition Keeping Children Safe. Nous avons développé cette politique parce que garantir le respect de la dignité de tous les enfants et assurer leur sécurité comptent parmi les principes fondamentaux du travail de CBM. Dans le cadre de cette politique, est considérée comme enfant toute personne âgée de moins de 18 ans. CBM s’engage à créer un environnement garantissant la sécurité des enfants. Pour ce faire, nous investissons dans les ressources nécessaires à l’application des procédures détaillées dans ce texte.
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Interim guidance, 26 October 2021
This interim guidance has been developed on the basis of the advice issued by the Strategic Advisory Group of Experts (SAGE) on Immunization at its meeting on 5 October 2021.
SAGE said moderately and severely immunocompromised persons should be offered an addition...al dose of all WHO approved vaccines “since these individuals are less likely to respond adequately to vaccination following a standard primary vaccine series and are at high risk of severe COVID-19 disease.”
People aged 60 and older who received the Sinovac and Sinopharm vaccines should get a third dose too, the experts added, though use of other vaccines may also be considered depending on supply and access.
“When implementing this recommendation, countries should initially aim at maximizing 2-dose coverage in that population, and thereafter administer the third dose, starting in the oldest age groups”, they said.
SAGE has also reviewed a vaccine developed by Indian company Bharat Biotech and will issue a policy recommendation after WHO greenlights it for emergency use.
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris...k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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Terminology used to describe the transmission of pathogens through the air varies across scientific disciplines, organizations and the general public. While this has been the case for decades, during the coronavirus disease (COVID-19) pandemic, the terms ‘airborne’, ‘airborne transmission’ a...nd ‘aerosol transmission’ were used in different ways by stakeholders in different scientific disciplines, which may have contributed to misleading information and confusion about how pathogens are transmitted in human populations.
This global technical consultation report brings together viewpoints from experts spanning a range of disciplines with the key objective of seeking consensus regarding the terminology used to describe the transmission of pathogens through the air that can potentially cause infection in humans.
This consultation aimed to identify terminology that could be understood and accepted by different technical disciplines. The agreed process was to develop a consensus document that could be endorsed by global agencies and entities. Despite the complex discussions and challenges, significant progress was made during the consultation process, particularly the consensus on a set of descriptors to describe how pathogens are transmitted through the air and the related modes of transmission. WHO recognizes the important areas where consensus was not achieved and will continue to address these areas in follow-up consultations.
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The United Nations Framework Convention on Climate Change (UNFCCC) established its Financial Mechanism to facilitate the provision and transfer of resources from developed to developing countries. The Global Environment Facility became the first operating entity of the Financial Mechanism after the ...Conference of the Parties (COP) to the UNFCCC, and the GEF Council agreed to a Memorandum of Understanding (MOU) in 1996. This agreement placed the GEF under the guidance of the COP, as Article 11 of the Convention states that the Financial Mechanism “shall function under the guidance of and be accountable to the Conference of the Parties, which shall decide on its policies, program priorities and eligibility criteria related to this Convention.”
The yearly COPs have provided an opportunity for Parties to update and renew their guidance to the GEF. To date, there have been 145 UNFCCC COP decisions and 526 paragraphs that offer guidance to the GEF (see Table 1). In addition, the Conferences of the Parties serving as the meeting of the Parties to the Paris Agreement (CMA) have issued 40 decisions and 115 paragraphs as guidance to the GEF (see Table 2). Key areas of Convention guidance have included: the GEF’s role as an operating entity of the Financial Mechanism, including the Paris Agreement; the GEF’s institutional and procedural reform; transparency and access to GEF funds; country engagement and empowerment; reporting on greenhouse gas (GHG) inventories; support for technology transfer; and ongoing programming in mitigation and adaptation.
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While the world was gripped by the unfolding COVID-19 pandemic in 2020, children continued to face the same crisis they have for decades: intolerably high mortality rates and vastly inequitable chances at life. In total, more than 5.0 million children under age 5, including 2.4 million newborns, alo...ng with 2.2 million children and youth aged 5 to 24 years – 43 per cent of whom are adolescents – died in 2020. This tragic and massive loss of life, most of which was due to preventable or treatable causes, is a stark reminder of the urgent need to end preventable deaths of children and young people.
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