PLOS ONE | https://doi.org/10.1371/journal.pone.0183180 October 9, 2017
In resource-limited countries, the number of available antiretroviral (ARV) drugs is relatively limited. Hence, caregivers face some caution and constraints in the changes of ARV treatment (ART) in people living with HIV (PLHIV). Our objective was to calculate the incidence, to describe the main cau...ses and to identify the predictive factors of the first change of ARV treatment in Senegal.
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Internationally, there is a growing concern over antimicro-bial resistance (AMR) which is currently estimated to ac-count for more than 700,000 deaths per year worldwide. If no appropriate measures are taken to halt its pro-gress, AMR will cost approximately 10 million lives andabout US$100 trillion... per year by 2050. In contrast tosome other health issues, AMR is a problem that con-cerns every country irrespective of its level of incomeand development as resistant pathogens do not respect borders.Despite the threat presented by AMR, the 2014 WorldHealth Organization (WHO) and the recent O’Neill re-port describe significant gaps in surveillance, standardmethodologies and data sharing. The 2014 WHOreport identified Africa and South East Asia as the regions without established AMR surveillance systems.
Tadesseet al. BMC Infectious Diseases (2017) 17:616 DOI 10.1186/s12879-017-2713-1
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Antimicrobials have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance is reversing the miracles of the past eighty years, with drug choices for the treatment of many ...infections becoming increasingly limited, expensive, and, in some cases, non-existent.
Conscious of the public health threats of AMR to both humans, animals and the environment, the ministries of health and sanitation, agriculture forestry and food security and the environmental protection agency put together a national multi-sectoral coordinating group tasked with the responsibility of establishing mechanisms to integrate all initiatives into a single concerted action and development of the national AMR strategic plan (2018-2022). The National Strategic Plan on Antimicrobial Resistance is the first approach which addresses AMR specifically.
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There is no secret to our procedure: the daily scanning of the literature helps us to stay afloat in the never-ending waves of new publications about SARS-CoV-2 and COVID-19. Many papers discussed in the Top 10 will eventually make it into subsequent editions of COVID Reference.
There are many calls for improved integration between
primary care and public health, but also sizeable obstacles to achieving
this, such as differences in the ways the two sectors are organised and
financed, as well as differences in education, culture and approach.
This article, based on a new... Observatory policy brief, describes the
types of interventions that come into consideration, the principles
that should be followed, and the factors that can facilitate successful
collaboration. While there is no universal template that can be followed
by all countries, improved integration promises to yield substantial
benefits to patients and wider populations.
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21 January 2022
The overall threat posed by Omicron largely depends on four key questions: (i) how transmissible the variant is; (ii) how well vaccines and prior infection protect against infection, transmission, clinical disease and death; (iii) how virulent the variant is compared to other varian...ts; and (iv) how populations understand these dynamics, perceive risk and follow control measures, including public health and social measures (PHSM).
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This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAH...O) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.
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FAO and WHO jointly developed a comprehensive tool to assist Member states in assessing the effectiveness of national food control system. The FAO/WHO Food Control System Assessment Tool comprises 162 assessment criteria under 25 system competencies over 4 Dimensions. This introductory booklet is de...veloped to facilitate application of the assessment tool.
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The WHO Ebola Virus Disease (EVD) Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with EVD. Providing guidance that is comprehensive and holistic for the optimal care of patients with EVD throughout their il...lness is important.
The living guidance is available in both pdf format (via the ‘Download’ button) and via an online platform in both French and English, and is updated regularly as new evidence emerges.
This first version of the Clinical management for EVD living guidance contains four new recommendations regarding use of therapeutics for EVD, this includes two strong recommendations for the use of monoclonal antibody therapies. This new living guideline is written to accompany the optimized supportive care (oSoC) for EVD standard operating procedures (5, 6). The living guideline aims to summarize high quality evidence for EVD therapeutics and make recommendations for their use.
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In one of his final essays, statesman and former United Nations secretary general Kofi Annan said, ‘Snakebite is the most important tropical disease you’ve never heard of’. Mr. Annan firmly believed that victims of snakebite envenoming should be recognised and afforded greater efforts at impro...ved prevention, treatment, and rehabilitation. During the last years of his life, he advocated strongly for the World Health Organisation (WHO) and the global community to give greater priority to this disease of poverty and its victims.
