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1
To evaluate the epidemiological evolution of patients with HIV (PtHIV), between 2002 and 2012, in a day-hospital that became an HIV reference centre for south-west Burkina Faso.
This was a retrospective study of PtHIV followed in the Bobo Dioulasso university hospital since 2002. The study was ba
...
sed on clinical data recorded using ESOPE software and analysed using Excel and SAS.
more
This article was published on December 10, 2020, and updated on December 16, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2034577
The paper provides the rationale for these recommendations, which are based on analyses of data from the TRACT trial.
BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc
...
e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
more
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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Studien der Sachverständigengruppe „Weltwirtschaft und Sozialethik“ Nr. 21
On the basis of a reflection on social ethics, the German Bishops’ Conference expert panel on "Global Economy and Social Ethics" has analyzed the role of economic growth in relation to environmental issues and sustain
...
able development. The chairman of the expert panel outlines the main results of this text.
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This analysis focused on the chronic form of HAT caused by T. b. gambiense, as it contributes to the majority of disease burden. Information from the literature review,
product development landscape, and stakeholder interviews was compiled to:
- Identify use cases and understand current diagnosti
...
c practices and tools associated with each use case.
- Analyze progress toward robust diagnostics for HAT across different biomarkers.
- Develop recommendations for steps to improve the availability, access, and adoption of HAT diagnostic tools.
more
PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768
Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to de
...
termine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
more
What are the political, economic, social and security implications of the Ebola crisis, with a particular focus on Sierra Leone?
PlosOne https://doi.org/10.1371/journal.pone.0165797; Food production is a major driver of greenhouse gas (GHG) emissions, water and land use, and dietary risk factors are contributors to non-communicable diseases. Shifts in dietary patterns can therefore potentially provide benefits for both the en
...
vironment and health. However, there is uncertainty about the magnitude of these impacts, and the dietary changes necessary to achieve them.
more
February 2020Earth's Future 8(2):e2019EF001377.The water planetary boundary attempts to provide a global limit to anthropogenic water cycle modifications, but it has been challenging to translate and apply it to the regional and local scales at which water problems and management typically occur. We
...
develop a cross‐scale approach by which the water planetary boundary could guide sustainable water management and governance at subglobal contexts defined by physical features (e.g., watershed or aquifer), political borders (e.g., city, nation, or group of nations), or commercial entities (e.g., corporation, trade group, or financial institution).
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What are the local beliefs and practices around illnesses and death, the transmission of disease and spirituality, which affect decision-making (around health-seeking behaviour, caring for relatives and nature of burials) and can inform effective behaviour change interventions for preventing Ebola i
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n Sierra Leone?
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Evaluation of a point-of-care blood test for identification of Ebola virus disease at Ebola holding units, Western Area, Sierra Leone, January to February 2015.
Walker, N.F.; et al.
(2015)
Euro Surveill. 2015 Mar 26;20(12). pii: 21073.
Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char
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acteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines.
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Community-based Reports of Co-Morbidity, Co-mortality, and Health-Seeking Behaviors in Four Monrovia Communities During the West African Ebola Epidemic
Sharon Abramowitz, Kristen McLean, Josephine Monger, Kodjo Tehoungue, Sarah McKune, Mosoka Fallah, Patricia Omidian
Ebola Anthropology Platform
(2015)