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Snakebite envenoming is a potentially life-threatening disease that typically results from the injection of a mixture of different toxins (“venom”) following the bite of a venomous snake. Envenoming can also be caused by venom being sprayed into a person’s eyes by certain species of snakes tha...t have the ability to spit venom as a defence measure. Not all snakebites result in envenoming: some snakes are non-venomous and venomous snakes do not always inject venom during a bite. About 50–55% of all snakebites result in envenoming. Snake venoms are complex mixtures of protein and peptide toxins, varying from one species to another, and even within species. The toxins in snake venoms are evolutionarily adapted to interact with a large variety of cellular targets in the organisms exposed to them. In humans and animals, snakebite envenoming affects multiple organ systems (depending on the particular species of snake and the classes of toxins present in the venom) and can cause, among other things: haemorrhage and prolonged disruption of haemostasis, neuromuscular paralysis, tissue necrosis, myolysis (muscle degeneration), cardiotoxicity, acute kidney injury, thrombosis and hypovolaemic shock.
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Las olas de transmisión de la fiebre amarilla ocurridas en la Región de las Américas entre el 2016 y el 2018 causaron el mayor número de casos humanos y epizoóticos registrados en varios decenios. La fiebre amarilla es una enfermedad hemorrágica viral grave que representa un desafío para el p...rofesional de salud: exige el reconocimiento temprano de signos y síntomas muchas veces inespecíficos, que pueden parecerse a otros síndromes febriles agudos. La detección temprana de los casos sospechosos o confirmados, el monitoreo de los signos vitales y las medidas de soporte vital, y el tratamiento de la insuficiencia hepática aguda siguen siendo las estrategias recomendadas para el manejo de los casos. El presente informe es el resultado de las deliberaciones sobre la experiencia de expertos de la Región en cuanto al manejo clínico de pacientes con fiebre amarilla, especialmente en brotes y epidemias, mediante la contextualización de esa experiencia en el conjunto actual de la evidencia médico-científica y la consideración de las directrices técnicas ya disponibles en los países de la Región. Presenta flujogramas para la evaluación inicial del paciente con sospecha clínica de fiebre amarilla y sugiere un conjunto mínimo de pruebas de laboratorio que puede ser útil cuando hay pocos recursos; además, detalla aspectos de la organización de los sistemas de salud para enfrentar brotes y epidemias de fiebre amarilla.
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This paper explores the angles and opportunities of digital health, with a look
at digital innovation and its potential to support patients with circulatory diseases.
In reviewing developments in the field, current applications as well as gaps, the paper aims to support policymakers in leveraging ...technology for better circulatory health and to capture the roles that various sectors have in making
digital health a tool for everyone.
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Expert Consensus Validation 2018.
This innovative approach aimed at improving and facilitating the screening, prescribing and monitoring of drug therapy for older patients, is currently being further developed in the area of Clinical Pharmacology at the University of Heidelberg in Mannheim. This ap...proach represents another advance in worldwide research efforts aimed at adding a new dimension to already-existing classification systems and negative listings of potentially inappropriate medications for the elderly.
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Other disorders
Chapter H.3
Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and that undernutrit...ion at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
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This fourth annual report monitors global progress towards the 2023 target for global elimination of industrially produced trans-fatty acids (TFA), highlighting achievements during the past year (October 2021 – September 2022). Countries are responding to the World Health Organization (WHO) call t...o action by putting into place best-practice TFA policies. Mandatory TFA policies are currently in effect for 3.4 billion people in 60 countries (43% of the world population); of these, 43 countries have best-practice policies in effect, covering 2.8 billion people (36% of the world population).
Over the past year, several additional countries took action to eliminate industrially produced TFA: best-practice policies came into effect in India in January 2022, Uruguay in May 2022 and Oman in July 2022. Best-practice policies were passed in Bangladesh in November 2021 (to come into effect in December 2022) and in Ukraine in September 2020 (to come into effect in October 2023), best-practice TFA policies are projected to pass soon in Mexico, Nigeria and Sri Lanka.
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